The epigraph of the book consists of a quote from Aristotle’s The Metaphysics which equates the activity of the mind to life.

Elyn Saks recounts incidents from a night at law school. She and a couple of other classmates are at the Yale Law School library on a Friday night to finish a memo assignment. Elyn starts speaking incoherently and runs onto the roof, scaring her classmates. Although she eventually comes back inside, her classmates leave in a hurry; Elyn stays on well past midnight, hiding among the stacks of books.

The next morning Elyn approaches Professor M to ask for an extension; she is still speaking gibberish. Concerned, the professor invites her home for dinner; Elyn accepts, then climbs onto a roof outside again.

Dinner at Professor M’s house does not go well, and Elyn ends up in the emergency room of Yale-New Haven Hospital. A doctor and his team forcibly strap Elyn onto a gurney and make her swallow medicine. Elyn reflects that though this is not her first hospitalization, it is “the worst ever” (4). Elyn continues to hallucinate, feeling anxious and helpless.