Every institution has its written rules posted in break rooms and staff manuals—medication schedules, documentation protocols, and emergency procedures typed in clinical sans-serif. Then there are the other rules, the ones whispered during shift change, the ones that keep you functional, and the ones that keep you alive. I learned the first kind my first day at Blackstone Asylum. The second kind took longer and cost more, and by the time I understood them completely, leaving was no longer an option I could afford to consider.
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I arrived at Blackstone Asylum on October 2nd, 1995, fifteen minutes early for my first shift because that's what professional nurses do, what they taught us at St. Catherine's—punctuality demonstrates respect for the institution and commitment to patient care.
The building looked worse in person than in the employment brochure. Three stories of gray stone gone darker with age and industrial pollution, windows tall and narrow like something designed to keep things in rather than let light through. The grounds were well-maintained enough—grass cut, hedges trimmed—but there was something about the proportions that felt wrong, as if the building was larger inside than outside, as if its footprint on the earth didn't quite match its actual mass.
I told myself this was nerves. First real job after graduation, first position that wasn't supervised clinical rotation. I was twenty-three years old with a brand-new RN license and enough student debt that I couldn't afford to be picky about employers, couldn't turn down the salary Blackstone offered even when my advisor raised her eyebrows and said, "Well, it'll certainly be... educational."
The intake coordinator—Mrs. Chen, middle-aged and briskly efficient—processed my paperwork in a windowless office that smelled of old coffee and photocopy toner. "Pediatric psychiatric ward," she confirmed, stamping forms with aggressive precision. "Twelve to twenty patients depending on admissions, ages six to seventeen, various diagnoses. Dr. Lee is primary psychiatrist, you'll report to Charge Nurse Morrison, shifts are twelve hours with rotating weekends. Questions?"
I had dozens. Asked none of them. Just nodded, signed where indicated, accepted my badge and keys and the employee handbook that was thicker than my pharmacology textbook.
Morrison met me in the second-floor nurses' station—a woman in her late forties with steel-gray hair pulled back so tightly it gave her a permanent expression of mild surprise. She shook my hand with the grip of someone who'd spent decades lifting patients and carrying supplies and generally performing the invisible physical labor that keeps institutions functioning.
"Reeves," she said, not quite making it a question. "Your first psychiatric placement?"
"Yes, ma'am. I did a rotation in pediatrics at County General, and some geriatric care, but—"
"This is different," Morrison interrupted, not unkindly. "You'll figure that out quickly enough. Come on, I'll show you the ward."
The second floor was arranged in a rough H-shape—two residential wings connected by a central corridor containing the nurses' station, medication room, and what Morrison called the "quiet room" (which I'd learn was institutional euphemism for isolation chamber). The walls were that particular shade of beige that appears in every institutional setting, chosen because it shows dirt less than white but doesn't depress quite as much as gray.
We passed other staff during the tour—two orderlies whose names I immediately forgot, another nurse named Stevens who was maybe thirty and looked fifty, a psychiatric aide who nodded but didn't smile. Everyone was professional, polite, and completely impenetrable. No jokes, no small talk, no "welcome to the team" warmth that I'd experienced during training rotations.
"They're not unfriendly," Morrison said, reading my expression with the accuracy of someone who'd oriented dozens of new nurses. "Just... cautious. High turnover here. People don't always last. Better not to get attached."
"Because of the work?" I asked. "The difficulty of the cases?"
Morrison's expression shifted—something flickered across her face too quickly to identify, gone before I could interpret it. "Among other reasons. You'll understand soon enough. Come on, let me introduce you to some patients."
The common room held perhaps ten children and adolescents in various states of engagement—some watching television with that particular glazed focus of the heavily medicated, others playing cards or board games with the careful concentration of people following rules they don't quite understand. A teenage boy sat alone in the corner, rocking slightly, lips moving in silent conversation with someone I couldn't see.
"That's Marcus," Morrison said quietly. "Schizophrenia, early onset. Hears voices, sees things. Been here four months. Stable on his current medication regimen."
She continued the tour, rattling off names and diagnoses with the efficiency of someone who'd done this presentation many times: Sarah, fourteen, bipolar with psychotic features. James, eleven, severe PTSD from abuse I wasn't given details about. Thomas, nine, selective mutism and what the file delicately termed "trauma-related behavioral disturbances."
Then we reached the girl in the window seat.
She was small—eight years old according to Morrison, though she looked younger, that particular smallness that comes from malnutrition or chronic stress or both. Dark hair cut in a bob that suggested institutional efficiency rather than style. She wore the standard ward clothing—gray sweatpants, white t-shirt—and sat cross-legged with a sketchpad balanced on her knees, pencil moving in slow, deliberate strokes.
"That's Lucy," Morrison said, voice dropping even lower. "Admitted six months ago. Hasn't spoken a word since intake. Not selective mutism—she's been evaluated multiple times. She just... doesn't speak. But she draws. Constantly. And she hums."
