Most people hated the smell of hospitals, but not Jocelyn. In a way it was almost an absence of scent. Scrubbed air. The opposite of the exhaust-pipe-and-hot-dog-stand funk she was forced to gulp down in Chicago. She breathed the specific mix of cleaning agents—crisp, devoid of anything sour or musky—and let it fill her whole body with that calming sense of right. That smell meant miracles were happening all around her, and here, at Brookline, those miracles weren’t hemorrhages being stemmed or heart medicine prescribed—here it meant ferrying patients from a broken mind to a whole one.

That almost seemed like a kind of magic.

Jocelyn forced herself to focus as their supervisor, Nurse Kramer, went over dispensary protocol with them in great detail. Apparently medicines were coming up short, and she wanted to give everyone a refresher on marking out what was used and what was thrown away. Soon after they would be released to work their shifts, but Jocelyn was alert, looking for an out. She wanted to speak to Warden Crawford alone, but she worried that what Tanner had said was true—that the warden wouldn’t have time for her now that she was just one of the many worker bees in his hive.

So she trained her eyes on Nurse Kramer’s plump, baby-smooth face and listened as she reviewed the hospital’s system for tracking medicines and sedatives distributed to patients, where to drop off samples, charts, notes. . . . Her skill for memorizing that kind of minutiae had proved useful in training, and it would prove useful again, she realized with a sigh, watching Madge twinkle her fingers at a passing Tanner.

“Nurse Fullerton, are we going to have a problem today?”

Madge snapped her head around, using the same big, fluffy lashes she used to ogle boys. “Charts there.” She pointed. “Mark down each and every dosage with dotted i’s and crossed t’s, and Dr. Aimes has been having a bad reaction to dairy, so no milk if he asks for coffee.”

“I didn’t say anything about Dr. Aimes.” Nurse Kramer’s bubbly cheeks rippled with irritation.

Shrugging, Madge tucked her hands meekly behind her back. “Just a hunch.”

“Nurse Fullerton is incredibly observant,” Jocelyn put it mildly.

“Yes. So am I.”

The girls went silent, falling into step behind the older nurse as she led them out of the tiny, many-cubbied room to the reception area and then the lobby. A nervous couple sat waiting near the magazines, holding hands but staring straight ahead. They flinched at the sight of the nurses, as if Jocelyn and her colleagues were a firing squad come to summon them to execution.

Nurse Kramer breezed by them with a placid smile fixed in place.

Mere steps from the corridor leading to the visitation and diagnosis rooms, they were intercepted by Warden Crawford, his large frame blocking the hall as he precipitously headed them off. Nurse Kramer jumped and squeaked in surprise, then collected herself just as quickly. But Jocelyn noted the way she flushed, and the way that her eyes began to dart along the fringes of her vision. Odd. She would bet money that Nurse Kramer’s heart rate had elevated, that her pupils were dilated.

Fear? Excitement? Why exactly did Nurse Kramer have so much trouble meeting his eye?

“Good morning, Nurse Kramer. Nurse Fullerton. Nurse Ash.” He turned to Jocelyn, snapping his heels together as he did so. In contrast to his office, his clothes were immaculate. His patent leather shoes practically glowed. “I need to steal Nurse Ash momentarily. I trust that won’t be a great imposition.”

“N-no. No, of course not, sir. Nurse Ash, you will go now, please.”

Her tone had taken a sudden dive into severe, almost challenging, as if she expected Jocelyn to refuse. Which Jocelyn didn’t. This was exactly what she wanted, after all. But now that he was looming in front of them, the full force of his attention trained on her, she began to lose confidence in her plan. The future of her job rested in his hands, and if she caused a fuss she could be out of work by the afternoon.

You know what you saw. You deserve an explanation. The patients deserve one.

“Right away, sir, lead the way,” she said brightly, channeling Madge but feeling anything but sunshine on the inside.

Jocelyn stared at the porcelain head sculpture on Warden Crawford’s desk. The regions of the brain were mapped and labeled, neat black script painted across the top of the skull, borders clearly defined as if the mind were a series of nations.

Her gaze strayed back to him as he touched his fingertips to his temples and rubbed. His office looked marginally cleaner today. Perhaps a maid had been in to straighten.

