Pepper, a big man with a big temper, is forcibly committed to the New Hyde Mental Hospital after assaulting three undercover policemen.  His stay, originally supposed to be only 72 hours, is extended almost indefinitely by a combination of potent sedatives and Pepper’s own bad decisions and volatile temper.  Everyone in New Hyde is medicated into passivity, kept restrained for illegal amounts of time for any infraction, and tormented in ways small and large by the underpaid and overworked staff.  Pepper soon falls in with a small group of other troublemakers, including his roommate Coffee; a teenaged girl who’s already a lifer; and the ward’s oldest female patient, who considers herself the mother to everyone else.  It isn’t long before Pepper discovers the hospital’s biggest secret…the Devil himself is kept in solitary confinement there, sneaking out at night to visit violence upon the other inmates of the wards. Or so the patients believe; according to the staff, he’s just a sick old man.  As Pepper tries to make sense of his new surroundings while surviving the Devil’s nightly excursions, a diffuse sort of plan begins to take shape—they will take revenge upon the Devil and escape New Hyde once and for all. But can they survive outside?

An odd sort of novel, neither truly horror nor truly realistic, The Devil in Silver is, at its core, a ringing indictment of the modern mental health establishment. The abuses committed within New Hyde are appalling, and the statistics given–medical, financial, etc—are equally so.