As if on cue, Lucy began humming—a melody that was almost familiar, like something you'd heard in childhood but couldn't quite place, rendered in a minor key that made it sound less like lullaby and more like warning.
I moved closer, professional curiosity overriding social caution. "May I see what you're drawing, Lucy?"
She didn't look up. Didn't acknowledge my presence at all. Just continued drawing, continued humming, and when I angled my head to see the sketchpad, I felt something cold settle in my stomach.
Circles. Dozens of them, overlapping and interlocking, creating patterns that hurt to look at directly, that seemed to suggest depth where there should only be flat graphite on paper. Some were perfect, compass-precise despite being drawn freehand. Others were deliberately imperfect, as if the errors were intentional, as if Lucy was correcting reality rather than misrepresenting it.
"She fills about three sketchpads a week," Morrison said. "Always the same patterns. We let her—it keeps her calm. Better than medication for managing her anxiety."
"What's her diagnosis?"
Morrison's pause lasted a beat too long. "Officially? Adjustment disorder with trauma. Unofficially..." She glanced around, confirming no one else was in earshot. "Unofficially, nobody knows. She was found wandering near the old cemetery, couldn't tell anyone her name or where she came from. Police think her parents abandoned her, but there's no missing persons report that matches. Social services placed her here temporarily while they investigate. That was six months ago."
Lucy's humming continued, steady and hypnotic. The melody wormed its way into my consciousness, made me want to hum along, made me feel like I'd known this tune my entire life without ever having heard it before.
"Why is she still here if it's temporary placement?"
"Because," Morrison said carefully, "every time they try to move her, something happens. Transport van breaks down. Paperwork gets lost. The receiving facility suddenly has an outbreak of flu and cancels the transfer. After the third attempt, Dr. Lee decided it was less disruptive to keep her here until a more permanent solution emerges."
That cold feeling in my stomach intensified. "That seems irregular."
"Everything about Blackstone is irregular," Morrison said, and the weariness in her voice suggested she'd had this conversation before, possibly with herself. "You'll learn. Come on, let me show you the medication room."
The rest of orientation was standard—medication protocols, documentation requirements, emergency procedures. Morrison walked me through a typical shift: morning rounds, breakfast supervision, medication distribution, therapy escort, lunch, afternoon recreation, dinner, evening meds, bedtime routine. Twelve hours of institutional choreography I'd performed variations of during training.
"The most important thing," Morrison said as we returned to the nurses' station, "is structure. These kids need predictability, need to know what comes next. We follow protocols exactly. No improvisation, no special treatment, no breaking routine even when it seems harmless."
"Of course," I said, because that was basic psychiatric nursing practice.
"I mean it." Morrison's intensity caught me off guard. "Some of the staff—especially newer ones—they think being flexible, being 'human' rather than institutional, that's better for patients. It's not. Not here. Routine is protection. Protocol is safety. When you deviate..." She trailed off, seeming to reconsider what she was about to say. "Just follow the rules. All of them. Even the ones that seem pointless."
An orderly—Jenkins, I think—stuck his head in. "Morrison, we need you in the west wing. Johnson's having an episode."
Morrison sighed, grabbed a clipboard, then turned back to me. "Stevens will finish your orientation. Remember what I said about protocol."
She left. Stevens appeared moments later, a man so nondescript I struggled to form any distinct impression beyond "male, thirties, exhausted." He showed me where supplies were kept, where to document observations, how to operate the ancient computer system that ran on software I was pretty sure predated Windows.
"You'll want to avoid the east wing after dark," he said casually while demonstrating the medication cart lock. "Especially alone."
I waited for explanation. None came.
"Why?" I finally asked.
Stevens's smile didn't reach his eyes. "Because the night shift guys avoid it, and they've been here long enough to know better. Just... if you need to check on east wing patients after 10 PM, take someone with you. Always."
"Is there a safety concern? Violent patients?"
"Something like that." He moved on to explaining documentation requirements, clearly considering the subject closed.
I wanted to press, wanted to understand what everyone was tip-toeing around, but I was too new, too aware of my probationary status, too conscious that questioning too much on the first day marked you as difficult, as someone who didn't fit institutional culture.
My first shift was uneventful by psychiatric ward standards—one patient refused medication and had to be coaxed over twenty minutes of careful negotiation, another had a minor meltdown during group therapy that required de-escalation. Lucy spent the entire day in the common room, drawing her circles, humming that melody, occasionally pressing her palm flat against the wall as if feeling for something, as if confirming presence of whatever she perceived behind plaster and paint.
At 7 PM, Morrison returned to check on me. "How are you holding up?"
"Fine," I said, because that's what you said. "It's been quiet."
"Good. Evening shift is usually calmer. Medications kick in, kids get tired, things settle down." She paused. "You're working until midnight tonight, right? Late shift orientation?"
