The narrator, 14-year-old Paul, has run away from home after being physically and emotionally battered by his father. He lives on the roof of a convenience store before being picked up by the police and taken into custody. The system—which is supposed to protect abused children—ushers the fragile, scared young man into another ring of hell. One of his early stops is the Robert Taylor Homes, the largest housing project in the world. Elliott's descriptions manage to be both gritty and lyrical.

They tower over the Dan Ryan freeway like broken teeth, with miles of chain-link fence casing in the outdoor stairwells…. Hidden in the shadows of these enormous buildings, these concrete mountains, among post offices covered in barbed wire and the green glass of broken bottles, there are a smattering of group homes where the state hides the children when there is nowhere else to go. They hide me in a tuft of grass called Adlai Stevenson House after a man that was almost president for boys that never will be.

In his journey from scared and scarred adolescent to adult, Paul seeks solace among a motley crew of troubled youth and adult professionals. In this netherworld, they emerge as almost archetypal. A boy nicknamed French Fry is terribly disfigured by an attempt to burn himself to death. A social worker named Molly becomes the source of Paul's lover-mother fantasies.

The book is billed as fiction, but stems from the author's own recollections of the horrors he experienced as he bounced among group homes, institutions and homelessness. Against many odds, Elliott obtained an advanced college degree and is now a creative writing fellow at Stanford. This is a promising and chilling debut.

Inner Worlds

After working for years as a psychiatrist in San Francisco's emergency rooms and city jail, Paul R. Linde figured he had seen just about every manifestation of mental illness. But then he went to Zimbabwe for a year and found himself shocked, confounded, dispirited and lifted up as he faced the intersection of western medicine and the spirit world.

As he explains in Of Spirits and Madness: An American Psychiatrist in Africa (McGraw-Hill, 288 pp., $24.95), he came upon patients facing problems as varied as poverty, AIDS dementia and postpartum depression, and people whose inner worlds were ruled simultaneously by devout Christianity, ancestor spirit worship, exorcism, demonic possession and witchcraft.

Visualize a misplaced Bedlam: a dusty courtyard in Africa, its perimeter marked by a chain-link fence topped by barbed wire…. Approaching the gate that day, I was taken aback by the chaos. Overmedicated and undermedicated patients wearing ill-fitting hospital pajamas and brightly striped bathrobes—some jabbering and zipping around, a few flapping and squawking, others motionless and voiceless, still others appearing completely normal—milled around the hospital's yard of patchy grass and dirt.

Linde is open to his patients' belief systems and eager to learn from them as he attempts to ease their suffering. He credits his open mind to living in the Bay Area: "A cultural hothouse for the study of the 'unnatural' world of spirits and its influence on the practice of medicine."

In the manner of Oliver Sacks, he tells stories of individual patients with good humor and sensitivity. A self-mutilator named Winston blames his wounds on witchcraft. A young woman falls into a depression after being newly infected with the AIDS virus by her husband. A farmworker suffers literally from reefer madness. One of the most evocative stories is of a nurse's aid who suffers from "kufungisisa," the illness of "thinking too much."

Linde does not shy away from being outraged when outrage is called for. For instance, he bemoans the country's scarcity of well-trained, sensitive medical personnel and pharmaceutical supplies. This is a compelling story and Linde is an excellent guide into a world that seems at first unbelievable but eventually becomes strangely recognizable in its human suffering.

Local Color

In the way that Carl Hiaasen takes on and spoofs South Florida, first-time novelist Robert Mailer Anderson inflates, twists and serves up characters from eccentric Boonville, Calif. The protagonist of Anderson's Boonville (Creative Arts Book Company, 256 pp., $21.95), a young man in the eternal search for self, packs his bags in Miami and heads west to live in a house left to him by his whacked-out alcoholic grandmother. Grandma, by the way, spent the final years of her life indulging her creativity in the form of dead squirrel sculptures—hundreds of them.

John heard that the town, population 715, was backward, that it even had its own language, "Boontling, which had sprouted around the turn of the century at 'hop-pickin' campaigns, a mish-mash of slang that used English as its base. Grandma had said it was as dead as Latin. Only a fistful of locals spoke it."

John was prepared for the language, but not for the locals, each recognizable to anyone who has spent time on the Northern California coast. The hard-drinkers are here, as are the ex-hippies, unrepentant hippies, rednecks, loggers, radical environmentalists and an overweight, caftan-wearing, health-food-eating radical feminist named Pensive Prairie Sunset.

Anderson, who was born and still lives in San Francisco, provides a lot of laughs in this rollicking light comedy. There are also plenty of cheap shots, but that is what makes good-natured California-bashing so much fun.