When authors refer to other great works, people, and events, it’s usually not accidental. Put on your super-sleuth hat and figure out why.
Literary and Philosophical References
Thomas Hobbes, Leviathan
The ward members give the nickname Leviathan nickname to Ellis. It's a reference to Hobbs, the D ward attendant who lacked empathy for the patients and treated them with detachment and condescension because he feared his own inner crazy. It's also is a reference to the book Leviathan, by Thomas Hobbes, published in 1651. It's a treatise on human nature and society.
Hobbes was a defender of materialism, which is the belief that only physical things truly exist. Hobbs, the staff member of D ward, probably wanted to believe this, too, because then he could ignore the demons in his own head, which probably drove him to commit suicide. Ellis seems a lot like Hobbs, so Deborah is clever to name Ellis after both Hobbs and Hobbes.
Dante Alighieri, Inferno
In Chapter 3, Deborah refers to the "gods and demons from Yr and the shades from Earth" (3.2). This is partly a reference to Dante's Inferno and the term given to spirits in the underworld there. When Carla moves back to B ward from D ward, Deborah is shocked to realize that she will miss Carla. Deborah realizes she is capable of having a friendship, and she's capable of feeling pain when she won't be around her friend anymore.
She tells Carla she'll miss her, not because it's the normal thing to express, but because it will deepen her own suffering. It becomes part of the ongoing pity party she likes to throw for herself. She even compares herself and some of the ward patients to the inhabitants of Dante's Third Circle of Hell, which is where the gluttons go. It's like she sees herself as a glutton for friendship, when really she's a glutton for punishment.
Charlotte Brontë, Jane Eyre
When Esther works up the nerve to tell Suzy how sick Deborah really is, she worries that Suzy will replace the image of Deborah she has with stereotypes of crazy women in attics, like the madwoman in Jane Eyre (16.1).
The madwoman in the attic is a stereotype embodied by Bertha Mason, an insane character who gets locked in an attic for ten years by her husband Rochester. Bertha acts like an animal and is presumed to be both unmanageable and a lost cause. Her husband didn't know insanity ran in her family, and he married her because she was beautiful and rich.
So why bring Bertha into this story? One of the points the author wants to make in this story is there are a lot of prejudices and misunderstandings that surround mental illness. Maybe if Bertha had someone like Dr. Fried, she could have lived outside the attic. And why portray Bertha as a rabid animal when she could be portrayed as a person? Deborah Blau is a chance for readers to see the face of a mentally ill person in a three-dimensional away.
Oscar Wilde, The Importance of Being Earnest
Miss Coral offers to read The Importance of Being Earnest with Deborah, and soon other members of the ward are acting it out with them and reading different parts. It's significant that the play is about honesty and being true to oneself.
This is exactly what Deborah is trying to learn to do throughout the course of the novel. The patients act it out and know the attendants are laughing both with and at them, but they feel magically transported out of their usual craziness.
John Milton, Paradise Lost
Deborah sees a high school couple holding hands and nuzzling and gets jealous, thinking she'll never have that with anyone. The gods of Yr tell her the same thing, and then they start to laugh at her. As Anterrabae flies past Deborah with his characteristic flames about him, Deborah sees another figure right next to him that she recognizes—it's an image of Satan she remembers from an illustrated edition of Paradise Lost her grandfather had (29.89).
She realizes, after all this time, that she borrowed the image of her most trusted and beloved god from a book she'd seen—and she modeled the god on Satan, no less. Anterrabae was like a fallen angel, after all, and he did deceive her—into thinking she wasn't human, into thinking she was poisonous, into thinking she should renounce the ways of Earth and live in Yr in secluded self-righteousness.
Yes, that sounds like something Satan would do.
Biblical References
Pontius Pilate
In Chapter 13, Deborah witnesses Ellis, a religious attendant who reminds her of Hobbs, smacking Helene in the face while she's restrained in a cold-sheet pack. She reports the incident to the ward doctor, who does nothing. She then reports the incident to Dr. Fried, who promises to mention the incident to her peers but reminds Deborah that she has no say in personnel or disciplinary matters that happen in the ward.
Deborah feels betrayed that Dr. Fried can't do more to bring justice to the situation, and she asks "Is Pilate everybody's last name around here?" (13.37). This is a reference to Pontius Pilate, the prefect of Roman Judea who presided over the trial of Jesus, which resulted in Christ's crucifixion.
It's fitting that right after she says this to Dr. Fried, she questions her faith in getting better and in siding with the world. Dr. Fried explains bluntly and honestly to Deborah that the world is not perfect, and neither are the people in it. But you have to have faith that participating in it is better than being locked in the prison of your own mind. She tells Deborah it isn't easy, and in her words, "I never promised you a rose garden. I never promised you perfect justice" (13.40).
