59 pages • 1-hour read
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Content Warning: This section of the guide includes discussion of gender discrimination, mental illness, child sexual abuse, sexual harassment, physical abuse, illness, self-harm, death, substance use, and graphic violence.
In March of 1930, Roach and his staff release Clara from the Rookie Pest House and give her a job in the laundry facility. She is happy to be unchained and makes friends with a patient named Matilda. Matilda often hugs the other patients, and Clara looks forward to this affection.
Two weeks later, Clara is given permission to spend time in the recreation room on a daily basis. There, she reunites with Madeline and Esther. Esther is heavily drugged, and Madeline explains that Esther sleeps most of the time. Roach tried to get Esther to sleep with him; she refused, and they put her in an insulin-induced coma for a week. When Roach had Esther returned to the general population, she repeatedly asked for Clara. Madeline also explains that at one point, Esther said a carpenter named Bruno woke her up and asked about Clara. Hearing this, Clara realizes that Bruno is working at Willard and is trying to free her.
After Alex rescues Izzy, they stay at Alex’s house. Ethan offers to let Izzy keep his sweatshirt, but she declines. However, she does keep a pin she found in the pocket. In the morning, Alex drops Izzy off at Peg and Harry’s house. Izzy gets cleaned up and examines her bruises and cuts from being imprisoned in the morgue vault.
When Izzy goes into the kitchen, Peg says that she located a nurse who cared for Clara; Peg has arranged a meeting with her. Then, Harry says that Izzy’s mother had a stroke overnight. She wasn’t discovered until the morning and is in a coma. When Peg sees the injuries on Izzy’s hands, Izzy claims they are from rollerblading. Izzy hesitates to make plans to visit her mother, declines Peg’s offer of a meal, and goes upstairs, where she vomits in the bathroom and then crawls into bed.
Izzy hoped for a long time that her mother would be cleared of her father’s murder, and that she would be reunited with her mother outside of prison. However, there is no longer a chance of this; her mother is dying. She cries and finally reads her mother’s letters, starting with the earliest, from July 1986. The letters reveal that her mother never stopped loving her and repeatedly asked her to visit. Her mother never sounds like she has a mental illness. Peg stops by Izzy’s room, offering to get her something to eat or drink. Izzy politely declines because she is still nauseous.
Izzy then reads a letter written when she was 13. In it, Izzy’s mother explains that she killed Izzy’s father because he was sexually molesting Izzy. Izzy is initially in denial but then remembers her childhood nightmare of a demon touching her and the demon turning into her father. She dry heaves in the bathroom and is overwhelmed with guilt about not reading the letters sooner. The letter also explained that Izzy’s mother refused to have Izzy examined, so there was no evidence of her motive. Her lawyer couldn’t get her a shorter sentence or any other leniency. Izzy recalls how Shannon’s mother tolerated Shannon’s father’s abuse. Izzy’s mother went to prison to ensure that Izzy would never be abused by her father again.
Izzy takes a bath and realizes that her self-harm is connected to her father’s abuse. She is grateful that she does not have clear memories of the abuse but worries that it will somehow show in her body. Izzy gets out of the bath and goes to bed. She vows not to let her father’s abuse hurt her future.
For the next couple of weeks, Clara tries to figure out where Bruno is working in Willard. This distracts her enough that her boss in the laundry switches her to sewing. Esther says that she told Roach about Bruno, but Roach told her that she was also hallucinating Bruno. Clara believes that her father is manipulating Roach with his money. Esther hopes Roach hasn’t fired Bruno.
Clara tries to dress up as a man and slip into the men’s section of Willard to look for Bruno, but she gets caught. Her punishment is spending a week in isolation. After she returns to sewing, she sees her boss change a light bulb. This inspires her to break something so that Bruno will come and fix it. When her boss goes to change a second bulb, Clara offers to help. While doing so, she intentionally knocks over the ladder, which breaks a window and a cupboard. Clara hides her injuries from the fall so that she isn’t sent to the infirmary. Her boss says that she’s going to get a worker to fix the mess.
The next day, the window in the sewing room is boarded up, and the cupboard has been removed. Clara is upset and cuts her finger while sewing. Then, workers bring in a window frame and a cupboard. Bruno is among them. She runs toward him but is stopped by orderlies. When Bruno says that Clara is his wife, Clara’s boss sends her and Bruno to Roach, escorted by the orderlies.
Roach questions Bruno about the name on his job application: Joseph Russo. Bruno says that it’s his father’s first name and his mother’s maiden name and that he used it because Henry told Roach not to allow anyone named Bruno near Clara. Bruno confirms what Clara has been saying: Henry committed her to keep her away from Bruno. Roach questions Clara, noting that she never said she was married. Bruno gives Roach a marriage certificate, but Roach declares that it is fake. He accuses Bruno of starting a relationship with Clara after he started working at Willard.
Then, Roach claims Bruno is taking advantage of Clara’s delusions and claiming to be someone he isn’t. Henry told Roach that Clara had sex with many men, any of whom could have fathered her child. Bruno demands to see his daughter. Roach says that the baby is safe “in a loving home” (239). When Bruno threatens to go to the police, Roach has the orderlies restrain Bruno and says that he is going to be committed. Roach then tells Trench to put Clara in an insulin-induced coma. Bruno breaks free and grabs Clara, but orderlies separate them. Roach drugs Bruno with a syringe, and the orderlies put Bruno in a straitjacket.
