Review: The Patient Admits

“I explain to my patients that abused children often find it hard to disentangle themselves from their dysfunctional families, whereas children grow away from good, loving parents with far less conflict. After all, isn’t that the task of a good parent, to enable the child to leave home?”
Irvin D. Yalom

This is not the story of a good parent. The Patient Admits, a ferocious and singularly inventive chapbook from author Avery M. Guess, is a harrowing look at parental abuse, psychiatric hospitalization, and the author’s own black-eyed fight for autonomy and survival. Some will feel intimidated by the book’s acidic subject matter, but for those willing to take the leap, The Patient Admits reads like an army field manual, or perhaps a forbidden spellbook. These poems ― which, on a personal note, contain the single most chilling piece I’ve encountered in almost 10 years of editing a literary journal ― draw the reader back like an arrow and never let go.

The chapbook begins deep in the always-lit hallways of a psychiatric facility, and it is here that Guess unveils her first survival tactic: the manipulation of letters and words. By a process of subtraction and reordering, she rips apart her own admission paperwork and tells a far-more lived and comprehensive history than the original document ever could. Subsequent pieces, culled from inpatient writing exercises, employ acrostic poetry to defiant effect. Guess’ utilization of found poetry reveals her rare power over the written word, which, after appropriate dissection and reassembly, can be used to pick locks:

Anything I say will be held against me. This complaint for instance. You’ll label me non-compliant for complaining. I may be held. There are restraints for that. Medicine. Jackets. Rooms. But I swear, I’m only moving two letters around. I-A-N-T. A-I-N-T. The beginning’s still the same.

The beginning can’t be changed, but the present can certainly be medicated. The Patient Admits is littered with medicine of ambiguous efficacy. Prozac. Wellbutrin. Effexor. White tablets that open portals to snow-covered forests, where the trees “wear their skeletons on the outside.” It’s details like this, authoritative and strange, that mark Guess as a fierce voice and true wordsmith. And when the words themselves fail and fall apart in her hands, Guess keeps going, manipulating the very paper said words are written on. This process feeds into an unusually lucid description of PTSD and its attendant flashbacks:

Draw two dots, six inches apart, on a sheet of paper.

Label the first dot childhood (or substitute a time in your life that haunts you).

Label the second dot with your name and location. Include the current day, date and time.

Draw a line between the two dots. Call this linear time. It travels from point A (the past) to point B (which is always right now).

Call this good. Call it the past staying where it belongs.

Fold the paper in half so the two dots line up exactly.

Take a pencil or other pointed object and punch a hole from point A through to point B.

See how the distance between the dots shrank from six inches to barely a whisper in an instant?

This kind of poetic meta-manipulation casts a disorienting spell upon the reader. Simply put, there is no ground here, and each such masterful choice, further reinforced by frequent and powerful references to the ocean, are dizzying to read. Electroshock treatments are re-imagined through the lens of boiled lobsters. Dark memories hover like jellyfish underwater, where the will to live becomes the will to float. Depakote becomes a portal to a violent and vodka-drowned dollhouse. These are choppy seas, and the ending isn’t necessarily happy… or, for that matter, an ending. But this book, dedicated to the “good therapists,” is one of the most haunting portrayals of mental illness ― and survival ― to emerge from any medium in years. The Patient Admits is not the story of a good parent, a tragedy which becomes clearer with every fucked-up page-turn. But it is the story of a child. A child who endured, and a child who left home.

A child who became a writer when she grew up.

Michael Young,
Editor, Rust + Moth

For the Dancing Girl Press catalog entry, please visit: