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It was weird not saying anything to Sam when he handed me the card. I patted him on the head instead. Then my mom started sniffling, so I was able to walk away and get her a tissue from the coffee table. That’s one good thing about this place, I’d tell you. There are tissue boxes everywhere.

I steered my mom and Sam over to a couch in the reception room. Sam looked around, his mouth hanging open like it does when he watches TV. “Why is this place called Sea Pines?”

He was waiting for me to answer, I think, but I was too busy pulling on a loose thread on the seat cushion. I pictured the whole couch coming unraveled and the three of us sitting on the floor in a giant pile of couch thread.

My mom was rubbing her temples. “It’s just a name, Sam, like Pennbrook Manor, where Gram lived,” she said finally.

“Where Gram died, you mean,” Sam said.

“Well ...” She gazed past Sam, around the reception room, trying to see what the other families were doing.

“That place smelled bad,” Sam said.

“Well, Sam, this is different,” my mom said. “This is a perfectly nice place.”

“But what is it? Why is Cal here, anyhow?”

“Lower your voice,” she said. “I already told you. She’s not feeling well.”

“She doesn’t look sick.”

“Shhh,” she said. “Let’s talk about something pleasant during the time we have, shall we?” She folded a tissue in her lap, then turned to me. “How’s your roommate? Is she a nice girl?”

I got up and stood by the window, scanning the parking lot for my dad. I saw a man coming up the sidewalk and I tapped on the window; he lifted his head and I realized he wasn’t my dad at all. The sliding doors opened and the man came in and gave Tara a big hug.

“If you’re looking for Dad, he’s not coming,” Sam said.

My mom blew her nose.

I kept looking out the window; I didn’t expect to see our car in the parking lot, since my mom doesn’t drive anywhere anymore. She’s terrified of big trucks and of missing her exit on the highway. She’s also terrified of E. coli in hamburgers, childnappers at the mall, lead in the drinking water, and, of course, dust mites, animal fur, molds, spores, pollen, and anything else that might give Sam an asthma attack. I don’t know what I expected to see in the parking lot. But I kept watching.

“Mommy,” said Sam, “can I get some candy?” He was pointing to the vending machine.

My mom said yes and I thought about how Sam could just walk over and buy himself a Snickers, without an escort. My mom gave him a bunch of quarters, and he skipped, actually skipped, over to the vending machine.

“Daddy’s putting in some extra hours,” my mom whispered when Sam was out of earshot. “He’s trying to make a little extra money.”

She folded her tissue into a neat square, then a smaller one, then an even smaller one. Keeping track made me dizzy.

“We got a letter from the insurance company.” She was speaking so quietly, I had to lean in to hear her. “They won’t pay for your … your treatment here.”

The reception room lifted off the foundation, floated for a second, then became solid again. I checked to see if my mom noticed.

“They say they won’t pay because this thing you do, you know, cutting yourself, they say it’s self-inflicted. They don’t cover things that are self-inflicted.”

The room hovered in the air again, then the floor slid away and I was on the ceiling looking down at a play. The character who was the mom was still talking; the one who was me was fiddling with a piece of thread from the couch. Offstage, a Snickers bar clattered down the insides of a vending machine. I tried to concentrate on what the mother was saying. Something about seeing friends at the mall. “I told them you were under the weather,” she said. The tissue, now a tiny, tiny square, wobbled in and out of focus. “Are you keeping up with your schoolwork?”

The mother’s mouth was moving, but the character who was me was walking away, through the maze of sofas and coffee tables and more sofas until finally I was in the visitors’ restroom, rubbing my wrist along the teeth of the paper towel dispenser. It was like my whole body was just this one spot on my arm that was begging to be scratched, carved, cut—anything, anything—for relief. There was a jab, bright beads of blood, and finally I was OK. I pulled my shirtsleeve down, pressed my cheek against the cool tile wall for a minute, then walked back into the reception room like everything was fine.

Except that the reception room was practically empty. I’d been in the restroom only a minute, I thought, but my mom and Sam and just about everybody else were gone. I made my way through the grid of sofas and coffee tables, forcing myself to concentrate, to slow down, so I didn’t break into a run.