Noah
After Deborah's mental break, when Yr and the real world finally collide full force, Dr. Fried asks Deborah if she feels she's getting sicker. Deborah feels exhausted and wants to give up fighting against the illness, but she also can't help feeling some hope. She tells Dr. Fried that she's not getting worse.
When she gives this answer, she compares herself to Noah sending out the dove after the flood to scout out land. It's as if her meltdown was a cathartic flood, and now, in the aftermath, there is the possibility of peace and health.
The Prodigal Son
In Chapter 25, Deborah goes home for a five-day visit and spends time with round after round of family members. Suzy, who is charming, attractive, friendly, outgoing, and a talented artist in her own right, sees the lavish praise her parents and family heap on Deborah and realizes she is frustrated by all the attention Deborah has received over the years. She's ticked at the way her family's happiness and peace have depended on how Deborah has been doing at any given point.
Deborah feels her sister's resentment and compares it to the biblical story of the prodigal son who left home and abandoned his family but was welcomed with love and celebration when he returned—which made his brother jealous: "[I]t seemed to Deborah that Suzy had darkened over these two days, She had been free to go out and leave the prodigal elder sister to all the praises, but she had stayed" (25.33).
Janus
In chapter 3, Deborah describes being able to see "reality" from Yr as if looking through a gauze partition. When this happens, she names herself "Januce," after Janus, the Roman god of beginnings and transitions. In ancient Roman architecture, there are many freestanding doorways dedicated to Janus, who was most often depicted with two faces. Deborah even describes herself as feeling like she has "a face on each world" (3.1) when she's between each world and can see both at the same time.
Charon
In Chapter 3, Deborah refers to the nurse who takes her to back to the mental ward after visiting Dr. Fried as Charon. Charon was the ferryman of the River Styx in Greek mythology. Charon's job was to bring the souls of the dead to their afterlife in the underworld. (3.52). Dr. Fried says allowed that she hopes that with time Deb can learn to see the world as something other than hell.
Titans
When Deborah goes home for a five-day visit after she's been in the hospital for over two years, she finds it exhausting to endure a family get-together that for most people wouldn't be such a big deal. She's on the verge of feeling healthy, but she's not quite there, and being home points that out to her. She feels like a burden to her family: they go out of their way to be nice to her when she doesn't have the means or the energy to reciprocate.
She calls her family Titans because their ability to manage the day-to-day stresses of social interaction so outmatches her own: "these Titans, who called themselves average and were unaware of their own tremendous strength in being able to live, only made her feel more lost, inept, and lonely than ever" (25.20).
According to Deborah, these people are like the larger-than-life creatures of myth who were strong and magical, while she's a weakling by comparison: a holiday dinner makes her feel as tired as if she had climbed Mount Everest (25.20).
Historical References
World War II
Dr. Fried recalls incidents with her mental patients during World War II in Nuremburg, Germany. Right after Deborah questions her about finding justice for Helene, who was beaten by an attendant, Dr. Fried admits that she can't promise justice, and this prompts a powerful memory for her of Tilda, a patient she treated in Germany.
Newtonian Natural Philosophy
Once Deborah is near the end of her stint at the mental hospital and on her way to recovery, a new patient asks Deborah what religion she is, and she responds: "Newtonian" (26.1).
Newtonian philosophy took on various meanings in the 18th and 19th centuries, but the original concept comes from Sir Isaac Newton and his principles of looking at the physical world according to attractive forces and expanded models of atomic theory.
Newton was also fond of looking at the natural world with a sense of wonder. This is probably how Deborah is feeling as she falls in love with world all over again. She can see colors again for the first time in years, and she can interact with people without all the walls and defenses of Yr between them. She starts creating artwork like crazy.
Western Expansion
In the end of the novel, Deborah says goodbye to Yr and its main god, Anterrabae, while she flips through her textbooks. She's recently earned her GED, and she's excited about the future. This victory came a huge price, though. She has one last meltdown as Earth and Yr collide, but she's smart enough to walk to the mental hospital while her mind is gearing up for the final showdown between Yr and Earth.
After the meltdown, Deborah calmly says goodbye to Yr while she reads about how "TECHNOLOGICAL ADVANCES AFFECTED WESTERN EXPANSION IN MANY SPECIFIC WAYS" (29.119). As she reads, various members of D ward scream out obscenities and cries for help.
The headings from her history book definitely apply to the situation at hand. Deborah herself is about to venture into the world without using her sickness and Yr as a crutch. This is very much like being an explorer and settling new territory and expanding.
The next heading she reads is also super appropriate: "THE INVENTION OF T.N.T MADE POSSIBLE THE JOINING OF THE COASTS BY RAILROAD" (29.121). It's a great parallel to what Deborah just went through: the explosion for her was the meltdown in her mind that happened every time Yr and Earth collided.
Those collisions had to happen in order for Deborah to break down the walls of Yr and connect with the real world. It was messy and explosive. But a new structure sometimes can't be built unless the demolition crew comes in first and blows some stuff up.