Book Review: Cries from the Fifth Floor (Erika Madden)

Reviewed by Maya Northen

When I read the description of Erika Madden's most recent book, Cries From the Fifth Floor, I was intrigued. As someone with a mental health condition, I can be a bit skeptical of fiction works that indicate a potential theme of mental health — a character who hears voices, sees visions, feels "crazy", and the like. At the same time, I'm always curious about how they'll handle it. Will they succumb to media bias, creating a protagonist who "loses their mind", wildly running about with constant extreme states of mind, never appearing "normal"? Will they paint a more realistic picture, and portray someone who has struggles but generally manages to function in everyday society? Or will they come up with another description all together.

As I began Cries From the Fifth Floor, I was immediately pleased. Claire Reed, the protagonist, stumbles upon an off-limits section of the hospital on the fifth floor. However, as opposed to being a "mental hospital", full of rambling men and women in straitjackets, the patients she encounters are in comas. While I am admittedly (and thankfully) unfamiliar with the medical ins and outs of coma patients, I feel that Madden describes the patients in enough detail to pull the reader in, but enough discretion as to not play into media stereotypes. The protagonist's initial interaction with these patients was just enough to entice further reading. Clearly, they were intricately involved in the development of the plot, all with their own story to tell, and yet I knew I'd need to read to the last page to discover each character's full potential.

Shortly after Clare "meets" these patients, she begins to experience changes in herself — courage and confidence she didn't previously posses, physical strength she had never experienced, talents she instinctively knew were not hers, yet were coming from her. She starts to hear their voices, speaking not only to her, but to each other. At first, she does in fact wonder if she is "going crazy". At one point early in the book she has hears the voice of Sir Rodney Hampton, one of the five coma patients, and is trying to rationalize it to herself:

What's he talking about? And why should I respond to these ludicrous voices in my head. Me, good old down-to-earth Clair, so snap out of it, think logically. Maybe I'm still asleep and having this horrible nightmare. Yes, that's it. I pinched myself. "Wake up."

Still the voices kept coming. I sat down, subdued, on the little mirror in the store restroom, listening to the idiotic gibberish in my head."

As the story unfolds, however, our protagonist realizes that the voices, unfamiliar traits, and unexpected talents belong to the patients in the coma ward.

Alone, new to New York City from a small town in the country, and barely making ends meet, Clare wonders why she's been chosen. Certainly, she doesn't have the skills, knowledge, or connections to make a difference. Have they taken over her brain for specifically this reason, she wonders. Does her lack of experience make the perfect canvas for whatever they hope to do? The patients seem to have big plans for her, and yet she's certain she doesn't have the persona or abilities to pull the plans off. At one point she finds herself in a restaurant looking at job ads after deciding, seemingly without her knowledge, to quit her own. She is using a pay phone in the back of the restaurant. Soon, however, she finds herself moving along as if in a trance, conscious of knowing the next step, yet with no idea how she is so certain:

I took my wallet from the side pocket of my bulging bad, went to the phone and dialed while pulling on the tethered pencil. I flattened my napkin to write on it when suddenly it hit me. What on earth am I doing? I stared at the piece of paper. "Director of Operations — a financial broker-dealer firm." What the hell is that? Up to now, all I'd accomplished was categorizing books in the library, waiting on tables, or juggling food trays in a hospital.

As the plot progresses, each of the patients emerges individually. She becomes familiar with their specific personalities and styles. Clare soon discovers that each character ended up in the coma unit under suspicious, or at best elusive, circumstances, and only through her can they tell their true stories. They soon become so familiar to Clare that their knowledge and skills start to merge with hers, and she finds she feels almost lonely without their guidance. The patients promise Clare that if she does this for them, that they'll help her in return. Their promise is vague, but Clare, not confident that anything positive can come from what is happening to her, seems to have no choice.

In the midst of her confusion and fear, Clare finds herself repeatedly encountering detective Caldwell, a young, attractive police detective who happens to be investigating each of the cases - even those that have technically been closed and filed away. Clare remembers seeing him visiting the coma patients on the day that she accidentally made her way into the ward. Their stories become intertwined, both personally and professionally, adding another human dimension to the story.

Overall, Cries From The Fifth Floor is an enjoyable, easy read that is both entertaining, and thought-provoking, offering a different perspective on the workings of the mind and the power of the spirit. It explores the idea that we have much more inside of us than we think possible, through a fast-paced story that keeps the reader turning the pages. The novel is available through Amazon and in Kindle Editions.


Maya Northen authors Lilies and Elephants, a blog about life with a mood disorder, and leads a mental health support group on Facebook. Her articles have been featured on and Partners for Mental Health, among other mental-health-focused sites. Northen has a B.S. in Kinesiology from Indiana University and an M.S. in International marketing from St. Joseph's University.