An elderly, poor Russian émigré couple intend to pay a birthday visit to their son. He is institutionalized in a sanitarium, diagnosed as afflicted with referential mania. It is an incurable disease in which the patient imagines that everything that happens around him is a veiled reference to his personality and existence. He is certain that phenomenal nature shadows him wherever he may be, that trees can divine and discuss his inmost thoughts, that coats in store windows want to lynch him—in short, that he must be on his guard every minute of his life. The boy’s most recent suicide attempt was brilliantly inventive, as he sought to “tear a hole in his world and escape.”

On the parents’ way to the sanitarium, the machinery of existence seems to malfunction: The subway loses its electric current between stations; their bus is late and is crammed with noisy schoolchildren; they are pelted by pouring rain as they walk the last stretch of the way. On their arrival, they are informed that because their son has again attempted suicide, their visit might unduly agitate him, so they do not see him.

While awaiting their bus on their way home, they observe a tiny, half-dead baby bird twitching helplessly in a rain puddle; it is doomed to die through no fault of its own. On the bus, they are silent with worry and defeat; the wife notices her husband’s hands twitching, like the bird’s body, on the handle of his umbrella.

At home, after a somber supper and after her husband has gone to bed, the wife pulls the blinds down to block out the rain and examines the family photo album, filled with the faces of mostly suffering or dead relatives. One cousin has become a famous chess player (an oblique reference to Luzhin, the protagonist of Vladimir Nabokov’s 1929 novel, The Luzhin Defense, who commits suicide). She follows photos of her son’s degeneration from moody toddler, to insomnia from the age of six, to his fear of wallpaper and pictures at the age of eight, to his special schooling by ten years old and, soon afterward, his disconnection with the outside world.

In the story’s last section, the time is past midnight and the husband staggers into the living room, sleepless and in pain, to join his wife. The couple decide, bravely, to remove their son from the hospital and care for him at home, each intending to give up part of the night to watch him in his bedroom. Then the phone rings: a wrong number. When it rings a second time, the wife carefully explains to the same caller how she must have misdialed. The husband and wife sit down to their midnight tea. Their son’s unopened birthday present shares the table with their cups. The phone rings for the third time; the story ends. Its signs and symbols suggest, in all likelihood, that this last call is from the sanitarium to announce that their son has finally succeeded in escaping this world.