Act I

The curtain rises on The Shrike in a bustling city psychiatric hospital. Ann Downs steps forward, burdened with the weight of her husband Jim's desperate attempt to end his life by swallowing a handful of pills. In time, Jim emerges from the shadows of unconsciousness, confessing the gravity of his actions. Dr. Kramer, the vigilant physician on duty, instructs nurse Miss Hansen to keep a watchful eye on him for the critical next forty-eight hours. When Miss Hansen worries about Ann's ability to afford such care, Ann firmly insists, "Jim must have whatever is necessary." Ann discloses to the doctor that she discovered him in his apartment, revealing the chasm that now exists between them as a separated couple.

As dawn breaks, Miss Cardell notices Ann’s unwavering vigil at Jim’s side and encourages her to rest. Yet, Ann resolutely refuses to leave. In her discussion with Dr. Barrow, a psychiatrist, Ann recounts Jim’s haunting question upon regaining consciousness: "why didn’t you let me die?" Barrow advises her to glean all she can from Jim’s unguarded thoughts, as his conscious mind gradually constructs barriers once more. To unravel the mystery of Jim's despair, Ann recalls his triumph as a Broadway director, a success now eclipsed by an unyielding struggle to find work.

In a heart-to-heart with Dr. Barrow, Jim bares his soul, declaring his desire to die stems from a belief that he is "no good," feels "stuck in a rut," and considers himself too old to taste success again. When Ann professes her love, Jim cautions her, stating he does not crave her affection. Yet, in a private exchange with Barrow, Ann remains convinced of Jim's love for her.

Two days hence, Jim finds himself sitting up, driven by a burning desire to leave the hospital. He confides in Grosberg, an attendant, entrusting him with a letter to Charlotte, his paramour. Ann brings news of a theater job opportunity, igniting a spark of hope and a fervor to heal swiftly. However, Ann fears his impatience may be detrimental. When Jim implores Barrow for an early discharge to pursue the job, the doctor decides to confer with fellow psychiatrists.

In a secluded conversation, Jim informs Ann that once discharged, he will not return to her, a topic she refuses to entertain. Dr. Kramer assures Jim of his imminent recovery, attributing his swift progress to Ann's support. Later, discussions between Dr. Barrow, Dr. Schlesinger, and Ann reveal her uncertainty about Jim's readiness to leave. She observes erratic behavior in his gaze and speech, though specifics elude her memory. When pondering Jim's fate if the job falls through, Schlesinger somberly concludes that failure would surely worsen his state.

Dr. Schlesinger mentions a persistent caller named Charlotte, eager to see Jim. Upon learning her identity, he deems it too stressful for Jim to meet her. Dr. Kramer foretells Jim's discharge by Monday.

Dialogues between Ann and Dr. Schlesinger delve deeper into her relationship with Jim. When Jim later confides to the doctor about his attempted suicide, he labels his life as "hopeless." He asserts no intention to reunite with Ann post-discharge. As questions turn intimate concerning Ann and Charlotte, Jim clams up, prompting a potential delay in his release and a transfer to a convalescent ward. The prospect leaves Jim disoriented and, upon realizing Ann sides with the doctors, a frigid realization courses through him.

Act II

Jim is ushered into Ward One, where he encounters fellow patients. During an evaluation, Dr. Bellman reveals to a startled Jim his reputation for being "belligerent and nasty." Their conversation veers towards his relationship with...