There's an EXIT sign glowing over a door at the far end of the corridor. I pant towards it, find it propped open and the alarm system disabled by means of a strip of surgical tape. Stepping through into the emergency stairwell, I see an ashtray fashioned from a wadded up bit of tinfoil, heaped with butts — evidence of late-night smoke breaks by someone on the ward staff. Massachusetts's harsh antismoking regs are the best friend an escaping loony ever had.

The stairwell is gray and industrial and refreshingly hard-edged after three padded weeks on the ward. Down, down is the exit and freedom. Find clothes somewhere and out I go into Boston.

From below, then: the huffing, laborious breathing of some goddamned overweight, middle-aged doc climbing the stairs for his health. I peer down the well and see his gleaming pate, his white knuckles on the railing, two, maybe three flights down.

Up! Up to the roof. I'm on the twentieth floor, which means that I've got twenty-five more to go, two flights per, fifty in total, gotta move. Up! I stop two or three times and pant and wheeze and make it ten stories and collapse. I'm sweating freely — no air-conditioning in the stairwell, nor is there anything to mop up the sweat rolling down my body, filling the crack of my ass, coursing down my legs. I press my face to the cool painted cinderblock walls, one cheek and then the other, and continue on.

When I finally open the door that leads out onto the pebbled roof, the dawn cool is balm. Fingers of light are hauling the sunrise up over the horizon. I step onto the roof and feel the pebbles dig into the soft soles of my feet, cool as the bottom of the riverbed whence they'd been dredged. The door starts to swing shut heavily behind me, and I whirl and catch it just in time, getting my fingers mashed against the jamb for my trouble. I haul it back open again against its pneumatic closure mechanism.

Using the side of my foot as a bulldozer, I scrape up a cairn of pebbles as high as the door's bottom edge, twice as high. I fall into the rhythm of the work, making the cairn higher and wider until I can't close the door no matter how I push against it. The last thing I want is to get stuck on the goddamn roof.

There's detritus mixed in with the pebbles: cigarette butts, burnt out matches, a condom wrapper and a bright yellow Eberhard pencil with a point as sharp as a spear, the eraser as pink and softly resilient as a nipple.

I pick up the pencil and twiddle it between forefinger and thumb, tap a nervous rattle against the roof's edge as I dangle my feet over the bottomless plummet until the sun is high and warm on my skin.

The hamsters get going again once the sun is high and the cars start pulling into the parking lot below, rattling and chittering and whispering, yes o yes, put the pencil in your nose, wouldn't you rather be happy than smart?

11.