Scowling, Nurse May snatched the clothes from Clara and tossed them onto a chair. She looked at Dr. Roach with wide eyes, as if expecting him to defend her. Ignoring the exchange, Dr. Roach went to the sink to scrub his hands, put on a pair of rubber gloves, then took his stethoscope from a wall peg and positioned the earpiece in his ears. He placed the cold chest piece above Clara’s left breast and listened, his brows knitted. The smell of rubber and Brylcreem filled Clara’s nostrils and she nearly gagged. Now that she was warming up, her stomach churned with a sour mix of hunger and nausea.

  “I really don’t understand why this is necessary, Doctor,” Clara said. “I can assure you, there’s nothing wrong with me.”

  “It’s just part of the admissions process,” Dr. Roach said. He gave her a condescending smile. “Nothing to worry about.”

  “But I don’t need to be admitted,” Clara said. “I’m perfectly fine.”

  “Uh-huh,” he said, taking the chart from Nurse May and writing something down. Nurse May stared at him, like a dog waiting for a reward.

  “What did she say?” she said.

  Dr. Roach scowled at her. “We’ll discuss it later,” he said, giving her a stern look.

  “Please,” Clara said. “Just listen to me. I don’t need to be here. My father just . . .”

  “This is a physical examination,” Dr. Roach interrupted. “We’ll talk about why you’re here another time. For now, let’s just cooperate, shall we?”

  “When?” Clara said.

  “A nurse will get you when it’s time,” Dr. Roach said.

  Clara sighed, clenching her teeth in frustration. Dr. Roach handed the chart back to Nurse May, who took it with both hands, her fingers lingering on his arm for several seconds. Finally, he smiled at her, a knowing look in his eyes. Nurse May’s shoulders relaxed. Dr. Roach checked Clara’s reflexes with a rubber hammer, then looked in her ears with a magnifying lens. He asked her to step down from the table and bend over so he could check the curvature of her spine. She did as she was told and he ran his fingers along her backbone, then pulled her arms backward and tugged on her wrists.

  “Do you have any pain in your back or shoulders?” he asked, pressing his pelvis against her buttocks.

  “No,” Clara said, wincing. Dr. Roach let go and she straightened, rubbing her wrists. Still behind her, Dr. Roach put his hands on her shoulders and pulled them back. He felt the vertebrae in her neck and pressed his fingers into her scalp, feeling the shape of her skull. He reached around and felt her collarbones, then pushed her arms up and out, instructing her to hold them there while he felt beneath her armpits.

  “Nurse May,” he said. “Will you be staying at the nurses’ residence again tonight?”

  “Yes, Dr. Roach,” Nurse May said, her voice dripping with sugar.

  “And how do you find the accommodations? You know how hard we strive to make our employees comfortable here at Willard.”

  “The accommodations here at Willard are the best I’ve ever had,” Nurse May said.

  Before Clara knew what was happening, Dr. Roach’s hands were on her breasts. He squeezed once, twice, then pinched her nipples and let go. It was over so fast it was hard to tell if it was part of the exam or something else. She dropped her arms and crossed them over her breasts, turning to face him, her cheeks burning. Dr. Roach ignored her, removing his gloves. He went to the sink and re-scrubbed his hands, soaping and rinsing them twice, the water so hot it was steaming. He dried his hands on a clean towel, put his gloves back on, then took a wooden tongue depressor from a glass jar on the medicine cabinet.

  “Up on the table, Clara,” he said. Clara climbed back on the examination table, her arms still over her breasts. “So you really like it here at Willard, Nurse May?”

  “Oh yes,” Nurse May said, moving closer, as if she needed to look down Clara’s throat too. “I enjoy it very much.”

  Dr. Roach smirked and held up the tongue depressor. “Open your mouth,” he said to Clara. “Say ah.” Clara did as she was told and Dr. Roach pressed her tongue down with the wooden stick. It was too much. Clara gagged and threw up, vomiting all over Dr. Roach’s hand and the front of his lab coat. He recoiled and looked down at his clothes, his arms out, his mouth curling in disgust. Nurse May gasped and dropped Clara’s chart on the floor, where it landed upside down in a puddle of vomit. For a second, they stood staring, wide-eyed and frozen.

