What She Left Behind: A Haunting and Heartbreaking Story of 1920s Historical Fiction

After finishing work, Izzy tries to distract herself by watching MTV but keeps thinking about Clara and Bruno, as well as Ethan. Izzy also struggles to sleep, thinking about Ethan and her late father. She worries that trauma will cause her to develop a mental illness like her mother’s. As she is resisting the urge to self-harm, she hears tapping against her window. It’s Ethan.

Ethan convinces Izzy to come outside by threatening to ring the doorbell. He brought Clara’s journal for Izzy to read. She doesn’t want to take it and get in trouble with her foster parents, who are the nicest she’s encountered, but she does want to understand the mind of someone who was in a psychiatric institution, like her mother. Ethan says that Willard is haunted and apologizes for his part in defacing her locker. He also explains that Shannon has had a difficult life—her mother has an alcohol addiction and her father was abusive before he abandoned them—and swears Izzy to secrecy about this.

Izzy can’t imagine her parents abusing her. She decides to keep the journal, and they arrange a way for her to return it later by dropping it in a locker; that way, Shannon won’t see them together and get more jealous.

Clara and other patients are forced to lie in tubs of ice water. One woman is unconscious and being pulled out of a tub. Another patient aggressively bathes Clara. Clara is released earlier than the other women because she has an appointment with Roach. When Clara arrives, Roach’s wife is waiting outside his office. Trench barges inside, where Nurse May is sitting in a chair with her skirt hiked up. Roach tells Trench that she’s supposed to knock. Trench tells Roach that his wife is waiting.

Roach orders May to take Clara to the examination room. May does, noting Clara’s height, weight, temperature, and blood pressure. Roach joins them, and Clara complains about May’s demeanor; she acts as if Clara doesn’t understand what’s being said. Roach ignores this exchange and listens to Clara’s heart.

Clara insists that she doesn’t need to be admitted. Roach says that he is only examining her physically today; they will meet to discuss her mental condition later. Roach continues an invasive medical exam, putting his pelvis against her buttocks and grabbing her breasts. Next, he looks into her mouth and presses down on her tongue with a wooden stick. Clara vomits on him. May drops Clara’s chart in the vomit and then starts cleaning Roach with some towels.

As Roach washes his hands, May yells at Clara and threatens her with isolation. Roach says that he doesn’t think Clara vomited intentionally, so isolation isn’t necessary. Clara explains that she’s pregnant. Roach doesn’t believe her and says the female physician who does gynecological exams is out for the day. May tries to convince Roach to get Trench to clean up the mess, but Roach tells her to get an orderly.

May then takes Clara to the cafeteria. There, a woman climbs up on a table, and an orderly pulls her down. May tells Trench about Clara vomiting and loudly announces that Clara thinks she is pregnant. Patients gather around Clara and grab at her. Trench and orderlies pull the women off of Clara, and Trench says that she’ll write up May for revealing this. May shrugs and leaves. Trench whispers to Clara to keep quiet about her pregnancy.

Clara gets her food: tea, prunes, and bread. She doesn’t want to eat but does so for her baby. A woman starts screaming and trying to steal another patient’s food for her doll. An orderly slaps her, and she sings a lullaby to the doll.

Clara shows no signs of mental illness in her journal. She seems like a typical teenager, and Izzy is surprised that Clara’s parents would have her committed for loving a lower-class immigrant.

When Ethan gets the journal from Izzy’s locker, he explains that Shannon has been overprotective, making him walk with her everywhere, because she hates that he’s working at the museum with Izzy. Just then, Shannon sees them in the hall, and Ethan says that Izzy’s locker was stuck. They all walk back to class, and Shannon kisses Ethan in front of Izzy in the doorway.

During class, the teacher, Mr. Defoe, asks students to consider whether people who commit crimes are acting out of character or in ways that reflect their fundamental personality. Shannon says that they should ask Izzy’s mother because she killed Izzy’s father and is in prison. Shannon’s friends begin taunting Izzy with questions about her mother. Defoe tells the students to stop, but the students ignore him and escalate their insults. Izzy starts to leave the room, but Ethan stops her and yells at everyone else. Students then begin to tease Ethan about liking Izzy, and Shannon is furious.

The class quiets, and Defoe gives Shannon detention. Shannon claims to have done nothing wrong. Alex mocks her and tells the class about Shannon’s family situation. Shannon lunges for Alex, but Ethan holds her back. Defoe threatens to suspend Shannon, who calls Alex a liar and her mother a “whore.” At this point, Defoe sends Shannon and Ethan to the principal’s office, and Ethan has to pull Shannon out of the room.

After class, Izzy goes to the bathroom, where she finds Shannon crying and being comforted by Crystal and Nicole. Izzy says that she knows what it’s like having a “fucked up” life, but Shannon insults Izzy and says that she doesn’t understand. Izzy offers to start over and be friends. Shannon tells Izzy to “start over” by getting a new job rather than working with Ethan, threatening Izzy when she refuses. Crystal and Nicole push Izzy against the wall and hold her there. Alex then comes out of a stall and tells them to release Izzy. They do. Shannon responds by pushing Alex, who stumbles but doesn’t fall. Izzy tells Shannon to leave Alex alone and threatens to steal Ethan, confessing that he came to her house. Shannon lunges for Izzy, but Alex pulls Izzy into the hall. They run outside to Alex’s car, though Shannon and the others pursue them.

