Welcome to the Bellevue Hospital Psychiatric Prison Ward, a maximum-security hospital and inpatient psychiatric unit for the inmates of the New York City jail system, with its hub on Rikers Island. It is a world of heartbreak, violence, and pain, where severely ill men are often lost in a tangle of courts, jails, and bureaucracy. It is also a place of challenges, redemption, and surprising joy, where tough, hardworking doctors and staff fight to care for and keep safe a population that many would like to forget. This is where Dr. Elizabeth Ford, now the Chief of Psychiatry for Correctional Health Services for New York City's Health and Hospitals, found her calling. Dr. Ford shares her stories of caring for these patients, from one of the most hated and alienated inmates at Rikers, who cries when discussing his abusive childhood, to the writer who agrees to treatment in exchange for Dr. Ford's take on the opening chapter of his book, to the twenty-four-year-old schizophrenic whom Dr. Ford later encounters on the streets of Manhattan, happy and healthy after finally finding the right medication. Ford's memoir is marked by explosive crises and episodes of violent psychosis, but also moving stories of compassion and hope in the face of overwhelming dysfunction.