If you had a chance, would you take it? (1 Viewer)

Can someone help me name the story from which this quote is from (not sure if I have it exactly right). I recall it from a short story in which our author is handed a hospital questionnaire about his mental health.
 
The Wormwood version is what Bukowski wrote (see the manuscript to confirm that).

You may want to dip a toe into discovering how Bukowski's work was mutilated by John Martin.

Then again, you seem to prefer the John Martin version of "fingernails," and I really don't know where to point you for help with that...
 

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