Worcester State Hospital in Massachusetts was the first state insane asylum established in the United States. In this witty and warm history of the facility founded in 1833, the author reflects not just on the events in this fortress-like place, but also how those events parallel advances and failures in the field of psychiatry itself. In addition to patient/psychiatrist vignettes showing treatment techniques of the period, from farm work to early electric shock therapy and insulin treatments that put schizophrenics in a 90-minute coma, the author gives us sharp insight into "natural" treatments by visiting experts that showed remarkable results, and unexpected recoveries stimulated by tools as simple as a hand mirror. Throughout the text, the author weaves comparisons to books and movies about the mentally ill and facilities that have housed them, from literary works including "I Never Promised You a Rose Garden", to cinema classics "One Flew Over the Cuckoo's Nest" and "A Beautiful Mind". Each either reflects or directly opposes the procedures, patients, treatments, tribulations, or compassion as they existed at Worcester. At times, Worcester on the surface may seem brutal, at other times its simplicity pure and caring. There were marvellous successes, and times when it seemed no more than a warehouse for the mentally ill. But the author argues that there are lessons in this story to be learned about the treatment of the mentally ill in society today. Asylums were places that sheltered the mentally ill, from harm they might do themselves and others, and from the criminal justice system. And with asylums near extinct now, the mentally ill are again being herded into the criminal justice system, where they get little to no mental health care. Can the successes and failures of a hospital that closed a half-century ago guide us toward something better? Readers from all walks will find this text at once absorbing, disturbing, amusing, painfully serious, and tremendously insightful.