I finally found Sam down the hall, sitting by himself in the game room, this dark little library-type place where they keep board games and cards that nobody ever plays. The game room is my favorite place here; I go there just about every night during free time to get away from the fake laughter from the TV in the dayroom, and the fake applause from the TV at the attendants’ desk, and all the radios and the blow dryers in the dorm. When I came in, Sam turned around and grinned, showing off his big, new rabbity front teeth.

“Cal! Look what game they have,” he said. “Connect Four.”

Connect Four, a kind of tic-tac-toe where you have to get four checkers in a row in a plastic stand, is our favorite game to play together. We started playing it when Sam first got sick and he wasn’t allowed to run around anymore. In the beginning I let him win, because he was younger and because he was sick. Now he beats me every time.

I don’t know how he does it, but Sam has this way of seeing two or three ways to win. Meanwhile, I use up all my moves trying to block him—or trying to get four in a row in a straight, up-and-down line—until Sam yells “Gotcha,” and points to some diagonal row I completely overlooked.

“Wanna play?” he said.

I checked to make sure no one was around. Sure, I wanted to say. Sure. I willed my myself to speak, but nothing happened. I sent commands from my brain to my mouth. Nothing. I wondered if a person’s voice muscles can forget how to work if they’re not used for a long time.

I stared out the window for a while, like the answer might be out there. I nodded.

Sam took the black checkers, I took the red. That’s the way it always is. We don’t even have to discuss it. The only sound, as we sat at the card table playing, was the click of checkers dropping into their slots. I imagined myself saying chatty, big-sister things—about Linus, about Sam’s hockey card collection—but just thinking about talking was exhausting.

Sam plunked a checker into the plastic stand; he pointed to a row of four blacks that seemed to appear out of nowhere.

“Gotcha,” he said. “Wanna play again?” He didn’t wait. “OK,” he answered himself.

It dawned on me then that Sam understood. Somehow, he knew—in his weird, wise, eight-year-old way—that I wasn’t talking. So he talked for both of us. I answered by putting a red checker in the center slot. It was my favorite opening move.

“Cal,” he said, shaking his head, an old, tired Sam who pretended to be disappointed in me. “You need to think laterally.”

I watched while he put a black checker in the last row.

“That means seeing things a couple of different ways,” he said. “Mr. Weiss says I’m good at that.”

I put another red checker above the first one and wondered who Mr. Weiss was.

“He’s my tutor.” Another black checker went in, blocking my row. “He comes to the house.”

That meant Sam was too sick to go to school again. Which meant my mom must be more upset than ever. Which meant my dad would be spending more time than ever at work—or more time out with customers, or people he hoped would be customers but somehow never turned into customers.

“Don’t worry,” said Sam. “We don’t have to pay for it. School pays for it.”

I had no idea where to put another checker, so I tried to start another row from the bottom.

“Gotcha!” Sam pointed to a diagonal row of black checkers. “Lateral thinking, Cal.”

He set up the game so we could play again.

“Mom went to talk to one of your, you know, your teachers.” Something about the way he said that, something about how it was such a little-kid thing to say, made me feel bad.

He put a black checker in the last row. “She went to find her when you were in the bathroom.”

I put a red checker in the center slot again. I didn’t have the energy for lateral thinking.

Sam held his checker in the air, poised to move. “When are you coming home, Cal? No one will tell me anything.”

We sat there a while, I couldn’t tell how long. Sam’s face went from hopeful, to serious, to worried, to something I couldn’t quite read.

“It’s OK,” he said finally. “It’s just that Linus misses you.”

I look up and take in the sight of you, still sitting there, your ankles crossed, your notebook in your lap. I hate that notebook because I know some random thing—like your chair reminding me of a dead cow—could end up in there, proof that I’m crazy. But what I really hate is how every day when I come in, you turn to a fresh page and write in the date, and how every day when I leave and you walk me to the door, I can see that the whole page is empty.

You cap your pen and stand up. It must be time to go.

The cafeteria here has a humid, steamed-vegetable smell that’s enough to give anyone food issues. What’s worse than the smell, though, is the noise. Sometimes, like when I’m in Study Hall or the game room, I can pretend that this place is a boarding school, but when all the guests from all the other groups are together in the cafeteria shouting and laughing and arguing and eating, you know you’re in a loony bin.

