Alice writes in her undated diary from a hospital. She is unsure how she has ended up here and can only think of the worms she thinks are eating her alive. She has apparently been biting her fingers down to the bone. The worms eat away her "female parts," and she wishes she were dead. She has clawed up her face and the rest of her body, as well. She continues being paranoid and violent—she thinks a fly in her room will lay maggot eggs on her, and she pulls out her hair and beats her body up more. Her mother and father visit her every day, but not for long, as there isn't much to say until she gets her mind "working again."
Alice reveals that an accidental dose of acid is the cause of her breakdown. Her father says that someone had put it on chocolate-covered peanuts Alice was eating while she was babysitting. Alice slightly remembers this: she had been thinking of her grandfather while eating the peanuts, since he used to like them, and then during the acid trip he materialized as a skeletal figure. Worms and maggots cannibalized his body, then the vermin moved on to Alice, who tried to fend them off as her grandfather pointed to a casket next to his. Other dead things and people forced Alice into the casket and locked her inside.
Alice's mother and father believe that someone else "tripped" Alice without her knowing it. Alice is happier because of this, and she thinks she knows who did it, but has no way of finding out for sure. She is feeling better and will be transferred soon to another hospital. Her body is healing, although her hands won't be fully healed for a year. She is learning to control her thoughts of the worms, which she knows aren't real but which feel very real. Her mother brings Alice a packet of letters Joel has written her.
(July 22) Alice finds out she is being sent to an insane asylum. Her father tells her that when her case was brought before a juvenile court, Jan and another girl testified that Alice had still been on drugs and was selling them. Further details of the acid episode emerge: when the neighbors of the couple Alice was babysitting for heard her screams, they locked her in the closet and checked on the baby and called the police. By the time they'd let her out, Alice had injured herself by beating her head against the door until she had fractured her skull and suffered a concussion. Alice fears the asylum more than the worms.
(July 23) Alice registers at the State Mental Hospital. She is frightened by the ugly building and by the inmates, whom she feels are different from her. (July 25) Alice is introduced to the daily regimen at the Youth Center, the asylum's school and recreational center. She feels alienated from the other kids, who seem comfortable. Dr. Miller, a psychiatrist, tells Alice she can only receive help once she admits she has a problem, which she doesn't think she has—she knows she can easily resist drugs.
(July 26) Alice meets a little thirteen-year-old girl, Babbie. Sitting in the crowded recreation room, Alice asks Babbie if she'd rather talk in her room. Babbie takes this as a sexual proposition and says they should go to the storeroom instead. Alice tries to explain what she meant, but Babbie ignores her and tells her life story. While living with her father after her parents' divorce, Babbie was introduced to drugs by an older man. She started cutting school and became a prostitute. Her parents started noticing something was wrong, but they were too late—Babbie ran away to Los Angeles. There, she worked for an older woman as a prostitute. Babbie ran away again, to San Francisco, where she was raped and beaten. Babbie then met a man who made his own LSD, and soon she landed in the asylum. Alice feels like the asylum is a prison that makes her crazier.
Despite the mental horrors Alice endures, her mind stays somewhat resilient and her diary becomes her true sanctuary, not only as a place to describe her feelings but now as a proof of her own sanity. Her physical self-abuse is a manifestation of all her previous bouts of self-loathing and morbid anxiety. Her old nightmares of worms and maggots eating away at dead bodies now haunt her imagination, yet the worms and maggots now take on a new significance. In her acid episode, the "dead things and people" that were trapping her in the casket intermingle, becoming one entity that seeks Alice's harm. While not explicit symbols, the maggots and worms stand for all the destructive impulses of society that Alice has internalized into low self-esteem. Just as society is "pushing" her inside the coffin, it pushes her into drugs, pushes her away from her family, and pushes her into a lonely corner at school. She comments on the symmetry of her first and last drug uses, both of which were without her knowledge. In another way, though, all times were without her full consent. the drugs were pushed on her by a society that was cold and harmful and only gave her love and self-esteem when she was high. Again, Alice meets an extreme example in Babbie, another exploited, abused victim of society's cruelty.
Society again rears its hypocritical head. Alice is sentenced to an asylum, while the real villains—Jan and the other girl—get off scot-free. As Alice puts it, the "whole world is crazy," and, while some of the inmates at the asylum are insane, the outside world is just as incoherent. The theme of defining insanity versus sanity has been prevalent in literature from Hamlet to One Flew Over the Cuckoo's Nest, and the reader can see that Alice, while mentally shaky from her episode, deserves freedom. Even her inability to understand whether the worms are real or not is partially a product of her vivid imagination that confuses fact and fiction.