“You needed to speak to me?” she prompted, stiff. Her skin prickled with cold; it was like being called to the head of the class, scolded, shamed. . . . But why would he scold her? She hadn’t done anything wrong.

You know why.

Warden Crawford fixed her with an unblinking stare, deepening her conviction that she was about to be unceremoniously sacked. The thought ought to unnerve her more, but a thin strain of reason insisted she would be glad to be away from this place. Except that would be selfish—something was wrong here and she would be a coward to turn her back.

“This may seem premature, Nurse Ash. . . .”

Jocelyn braced. Here it was. She was definitely getting fired.

“But I’m selecting you for a special program. An experimental program.”

She blinked at him robotically in response. Either she was hearing things or she wasn’t getting fired, she was getting a kind of promotion. “I . . . beg your pardon, sir?”

He laughed, a warm, curious laugh that reminded her of being a child, of being affectionately indulged. The warden plucked off his spectacles and then rubbed them on the bottom of his white coat. Pulling a small tin from his pocket, he flicked it open with his thumbnail and popped a mint into his mouth.

“Want one?” he asked, offering the tin to her across the desk.

Jocelyn shook her head, still a little dazed. So that was where the sharp, spearmint smell came from. His office smelled different from the rest of the floor, free of that clean, antiseptic hospital smell she liked so much.

“No, thank you. I’m still . . . I guess I’m still wondering what you mean by special program? What exactly would that involve? I mean, I haven’t even gotten into a routine here.”

Warden Crawford put up a hand, tucking the mints away and nodding. She could tell from the soft sucking sounds and the distortion of his cheeks that he was flipping the mint around in his mouth. “Sit, please. I sprang that on you too soon, I know.”

She did sit, grateful for the grounding presence of the chair underneath her.

Propping his elbows on the desk, he sat, too, the porcelain skull with its territories of the mind centered between them as if there to mediate or observe. “Do you know how one comes to be in charge of a place like this?”

Jocelyn did, in the vaguest sense. She had studied the career path herself, dreaming a dream she knew was utterly ridiculous in the eyes of most. The Warden didn’t need to know that. Damn. He was drawing her away from the topic she actually wanted to discuss. But maybe accepting this new position would make her more valuable in his eyes. If she could become a trusted employee, then maybe he might be more amenable to addressing the strange situation in the basement more openly.

“I do,” she said, risking: “But we’re not exactly encouraged to strive for that ourselves.”

“Ah. You mean as a young woman. Yes. I quite understand. Archaic, really, that manner of thinking. Most of our colleagues would insist a woman’s compassion makes her immanently suited for caretaking professions, but we both know this work demands a degree of coldness, of distance that stands directly at odds with that belief.”

Jocelyn couldn’t help but agree, remembering the last, painful days with her grandmother, when implementing that kind of distance was the only thing that had gotten her through. She nodded slowly, hoping he wasn’t drawing her into a trap, making her trip and stick her foot in her mouth. Maybe he wanted to know if he had uppity, defiant girls operating in his institution.

She said, “There will always be patients who are beyond our help, even if it’s awful to say so.”

His eyes seemed to glow at her words, and he lowered his head slightly, sighting her like a predator might their prey.

“You honestly believe that?” he asked.

“I . . .” Jocelyn trusted her gut, straightening and saying firmly, “Yes, I do. Some people cannot be cured. Not really. And it’s a misuse of hospital resources to insist otherwise.”

“You . . . you’re clever.” He wagged a finger at her, that strange light still filling his eyes. “Exactly as I suspected—you’re the right choice for this new program.”

“What new program?” Jocelyn asked, perhaps too sharply. “What would I be doing?”

“That’s complicated, Nurse Ash. As I said, it’s experimental, and it’s to do with exactly what you just expressed so eloquently—that some people cannot be helped. I am of the same mind, but I’d take it a step further. Some patients are beyond help, but they are not beyond use.”

She stilled. Use? That felt like an odd choice of words.

“How do you mean?” she asked, shifting.

The warden wiped off his spectacles on his coat again and tucked them into his pocket. Then he stood, placing his knuckles on the desk and looming over it, leaning toward her. His shadow fell across the skull statue, spilling over files and papers and then onto her lap.

