The river was hammered bronze beneath the dawning sun. Andrew resisted the urge to check his watch yet again, knowing it wouldn’t get him onto the ferry any faster. There had been a death on the island overnight, it seemed, and the dockworkers refused to unload the coffin until the city wagon arrived to carry it away. Fair enough. In their place, he wouldn’t want to be left with a corpse and nothing but a promise that someone would come and take it away. But the delay—and its cause—only further increased his unease.
He’d woken shortly after midnight from ragged, ponderous dreams and tossed for several hours before resigning himself to wakefulness. He lit the lamp and sat at the desk to reread the letters Ned had given him, already knowing he wouldn’t find anything new. The maid’s—Ellen’s—letter recounted precisely the story Ned had told him the day before, though he’d thought of several additional questions for her. He would ask Ned for the address, or perhaps have him write to her. Julia’s letter was unremarkable. There was no hint of any mental distress or disordered thought. The letter was warm, full of news of her daughter and the little doings of her household. The kind any fond sister might write to a sibling.
The kind Susannah might have written to him someday, had things been different.
Andrew folded the letters back into their envelope without looking at the photographs. He remembered well enough what they showed. The first, a simple portrait, revealed Julia Weaver to be a plain-faced, solemn woman—though there was kindness in her eyes. The other was a wider shot of Julia seated, her arm around the shoulders of the little girl standing beside her—Catherine, presumably. Julia was turned toward the child, and the angle of her hat meant only part of her face was visible. It would be next to no use in identifying her. It could have been anyone.
The photos had lingered in his mind. In the most unsettling of the night’s dreams—the one that drove him from sleep and spurred his eventual rising—Andrew opened a door and came upon the precise tableau in the second photograph. For a moment, his dream self was delighted—Ned had asked him to find Julia, and there she was. Then the woman turned her head toward him. The face beneath the hat’s brim was Susannah’s.
A little shudder ran through Andrew. He put his hand in his pocket and traced the outline of Susannah’s locket with his thumb. He’d plucked it from his desk that morning along with Julia’s photographs, which now resided in the pocket of his waistcoat. He had no idea why he’d brought both photographs, except that Ned had presented them as a pair, and so, to Andrew’s hazy, overstimulated brain, a pair they must remain. He shook himself alert as the wagon arrived. Still holding the locket, he waited as the coffin was carried away, then boarded the boat.
Once on the island, Andrew fetched himself a cup of the asylum’s burned, tarry coffee, dumped in enough sugar to kill the taste, and got to work.
By the time the head clerk, Winslow, arrived, Andrew had done a thorough review of the admissions register. There was no Julia Weaver or Julia Glenn anywhere in its pages.
He questioned the young man, just to be certain. What, precisely, were the admissions procedures? Did patients ever arrive without paperwork? What happened when a patient’s name was unknown? Was Winslow absolutely certain that every patient in the asylum was in the register?
Winslow answered his inquiries, at first easily and then with a growing thread of carefully suppressed irritation in his voice. Andrew finally realized he was verging on insult and forced himself to break off the interrogation.
“Thank you,” he told the young man, who nodded stiffly and handed him his ward assignment before turning toward the pile of paperwork on his desk.
Andrew left the main office strangely deflated. It seemed his initial instinct had been right. Ned’s sister wasn’t here. He would have to give his friend the news that evening. But perhaps he could still help. Andrew had contacts at other asylums, knew many of the small, private facilities that didn’t advertise. Julia could well be in one of those. He could at least give Ned a list of other places to look.
That decided, Andrew glanced at the paper in his hand and couldn’t suppress a sigh. Ward five again. His mood darkened further when he arrived to find Klafft already there, preparing to begin “cold treatment” of a catatonic patient. The older doctor’s preferred methods were, according to everything Andrew had read, at least a quarter century out of date. But the man persisted in using them, and as Andrew had discovered, he was deeply resistant to newer theories.
The woman in question lay on the cot, her eyes vacant and staring. She appeared entirely indifferent to the fact that she was about to be repeatedly dunked in icy water, wrapped in a wet sheet, and left to lie in a frigid room for several hours.
But the plan struck Andrew as not only useless but actively cruel, so he ignored Klafft’s warning scowl and attempted to intervene.
“I must question the utility of such a treatment,” Andrew said carefully.
From the corner of his eye, he saw a pair of nurses exchange a knowing look. The two doctors’ tendency to clash had been noted by the staff, and Andrew suspected many of them found it entertaining. He reminded himself to remain calm.
“Nonsense,” Klafft snapped. “It’s well-documented that cold baths are effective in treating the physical roots of hysteria and other feminine neuroses.”
“But given Donkin’s theory that such neuroses are often the result of intellectual repression—”
Klafft’s face tightened. “Intellectual repression! What rubbish. The average female brain weighs five ounces less than that of the average man’s. That alone must prepare us to expect a marked inferiority of intellectual ability—”
“But if—” Andrew began.
“—as well as greater risks from prolonged mental exertion,” Klafft continued. “It therefore follows that such exertion would lead to poor outcomes. Women’s minds and bodies are not equal to those of men. When they step outside their appropriate sphere—whether mentally or physically—they risk becoming unbalanced. Hysteria and other forms of instability”—Klafft indicated the patient without looking at her—“are the result. Physical treatments are a logical response.”
