It's 1954, and U.S. Marshals Teddy Daniels and Chuck Aule arrive at a small island in Massachusetts' Outer Harbor. It is home to Ashcliffe Hospital, a federal institution for the criminally insane, and one of the patients has escaped. Although the two men are new partners, they have already developed a wry, jocular relationship while also swapping personal, painful details. Daniels' lost his much-loved wife two years prior in a fire, while Aule requested a transfer out of Seattle after being harassed over his personal relationship with a Japanese American woman. After interviewing the hospital's medical personnel, both men have the feeling they are being stonewalled, especially by the director, who seems to alternate between a cold authoritarianism and a sudden and sweeping compassion. When the island is hit by gale-force winds and Aule disappears, Daniels must go it alone, beset by the fear that he has been fed psychotropic drugs and the belief that the hospital is performing radical brain surgery as part of a secret-ops program. Lehane throws in one mind-bending plot twist after another in a psychological thriller that will leave readers in suspense right up to the end. A master of the adroit psychological detail, Lehane makes the horrors of the mean streets pale in comparison to the workings of the human mind.