Behind the Gates of Gomorrah

A Year with the Criminally Insane

Behind the Gates of Gomorrah

A darker twist on Orange is the New Black, this true insider's account delivers an eye-opening look into the nation’s largest state-run forensic hospital, a facility that houses the real-life Hannibal Lecters of the world.

Psychiatrist Stephen Seager was no stranger to locked psych wards when he accepted a job at California’s Gorman State hospital, known locally as “Gomorrah,” but nothing could have prepared him for what he encountered when he stepped through its gates, a triple sally port behind the twenty-foot walls topped with shining coils of razor wire. Gorman State is one of the nation’s largest forensic mental hospitals, dedicated to treating the criminally insane. Unit C, where Seager was assigned, was reserved for the “bad actors,” the mass murderers, serial killers, and the real-life Hannibal Lecters of the world.

Against a backdrop of surreal beauty—a verdant campus-like setting where peacocks strolled the grounds—is a place of remarkable violence, a place where a small staff of clinicians are expected to manage a volatile population of prison-hardened ex-cons, where lone therapists lead sharing circles with sociopaths, where an illicit underground economy flourishes, and where patients and physicians often measure their lives according to how fast they can run. To cross through the gates of Gomorrah is to enter a looking-glass world, where the trappings of the normal calendar year exist—Halloween dances and Christmas parties (complete with visits from Santa), springtime softball teams and basketball leagues, but marked with paroxysms of brutality (Santa goes berserk), and peopled by figures from our nightmares.

Behind the Gates of Gomorrah affords an eye-opening look inside a facility to which few people have ever had access. Honest, rueful, and at times darkly funny, Seager’s gripping account of his rookie year blends memoir with a narrative science, explaining both the aberrant mind and his own, at times incomprehensible, determination to remain in a job with a perilously steep learning curve.

Reading Group Guide

This reading group guide for Behind the Gates of Gomorrah includes an introduction, discussion questions, ideas for enhancing your book club, and a Q&A with author Stephen Seager. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book. 



Behind the Gates of Gomorrah is psychiatrist Stephen Seager’s account of his first year working at California’s Napa State Hospital, one of the largest forensic mental hospitals in the United States. While Dr. Seager is no stranger to locked pysch wards, nothing can prepare him for the dangerous reality of his post in Unit C, reserved for the “bad actors”: the mass shooters, the child rapists and murderers, and the serial killers. Surrounded by a volatile population of criminals in a hospital environment, Dr. Seager and his colleagues risk their lives on a daily basis.

Over the course of his rookie year at Napa State, Dr. Seager climbs a precipitously steep learning curve, navigating the often bizarre world of Napa State, learning to cope with fear and violence, and finding humor and grace where he least expects it. His memoir is an intimate, behind-the-scenes portrait of the nation’s justice and mental health systems, told with honesty an see more

About the Author

Stephen Seager

Stephen Seager is a board-certified psychiatrist, a former assistant professor of psychiatry at UCLA School of Medicine and a multiply published author. His work has been featured on national television and radio, including Oprah, GMA, NPR, and Larry King, among others.