Andrew’s resolve failed him. “That is an utterly antiquated notion,” he snapped. “Next you’ll be prescribing cures for a wandering womb. Any modern practitioner should know better than—”
Klafft put up a hand, his face stony. “Enough. Dr. Cavanaugh, I have been treating mental disease for thirty years, and I will not be lectured to like a rank novice. Six months’ reading and an overenthusiastic self-regard do not entitle you to question my judgment.
“You claim,” he continued, “to have come here to learn, and to do a particular kind of research. But I cannot say I’ve seen you doing either. Instead, you persist in inserting yourself into cases I and the other doctors already have well in hand, and which clearly do not fit your so-called research criteria, all the while putting no apparent effort into finding those that do.
“You want to treat patients?” Klafft made a sweeping gesture with one hand. “There are more than enough of them here. Go find your own and leave off interfering with mine.”
He turned his back in unmistakable dismissal.
Andrew swallowed a retort as the nurses whispered to each other and glanced in his direction. His face flaming, he left the ward with as much of his dignity as he could scrape together. Damn the man for a quack. Leeching that poor woman would do as much good as half freezing her.
He stalked through the main hall, brooding, though a touch of chagrin crept in as he neared the main office. Klafft might be a jackass and a poor excuse for a physician, but Andrew had to admit he was not entirely wrong in his observation about Andrew’s work. It was true he spent much less of his time than he’d intended seeking subjects for his research. Partly, this was because all the cases were interesting in their own way. And with such overcrowding and poverty, his skills as a general practitioner were much in demand.
But it was also because he was a coward.
He’d meant to start at once. He wanted to understand, needed to. He owed it to Susannah to—
Andrew stopped in the hallway, his eyes stinging. He closed them and swallowed hard, then turned back toward the main office, determined to salvage something from this wreck of a morning.
Winslow was still there. He looked up as Andrew entered, and his face tightened, as if he expected Andrew to resume questioning him.
“Dr. Cavanaugh. Can I help you with something else?”
“Yes, actually,” Andrew said, in as friendly a tone as he could manage. “I would like to examine some of the patients who have shown a particular set of symptoms. I need some help identifying them.”
“What symptoms?”
“Abrupt shifts in mood or behavior. Sudden, deep melancholia. Auditory or visual hallucinations. Bouts of aggression without any apparent trigger. These would have begun to appear in adolescence or young adulthood, at the latest.”
Winslow frowned. “There are a great many patients with at least some of those symptoms. It might be difficult to put together a list. But…” He walked to one of the desks and opened a folder. “I believe I heard something recently. I try to keep track when patients are moved between wards. I don’t always hear about why—ha! Here it is!” He pointed to an entry, his pride in his accurate record-keeping melting away his earlier stiffness. “There was an incident in one of the wards a few days ago. Three patients moved into isolation. Two of them are younger. Perhaps while I’m looking for others, you might want to examine them?”
Andrew hesitated for only an instant. “Yes. I’ll do that. Thank you.”
Five minutes later, Andrew was following Mrs. Brennan, the stout, dull-featured nursing matron, down the noisy hallway of the isolation wing, trying to calm his racing heart. This was why he’d come here.
Mrs. Brennan came to a stop so suddenly he almost trod on her heels. She glared at him, and he stepped back, straightening his sleeves and trying to look nonchalant. He peered past her into the cell.
The patient lay on her cot, asleep, it seemed. But when the matron’s heavy keys clanged against the lock, she did not start as if awakened, only rose smoothly to her feet and stood, waiting.
“Good afternoon, Miss Casey, is it?”
“Yes.”
Andrew stepped into the cell and got his first look at her.
She was tiny. He was not particularly tall, and yet he doubted she would reach much past his shoulder. Young, obviously—she couldn’t have been more than twenty. Painfully thin. Her hair was cropped and ragged beneath her cap. Bruises, purple and swollen, stretched from the side of her pointed chin up over her cheekbone, framing an eye swollen nearly shut. The other regarded him warily.
Without turning around, he asked, “Why isn’t she in the infirmary, with an injury like that?”
Mrs. Brennan stepped into the cell, and the patient, who had been studying him as he studied her, snapped her attention to the woman behind him, naked hostility overtaking her face.
“She’s a troublemaker,” the matron said in a flat tone. “Best to keep her away from the others.”
Andrew frowned. “That will be all. You may step outside.”
Mrs. Brennan shot a poisonous glance at the girl but did as Andrew instructed, taking up a place outside the door.
The girl relaxed a fraction and shifted her eyes back to him. “I am Dr. Cavanaugh,” he said gently. “With your permission, I’d like to examine you.”
She opened her mouth as if to speak, but in the same breath her gaze moved away from him again and froze. Her eyes widened as they focused on something behind him. He glanced over his shoulder, ready to reprimand Mrs. Brennan for returning. She hadn’t moved.
“I’m interested in cases such as yours,” he continued in the same tone.
