John Cawley, Rachel’s psychiatrist, refuses to share his notes on her, his personnel files, or the treatment files of Dr. Rachel has left behind a series of tantalizingly cryptic clues as to her fate. How did she get out of the third-floor room she’d been locked into two hours earlier without disturbing the door or windows or any of the three orderlies between her and the outdoors? Other false notes seem even more disturbing. The Cold War is simmering and a hurricane approaching the Massachusetts coast when Edward Daniels and Charles Aule, his new partner, arrive at Ashecliffe Hospital in 1954, the morning after Rachel Solando, a housewife who drowned her three children, has gone AWOL. A pair of US Marshals are sent to an island-bound institution for the criminally insane to find an escaped murderer-in Lehane’s lollapalooza of a corkscrew thriller.
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