In 1974, Bette Howland (1937–2017) published her first book, W-3, which details her stint in a Chicago psychiatric ward. In the ensuing decade, Howland would release two more books and receive a MacArthur Fellowship. Soon, however, like many brilliant women of her era, she fell out of print. Thanks to the efforts of A Public Space Books, Howland’s work has resurfaced for contemporary readers; 2019 saw the publication of Calm Sea and Prosperous Voyage: The Selected Stories of Bette Howland, and this week marks the reissue of W-3. An excerpt from W-3 appears below.

Bette Howland. Photo courtesy of A Public Space Books.

Iris had posted herself in the lounge with her cigarettes, emery boards, and stationery, writing letters on a silk-trousered knee. One hand fanned and fluttered the while, drying her nail polish. She was new to W-3; arrestingly tall, white faced, with frosted gray bangs and a black Nehru jacket buttoned to her chin. But her eyes were smeared; her pasted lashes sank like weights. In other words, like the rest of us, she seemed untidy. We were looking for such signs, of course: What’s wrong with her? Why is she here? “Here” being the small psychiatric ward of the sprawling university hospital.

On the windowsill there would be some withered, dusty plant, long dead, still wrapped in bows and silver foil from the florist’s: inmates received them rarely. Magazines accumulated all over the place, discarded heaps, old Times and Newsweeks mostly; no one read them. The cupboard was crammed—boxes of puzzles, games protruding from every angle. All those boxes would have tumbled down at once if anyone ever attempted to disturb them. No one ever did.

The manifestation, therefore, of a stylish middle-aged woman in lounging pajamas, dashing off her correspondence and doing her nails, should have been tip-off enough; this was no place for such ordinary pursuits. But it seemed, after all, normal. Supremely.

Iris described herself as a “manic-depressive of twenty-seven years’ standing.” This, the first thing next morning at community rounds when, as a new patient, she was called upon to introduce herself to the group. For most, such a request could only come as a shock—at least it had for me. But in Iris I detected no hesitation and no irony either.

“Do I stand?” was all she asked.

No, she could sit. She straightened her shoulders, cleared her throat, and launched promptly and forcefully into an account of her life from age twenty-one—her first diagnosis. Her voice was strong, imposing, like her presence. She was counting on the platinum tips of her fingers. It was plain that she meant to begin at the beginning and to leave nothing out.

This was not the customary response. This was a power play. Iris was claiming seniority, like a bird in a barnyard. Too bad other patients—less seasoned—were too inexperienced to appreciate it. But it wasn’t aimed at us, other inmates, anyway; this was directed at the doctors. Iris was not taken in by all this community stuff, the illusion—successfully maintained with a good many of us—that it was our relationship with other patients that was of importance to us, that was going to help us. She had been around long enough to know that her survival in a mental ward depended upon her status with the doctors. They were the ones who doled out the pills, the passes, and finally, the discharges. She knew the score and she was letting them know.

She was stately, strikingly erect. Her eyes were an indelible cosmic blue. She ticked off her fingers, arching them backward. Twenty-seven years to go! But we were glad to let her talk; it meant we wouldn’t be called upon, wouldn’t draw fire; we could be safe, we could be private, even, while Iris told us the story of her life.

We had many meetings. Patients’ meeting—our own self-government with duly elected officials—two nights a week; team meeting, a smaller, more intimate group, one or two afternoons; and this one, community rounds, the first thing after breakfast every morning except Sunday.

Rounds—that’s a hospital word, part of the doctors’ daily routine, checking up on all their patients. But this occurs to me only just now—obviously I didn’t figure these things out right away. You figured nothing out; you accepted. At first these words, names—everything seemed to be named—had a brash strangeness, the strangeness of the surroundings. The brashness perhaps in the mind, a bright, stunned state; everything rang out audaciously, like solid brass. If you have swallowed a lethal dose of sleeping pills, your experience moves from the plane of the particular to the general. I didn’t understand this yet. Still, the surroundings were strange, all the same. Meetings? Why meetings? In this place?

This was the situation I had found myself in, my first morning on W-3; a newcomer, just delivered, sitting in the lounge and waiting for rounds to begin, clutching to my lap a little flat gray box of tissues—boxes distributed liberally all over the ward. Weeping was mightily encouraged here. I did not much feel like weeping, but wasn’t so sure either that a sudden cloudburst might not overtake me. The prevailing winds being uncertain. I felt doubtful and uncertain about my appearance, too. My arms and legs were covered with sinister bruises and my hair had been clipped—shorn, skinned practically—like when I used to have lice as a child and got my head dunked in kerosene. I was wearing a short bunchy housecoat of faded terry cloth, and a pair of wide—gaping—pink slippers. They were several sizes too large to begin with and already well stretched with wear. Whose wear? I didn’t know where these items had come from, but they were all I seemed to have; and I had been forewarned: on W-3 all inmates were expected to wear “clothes.” This had me worried. But it meant, apparently, anything that was not hospital garb—no uniforms.