Our group has to sit together at meals. Sydney sets her tray down in the empty space next to me.

“I’ve figured out the Sick Minds food philosophy.” She says this to the table at large.

The food-issue people lean in attentively. I twirl my pasta around and around my fork until it slips off.

“There are four basic food groups here: pasta, purees, puddings, and potatoes,” she says. “They only serve things that begin with a p.”

Debbie sighs.

“Seriously,” Sydney says, “have you ever noticed?”

“I’m sick of pasta,” Tara says. “All those carbohydrates are an issue for me.”

“Yeah,” says Tiffany. “This stuff is crap.”

“We had chicken last week,” says Debbie.

“Yes, Debbie, we remember,” says Tiffany. “It was the high point of your life.”

Because we guests can’t be trusted with real silverware, the food usually has to be mushy enough to eat with plastic spoons. Last Thursday, though, we had chicken à la king, and since Debbie’s the only Level Three in our group she got to hand out stubby plastic forks and knives. She also got to collect them at the end of the meal. “It’s sort of like being on a picnic,” she said.

Sydney changes the subject. “Look,” she says, pointing across the room. “It’s the Ghost.”

A woman with a gray braid down to her waist is waltzing around the salad bar. She’s wearing a long white dress and her arms are stretched out like she’s got an imaginary partner.

“She’s from Humdinger,” says Sydney.

“What’s that?” asks Tara.

“The wing where they keep the real psychos.”

“You mean Hammacher,” Debbie says.

“Humdinger,” says Sydney.  “You have to be a real humdinger to get in.”

People laugh.

“Once you get in, you never get out.”

No one laughs this time.

Dinner doesn’t take long. That’s because the first person back to the dayroom gets the remote control. Tonight, though, there seems to be a delay; I pick up from the chatter that something special is going on.

“That’s great,” Debbie coos to Becca “You’re doing really great.”

Becca lowers her lashes and picks a crumb off the corner of her brownie. Then she puts the crumb on her plate and cuts it in half with her plastic spoon.

“You’re going to eat the whole brownie, right?” Debbie says this loudly, for everyone’s benefit.

Becca nods demurely. “C’mon,” she says, giving Debbie’s arm a nudge with her thin little elbow. “You know I can’t eat if you’re all watching.”

“OK, OK,” Debbie announces. “No one look at Becca.”

Sydney pinches her thumb and index finger together, giving Becca the A-OK sign. Then everyone makes a big show of looking away. I push my chair back, finger the metal strip around the edge of the table, and stare underneath at people’s feet. The din of plates and cups clattering and people shouting ebbs, then picks up, louder than ever. That’s when I see Becca slide the brownie off her plate into her lap. She wads it up in her napkin, mashes it flat, and stuffs it in her pocket.

After a while Becca says it’s OK for people to look again. There are oohs and ahhs. Three chimes sound, signaling the end of dinner; Debbie says we should let Becca be in charge of the remote control that night.

Later, while the other girls are in the dayroom watching Jeopardy, I hide in a nook near the attendants’ desk, holding a pile of laundry and waiting until the coast is clear. I have to do laundry every couple of days because just about all my mom packed for me is pajamas. Nightgowns, actually Brand-new ones with daisies and bows.

I watch for Rochelle, the bathroom attendant, to leave the desk and take her post on the orange plastic chair between the toilets and the showers. Then I inch up to the desk and wait for Ruby to notice me.

Ruby’s skin is indigo and her hair is the silver of an antique teapot. But the thing about Ruby is her shoes: they’re old-fashioned white nurse’s shoes. Unlike the other attendants, who dress like they’re going to an office or to the mall or something, Ruby wears thick white stockings and real nurse’s shoes. The first night I got here, the only way I was able to fall asleep was listening for the squeak of her footsteps on the slick green linoleum as she made her rounds. I can’t say why exactly, but I trust those shoes.

Ruby’s sitting down, knitting, something pink, maybe a baby blanket. As I watch her knobby hands fly over the yarn in time with the whish and click of the knitting needles, I wonder what Ruby does when she’s not at Sick Minds. If she’s somebody’s grandmother, maybe, or somebody’s next-door neighbor.