“What did you see in the basement, Nurse Ash?” he asked. “Or should I say, what do you think you saw?”

Of all the scenarios Jocelyn had considered the night before and that morning, ending up back in the basement with Warden Crawford was not one. Fired? Sure. Lectured? Most definitely. This was, theoretically, the best outcome. So why did her blood feel icy and sluggish in her veins? The trip down felt shorter this time, probably because Warden Crawford obviously knew the way, and the stairwell was well lit in the daytime.

Was she completely mad? It looked so harmless, so normal, like this. Maybe the shadows and her own anxieties had altered her perspective. This was totally possible—she knew enough about the field of psychology to understand that context and one’s own fears could change something harmless into a threat.

She followed her superior closely, as if afraid she might stumble into a wrong turn and never find her way out again. Just as she remembered, the bottom level was uncomfortably cold, the tall, foreboding archway ushering them toward the corridor with its many doors. The screams were absent this time. No doors rattled. In fact, a few orderlies wandered the corridor, clipboards in hand, trays laden with small cups of water and pills. They smiled distractedly at her as they passed.

“I didn’t mean to snoop,” Jocelyn suddenly said. She had apologized already in his office after the accusation that she had been to the basement. The correct accusation. The warden had waved off her apology then, just like he shrugged her off now.

“Curiosity is natural,” he replied casually. “But your response is perhaps not.”

“You don’t know that.” She was pushing too far again. That would get her into trouble, she knew, if she wasn’t careful.

“You showed up to work this morning,” the warden pointed out. “As far as I know, you said nothing to anyone, despite witnessing something rather unorthodox.”

“I didn’t understand why patients were put down here—I still don’t—and frankly I was going to ask you about it today. In your office.”

“Well, this should suffice for an explanation, then, mm?”

Jocelyn watched the doors going by, shocked by how many there really were. The daylight hours did nothing to banish the sad, abandoned ugliness of this lowest level. The staff could paint the walls yellow and put teddy bears in every corner and it would still feel like a hidden, shameful hell. The damp remained oppressive during the day, and while the floor was swept, it didn’t at all measure up to the rigorous hygiene standards of other hospitals.

And the hospital smell was gone. She hadn’t noticed it until now, but all at once it became offensively apparent. There was a distinctly unwashed-human-being smell that wafted in intervals from the closed doors, like the rooms were ovens, heating up bodies and churning out their humid sweat stench.

“Basements. Experiments. I’m not sure I like this,” Jocelyn said. She stuck her hands into the pockets of the clean, tailored coat buttoned tightly around her. “Are these the most troublesome patients?”

“They are, yes.” The warden paused outside a door toward the end of the corridor. He rocked up onto his toes and pulled open a slot in the door, peering inside before producing a giant set of keys from his pocket. “They have resisted known treatments. I never would have said this when I was just a young, green orderly, but some of them seem to prefer their madness.”

“That’s not possible,” Jocelyn said, frowning. “It’s a prison they don’t even know they’re in, how could they prefer it?”

“Perhaps it’s an intuition that comes with age and experience,” he replied, unlocking the door. “You’ll see.”

I doubt that.

But she kept her mouth shut, aware that she was sliding closer to the answers she wanted out of him. Why hide these people away? Were the orderlies down here part of his strange new project? And just what did he expect from her. . . .

She could still leave, she reminded herself. Jocelyn still hadn’t technically agreed to be part of his new program. As she stepped through the open door and into the room beyond, she noticed Warden Crawford watching her intently, scrutinizing her for the tiniest reaction.

The room, small but tall, padded floor to ceiling, resonated with cold. A single window let in a pale shaft of sunlight from high, high above, with bars obscuring the view, just like in her room. Jocelyn took a single step into the room, trying to orient herself. That window probably looked out the same way hers did. She slept the night before floors and floors up, possibly situated on top of this very cell. And taking one look at the patient inside, a baby-bird fragile girl in a threadbare nightgown, Jocelyn knew she was the one who had roused her with screams.

“Do . . . do you have her chart?” Jocelyn asked. She spoke softly, afraid to startle the girl.

“You can review it later.”

“I’d like to review it now,” Jocelyn said, turning and standing to face him. “I shouldn’t even be here with her, not without knowing her history.”