"Yes, ma'am."
"Okay. Just... remember what I said. Protocol. Structure. And if you hear anything strange—"
"Strange?"
Morrison's professional mask slipped slightly, revealing something underneath that might have been fear or might have been resignation or might have been both. "Pipes make noise in old buildings. The heating system is ancient. Sometimes sounds travel in ways that seem... unusual. Don't worry about it. Don't investigate it. Just note it in the log and move on."
She left before I could ask what she meant.
The evening progressed normally. Dinner at 6, evening medications at 7:30, quiet time at 8, lights out at 9. By 10 PM, most patients were in their rooms, settled or sleeping or at least quiet behind closed doors. The ward was never truly silent—always some ambient sound, some murmur or movement or the simple acoustic presence of forty people breathing in close proximity.
I was updating charts at the nurses' station, documenting Lucy's day (no verbal communication, appropriate engagement with art materials, adequate food intake, no behavioral incidents), when I heard it.
Whistling.
Faint at first, barely audible under the fluorescent hum and the distant sounds of the night orderly making rounds. A melody I didn't recognize but felt I should, rendered in tones that suggested breath moving through confined spaces, through pipes or vents or the hollow channels that carry air and sound through buildings.
I looked up. The corridor was empty. Stevens was on break. The night orderly was in the west wing. I was alone at the station, just me and a dozen sleeping children and that whistling that seemed to come from everywhere and nowhere, that seemed to be not traveling through the building but emerging from it, from walls and floor and ceiling, from the structure itself learning to make sound.
The melody was familiar. Took me a moment to place it.
Lucy's lullaby. The tune she hummed constantly, the one that made you want to hum along, the one that felt like memory of something you'd never experienced.
But Lucy's room was at the far end of the hall, door closed, and this sound was coming from directly above me, from the vent in the nurses' station ceiling, from the pipes that ran through walls, from everywhere at once.
I stood. Moved to the vent. The whistling continued, steady and patient, and now I could hear something underneath it—words maybe, or syllables that suggested words, or the rhythm of language without the content, like listening to conversation in a language you don't speak but recognize as communication nonetheless.
Morrison's voice in my memory: Don't investigate it. Just note it in the log and move on.
I sat down. Picked up my pen. In the incident log, I wrote: "10:47 PM - Unusual sounds from ventilation system. Possible heating system noise. No patient disturbance. No action required."
The whistling stopped the moment I finished writing.
Complete silence. Not even the ambient hum that usually persists in institutional spaces, just absolute quiet that pressed against my eardrums, that made me aware of my own heartbeat, my own breathing, my own presence as lone waking consciousness in building full of sleeping minds.
Then, from Lucy's room at the end of the hall: humming. Soft, melodic, the same tune. As if responding. As if acknowledging. As if confirming that yes, she'd heard it too, that yes, she understood what I was only beginning to perceive—that Blackstone communicated through sounds that weren't quite sounds, through music that wasn't quite music, through language that predated words and would persist long after words failed.
I didn't investigate. Followed Morrison's instruction exactly. Noted it in the log: "10:50 PM - Patient Lucy humming in room. Normal behavior for patient. No intervention required."
And I sat there for the remaining hour of my shift, pretending to complete paperwork, pretending I couldn't hear the occasional creak of pipes or whisper of ventilation or soft murmur of building settling, pretending that my first day at Blackstone Asylum had been normal, routine, exactly what I'd expected.
Pretending I hadn't heard the building breathe.
Pretending I hadn't heard it sing.
Pretending I didn't already know, on some level I couldn't yet articulate, that everything Morrison and Stevens had been too careful not to say was absolutely true.
That there were rules here. Unwritten ones. The kind that keep you functional. The kind that keep you alive.
And I'd just learned the first one: When the building speaks, you document and move on. You don't acknowledge. You don't investigate. You don't confirm what you're perceiving because confirmation makes it real, makes it official, makes it something you can't unsee or unhear or unknow.
You just follow protocol. Keep your head down. Do your job.
And hope that's enough.
[END OF CHAPTER]
Coming Up:
By her first week's end, Reeves has learned the unofficial shift-assignment hierarchy—new nurses get east wing rotations nobody wants, work hours nobody requests. She discovers why when a patient goes missing during her watch, found three hours later in a supply closet that was locked from the inside, claiming he was "helping the others" though he won't specify who. Morrison takes her aside with the first explicit warning: "Some children here aren't sick. They're sensitive. They see what we've learned not to see. Your job isn't to cure them—it's to keep them alive long enough to learn the rules." Reeves begins noticing patterns in patient behavior, correlations with building sounds, with Lucy's drawings, with the particular way shadows fall in the east wing after dark. And she starts keeping two sets of notes: official documentation, and a private journal where she records what she can't write in institutional logs, what protocol won't allow her to acknowledge.