That did not make the disorderly assortment I saw around me any less drab. Patients in nightgowns, pajamas, robes, wigs, wraithlike in towels heavily draped over their heads, with sleepy, hanging faces, were finishing breakfast and reluctantly dragging chairs across the dining hall into the lounge. The plastic armchairs and sofas were already filling up; doctors were seating themselves, parting the tails of their long white coats. While we waited, I contemplated my feet resentfully in the loose pink slippers.

Perhaps once a month an inmate turned up with a voice like mine; invariably an attempted suicide who had spent several days in a coma in the intensive care unit before being transferred. Everyone knew what it meant. The coughing machine with its snorkels and seething mists rolled down the corridors, seeking me out. The coughing must have sounded like terminal agonies—like my voice. But inmates who had been around long enough recognized and accepted these peculiarities immediately. They nodded as soon as I opened my mouth: Zelma had had “that voice”; she had been trailed about by “that machine.” Zelma had been released only a few days before I came—though she had promised to return. And now there was me.

I should explain right away that I didn’t belong here. But that goes without saying, no one belonged here. That was the ordinary, the average, you might say the normal, reaction. On W-3 you encountered the terrible force of a generalization, and it had to be resisted, the self had to be exerted. Anything to deny this grim, inert, collective state.

The first thing I noticed was the uniformity of appearance, the carelessness of expression, dress. Everyone looked essentially the same—peculiar. Peculiar was what I expected everyone to be. So that seemed to be the explanation for these first impressions. I didn’t understand that we were all in the same straitened circumstances. You don’t get much notice for a trip to a place like W-3; there’s no chance to pick and choose, to pack your bags and powder your nose. All of a sudden your number is called, you are claimed; you pick yourself up and come as you are.

There was another, more powerful, explanation for the general aspect of negligence—and that was the drugs. Drugs were far and away the most pervasive fact of life on W-3, but I didn’t know that yet. I was not put on drugs automatically because of the medication I was still taking for my lungs. (I had a touch of pneumonia, not an uncommon occurrence here either.) So I was seeing them in action—a rare privilege, for a patient. But I could not account at first for the slurred voices, thick-tongued faces, the strange, uniform shrugging indifference. It horrified me. I thought it was the inmates themselves I was seeing, and that these people must be very different from me.

What if suicide is a sin? That is, to die benighted, in a state of total ignorance? If so, I had almost committed the sin, for I had come very close to dying—unhousel’d, unanointed, unanneal’d, no reckoning made but sent to my account with all my ignorance upon my head. That was the real truth of my condition, stripped to its essentials. I sat there, gripping my Kleenexes and gazing into my lap.

The room fell silent. Community rounds was about to begin. I looked up, ready and willing to pay attention; all this was new to me, and I was wondering what the meeting was going to be about. At once a freckled nurse with a blond ponytail and sweater sleeves knotted about her shoulders called upon me. Would I introduce myself? Would I tell everyone what I was doing here? This was a surprise! My neck was still craning with curiosity, but now, it seemed, I was to be the curiosity. Heads were turning, everyone was discovering me. The nurse, apparently presiding, was smiling at me encouragingly—indicating my whereabouts with an outstretched arm. She was doing this to make sure I knew who was meant: no one else was in doubt. All those other faces had turned on me like a shot. Raised without expression. Some fifty faces in a circle several rows deep. Some of these faces I had already encountered walking about the ward—fixtures of the place. So they had seemed. They now for the first time took on a dimension of recognition, familiarity.

An old fellow, a wizened black man with a fringed bald head, had swung his chair around and sat facing backward, looking away from the center of the room. I had noticed him earlier, at breakfast, smoking in the same way with his back to the table. “That’s poor old Jesse.” His long, powerful-looking arm moved across his chest, feeling in his shirt for matches; tufts of cotton stuck out of his ears. A small coppery-skinned black girl in a pink peignoir was curled up sleepily in an armchair, plucking large pink hair curlers from her head and dropping them into her lap. Deronda. I looked toward Deronda, hoping for a cue.

She yawned, cat’s slits, behind a fist of Kleenex. She knew what it was like. I would have to find out for myself. These faces, waiting, conveyed no information: they didn’t care one way or another whether I answered or not—just so long as, whatever I did, it took up enough time.

I didn’t feel like telling this bunch of strangers how greedily I had wolfed down a whole bottle of sleeping pills; or about the considerable time I had spent in livid imagination, laying my cheek to the greasy doors of cold gas ovens. I didn’t feel like telling them anything. I could explain, all right, but it would take too long. It would take my whole life. I could sense it behind me, cold, submerged, like an iceberg.

I declined to speak, on account of my voice.

