This novel provides an inside look at schizophrenia and the experience of mental hospital patients, as well as a glimpse of the emotional cost to the family of a mentally ill child. Jacob and Esther Blau commit their sixteen-year-old daughter, Deborah, to the care of a well-known psychiatrist, Dr. Clara Fried, after the girl has attempted suicide. Three years of slow, almost imperceptible progress with occasional backslides into Ward D, the last refuge for the violent and the lost, must pass before Deborah finally chooses reality over the private world that she calls the Kingdom of Yr.

As Deborah gradually reveals more of her past and her imaginary world to the skillful and sensitive Dr. Fried, the roots of her illness come to light, yet they are never entirely clear. This lingering uncertainty actually lends plausibility to the story, for it avoids oversimplification.

Deborah’s problems apparently started when she was five years old, with two traumatic events: a very painful operation for a tumor and the birth of a baby sister. She had presumably been caught by her parents just as she was about to murder the new baby by dropping it out the window. Her parents had pretended to ignore the episode, beginning the sustained “lie” that she could be a worthwhile person. The therapy is quite advanced before Dr. Fried demonstrates that the murder scene was entirely imaginary, a projection of a child’s momentary death wish for the new rival. Deborah at last realizes that her parents had not been covering up the dreadful truth about her attempted murder all those years. They had not even known about it.

The terror and pain of the operation apparently got mixed up with Deborah’s need for punishment for her sin. Even years later, the pain of the no-longer-existent tumor returned to torment her, part of the nightmare elements that sometimes intruded into the fantasy world initially devised to protect her from reality.

The conviction of her own hatefulness was deepened by a bad experience in a summer camp in which she was the only Jew. Her ordeal confirmed the bitterness displayed by her grandfather, a clubfooted immigrant from Latvia, who had suffered the full brunt of European anti-Semitism. She gradually withdrew from companions her own age, always managing to do something dreadful which she could never afterward remember but which effectively drove away whatever friends she might have had.

As Deborah struggles with her alienation from ordinary mortals, she gradually regains a limited power of relatedness to her doctor and to one or another of her fellow patients. Dr. Fried’s absence for several weeks, though she had carefully prepared her patient for it, seems to Deborah to be evidence of renewed betrayal and rejection, and Deborah ends up in the violent ward. She witnesses, as well, the sadistic beating of a fellow patient by an attendant, ironically a religious zealot who is serving alternative duty as a conscientious objector.

In spite of these setbacks, which bring on a pattern of self-torture—she secretly burns herself with cigarettes—Deborah finally ventures from the hospital to a special school for those seeking a high school diploma by examination. When she passes that hurdle with a score that is high enough for her to qualify for college, she suffers her last descent into the emotional Pit, which requires restraint on Ward D. There she again encounters the self-created gods that rule her psychic life, and she makes her decision known to them—her choice of the “other” world on the outside.

There is no unrealistic implication that Deborah’s emotional problems are entirely at an end; as Dr. Fried once warned her, “I never promised you a rose garden.” The mental patient, like the Jew in a narrowly Christian community, suffers a social stigma which may be hard to overcome. Yet the doctor has made it clear that sanity must be deliberately chosen by the patient. When that happens, a new world and a new life can open.