Peg takes Izzy to Bedford State Prison, but Izzy insists on going inside alone. A guard checks her school ID and birth certificate and then sends her to the visitors’ lobby. As Izzy fills out paperwork, she sees children there to visit parents and feels guilty for not visiting before. Guards search Izzy’s bag and body before admitting her to the infirmary. They lead her to a waiting area there, and she thinks about the coma patient in the novel The Dead Zone.
Eventually, a guard sends Izzy to a nurse, who takes her to her mother, Joyce. Even on her deathbed, Joyce is beautiful, Izzy thinks. The nurse says that Joyce will not wake up and gives Izzy a few moments to talk to her mother alone. Izzy is upset that Joyce is chained to the bed. She is afraid to touch Joyce’s hand and compares this feeling to not wanting to touch the Willard suitcases; both reflect an irrational fear of infection.
Izzy cries, apologizes to Joyce, and tells Joyce that she loves her. Izzy recalls how her grandmother didn’t want to talk about Joyce. Now, Izzy is even more determined to find Clara’s daughter and tell her the truth about her mother. Izzy kisses her fingers and puts them to Joyce’s cheek, assures Joyce that she has people who care for her, and says goodbye.
Clara is given daily insulin injections and put in a coma for two months. Eventually, she is given glucose, which wakes her up, and the nurses play games with her to help prevent hypoglycemic shock. She spends three weeks in the infirmary and struggles to think clearly. Once back at her job in the sewing room, she starts looking for Bruno whenever she gets a glimpse of male patients. The thought of him keeps her going. Roach, at Henry’s insistence, says that Clara will never be able to leave Willard and return to society. Then, Roach stops seeing her.
On Valentine’s Day of 1932, Willard has a party where men and women are allowed to dance together. Clara was given permission to attend events a month ago, and this is her first co-ed event. She looks for Bruno. Roach dialed back Esther’s drugs, so she is able to dance at the party. Madeline was briefly released while Clara was in a coma but is now back and worse than she was before. When Madeline dances too close to her partner, Trench comes over to make space between them.
Bruno appears; he now has a beard. Clara goes to embrace him, but he worries that they will get in trouble if they do, so she resists. Instead, they dance with the required space between them. Bruno explains that he was in isolation for three months. Once he got out, he became friends with Lawrence, the gravedigger. Lawrence and Bruno have come up with a plan to escape using coffins. Trench comes by and insists on more space between Bruno and Clara. Clara wishes Trench a happy Valentine’s Day, and Trench warns them to behave.
Bruno continues telling Clara about the plan: They will hide in Lawrence’s shack after escaping via coffins. Then, they will use a rowboat that Bruno has repaired to leave on the lake at night. Clara worries about this, saying that the lake is frozen, but Bruno says that the ice is thin because it’s been unusually warm. Clara says that she’ll get herself taken to the infirmary tomorrow and then sneak to the morgue. The next song Nurse May plays is “Someone to Watch Over Me,” the first song that Bruno and Clara danced to together.
The following afternoon, Clara complains of stomach pain in the recreation room. An orderly takes her back to her bed. Once alone, Clara takes her overly full menstrual pad and smears blood over herself and the bed. She begins moaning until a nurse comes, sees the blood, and sends Clara to the infirmary. Dr. Slade says that Clara should be seen by King, the gynecologist. However, Clara says that she feels better and just needs to walk. Slade reluctantly agrees to let Clara walk with a nurse to the end of the hall.
When Clara sees a sign for the basement, she walks toward it. The nurse objects, but Clara says that she needs to walk more. She then collapses and pretends to have a seizure. When the nurse goes for help, Clara runs for the door to the basement. On the way to the morgue, she sees the iron cages that hold chained patients in the cellar. She vows to tell the authorities about the cages. Once in the morgue, Clara climbs into a coffin.
After a short while, Clara hears Bruno and Lawrence talking. When someone comes into the morgue, Lawrence says that he and Bruno are burying Annie Blumberg and that he hasn’t seen a female patient. Once the man leaves, Bruno finds Clara. Lawrence tells her that Roach taking her baby was immoral. Bruno says that they hid Annie’s body in the woods and that they have to take the coffin to the cemetery. In order to do so, they have to nail it shut with Clara inside. Bruno kisses her, promises everything will be alright, and puts as few nails in the coffin as possible for transport.
They take her to the cemetery and open the coffin. Bruno holds and kisses Clara. As Lawrence recovers Annie’s corpse, Clara hides in his shack, under his bed. Later, Lawrence comes into the shack and tells Clara that Bruno is burying Annie. Willard staff are looking for Clara, and she needs to hide somewhere else. Lawrence shows her a trap door under his rug. She asks for a light and promises to put it out if she hears someone coming. He puts some sticks from his fire in a tin can for Clara.