  Finally, Nurse May came to her senses. She opened the doors beneath the medicine cabinet and pulled out a stack of towels, then stepped over the puddle of vomit and began mopping the mess off the front of Dr. Roach’s lab coat. Dr. Roach stood stock still, his lips pressed together in a thin, hard line. Nurse May unbuttoned his coat and peeled it off his arms, careful not to let it touch his clothes. Then she removed his gloves, threw them away, and quickly washed her hands. Dr. Roach moved back, carefully stepping over the vomit, then went to the sink and scrubbed his hands with a stiff brush, pressing so hard his skin turned red. Nurse May grabbed Clara by the arm, digging her fingernails into her skin.

  “How dare you!” she hissed. “Do you want to be put into isolation? Is that it?”

  “It’s all right,” Dr. Roach said, drying his hands. “I don’t think she did it on purpose. Just clean up the mess and we’ll get this over with.”

  Nurse May scowled, retrieving more towels from beneath the cabinet. “Shall I get Nurse Trench to come take care of this?” she said.

  “No,” Dr. Roach said. “Give Clara a towel to clean herself up and let’s finish.”

  “I’m sorry,” Clara said, wiping splatters from her arms and legs. “I didn’t mean to. It’s just . . .”

  “Are you not feeling well?” Dr. Roach said. “Have you been ill?”

  “No,” Clara said. She drew in a breath and held it, unsure if she should tell him the truth. Maybe she’d be treated better if they knew she was expecting. Maybe they would let her go free. An insane asylum was no place to give birth to a baby. Surely the doctor would agree. She bit down on the inside of her cheek, fighting the urge to throw up again. “I’m not sick. I’m pregnant.”

  Dr. Roach frowned, his brows knitted together. “Maybe you’re just nervous, or ate something that didn’t agree with you,” he said.

  Clara shook her head. “No,” she said. “I have a boyfriend and the baby is his.”

  Dr. Roach lifted his chin, nodding slightly as if having something confirmed. “You can tell me all about it later,” he said. “I’m here to help you, remember? Right now you need to go to the cafeteria and get some breakfast.”

  “But you’re a doctor,” Clara said. “You can tell if I’m pregnant or not. Surely you agree an asylum is no place for a pregnant woman.”

  “We have a female physician to do gynecological exams,” Dr. Roach said. “But I’m afraid she’s not here today.”

  Clara thought about asking why he felt the need to examine her breasts if they had a female doctor to do those things, but knew it was a waste of time. The most important thing was to make him realize she was going to have a baby. She put a hand on her abdomen. “Look at my stomach,” she said. “It’s swollen.”

  Dr. Roach gestured toward Clara’s clothes on the chair. “Get dressed,” he said. “If you’re really pregnant, we’ll know soon enough now, won’t we? Nurse May, will you take Clara down to the cafeteria, please?”

  Nurse May was on her hands and knees cleaning up the floor, her mouth twisted. She pushed herself up and waited by the door while Clara got dressed. “Shall I send Nurse Trench to finish up in here?” she asked again.

  Dr. Roach shook his head. “No, she’s got other patients to take care of this morning. Get one of the orderlies to help you.”

  Nurse May’s face turned red, her jaw working in and out. Clara buttoned her sweater, thinking that, for now, she’d have to go along with what they wanted. Dr. Roach said they would talk later. She still had a chance to make him understand, to make him see that she didn’t need to be instit
utionalized. She followed Nurse May out of the office, through the lobby of Chapin Hall, to the end of the first wing. An orderly unlocked two iron doors and let them through, the screeching and slamming of metal echoing through the halls. Nurse May led Clara down a narrow staircase to the basement, where they followed a short, stone passageway to the cafeteria.

  The cement walls of the cafeteria were a dingy, mottled gray, the upper corners and edges of the room revealing an old coating of white paint. The blue floor was scuffed and pockmarked; circular chunks missing as if someone had gouged the stone out with a spoon. The air smelled like spoiled milk, cabbage, and grease. Dozens of female patients sat and stood at long tables while attendants strolled the perimeter of the dining area, watching them eat. Nurse Trench and two other nurses moved back and forth on the far end of the cafeteria, keeping a row of patients in line. The patients carried trays, picking up their food from workers on the other side of a long counter. Among the women in line were the woman with the baby doll and the woman who constantly rocked back and forth in her bed. Everywhere she looked, Clara saw blank stares, puffy eyes, scowling mouths.

