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A obra narra a experiência do protagonista, Vicente Mascarenhas, que é internado em um hospital psiquiátrico. O livro é uma crítica mordaz à sociedade e ao sistema de saúde mental do Brasil.
A internação de Vicente é baseada na própria experiência de Barreto, que foi internado em um hospício devido ao seu alcoolismo e aos problemas emocionais. .
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