The hidden room is lined with cross markers that Lawrence made for all the people he buried, and he explains that it’s wrong to have so many unmarked graves. Clara says that he’s a good person. Lawrence then closes the trapdoor and goes to sleep in bed. A little later, someone comes barging into the shack and yells at Lawrence for sleeping. Clara blows out the tin can of fire. Lawrence says that he’s sick and hasn’t seen anyone. However, the Willard staff sees the smoke from the extinguished fire.
Clara hears people fighting outside the trapdoor, and eventually Bruno opens it. There are two unconscious orderlies in the shack. Lawrence gives Clara his jacket, and she gives him a hug. He says he hopes that they will find their baby. Lawrence, Bruno, and Clara then run to the lake. They get Clara on the lake and start pushing the rowboat out, but then more orderlies and Roach appear at the shore. Bruno gets in the boat and tells Lawrence to get in, too. Lawrence refuses.
An orderly grabs Lawrence and pushes him underwater. Bruno tries to get the orderly off Lawrence, and another orderly grabs Bruno. A third orderly appears, hits Bruno on the head, and drags him to shore. When the orderly reaches for Clara in the boat, she hits him with an oar. Before she can hit him a second time, she hears Roach fire a gun. He demands that she stop. She gets out of the boat and walks to shore as an orderly drags Lawrence to shore. Both Lawrence and Bruno are dead, and Roach blames Clara for their deaths.
Wiseman’s narratives feature multiple layers of parallels. Plot points recur across Izzy and Clara’s storylines, but so too do character arcs and thematic elements. For instance, Izzy’s mother ends up in a coma from a stroke, while Clara is put into an insulin coma. Likewise, both Izzy and Clara feel guilty for the imprisonment of their respective loved ones, Joyce and Bruno. However, their narratives diverge in the circumstances surrounding the deaths of their loved ones. Clara is able to talk to Bruno after they are reunited and before he dies, but Izzy only sees Joyce in a coma. This motivates Izzy to make sure that Clara’s daughter knows the truth about her mother before it’s too late. The structure of the novel, with its interwoven narratives, thus evokes the theme of Intergenerational Trauma and Resilience, showing how women draw strength from one another amid hardship.
Izzy’s confrontation with the truth about her father also develops this theme substantially, exploring both the physical effects of trauma and what motivates trauma survivors to keep on going. For example, Izzy self-harms while repressing the trauma of her father molesting her and vomits when she learns the truth about what she’s been repressing. This suggests that trauma is not just emotional; it is something that takes a serious toll on the body. However, learning the truth becomes a turning point, as Izzy thinks, “I’m not going to spend the rest of my life paying for my father’s sins” (228). This is a significant moment, as Wiseman narrates most of the novel—even Izzy’s internal monologue—in the third person. Wiseman uses the first person to give Izzy a quite literal voice, underscoring Izzy’s determination to take control over her life.
The fact that this moment comes immediately after Izzy’s ordeal in the morgue is significant; coupled with the imagery of death, it becomes a symbolic rebirth. By contrast, Clara’s experience in the coffin leads only to more death—a point underscored by Wiseman’s use of water imagery. Wiseman uses a water simile when Clara is released from the coffin, describing her as “taking deep gulps of fresh air, like a woman rescued from drowning” (265). This ironically foreshadows the events that follow: A short while later, Bruno dies in the lake after being hit on the head, and Lawrence dies in the lake by being drowned.
Izzy’s mother offers another example of the Institutional Control of Women’s Bodies. Joyce is chained to her bed, and “the absurdity of chaining a comatose patient to a bed briefly crosse[s] Izzy’s mind” (247). Even unconscious, prisoners’ bodies are under the control of the prison staff. Indeed, the parallel to Clara’s artificially induced coma suggests that the state has symbolic significance; in their comatose state, the women are absolutely at the mercy of those around them, their bodies fully vulnerable. Joyce’s chaining also mirrors how Clara is chained to her bed in the Rookie Pest House, simultaneously illustrating how psychiatric institutions treated patients like prisoners in the 1920s and how the carceral state mistreats prisoners in the 1990s. Secondary female characters are subject to similar policing. For instance, Roach drugs Esther so that she sleeps all the time after she refuses his sexual advances and defends Clara. This highlights his belief that the bodies of his female patients are his to control.
The novel also continues to demonstrate how women who speak out against powerful men are pathologized. Clara thinks about the “Throngs of thrown-away wives, mothers, sisters, and daughters” at Willard (250). People like her father and Esther’s husband have their female family members committed when they challenge the patriarchal norms. Wiseman uses her novel to bring attention to this misuse of mental health facilities, developing the theme of Defining Female Autonomy as Mental Illness.
The letters from Izzy’s mother furnish further proof of this process. As the symbolism surrounding them evolves. As Izzy plows through them, she is “waiting to read that one sentence, that one group of words that would confirm her mother’s mental illness” (224). Instead, Izzy finds a confession that her mother killed her father because he was molesting Izzy. Joyce taking her daughter’s protection into her own hands is the kind of autonomy that gets women imprisoned—or, as Izzy’s assumptions demonstrate, labeled “insane.” Her letters ultimately represent what Izzy has repressed: the truth about her father.



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