The Girl Behind the Gates

The novel follows two timelines. The first traces the life of Nora Jennings, a seventeen-year-old from a respectable Catholic family in the English village of Fenshaw, who in November 1939 is secretly pregnant and terrified. The second, beginning in 1981, follows Dr. Janet Humphreys, a junior psychiatrist who discovers Nora still institutionalized over 40 years later and works to help her reclaim her life.

After Sunday mass, Mrs. Lampeter, the family housekeeper, notices Nora's condition and slips her quinine tablets to end the pregnancy. Nora takes four instead of the recommended three, but the tablets fail and leave her ill. When her mother, Mildred, presses for the truth, Nora confirms the pregnancy but refuses to name the father. Her father, Henry, beats her with a leather belt and summons Dr. Rayne, the family doctor; Father Matthews, the parish priest; and Dr. Mason from Hillinghurst Hospital, a feared psychiatric institution. Dr. Rayne confirms the pregnancy, discovers cuts on Nora's wrists, and informs the family that attempted abortion and attempted suicide are criminal offenses. Dr. Mason invokes the Mental Deficiency Act of 1913, which classified unmarried mothers as "moral defectives" who could be indefinitely segregated from society. Henry chooses commitment over prison, and that night Nora is driven to Hillinghurst.

At Hillinghurst, Nora is stripped of her possessions, given institutional clothing, and has her hair roughly cut. Dr. Stilworth, a young physician, introduces himself as her doctor, while Dr. Mason tells Nora to consider her family dead and confiscates her most treasured possession, a music box. Nurse Hatton, one of the few compassionate staff members, is dismissed after defending Nora against Sister Cummings, the senior nurse in charge of the ward, who slaps Nora and punishes her with days of reduced rations.

On Christmas morning, Nora watches from a window as her cousin Robert arrives in army uniform with a present but is turned away. She hammers on the glass, screaming his name, but he cannot hear her. A flashback reveals Robert is the father of her child. In April 1940, Nora goes into labor during a visit from Mrs. Lampeter and gives birth in the treatment room, her wrists and ankles strapped down. The baby is taken away immediately, and Nora is told nothing about the child.

Nurse Jamison, a trainee nurse, discovers the newborn, a perfectly formed girl, left on a cold slab in the hospital sluice, a utility room, to die of exposure. Dr. Stilworth confronts Dr. Mason, calling the act infanticide, but Mason invokes eugenic philosophy, arguing that "nature was simply allowed to take its course" (54). The baby dies.

Nora descends into grief and refuses food. After staff force-feed her, she is thrown into a padded isolation cell. Dr. Stilworth intervenes and challenges Sister Cummings's authority. Peggy Hart, a long-term patient, befriends Nora by offering her a biscuit. Over the following years, Nora meets Joe McConachie during supervised walks. Joe was sent to Hillinghurst after losing limbs in a suicide attempt. Sister Cummings uses Nora's friendship with Joe as evidence of moral deficiency and arranges Nora's forced sterilization in 1943, telling her it is an appendectomy. Dr. Stilworth confronts Dr. Mason but is overruled.

In 1944, Mrs. Lampeter makes a final visit, revealing that Robert was badly wounded at Monte Cassino in Italy and that Nora's parents visit him but have never visited Nora. She also reveals she has tuberculosis. After the visit, Nora is subjected to a wet-pack punishment: She is wrapped in ice-cold wet sheets with her mouth taped shut. During the ordeal, Sister Cummings reveals that the earlier surgery was a sterilization. Mrs. Lampeter later dies, and Nora is denied permission to attend the funeral. Dr. Stilworth has Sister Cummings dismissed in 1946 after discovering deliberately inflicted wounds on Nora's feet.

In 1961, Nora discovers the hospital cemetery during a walk with Gladys, a longtime nurse. Among tiny markers bearing only patient numbers and dates, she finds marker 1529, her own number, dated 30 April 1940. She realizes her daughter died here and claws at the earth before staff carry her back. Nora enters a catatonic state lasting months. Dr. Stilworth, despite opposing electroconvulsive therapy (ECT), authorizes treatments as a last resort. After 18 sessions, Nora regains consciousness. During recovery, a male aide sexually assaults her while she is restrained; Dr. Stilworth catches him and calls the police. When Nora recovers, she whispers to Stilworth, "You knew about my baby" (133).

In 1966, Dr. Mason retires and returns Nora's music box along with letters from her mother that he withheld throughout her incarceration. The letters trace Mildred's descent from hope to despair and early death. Nora also reads an unfinished wartime letter from Robert describing his guilt, his love, and his carrying her handkerchief into battle. The letter breaks off mid-sentence.

Part two opens in 1981. Janet Humphreys, a junior psychiatrist at Hillinghurst, clashes with her supervising consultant, Dr. Derek Pauling, whose harshness masks grief over his son's death from cancer. Reviewing neglected back-ward patient files, Janet is drawn to a woman admitted at 17 for being pregnant and unmarried, institutionalized for over 42 years. Janet's marriage to Ian is failing, and she is haunted by her own childhood with a violent, war-damaged father, a parallel she acknowledges: "There but for the grace of God" (156).

Janet begins sessions with Nora on Rowan ward, guided by Ellen Saunders, the ward's senior nurse. Nora is initially silent but gradually reveals her past: the pregnancy, the death of her baby (whom she named Angela), the sterilization, and the abuse. Janet proposes a memorial ceremony. On April 30, 1983, Nora, Janet, Audrey (the hospital social worker), and Joe gather at the grave. Nora lights a candle, reads a poem she has written, and buries a memorial stone.

Janet's marriage collapses, and she throws herself into her work. As Nora progresses, she delivers an impassioned speech about the injustice of her institutionalization and reveals her deepest desire: to sing again. Janet secretly arranges singing lessons. When Hillinghurst is placed on the closure list, the team begins preparing Nora for discharge. Nora's anxiety nearly derails the process when she barricades herself in her room and cuts her wrist with a razor blade she has kept hidden for years. Janet tells her she can move forward or "let all of those who abused you over the years win" (251). Nora recovers.

In March 1987, after 47 years at Hillinghurst, Nora is discharged to a group home. On her last morning, she visits Angela's grave and places her snow globe on it. She joins a choir, volunteers at a library, and begins traveling alone by train. She encounters Bill Oldbury, a childhood acquaintance who reveals that Robert was homosexual, finally explaining his distance after their night together.

In 1990, Nora moves into her own flat, the first independent home of her 68 years. Her choir is invited to perform in Berlin, and Janet arranges for Joe and the retired Dr. Stilworth to attend as a surprise. In the cathedral, Nora performs a solo "Ave Maria," her voice strong and clear. Afterward, Stilworth takes her hands, and she tells him, "Dr Stilworth, you saved me" (326).

Janet reconciles with her estranged parents and reunites with Ian, inspired by Nora's example of forgiveness. When Robert dies of cancer, Nora receives a posthumous letter revealing he was not her cousin but her half-brother: His mother, whose husband was sterile, had arranged with Henry to father the child. Robert leaves Nora his money, and she buys a bungalow by the sea, a piano, and a dog.

In 1994, Nora arrives at Janet's London office and announces, "I came to sing for you" (335). Accompanied by her piano teacher, Susan, she performs three songs culminating in "Ave Maria." When the music ends, she takes Janet's hands: "We did it, Janet. We did it" (338).