If you are going to deal with the issue of health in the modern world, you are going to have to deal with much absurdity.

It’s appalling that one person’s illness would be an opportunity for another to make money. The care of human beings should not be a commodity.

Then ahead I saw a small, dark shape perched on the sand, well back from the water. As I drew closer, the shape revealed itself to be a bird, sitting back on its tail feathers. It was vaguely penguin-like, about eighteen inches tall, with black back and head, white breast and cheeks.

Eleven years ago I woke up to find the room spinning. In the soft blue-gray light of morning, the walls folded and slid and picked up speed. I pressed my body hard against the mattress, frantically searching for something to hold on to, but everything was moving with me.

I’ll tell you what we don’t do: we don’t call the person’s doctor, or dial 911, or drive people to the emergency room. We ask what’s going on for them — not what’s “wrong” with them or if they have been given a diagnosis. If they do mention a diagnosis, we ask what it means to them. If they talk about voices, visions, suicidal thoughts, or injuring themselves, we meet this with calm curiosity. We’ve found that what helps people move through such feelings is being able to talk openly about them. Unfortunately many people don’t talk openly in clinical environments for fear that alarms will be sounded.

I stood inside the entrance of Central State Hospital in Indianapolis, Indiana, waiting to get patted down. It was my first visit to the institution, in 1992. I was twenty-four and had been working in the field of disability and mental health for two years.