Inferno

Catherine Cho, a Korean American woman living in London with her husband James, a professor and scientist, opens the memoir by describing a Korean tradition: After a baby is born, mother and child stay home for 21 days, and after 100 days, a celebration marks the baby's survival. Cho and James ignored these customs. When their son Cato was two months old, they left London for a trip across the United States to introduce him to family and friends. Eight days before Cato's 100-day celebration, Cho began to see devils in his eyes. James rushed her to a hospital emergency room, where she screamed and tore off her clothes. After four days without sleep, she was transferred to an involuntary psychiatric ward at New Bridge Medical Center in Paramus, New Jersey.

The memoir alternates between Cho's account of life in the ward and her memories of the past, which she pieced together in a notebook James left for her. Her first conscious memory was waking in restraints in a bright white room. There she met a nurse named Nmandi, whom she simultaneously perceived as the archangel Michael. She wrote a list of truths on a folded piece of paper: She was alive. She was married to James. She had a son. She had postpartum psychosis, a condition she had never heard of, involving a loss of objective reality. Her memory was fragmented, filled with looping visions that replayed with different outcomes.

The ward housed 25 men and women. Residents followed a rigid schedule of meals, medication, and group sessions. Cho was the only Asian resident. Key figures include Tamyra, a 21-year-old pregnant returner who presided over the ward; Emma, a college student whose questions exposed the ward's restrictive rules; and Will, a returner who had been in institutions since childhood and advised that the fastest way out was to act like you did not want to leave. Cho secured a pen and began reconstructing her identity by drawing a family tree and tracing memories in the notebook.

Cho reflects on Korean cultural beliefs about love and suffering. Her grandmother warned her never to find love, trying to protect her from the pain that accompanies it. Cho's grandparents escaped North Korea during the Korean War, leaving behind family they would never see again and establishing a legacy of separation and grief. Cho frames her psychosis as a distorted love story: She believed she was Beatrice, the guiding spirit in Dante's Inferno, assigned to lead James through hell, sacrificing herself for him.

Cho recounts growing up in Kentucky, the daughter of a math professor who imposed strict rules and whose unpredictable temper was directed at her younger brother Teddy, always outside their mother's presence. The siblings became "foxhole buddies," communicating in whispers and silences. When their mother took a government job in Virginia, the family split. Cho chose New York for college; Teddy studied mathematics in Chicago.

After college, Cho moved to Hong Kong, where she entered a relationship with a man named Drew. Drew presented himself as a gentleman, but his violence escalated unpredictably. Cho stayed because she believed her suffering was a form of sacrifice rooted in love. She left one night after discovering Drew was communicating with his ex-girlfriend, realizing he had never loved her. She finished law school in Hong Kong, then returned to her parents' home in Virginia.

She met James at a wedding in New Jersey. They talked all night and felt immediate recognition. James, the youngest of three brothers in a Korean American family, researched non-invasive surgery using ultrasound. After a long-distance courtship, they married at City Hall in San Francisco with two witnesses, and Cho moved to London. She met James's family, including his anxious pediatrician father and his energetic mother, who told Cho she must learn to "surrender" in marriage, a directive that unsettled her.

In the ward, James visited looking haggard. He brought photos of Cato, but Cho did not recognize the baby. James cried when she told him she had drawn a family tree, because during her psychosis she had been unable to do so. A doctor later told Cho that James did not believe she was fully herself, noting that she never asked about Cato. Cho recalls her pregnancy at 30 and an emergency C-section after developing sepsis. When Cato was placed on her chest, she felt curiosity rather than the rush of love she expected.

The cross-country trip began with a New Year's wedding in San Diego, where Cho felt triumphant. In Los Angeles, she developed mastitis, a painful breast infection, at the home of Matt, James's older brother, where she also discovered surveillance cameras that unsettled her. In Virginia, her father surprised her by holding Cato constantly and playing Bach on the piano. The family arrived in New Jersey exhausted after 31 days of travel.

At her in-laws' home, relentless criticism compounded Cho's sleep deprivation. Every parenting decision was questioned. James's father diagnosed her with postpartum depression but ended the conversation with a story about a mother who shook her baby. James discovered surveillance cameras in the house and tore one from the wall. Cho felt trapped, her in-laws' voices looping in her head.

Cho identifies the trigger as a sudden insight into the family dynamics. She perceived her mother-in-law's exaggerated laughter as a performance to manage her father-in-law's anxiety and saw James as shaped by these forces into a man of principles and certainty. She processed everything in a single moment and felt the world flip. She looked at Cato and saw devils' eyes.

James drove them to a hotel. That night, Cho heard what she believed was the voice of God telling her Cato must die. Her reality fractured into infinite loops. When James's parents arrived, Cho screamed that they were in hell. James rushed her to Englewood Hospital, where she fought nurses and tore off her clothes, believing the building was a set designed by hell. Over four days she did not sleep. Cho's own parents drove from Virginia; she did not recognize them and called her mother a devil. Her father held her hand, unable to promise they were not in a simulation but assuring her that as far as he knew, they were not. Doctors transferred her to New Bridge, where she was finally sedated.

In the ward, Cho's memories sharpened. The doctor told her she could leave the next day. She said goodbye to the residents and walked the hallway to where Christine, the social worker, opened the door. James was on the other side, teary-eyed. Cho stepped through without looking back.

She had spent 12 days away from Cato: four at Englewood and eight in the ward. James took her to a hotel near Manhattan. When her parents brought Cato, she did not recognize him and felt nothing. They visited James's parents, where her mother-in-law embraced her and cried, before flying back to London.

Weeks later, Cho developed severe depression, a common aftermath of postpartum psychosis and antipsychotic medication. A Mental Health Crisis Team visited each morning. Her mother came from Virginia to care for her. Cho learned that in the UK she would have been treated in a mother-baby unit alongside Cato rather than separated from him, and the unnecessary separation deepened her anger.

She held Cato each morning but felt nothing. She went through the motions of mothering, practicing smiles and smoothing his hair. She took medication for a year. James packed an emergency hospital bag, revealing how deeply his certainty had been shaken. Then one ordinary day, while holding Cato, Cho suddenly remembered him: his smile, his breath against her arm, the warmth of sun on their cheeks. She was a mother again.