As she drives, Alex lights a cigarette and explains that she and Shannon used to be best friends. Shannon revealed that her father was physically and sexually abusing her. Alex told her mother, who confronted Shannon’s mother. Shannon’s mother already knew but confronted her husband. In the ensuing fight, Shannon tried to protect her mother, so her father injured Shannon badly enough that she ended up in the hospital. Shannon’s father left town afterward, and Shannon stopped being friends with Alex. Ethan is just a trophy to Shannon, who is cheating on him.

Izzy reflects on the similarities between Shannon’s father and Clara’s father; they are both monsters. Izzy’s father was good to her, she believes. Alex says that her father died in a car accident and that her mother is obsessed with contacting him through mediums. Izzy explains that she doesn’t know why her mother killed her father. Alex drops off Izzy, who plans to give the journal back when Peg and Harry get home.

Clara and many other patients sit in the “Sun Room” much of the time. It is physically painful for Clara to spend the majority of her days this way. One day, she is nauseous and stands to ask to use the restroom. An orderly named Richard tells her to sit down and wait for the next bathroom break. She vomits on the floor next to Richard. This upsets some patients, and Trench comes into the room and tells Richard to take Clara to room C.

Room C is an isolated cell. There, Richard hits Clara and, with the help of another orderly, straps Clara to the bed. A nurse comes in and gives Clara an injection. Clara vomits again and passes out. When she comes to, Trench is in the room, reading The Sun Also Rises. Trench lectures Clara about following the rule about asking before standing. Clara promises to follow the rule and do what Trench says. Trench undoes the straps, freeing Clara’s hands and feet. Clara has been asleep for two days, but Trench says that she must go directly to bed without eating. Clara tries to talk to Trench about love and her relationship with Bruno, but Trench threatens to put Clara back in isolation.

Clara does what Trench says for a couple weeks and is ultimately allowed to work as a potato peeler. Clara prefers this to the Sun Room because she can stand when she wants to. Undernourished, Clara can also steal bites of raw potatoes as she works. She enjoys taking the peelings outside and getting some fresh air.

One day, while putting the peelings in the compost pile, Clara follows a rat to a hole in the fence. She starts to make the hole larger, hiding it with peelings. She continues to enlarge the hole over the course of a week. When she tries to pull herself through, however, she gets stuck on her pregnant belly. She is pulled out of the hole by a man who explains that the boiler room is on the other side of the fence; it’s not a route for escape. The man shows her a trick to open a barely visible door in the fence.

Clara runs out the door, but the man follows. He catches her and says that she can’t break the rules. When she asks, he tells her that his name is Stanley and that he’s been at Willard for 20 years. She asks if he’ll show her the pigs that he was collecting scraps for, but he refuses. Stanley is called back to work, and his boss chastises Clara for distracting Stanley. Then, Stanley’s boss calls over Clara’s boss, who orders Stanley’s boss to patch the fence and takes Clara to Roach.

Roach interrogates Clara about her escape plan. She explains that she just wants to be free and is only here because of her father’s machinations. However, Roach accuses her of being paranoid about her father. She says that he should stop cheating on his wife with his employees. In response, he has her put in isolation for six days. The room is disgusting, containing one bulb, a toilet, and a cot. Meals come in twice a day through a slot. Trench eventually releases Clara.

In April, Clara guesses that she is two months away from giving birth. Clara’s body hurts during her appointment with Roach. It is their second meeting in five months, and Clara asks how he can evaluate her mental state with such infrequent interactions. He accuses her of wanting special treatment. She asks to be released. He asks if she thinks her father committed her to get rid of her, and she says that she’ll agree to whatever her father wants if she can be free. Roach asks if Clara is considering suicide, and she says that she isn’t: She wants to live with Bruno. However, Clara’s father told Roach that Bruno doesn’t exist.

By June, Clara is friends with two other patients. Esther was committed because she kissed someone who wasn’t her husband, and Madeline’s landlady claimed that she was swearing and talking to no one. Another patient, Ruby, is an Italian immigrant whose husband died; she was committed after becoming a sex worker. Clara wonders how many women at Willard have similar stories. Aloud, she wonders if she will be released when her baby is born.

Clara considers trying to escape via the creek, but it is too dangerous to swim in, and she doesn’t know how to swim anyway. The three women walk past Lawrence Lawrence, a patient who works as Willard’s gravedigger and lives in a run-down shack on the grounds. They also pass patients from the Rookie Pest House, who are separated from the general population and chained to their beds. She wonders if the people visiting Seneca Lake ever wonder about the patients at Willard that they can see in the distance.

As Clara works peeling potatoes, Madeline washes dishes nearby. She makes a face at their boss behind her back and drops a plate. Their boss turns around and pushes Madeline’s head against the cupboards. Clara intervenes to stop their boss from hitting Madeline, and their boss pushes Clara. Clara falls, hits her head, and her water breaks.

Clara wakes up in the infirmary on a stretcher. She tells the doctor that she’s in labor and that the father is named Bruno. The nurses move her to a bed. As Clara gives birth, a nurse gives her an injection of morphine, which causes her to pass out.