or external remedies. Finally, when it became apparent that neither weakness nor delirium accompanied the fever, Dr. Cawthorne had stopped trying to lower it.

Ash had clear memories from those days. She remembered nothing from before Nightingale House, and everything after. She could recall how she hadn’t spoken, but had automatically obeyed every instruction given to her: to get up in the morning, to shower, to dress, to eat breakfast, to sit and watch television, to eat dinner, and then to lie in bed until she was told to get up again. At the end of the first year, Cawthorne had noted in his spidery scrawl: Mary-052007 will not respond to any name, but displays clear comprehension of verbal and written instructions when they are spoken directly to or placed in front of her. She performs both menial tasks and more complex operations, such as solving mathematical equations, tending the garden, or typing and sending an e-mail (dictated).

They’d instructed; she’d performed. When they asked her to accomplish tasks that were impossible to carry out, such as urinating into a cup, they never tried to force her. The nurses simply noted “Mary’s” lack of response in her chart, and Dr. Cawthorne would write the name of another disorder in his notes, followed by another question mark.

The second year had passed in the same way. A few weeks into the third year, the doctor had been thumbing through the calendar on his desk and making his usual, halfhearted attempts to draw out a response—

How are you today? Pause. The rain has let up. You’ll be able to take your afternoon walk through the garden, though it will be too wet for planting. What sort of flowers should we add this year? Pause. Peonies would be lovely, wouldn’t they?

—when he’d cut his thumb on the edge of the calendar paper. Another pause had followed the peonies as he’d stuck his thumb into his mouth, and Ash had remembered that she’d once drunk her own blood, too. She’d remembered the blade carving symbols into her face, her torso and arms. She’d remembered the knife at her chest, and the dark figure pronouncing her name—but she’d only heard the first syllable before his terrible voice had torn everything apart.

Sitting in Dr. Cawthorne’s office, that memory had quickly faded—or she’d stifled it, just as she stifled the tremors that shook her body when she thought of that dark figure. Just enough of the memory remained, however, to remind her that she had to tell Cawthorne something.

“My name isn’t Mary,” she’d said.

Dr. Cawthorne’s hand dropped away from his mouth. He’d stared at her, his jaw agape. Whenever someone on the television wore that expression, a faceless crowd laughed on the soundtrack. No one in Cawthorne’s office laughed in the background. The only reaction that Ash could detect was the sudden shift of Cawthorne’s emotions: from frustration and resignation to surprise and excitement.

But though she could sense his exhilaration, he didn’t show it. Evenly, he’d asked, “What is your name, then?”

“Ash . . . something. I don’t know the rest.”


“No.” She was certain.

He’d nodded in that same slow, calm way, but to her ears, his heart pounded almost as loud as his voice. “Until we know, may we call you ‘Ash’?”


Smiling, he leaned back in his chair and studied her. “And you’re an American? Canadian?”

“I don’t know.”

“But your accent is . . .” He’d shaken his head. “No matter. You’re here now, and it’s wonderful to hear your voice after all this time. Is there something you’d like to tell me?”

“No.” She’d already told him that her name wasn’t Mary. That was all she’d had to say.

His excitement dimmed, followed by his relief when he’d continued talking and she’d continued answering him. But by the time he’d ended the session—an hour later than usual—unease threaded through his curiosity. He’d already been jotting notes when she rose from her chair to leave.

She’d stopped long enough to ask, “What does ‘complete lack of affect’ mean?”

His pencil lead snapped. He’d looked up from his notebook, his face carefully blank and his emotions an indistinguishable riot. “Why do you ask?”

“Because you’ve written it about me in your notes.”

It was one of the few phrases he’d scribbled that hadn’t been followed by a question mark. Another had been “source amnesia,” but he’d explained that while they’d been talking: It meant her procedural memory and factual knowledge remained, though she’d no recollection of how or when she’d learned them.

“Ah.” His gray eyebrows had lifted into an open expression. A friendly smile shaped his mouth. “A lack of affect simply means that someone doesn’t display a marked emotional reaction . . . or empathy for others.”

His conflicting feelings and facial expressions suggested that he assumed Ash would be disturbed by that explanation, and that he was trying to soften its delivery.

She wasn’t disturbed. She’d already known that she didn’t feel anything like the emotions she regularly sensed in other people. Nodding, she’d turned to go.

“Ash . . .” When she’d glanced back at Dr. Cawthorne, he wore a puzzled frown. “How did you know what I’d written? My notepad was angled away from you.”

“Yes. But it reflected in the glass.”

She’d pointed to the framed diplomas hanging on the wall behind him. He’d looked around; when he’d turned back to Ash, his smile had been bright. He’d said something about her cleverness, but she’d tasted his sour fear.

The reaction of the nurses and caregivers had echoed his: excitement followed by unease, and punctuated with spurts of fear. They began calling her Ash, but when they spoke together in other rooms and thought she couldn’t hear them, they referred to her as “the American,” as if trying to put distance between themselves and her. Ash paid closer attention to the actors on television after that, particularly the never-ending soap operas. Mimicking those accents upset the nurses more, however. Only after she’d overheard two of them discussing how unsettling they found her tendency to watch everyone without evincing any emotion, Ash had finally understood that her American origin had never been the issue. It was her lack of affect that disturbed them.

“Even psychopaths learn to fake it,” one of them had said.

But Ash didn’t care enough to fake her emotions, and by the time she’d decided to leave Nightingale House, the nurses didn’t even refer to her as “the American” anymore. She’d become “that one.”

That one, who’d caused an uproar of hilarity and shock when her clothes had vanished during a group therapy session—followed by greater shock and fear when, after Ash had noticed her nudity, jeans and a T-shirt that the nurses hadn’t seen before simply appeared on her body. That one, whose blond hair—which the nurses had kept short for easy care—had grown to the middle of her back during a walk through the garden one August afternoon. That one, who’d pulled a prank with glowing eyes, and terrified one of the nurses so badly that she’d quit her position the next day. That one, whom the nurses had found crouching atop the roof of Nightingale House one morning, and who’d given no believable explanation of how she’d climbed the turrets. That one, who’d dropped from the roof to the ground as easily as another person stepped out of her bed, despite their pleas for her to stop.

They’d shrieked when she’d jumped—but Ash hadn’t detected any relief from them when she’d landed on her feet, uninjured. There’d only been fear, followed by hot anger.

Another nurse had quit after that, screaming to her supervisor that she’d expected Nightingale House to treat only drugaddicted celebrities and depressed aristos, and that she’d left the government-run hospitals for a posh situation to avoid the psychos. Ash had decided to leave, too, albeit for a different reason. The answer to the one question that interested her—Who am I?—hadn’t been at Nightingale House. No answers were there—except for one, and she’d asked Dr. Cawthorne for that information during her final therapy session.

“A posh hospital must be expensive,” she’d said. “So who is paying for my treatment?”

He’d paled. In the months since she’d begun speaking, the wrinkles around Cawthorne’s eyes and mouth had become more pronounced. His skin had loosened as if he’d dropped weight. But although she’d frightened him at times, he’d never lost color in his face or broken out with a sheen of sweat, as he had then.

His gaze had skidded away from hers. “The money comes from a numbered account. The donor wishes to

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