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in its own right. That year the medical facility that would grow into Kings County Hospital opened as a one-room infirmary. Over a century, it became the third-largest medical center in the United States, its collection of buildings in ugly juxtaposition, their unseemly mix of architectural styles spread over twenty-four acres of flat city land. The G Building arrived with World War II. Its Gothic architecture suited its label: insane asylum. Of course no one called it that anymore—now it was Behavioral Health—but it was still an asylum in the popular imagination. My intern class would be the last to both begin and end its tenure in G. A new, $120 million facility for psychiatric patients was scheduled to open a year and a half after my start date.
    When I arrived there in the summer of 2007, the decaying G Building’s seven floors housed 230 psychiatric inpatients when filled to capacity, which was more or less always. Its first floor held administrative offices, a small deli window where staff or visitors could buy coffee and sandwiches, and CPEP—the Comprehensive Psychiatric Emergency Program, more commonly known as the psych ER. The second floor washome to a pharmacy and, without irony intended, a unit dedicated to “dual diagnosis” patients, those with co-occurring substance abuse problems and mental illness. The third, fourth, and fifth floors were each home to two locked general wards. The sixth floor had once been for forensic inpatients—men and women convicted of crimes and also in need of treatment for psychiatric problems. The serial killer Son of Sam had been incarcerated there for a time in the late 1970s. No patients had resided there, though, since Kings County’s forensic unit had merged with Bellevue’s in Manhattan some years back, and now the cavernous sixth floor was almost deserted, a dimly lit ghost town with a big empty space for meetings, a handful of offices for staff, and one dank room for the seven adult interns to share. On the seventh floor was a bare-bones gym where patients who were well enough could supposedly get some exercise. Though the building was cleaned regularly and thoroughly, it appeared almost filthy, the years of grime and bad feeling having finally worked their way into the linoleum and the concrete.
    Jen and I walked through the back door of G to wait for the elevator that would take us to the sixth floor. The elevator system—which we had been introduced to when we came for our internship interviews six months prior—was arcane. The call buttons didn’t work, and like so many problems in G they must have been deemed unfixable because the hospital had hired elevator operators to run each lift. To let the operator know you needed to go up or down, you had to pound on the metal door, shouting “one,” or whatever floor number you happened to be calling from. If the elevator operator—usually perched on a stool inside the shaft reading the
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or texting or selling knockoff designer handbags, depending on who was working that shift—happened to hear you, you wouldbe granted your ride, as long as the operator could get his or her car to actually stop at your floor. (Sometimes the buttons inside the elevators didn’t work either, and the operator would yell “I’ll be back” as he glided past.) The inpatient units and the stairwells were locked and unlocked with old-fashioned skeleton keys—five inches of nickel-plated steel and heavy in the hand—and the staff took advantage of their cartoonish bulk to make the necessary ruckus on the elevator doors. By six weeks into the year, all of us interns were quite fond of the elevator operators, who greeted our trainee eagerness with almost equal enthusiasm each morning. I asked someone on staff what would happen to the operators once Behavioral Health moved to the $120 million building. “They’ll still run the elevators,” said the person quizzically. Had anyone ever been so new to Kings County Hospital as