'We got a small plane at three o'clock,' she said through her mike. 'See it?'

'Yes.'

'Then you say, tally-ho. And it's above horizon. You can tell that, right?'

'Tally-ho.'

Lucy laughed. 'No. Tally-ho does not mean ten-four. And if something's above horizon, that means it's also above us. That's important, because if both aircraft are at horizon and the one we're looking at also doesn't seem to be moving, then that means it's at our altitude and either heading away from us or straight for us. Kind of smart to pay attention and figure out which one, right?'

Her instruction went on until the New York skyline was in view, then I was to have nothing more to do with the controls. Lucy flew us low past the Statue of Liberty and Ellis Island, where my Italian ancestors had gathered long ago to begin with nothing in a new world of opportunity. The city gathered around us and the buildings in the financial district were huge as we flew at five hundred feet, the shadow of our helicopter moving below us along the water. It was a hot, clear day, and tour helicopters were making their rounds while others carried executives who had everything but time.

Lucy was busy with the radio, and approach control did not seem to want to acknowledge us because air traffic was so congested, and controllers were not very interested in aircraft flying at seven hundred feet. At this altitude in this city, the rules were see and avoid, and that was about it. We followed the East River over the Brooklyn, Manhattan, and Williamsburg bridges, moving at ninety knots over crawling garbage barges, fuel tankers, and circling white tour boats. As we passed by the crumbled buildings and old hospitals of Roosevelt Island, Lucy let La Guardia know what we were doing. By now Ward's Island was straight ahead. It was appropriate that the part of the river at the southwestern tip was called Hell Gate.

What I knew about Ward's Island came from my enduring interest in medical history, and as was true of many of New York's islands in earlier times, it was a place of exile for prisoners, the diseased, and mentally ill. Ward's Island's past was particularly unhappy, as I recalled, for in the mid-eighteen hundreds, it had been a place of no heat or running water, where people with typhus were quarantined and Russian Jewish refugees were warehoused. At the turn of the century, the city's lunatic asylum had been moved to the island. Certainly conditions were better here now, although the population was far more maniacal. Patients had air conditioning, lawyers, and hobbies. They had access to dental and medical care, psychotherapy, support groups, and organized sports.

We entered the Class B airspace above Ward's Island in a deceptively civilized way, flying low over green parks shaded with trees as the ugly tan brick high-rises of the Manhattan Psychiatric and Children's Psychiatric Centers and Kirby loomed straight ahead. The Triborough Bridge Parkway ran through the middle of the island, where incongruous to all was a small circus going on, with bright striped tents, ponies, and performers on unicycles. The crowd was small, and I could see kids eating cotton candy, and I wondered why they weren't in school. A little farther north was a sewage disposal plant and the New York City fire department training academy, where a long ladder truck was practicing turns in a parking lot.

The forensic psychiatric center was twelve stories of steel mesh covered windows, opaque glass, and air conditioning units. Sloppy coils of razor wire bent in over walkways and recreation areas, to prevent an escape that Carrie apparently had found so easy. The river here was about a mile wide, rough and foreboding, the current swift, and I did not think it likely that anyone could swim across it. But there was a footbridge, as I had been told. It was painted the teal of oxidized copper and was maybe a mile south of Kirby. I told Lucy to fly over it, and from the air I saw people crossing it from both directions, moving in and out of the East River Housing of Harlem.

'I don't see how she could have gotten across that in broad daylight,' I transmitted to Lucy. 'Not without being seen by someone. But even if she could and did, what next? The police were going to be all over the place, especially on the other side of the bridge. And how did she get to Lehigh County?'

Lucy was doing slow circles at five hundred feet, the blades flapping loudly. There were remnants of a ferry that at one time must have allowed passage from East River Drive at 106th Street, and the ruins of a pier, which was now a pile of rotting, creosote-treated wood jutting out into unfriendly waters from a small open field on Kirby's western side. The field looked suitable for landing, providing we stayed closer to the river than to the screened-in walkways and benches of the hospital.

As Lucy began a high reconnaissance, I looked down at people on the ground. All were dressed in civilian clothes, some stretching or lying in the grass, others on benches or moving along walkways between rusting barrels of trash. Even from five hundred feet, I recognized the slovenly, ill-fitting dress and odd gaits of those broken beyond repair. They stared up, transfixed, as we scoured the area for problems, such as power lines, guy wires, and soft, uneven ground. A low reconnaissance confirmed our landing was safe, and by now, more people had emerged from buildings or were looking out windows and standing in doorways to see what was going on.

'Maybe we should have tried one of the parks,' I said. 'I hope we don't start a riot.'

Lucy lowered into a five-foot hover, weeds and tall grass thrashing violently. A pheasant and her brood were appropriately startled and darted along the bank and out of view amid rushes, and it was hard to imagine anything innocent and vulnerable living so close to disturbed humanity. I suddenly thought of Carrie's letter to me, of her odd listing of Kirby's address as One Pheasant Place. What was she telling me? That she had seen the pheasants, too? If so, why did it matter?

The helicopter settled softly and Lucy rolled the throttle to flight idle. It was a very long two-minute wait to cut the engine. Blades turned as digital seconds did, and patients and hospital personnel stared. Some stood perfectly still, pinning us with glazed eyes, while others were oblivious, tugging on fences or walking with jerky motions and staring at the ground. An old man rolling a cigarette waved, a woman in curlers was muttering, and a young man wearing headphones started into a loose knee rhythm on the sidewalk, for our benefit, it seemed.

Lucy rolled the throttle to idle cut-off and braked the main rotor, shutting us down. When the blades had fully stopped and we were climbing out, a woman emerged from the gathering crowd of the mentally deranged and those who took care of them. She was dressed in a smart herringbone suit, her jacket on despite the heat. Her dark hair was short and smartly styled. I knew before being told that she was Dr Lydia Ensor, and she seemed to pick me out as well, for she shook my hand first, then Lucy's, as she introduced herself.

'I must say, you've created a lot of excitement,' she said with a slight smile.

'And I apologize for that,' I said.

'Not to worry.'

'I'm staying with the helicopter,' Lucy said.

'You sure?' I asked.

'I'm sure,' she replied, looking around at the unnerving crowd.

'Most of these are outpatients at the psychiatric center right over there.' Dr. Ensor pointed at another high rise. 'And Odyssey House.'

She nodded at a much smaller brick building beyond Kirby, where there appeared to be a garden, and an eroded asphalt tennis court with a billowing torn net.

'Drugs, drugs, and more drugs,' she added. 'They go in for counseling, and we've caught them rolling a joint on their way out.'