  “Time to go to the Sun Room!” one of the orderlies yelled at the patients sitting at the tables. “Clean up your mess!”

  The patients stood and picked up their dishes, but a few remained seated, chewing their breakfast in a daze. The orderlies pulled the uncooperative women off their stools, taking the utensils from their hands. One patient tried to climb on the table, her bare foot in the middle of a plate. An orderly reached up and grabbed her arm, swearing as he pulled her down. Finally, the orderlies got everyone to pick up their tableware and file out of the room. Four cafeteria workers picked up the remaining flatware and plates while the women from Clara’s ward shuffled over to the tables with their trays. Nurse May led Clara across the room to deliver her to Nurse Trench.

  “This patient made a mess in Dr. Roach’s examination room,” she said to Nurse Trench. “Dr. Roach wants you to bring an orderly over after breakfast and get it cleaned up.”

  “I don’t have time for that,” Nurse Trench said, frowning. “You’re his head nurse. It’s your job to take care of things over there.”

  “I’m just following orders,” Nurse May said, her chin in the air. “He said to send you over.” She turned on her heels to leave, then changed her mind. “One more thing.” She wiggled a finger at Clara. “This one thinks she’s pregnant.” This last thing she said in a loud voice, as if making an announcement.

  Nurse Trench’s eyes went wide. She uncrossed her arms and took a step toward Clara, but it was too late. Half a dozen patients dropped their trays and hurried over, one grabbing at Clara’s stomach, another touching her hair, a third wailing and pulling at her face. Clara ducked and put her arms around her head to protect herself. A cluster of dirty fingers touched her mouth and scratched her cheek. Nurse Trench and the orderlies pulled the women away, shouting at them to get away from Clara. Nurse May stepped back to watch, a satisfied smirk on her face.

  “Leave her alone!” Nurse Trench yelled at the patients. “Pick up your trays and get over to the table! Right now or you’ll be put in isolation!” Most of the women did as they were told. One fell to the floor, howling with her head in her hands. Two orderlies yanked her to her feet and dragged her out of the cafeteria. Nurse Trench looked at Nurse May with fire in her eyes. “I’ll be writing you up for that,” she said.

  Nurse May shrugged. “One other thing,” she said. “I’m just wondering. Does Dr. Roach realize what little control you have over your patients?”

  “I’ve been working with Dr. Roach for over fifteen years,” Nurse Trench said through clenched teeth. “And I’ll be working with him long after you’re gone.”

  Nurse May rolled her eyes and left the cafeteria. Nurse Trench took Clara by the arm and led her over to the counter to get her breakfast. “Whether what she says is true or you’re just making it up,” she said under her breath, “you better keep quiet about it. Telling everyone won’t do a thing to help you. The doctors won’t care and the other patients will rip you apart.”

  She left Clara in line and walked away. Another group of women began filing in the doors at the far end of the room. Clara picked up a tray at the counter and tried to catch her breath, her heart thundering in her chest. The tray held a thick, milky mug filled with what looked like weak tea, and a plate with four prunes and a hard piece of bread. She carried the tray over to a table and found an empty seat. As soon as she sat down, the woman next to her snatched the bread from her plate. Clara hunched over her food and reached for her tea with shaking hands. She had no appetite, but knew she had to eat and drink for her baby. She took a sip of tea. It was barely warm and tasted like urine. She swallowed it anyway. The prunes were hard and dry and it was all she could do not to gag when she put them in her mouth.

  The orderlies walked up and down the cafeteria, telling the women to hurry up so the next group could sit down. At the far end of the table, the woman with the baby doll stood and started screaming, pulling at another patient’s hands and hair. The other patient slapped at the woman’s arms, trying to push her away. The orderlies rushed over to break up the fight.

