The Patient's Secret

Set in Story Cove, a wealthy oceanside enclave, the novel opens with a nameless woman fleeing through an old-growth forest during a violent nighttime storm. Tormented by voices and fragmented memories of blood, she is pursued by a hooded figure who corners her at the cliff edge. In a flash of lightning she recognizes his face, but he strikes her with a flashlight and pushes her off the cliff. She plummets down the sandstone face, and her world goes dark.

On Monday morning, Dr. Lily Bradley, a psychotherapist who runs Oak Tree Therapy from her home, is conducting a session when police sirens approach. Her husband, Tom Bradley, a psychology professor at Kordel University, tells Lily he found a woman's body on Grotto Beach during an early run in the storm. Their eight-year-old son, Matthew, who photographs neighborhood activity from his attic window, watched Tom return without his jacket or flashlight, his shirt stained with blood, and photographed Tom hiding the shirt in the garden shed.

Detective Rulandi Duval, known as Rue, leads the regional "Jogger Killer" investigation into serial murders of female runners. Tom claims he saw the body from a lookout platform and attempted resuscitation, but Rue notes inconsistencies: The sight line does not support his account, he entered the house through the back gate, and blood marks his hands and neck. On the beach, the victim shows massive skull fractures consistent with a cliff fall. Unlike previous Jogger Killer victims, there is no sign of sexual assault, but her face was covered, a detail police had withheld from the public in those cases. In her jacket Rue finds Tom Bradley's business card.

While Tom is at the station, Lily finds his blood-soaked running shirt hidden in the shed. She washes it with family laundry and hides the refuse bag in the freezer wrapped in raw ground beef. Tom tells her to contact Dianne Klister, a criminal defense attorney and family friend, who takes the case.

The timeline shifts two months earlier. A stalker on a bike has been watching the Bradley house, learning the family's routines. Lily begins receiving anonymous threatening notes, including one reading "YOU CAN'T HIDE FROM SATAN IF SATAN IS INSIDE YOUR HEAD" and another embossed with the image of Baphomet, a goat figure associated with satanism. The notes trigger visceral terror connected to a past Lily has buried.

Meanwhile, Arwen Harper, a 41-year-old single mother, artist, and former investigative reporter, takes a calculated job at the Red Lion Tavern, where Tom and his professor friends gather every Friday. She befriends Tom through flirtatious service and shared runs on the bluffs, having moved to Story Cove to work on a secret true crime book she tells her 16-year-old son, Joe Harper, will be their "big break."

Interspersed "Taken" chapters, styled as excerpts from Arwen's manuscript, recount a familicide in Glenn Dennig, near Medicine Hat, Alberta. In 1989, 23-year-old Vincent Ellwood entered the McNeill home and murdered both parents and two young boys. Twelve-year-old Sophie McNeill had pressured Vincent to kill her parents so they could escape together. Nine-year-old Chrissie Whittaker, sister of one of the slain boys, hid under a bed and witnessed the killings. Sophie became the youngest person in Canada convicted of multiple first-degree murder. Under the Youth Criminal Justice Act, which protects offender identities, she served in a rehabilitative program and by 22 had her record expunged and identity sealed.

Joe arrives at the police station to report his mother missing; his photograph matches the dead woman. He reveals he has been dating Phoebe Bradley, Lily and Tom's 12-year-old daughter. The investigation also exposes a crisis for Rue: Her husband, Seth Duval, was having an affair with Arwen. The autopsy reveals unidentified semen and a broken strand of beads stamped with a rhinoceros logo on the victim. Rue recognizes the beads as Save the Rhino Foundation bracelets identical to ones she and her son Ebrahim purchased in Botswana. She confronts Seth and demands a divorce.

In the weeks before her death, Arwen infiltrates the Bradleys' world, and Tom secures a cottage for her near their home. On his boat after a Friday happy hour, Arwen drugs Tom's drink and reveals she knows his secret: His deceased common-law partner, Dr. Deirdre Carr, treated a young killer at the Margot Javinski Institute, a psychiatric facility. She tells him she also knows about his wife. As Tom stumbles off the boat, he discovers Simon Cody, a philosophy professor and neighbor, on a nearby vessel with a telescopic camera. During this same period, one of Lily's therapy patients, calling herself "Paisley," names her destructive inner child "Sophie," a dark-haired 12-year-old with a knife. Shaken, Lily retrieves from a locked safe a newspaper clipping of a missing girl named Sophie McNeill.

The crisis peaks at the neighborhood barbecue on June 19, the day Arwen dies. Armed with photos that Hannah Cody, Simon's wife and Lily's neighbor, found showing Tom kissing Arwen, Lily confronts Arwen in the pool house and recognizes her as "Paisley." Arwen reveals she is Christine Arwen Whittaker, the girl who hid under the bed in Glenn Dennig. She identifies Lily as Sophie McNeill and declares they are the only two people who know the full truth. She also reveals Tom has known Lily's identity all along: Dr. Carr was his partner, and he married Lily as a continuation of her rehabilitation project.

Tom bursts in, sustains deep scratches from Arwen, and takes Lily home. He confirms he knew she was Sophie but insists he fell in love with her. Devastated, they agree that protecting their children must come first. Joe, who has read the manuscript and overheard the confrontation, breaks into Arwen's studio, burns her research, and smashes her laptop. Arwen discovers the destruction and breaks down; Joe puts her to bed.

That night, Lily walks to the cottage hoping to stop Arwen but finds no one home. Arwen, who has schizoaffective disorder, is experiencing a psychotic episode and has fled into the forest. Joe spots her and drives to the far end of the trail, entering the woods wearing a cap and headlamp Phoebe left at the cottage. In her delusional state, Arwen perceives Joe as a threat and flees toward the cliff. A falling branch strikes her head, and she stumbles backward, ripping a Save the Rhino bracelet Phoebe had given Joe from his wrist as the sandstone crumbles. She falls to her death. Joe flees in shock, terrified of prison and of exposing Phoebe's family.

Tom and Lily are arrested after police search their home and find the washed shirt, the refuse bag, and a framed safari photo showing Tom wearing an identical bead bracelet. DNA under Arwen's fingernails matches Tom. The case pivots when Matthew brings his camera to the station. He shows Rue photographs of Simon and Arwen having sex in the pool house after the barbecue, explaining the unidentified semen. More critically, his photos from inside Simon's shed reveal trophies matching items taken from the Jogger Killer victims. Simon is arrested.

Joe then tells Rue the full truth: He was on the cliff that night, and his mother's death was an accident. He destroyed the manuscript to protect the Bradley children. The coroner rules the death accidental, and no charges are filed.

In the September epilogue, media attention has shifted to Simon, who is charged with three murders. Hannah has fled with her children. Joe, with Rue's help, locates his biological father and flies to Ontario. Rue ends her marriage. Lily and Tom walk home from church with their children, tentatively rebuilding trust. Lily begins a private journal documenting her past for her children. On the first page she copies the artist's statement from one of Arwen's paintings, which Joe gave to Phoebe: a meditation on the Death tarot card and the necessity of releasing what no longer serves.