Violence is never far away, with the patients ready to lash out at any perceived slight.
All of the patients are dangerous criminals declared insane.
The stress of the job placed on him and on his family causes him much internal debate.
The patients are a horribly fascinating bunch: McCoy, the kingpin who may or may not be faking illness to avoid a return to normal prison; NPR Man, a bomb-maker with a habit for monologuing like an access radio announcer; and Boudreaux, from New Orleans, who assaults Seager in the opening pages of the book.
Long periods of routine and tedium are interrupted with flashes of mayhem and occasionally sheer weirdness; the hospital is surrounded by a well-kept garden including a flock of peacocks noted for their aggressiveness.
A Santa parade, complete with vintage cars, turns into a brawl between patients.
Seager takes the time to explain how Gomorrah got into the state it's in and what needs to be done to make things better for staff, patients and their families.
While it is certainly disturbing and upsetting, you will come away from this book thoughtful.
In these times when the issue of how to treat the mentally ill with care and respect for both them and their caregivers is of great importance, the author shows all too well how an institution can become anything but a place of healing.
• Doug Anderson is a former public service worker, recently returned to Dunedin.