  “My little girl is starving!” the woman screeched, clawing at the slice of bread on the other woman’s tray. “Can’t you hear her crying? She needs food!”

  An orderly grabbed the screaming woman under the arms and yanked her away from the table. The other orderly struck her across the face, then ripped the doll away and threw it across the room. The woman howled and ran after it, her face contorted in agony. She dropped to her knees and picked up the baby doll, cradling it in her arms and crying. The orderlies pulled her upright and led her back to the table, their faces void of emotion. The woman sat down and started singing a lullaby, rocking the doll back and forth, her stringy hair hanging over her face. Everyone went back to eating.

  Clara looked at the last shriveled prune on her plate, her stomach growing more and more nauseous. She thought about giving the prune to the woman with the baby doll, then picked it up and put it in her mouth, trying not to throw up as she chewed and swallowed.

  CHAPTER 9

  IZZY

  By Monday afternoon, Clara’s journal still sat on the upper shelf of Izzy’s locker, resting on top of her math and English books. Unfortunately, the journal hadn’t provided Izzy with any answers. Instead, it left her confused. The glimpse into life during the 1920s was fascinating, and Clara’s words read like the diary of any normal young woman dealing with the confusion and frustration of being on the verge of adulthood. But there was nothing to suggest that Clara had lost her mind. Nothing at all. Except for what seemed like an overly strict upbringing and her grief over losing her brother, it seemed like Clara’s future was destined to be bright. Until she met Bruno. That was when things changed.

  Could Clara’s fear of not being allowed to be with the man she loved have manifested itself into some kind of mental illness? Could her strict upbringing have caused her to grow nervous, paranoid, or delusional? No, it didn’t ring true. Clara’s journal read like that of a young woman with a firm grasp on reality. Izzy knew that, back then, doctors didn’t fully understand depression or women acting out, but she could barely comprehend Clara’s father sending her away because she was in love with a man he considered lower class. Even more unbelievable was that Clara’s mother had gone along with her husband’s decision! The whole thing was unimaginable. Now, Clara’s story haunted Izzy. More than ever, she wanted to find out what happened to her after she was sent to Willard.

  During the short break between eighth and ninth periods, Izzy stood at her locker, chewing on her lip and wondering why Ethan hadn’t picked up the journal yet. He was in school that day; she’d seen him walking with Shannon in the halls. He had ignored Izzy when she passed, laughing and talking with his friends as if she were invisible. It was all she could do not to walk up to him and ask if he thought she was an idiot. She knew when she was bein
g duped. She yanked her psychology book out from beneath her gym bag and slammed the locker door. What the hell was he up to? He’d had plenty of time to pick up the journal.

  The bell rang and she hurried down the hall, her chest tight, thinking she would probably have to take the journal back to the museum herself. She wondered what Peg would do if she caught her with it. Then, halfway to class, she realized she’d left her essay on “Understanding the Criminal Mind” in her other notebook. She turned and rushed through the empty halls, swearing under her breath because she was going to be late. When she got to her locker, Ethan was there, reaching in to get the journal. He jumped when he saw her.

  “Finally!” she said. “I was starting to wonder if you were full of shit the other night.”

  “Sorry,” he said, red-faced and out of breath. “Shannon has been acting really weird today. She made me walk her to all her classes, even when it made me late for mine.”

  “Don’t you have psychology with her right now?”

  “Yeah,” he said. He glanced up and down the hall. “I told her to save me a seat because I was going to the boys’ room.”

  “Why are you acting so paranoid?”

  “I think she knows something is up.”

  “What do you mean?”

  “She knows I’m working at the museum with you,” Ethan said. “And she’s not happy about it.”

  Izzy rolled her eyes. “So what? That doesn’t mean something is up!”

  “You don’t know Shannon.”

  She snorted. “Oh, I think I do. How did she find out we were working at the museum together?”

  Just then, Ethan looked past Izzy. His face dropped and Izzy turned to look. Shannon was standing near the end of the hall, her arms crossed, watching them.

  “Oh shit,” Ethan whispered. He shoved the journal into Izzy’s hands and hurried toward Shannon. “Hey, babe,” he said, trying to sound casual. “Izzy’s locker was stuck. She asked me to get it open.”