The tale opens with the unnamed narrator arriving at the house of his boyhood friend, Roderick Usher, having received a letter from him in a distant part of the country complaining of an illness and asking for his help. Although strong-willed Poe wrote this short story before the invention of modern psychological science, Roderick's symptoms can be described according to its terminology. They include hyperesthesia (hypersensitivity to light, sounds, smells, and tastes), hypochondria (an excessive preoccupation or worry about having a serious illness), and acute anxiety. It is revealed that Roderick's twin sister, Madeline, is also ill and falls into cataleptic, death-like trances. The narrator is impressed with Roderick's paintings, and attempts to cheer him by reading with him and listening to his improvised musical compositions on the guitar. Roderick sings "The Haunted Palace", then tells the narrator that he believes the house he lives in to be sentient, and that this sentience arises from the arrangement of the masonry and vegetation surrounding it.