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Nearly two decades after it closed, the South Carolina State Hospital continues to hold a palpable mystique in Columbia and throughout the state. Founded in 1821 as the South Carolina Lunatic Asylum, it housed, fed, and treated thousands of patients incapable of surviving on their own. The patient population in 1961 eclipsed 6,600, well above its listed capacity of 4,823, despite an operating budget that ranked forty-fifth out of the forty-eight states with such large public hospitals. By the mid-1990s, the patient population had fallen under 700, and the hospital had become a symbol of captivity, horror, and chaos. Author William Buchheit details this history through the words and interviews of those who worked on the iconic campus.