“I’m giving you special permission.” She heard the irritation, the impatience, in his voice.

The girl, previously facing away from them, finally noticed their presence. She turned, slowly, bare feet slapping on the floor as she shuffled around, arms at her sides, hair darkened with grease and grime hanging lank down her back.

“These conditions . . .” Jocelyn began, stuffing down an urge to spin and throttle the man behind her. How could he let a human being live like this? It wasn’t right. Her stomach turned, her whole body rebelling at the sight of the poor, neglected girl.

“You want to help her,” Warden Crawford observed.

“Yes. Yes, of course I do. Don’t you?” She pinned him with a helpless look. The girl now stood motionless, pale and unnatural as porcelain.

“And how would you help her, Nurse Ash?”

He had sidestepped the question, but Jocelyn had more important things on her mind. “Bathe her, for one. Dress her in warmer clothing. House her in a place fit for humans. My God, I wouldn’t keep a rabid dog in here.”

He had the grace to flinch at that assessment of his facility.

But then he was taking the spectacles out of his pocket and placing them serenely back on his nose. He didn’t seem to notice the girl, and when his eyes chanced in her direction he only looked through her.

“Then help her.”

Jocelyn knew it couldn’t be as simple as all that, but she never backed down from a challenge. This was a thrown gauntlet, and she would pick it up, if only to prove that it was never right to give up on a person, especially one so young.

Her own foolish words came back to haunt her.

Some people cannot be cured. Not really. And it’s a misuse of hospital resources to insist otherwise.

This was different. This was a child. Jocelyn drummed up her courage and turned to face the young girl, but she dropped the stern expression on her face, approaching with extreme caution. As a child she had always thought nurses looked so kindly and innocent, like guardian angels in their clean white uniforms. Angels were not always so good, Jocelyn knew that. She had read the Bible. But she was not an avenging angel today—no, this poor little bird needed to be cupped in warm hands and brought back to a nest. She was a tumbled sparrow, something to be treated gently and with ultimate care.

Jocelyn crouched, holding out her hand to the fragile child.

“Here now, little birdy, little sparrow. Why don’t you come here to me? You look awfully cold. Wouldn’t a warm bath be nice?”

The girl hesitated, eyes shifting from the floor to Jocelyn’s face and back again. Her eyes were black marbles, colorless pits.

“What’s your name, sweetheart?” Jocelyn asked, letting her hand fall to her side.

Warden Crawford didn’t wait for her to answer. “Lucy. Her name is Lucy.”

Lucy’s dark eyes found focus, gliding from Jocelyn to the man behind her. Speaking her name was like a curse, a spell. Suddenly she lunged forward, blindly, fingers unexpectedly strong and curved into talons. She tore at whatever was in her path, and that happened to be Jocelyn. Dodging, flailing, Jocelyn just managed to avoid one of those hooked hands coming for her eye and grabbed the girl around the waist, twisting and holding her, doing what she could to pin her arms.

She heard Warden Crawford take one resolute step backward.

If this was the first test, Jocelyn would not give up. She tried again, coaxing the girl’s arms down to her sides and holding them fast. This did little to deter Lucy in her rage. She wriggled and bucked, hurling herself back and forth until the force of it was too much for Jocelyn.

She fled, releasing the girl and retreating to the door. But Lucy didn’t follow. Instead, she tore around the room, spinning, pulling at her own hair, knocking herself against the walls until she was breathless and panting.

Jocelyn paused on the threshold of the room, feeling helpless. Smash. Smash. Smash. With every brutal toss of her body against the wall the girl was saying something, whispering it, hissing it out in a slice of a whisper.

It took Jocelyn a moment to catch the word, hearing it cleanly just as the warden tugged her out by the shoulder and closed the door.

“Do you still want to help her?”

It was a ridiculous question. Jocelyn ground her teeth together as she followed Warden Crawford back through the basement and toward the staircase leading up.

“Yes. Naturally.”

“You saw how she reacted to the mere suggestion of a bath,” he replied, taking another mint from his tin and eating it before starting up the stairs. He walked with his hands tucked behind his back. It struck her as indecently casual, given what they had just witnessed.

But that was a doctor’s life, she reminded herself. If every wound or tantrum or spot of blood knocked them off their post, nothing would ever get done.

