An original Max Ernst vanished from the hospital where I worked in the summer of 1999. I hadn’t examined it closely before it disappeared, but I remembered a silver painted wood frame around a small abstract with a red circle in its center and the unmistakable signature in the lower-right corner. I’m not sure what shocked me most: the fact that a valuable work of art had hung for years in an ailing institution, its theft, or the lack of reaction when I reported its disappearance.

Today I’d put my hopes in an institutional-size roll of heavy-gauge aluminum foil. We were going to make little sculptures by wadding the foil into tiny figures, covering them with masking tape, and painting them with acrylics. Many of the kids became absorbed in the process, sitting in silence as they compacted the foil. There was less of the usual posturing and challenging, so the staff could sit back and relax for an hour.

She dropped her head slightly and in a soft voice said, “Yes.”

When I first went looking for work as an art therapist five years ago I told myself I wouldn’t be one of those eager graduates motivated by altruism who felt grateful for whatever meager salary they earned managing heavy caseloads of severely mentally ill patients in a hot, windowless basement. When my best job offer landed me in an hot, windowless basement office at Michael Reese I went through all the stages of loss. I denied it. “It’s wonderful,” I said. “I have my own desk.” I had fits of anger, though usually not until I got home. I complained to my wife that so-and-so had tested positive for TB, but I hadn’t been told until after he sneezed on me. I told myself that my colleagues were in similar situations and that my patients, including Victor, were a lot worse off.

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I looked at Victor, who was still standing in front of his painting.

A few weeks later on the same ward, the staff were trying to calm an agitated man, which gave another patient time to disassemble the lock on his door with his fingernails, then use a steel plate from the lock to pry open his second-floor window. He jumped and broke both his ankles on the cement walkway below.