“What’s the matter with her voice? Can’t she speak up?” A pair of long blunt sideburns; a compact, forceful body in a white lab coat. This was Dr. Lipman, the head of the ward; most patients called him “Lipton.”

“Is that why you’re here? You can’t talk? There’s something wrong with your voice?” Cigar smoke irritably surrounded him. He seemed to think this hoarseness was a symptom! But the voice was extremely characteristic; even other patients, in the midst of their own preoccupations, had grasped my situation without any difficulty. How come he, a doctor, didn’t know?

It never occurred to me that this was a ploy. I had had no experience to speak of with the psychiatric sector before; and anyway I felt new—tender. I think I was expecting some sort of moratorium at first. For things to be more gradual, or some sort of exemption to be made in my case. But moratorium, armistice, truce, respite—that was what you never got on W-3. You plunged right in, in medias res, and life went on twenty-four hours a day. This was the hardest thing to get used to. Since this life was so plainly arbitrary and unreal, it often seemed to me that there would be no harm in it if every once in a while the pretenses were dropped, the flag was waved, the truce declared. But that never happened.

I tried to explain: there was nothing “wrong” with my voice, I just didn’t have any.

“I can hear you,” the freckled nurse insisted, ever prompt. Ever cheerful. This mode of pursuit was to become very familiar.

“Well I can’t, dammit!” said Dr. Lipman, his starched coat scraping audibly as he shifted in his chair. His gruffness at least seemed more genuine; it really was impossible to hear me.

“Oh! I can hear her perfectly well! How about you people back there?” The blond ponytail spun about. “Back there,” the rows of faces nodded. It didn’t matter, they didn’t need to listen. Forty-five minutes had to be used up, one way or another—that was all that mattered.

These are not impressions after the fact; then and there I grasped the essentials. It was early yet, no one else seemed moved to speak; I could not be let off so easily. Time was our common oppressor.

“Why don’t you stand up?” the nurse suggested.

By this time I had already revealed anything anyone really needed to know about me. It never mattered what you said you were doing here. Some outward sign, some characteristic peculiarity, something all the rest could recognize right off—that’s what mattered, that’s what you were doing here. A certain point had been reached; no one had to hear how.

I must have seemed the only inquisitive person left in the room as I got—somewhat gropingly—to my feet, feeling for my Kleenexes, with my head poked to one side.

“There!” the nurse said. “Now everyone can hear you.”

Hear me! Hear me! But the voice that was coming from me was not my own voice! How could they hear me?

*

Each of us had a story—as long, as involved, as hoary as Iris’s—though few had the wind to launch into it. But Iris was overwhelming. After ten or fifteen minutes she was still strongly holding forth, her shoulders upright, her neck as stiff as ever in her black silk collar—still counting on her fingertips. And she hadn’t used up the first hand yet!

I looked around the room. Guz had folded his arms—white to the elbows with tape—and gone back to sleep, his big, deep, trustful body collapsed in the chair. His feet were sticking out in bloody socks. Simone stuck her hands above her bowed head, catching up on her prayers. Her long black fingers rippled with bones. This was always unsettling. At such times it seemed to me that she was the only one who had any real grasp of our situation. But one thing was clear: Iris was crating no tension, no interaction. Our “community” was suffering a relapse.

Night and day we were a “community”; the fact was relentless. THIS UNIT IS NOT TO BE USED AS A THOROUGHFARE—the sign on the thick glass door spelled it out. Though the ward was locked, our doors must be at all times open. Patients must have roommates; except for those in isolation (and they were envied for it, and for their locked doors), we were not to be alone. The little rooms with their dormitory bunks, colored bedspreads, plastic desk lamps were not to be a refuge. We were expected to be out, out in the communal areas of the ward: in the rec room, lounge, occupational therapy; gathered round the piano or pool or Ping-Pong tables (the eternal triumvirate of psychiatric wards); active, participating, colliding with life—life that was to be found somewhere out there and not in ourselves. Demonstrably not. The faces at our meeting were lifeless enough. Faces: present and accounted for. We were faces, not bodies and souls.

Dr. Lipman interrupted Iris at last, pulling on his glowing cigar: “We’ll get back to this next time.” “Next time,” Iris was put on lithium and fell silent. Disheveled bangs flopped on her brow—very distracting as she bent over her boxes of stationery, scribbling away. Her great smeared eyes were blank and cloudy, like cosmic dust.

Bette Howland (1937–2017) was born in Chicago. She was the author of three books: W-3, Blue in Chicago, and Things to Come and Go. She received a MacArthur Fellowship in 1984, after which she did not publish another book. A posthumous collection of her stories, Calm Sea and Prosperous Voyage, was published in 2019.

Excerpted from W-3, by Bette Howland, published this week by A Public Space Books. Copyright 1974 Bette Howland. Reprinted by permission of A Public Space Books