Guests on Earth by Lee Smith tells the story of Evalina, the child of a New Orleans exotic dancer. In 1936, left fatherless and orphaned, her mother’s married ex-boyfriend assumes her care. While in his home, the first sign of mental illness presents itself, and she is sent to Highland Hospital in Ashville NC—a progressive insane asylum for the wealthy who call the residents guests. At Highland, Evalina forms a makeshift family of colorfully tragic characters, finds love, herself and maybe even hope for a future.Music features heavily as we follow Evalina from her childhood in New Orleans into her early 20’s at the hospital. Real residents like Zelda Fitzgerald and Nina Simone make appearances; and having read other reviews of the book, I knew not to expect a Zelda heavy story. Since it spans so many years, some parts are breezed through with the use of postcards and newspaper clippings, which were a great way to prevent the story from becoming overwhelming.Many of the characters were repeat guests who came to view Highland as their home, Zelda and Evalina especially. At one point, a nurse and patient muse that the reason so many of the women return is that they just don’t fit in and society doesn’t know what to do with them. The splashes of local culture and color kept me aware that no matter how homelike Highland came to feel for the characters, it was still a mental hospital for the privileged. Though not really featured in-depth, there were discussions and use of ‘modern’ psychiatric treatments like insulin comas, electroshock therapy, and equine serums, and the disapproval of horrifying lobotomies and forced sterilizations were touched on.The novel ends with the famous fire that killed several of the residents trapped in a lock ward and conjecture as to who really started it. I’m not really sure what to make of Evalina’s ending, She returns to New Orleans where she’s built a life, but is still holding onto delusional hopes from the past. But, maybe that’s the point–Highland will always be her real home because she just doesn’t fit. In society, she’s only a guest.