Her eyes flicked back at him for an instant before returning to the spot behind him. He almost spun to look again but controlled the instinct.
“I’m not sick,” she said with a bitter laugh, her eyes still not meeting his, “and I very much doubt you’ve ever seen a case such as mine.”
“I’d like to start by taking your pulse.” Even from where he stood, he could see it beating a rapid tempo at her throat.
She paused. “Very well.”
Her gaze never moved from the spot behind him as he stepped forward and took her wrist.
She gasped as he touched her, and her eyes rolled white. He only just managed to catch her before she crumpled to the floor. Before he could lower her to the cot, even before Mrs. Brennan, watching like a waiting vulture, had taken a step from her place by the door, she recovered. Her face and body were relaxed, nothing like the watchful, tentative demeanor of a moment before.
She focused on him. And smiled. Recognition—and profound relief—flared in her eyes as her hands clutched at his shoulders.
“Jamie!” she breathed. “Thank heaven you’re here. You have no idea how awful it’s been.”
Andrew’s own breath all but froze in his lungs at the sound of her voice. The timbre, the pitch. If he’d closed his eyes, he would have thought Susannah stood in the cell with him.
His head throbbed as blood rushed to his face. His heartbeat pounded in his ears. His vision grayed.
He nearly dropped her as she went on, taking no notice of his shock.
“You have to tell Mother and Father not to make me go back. Make them understand. They’ll listen to you.” Her tone was low, confidential, and heartrendingly familiar. “I’m so glad you’re here. You can tell them. You will, won’t you? I can’t bear the idea of it. That place.” She shuddered. “There’s no need for it. I’m perfectly well now, you know, and if they let me stay, I’m sure I won’t…”
She trailed off as she seemed to catch sight of the cell, to all appearances for the first time. Her jaw dropped, and she looked up at him in horror. She thrust him away and stumbled backward. He took a half step toward her. She shrank into herself, her hands coming up to ward him off. That, too, was so familiar his chest clenched. She looked around in wild, panting terror, betrayal etched on her features.
“What… How… How did I…” She choked on a sob. “This isn’t…” She stopped. Her eyes narrowed as they swung back around to focus on him, flashing with sudden fury. “You did this. I don’t know how you did this, but you did. You tricked me,” she said, rage and accusation in her tone, outrage in every line of her face. “Somehow you brought me here, and now— Oh, what did you do? You drugged me, didn’t you? It had to be you. No one else could have. Jamie, I trusted you. I trusted you! But you’re working with them.”
She sprang at him with a low growl, her hands clawed, fury radiating from her. Too stunned to react, Andrew barely felt it as her fingernails raked the side of his face.
He stumbled back and got his hands up only as she drew back for another assault. She flung herself at him again, and he caught her, pulling her body into his chest and wrapping his arms around her own, pinning them to her sides. She thrashed and kicked, cursed him with every breath.
“Use the chloral!” Mrs. Brennan shouted from the doorway. “I’ll call for the restraints.” She disappeared down the hall as the girl slammed her head into his chest.
Andrew sucked in a wheezing breath. Desperately, instinctively, without thinking, knowing he had to quiet her, he lowered his mouth to her ear and spoke. “Susannah. Susannah, please. You must listen to me.”
Shocked into immobility by the words he’d spoken, he went as still as she did, his mind scoured of rational thought. The sound of their breathing, ragged and discordant, filled his ears. Her heartbeat against his chest was as rapid as a bird’s. They remained frozen there for a long moment, until she made a little noise, almost a sob.
The sound nearly drove Andrew to his knees, but it woke him from his stupor. He tried to swallow past a knot in his throat as something hot and terrible bloomed inside his rib cage. The backs of his eyes stung. His head buzzed. He licked his dry lips and set her carefully on her feet. He stepped back, raising his shaking hands more in denial than in defense against another attack.
She turned to face him again, and her eyes were terrified, full of questions. Lost.
“Jamie?” A tiny voice. She looked around again, down at her hands, slow horror spreading over her face. “These aren’t mine.” Her eyes welled with tears. “She’s here. And I’m not. I’m not here.” A low moan started in her throat. Built. Erupted from her mouth in a howl of despair.
Unable to stop himself, he stepped toward her again and took her in his arms, rocking her against his chest as she cried. Tears leaked from his own eyes as he struggled to breathe through a fog of disbelief. Of guilt. After a moment she quieted, then reached up with one trembling hand and brushed the hair away from his forehead. The gesture was so tender, so familiar, his heart broke inside his chest, and he had to will himself to breathe.
As she moved, the scent of the asylum’s harsh soap wafted from her skin and pinned him to the moment. Andrew clung to it like a man anchoring himself against a gale. She stepped back, pulling out of his embrace, and, numb, he forced himself to let her go.
“It was the voices,” she said in that same small voice, sorrow and regret in every feature. “They were so loud. I had to make them stop. But now I’m not here, and I can’t stay. I’m so sorry. I’m not… I can’t…” She clutched her head, groaning. The muscles of her face twitched, and her hands dropped to her sides. Then her eyes went white again, and this time Andrew did not manage to catch her. She landed on the floor in a heap.