Protagonist David Mitchell is a World War II veteran who, under the weight of his too-real experiences, rages at his family, burns cigarette stigmata into his palms, and stares down the sun. The reader learns of this from Mitchell's stream-of-consciousness ravings-our narrator is in the throes of a psychotic break.
Mitchell improves, both due to and in spite of the treatment he receives in the VA hospital in which he is trapped. Insulin coma therapy, restraint with wet blankets, and blunt-force electroshock are elements of his care. Mitchell is fortunate that his doctors refrain from treating the homosexuality in his military record, about which he is unapologetic. Ultimately, Mitchell's illness can only be overcome by his own shattered mind. While the significance of his breakdown can only be comprehended by Mitchell himself, we can all gain insight from witnessing his struggles.
The legitimate forerunner to One Flew Over the Cuckoo's Nest, but more harrowing and convincing because the horror, pain, fantasy (and even humor) is real. When The World Next Door was first published, it was nearly categorized as an autobiography. Ultimately released as a novel to critical acclaim, it caused a splash in the psychiatric community for its illuminating view of a mental institution from a patient's perspective.