“I think she reacted to you, or to her name,” Jocelyn replied. “I’m sorry if it’s offensive to say so.”

Warden Crawford shrugged. “Not at all. Lucy is a strange case. Her parents swear up and down that she has no history of abuse. That one day she simply stopped speaking. They took her to specialists—speech therapists, hypnotists, you name it, they tried it. Then the outbursts began. Silent, furious storms not unlike what you just observed.”

“That was anything but silent,” Jocelyn murmured, hugging herself.

“The screaming didn’t begin until she came here. Her muteness persists between episodes, then something causes the hysterical fits. Men, usually. She is mostly docile if only nurses see to her. Bathing and clothing her remain . . . challenging.”

Jocelyn paused on the landing, feeling the dread atmosphere of the basement slip off her like chilled silk. “Then why did you go into that room? You deliberately wanted to frighten her?”

He stared back at her evenly, one eyebrow cocked in amusement or irritation. “Perhaps. Perhaps I wanted you to see just what you’re up against.”

“And this is all part of your . . . your program?”

“Lucy and the others in basement confinement are difficult cases. Traditional methods have proven ineffective, counterproductive, even. Medicine must march forward, Nurse Ash. Surely you understand that.” He turned, assuming she would follow. He continued, “We could sedate Lucy, true. She could live out a long, wasted life in a stupor, or we could do what others will not.”

A hard shiver raced down Jocelyn’s spine. “You want to experiment on her.”

“You make it sound so dreadfully Frankensteinian,” he said with a chuckle. They had reached the lobby level and he held the door for her. Jocelyn flinched, afraid even to get too near to him. “Most leaps forward happen by pure accident. What I’m suggesting is far more methodical. Hypnotism, surgery, drug therapy . . . These techniques are often used independently of one another, but I foresee a future in which we can control and guide these patients back to productive living through an aggressive combination of all three.”

He led her swiftly back to his office, and again she ducked past him into the room, curious and listening despite herself. “Why hasn’t this been done before?”

“Cowardice?” Warden Crawford suggested, sauntering behind his desk and dropping down into his chair. “Lack of vision? Fear of failure? Take your pick, I suppose. We stand on the cusp, Nurse Ash, and to be the vanguard we must be bold.”

“I . . . I don’t know.”

“Would it help if I asked Nurse Fullerton to participate, too?” he asked gently. “She seems capable enough. Perhaps between the two of you, you can keep me in check. Two heads are better than one, and three is certainly better still.”

His smile was wide, movie-star white. For a moment he almost looked boyish. His face defied the look of a true age, as if he was hovering always between adolescence and adulthood. Timeless, her mother would say. Madge would probably say it, too.

Something gnawed at the edge of her subconscious. Jocelyn cleared her throat softly and asked, “What was she saying? Lucy, I mean. That word she kept saying . . . What does it mean?”

His smile collapsed in on itself. “Nonsense, I imagine. We have patients here who have made up entire languages to confound.”

It sounded like Spanish. It didn’t sound made up at all.

The thin remnants of his smile cracked with impatience at the edges. Jocelyn weighed her options quickly—there was always leaving, of course, but she worried about leaving Madge alone. And now she worried about Lucy. The girl was human like anyone else and she deserved a better life than she was getting at Brookline. If Jocelyn could improve it, she would, and if the warden insisted on trying to cure Lucy with newfangled ideas, Jocelyn would be there to make sure he didn’t do more harm than good.

First, do no harm. And second, make sure nobody else does harm either.

“All right,” she said quickly. “I’ll do it.” She swallowed around a golf ball–sized lump of anxiety in her throat. “When do we begin?”

“Tomorrow, I think,” Warden Crawford said cheerfully. He winked. “After you tell Nurse Fullerton the good news.”

The path is set down. I have already instructed the cooks and provided them with the necessary embellishments. I know the treatment works on the vulnerable, it will be exciting to see if it similarly affects the whole of mind. Though really, it is debatable how whole that ninny’s mind truly is. No matter. She will be the perfect demonstration—Lucy is tragic, yes, but to witness a fall from sound to unsound? To be powerless to stop such degradation? It will bring the girl around and it will sharpen her into a fine tool for my use.

—Excerpt from Warden Crawford’s journals—April