Mrs. Clay pulled the younger girl’s hand into the crook of her own elbow. “So what’s this dinner, do you think?” she asked, knowing full well that there would be no answer. “I don’t see any room for kindness in this place, but let’s put a good face on it and see, shall we?”

There was silverware. Grace was unprepared for how much it set her back to see a table set properly, and she stood still in the doorway for a moment before entering. Mrs. Clay gave her a slight push to get her into the dining room, followed by two other women she didn’t know, faces pink from fresh scrubbings and wet buns pulled tightly back from clean scalps. Already seated were three male patients, who rose when the women entered, although one of them lagged slightly behind the others, not accustomed to the tradition.

“Mr. Baltingham, Mr. Crow,” Mrs. Clay said congenially, nodding toward them before she sat down. Grace followed her cue, lowering her eyes when the men glanced toward her and staring at the plate setting in front of her. It was heavy and awkward, nothing like the slight china she’d had at home, but it meant that there would be real food to eat, not only bread to grab and run with.

“I’m sorry, I don’t believe we’ve met,” Mrs. Clay said to the third man, who reddened under her attention. “It seems we’re allowed to pretend to be civilized this evening. You may as well tell me your name.”

“Moore, ma’am,” he said.

“Hello then, Mr. Moore,” she said. “I am Mrs. Clay and these ladies are Miss Holstein, Mrs. Ubry, and . . .” Her hand fluttered to Grace’s shoulder for one second. “I’m sorry, I don’t know our young friend’s name.”

It pulsed in Grace’s throat for one second, the syllable that meant her. Yet it remained halfway up, lodged like a chunk of her supper from the evening before.

There were murmured hellos around the table, and then Mr. Baltingham cleared his throat. “What’s this about, then? Anybody know?”

“I believe you’re all going to be used like I am, shining examples of—” Mrs. Clay began, when the dining room door blew open and Dr. Heedson came in, a half-empty wineglass in hand and one of the cooks at his heels with a tray of ham.

Heedson took his seat at the head of the table, to Grace’s right. “Looks like you’re all here, then,” he said.

The cook moved between Mrs. Clay and Grace to set the ham-laden platter on the table, and the wafting scent filled Grace’s mouth with saliva. In her belly, the baby awakened and kicked hard, its tiny foot striking the edge of the table.

“I’ve handled the introductions, Dr. Heedson,” Mrs. Clay began.

“I believe I’ll do my own version, nonetheless,” Heedson said, unfolding his napkin into his lap before pointing at the patients in turn. “Moore here is a syphilitic; Crow went after his wife with a pitchfork after catching her in the haymow with his brother—which hardly makes him crazy, to my mind. Baltingham’s an alcoholic, Ubry’s a nymphomaniac, Holstein insists that her menstrual blood is made of demons, Mrs. Clay is a cast-off wife, and little Grace here is an aristocrat of loose morals.”

“So much for a pretense of civility,” Mr. Baltingham muttered.

Mrs. Clay’s fingers found Grace’s wrist. “Hello, Grace,” she said, her voice quiet and kind under the mutterings of the other patients. A shy smile swept Grace’s pale features.

“All’s I said was that my monthlies hurt like the devil,” Miss Holstein said, her napkin twisted tight in her hands. “And my stepfather takes me to a judge—”

“And a hundred years ago you’d have been burned at the stake,” Heedson said, cutting her off, as the cook brought out a fresh glass of wine and set it before him. “So shut your yap.”

“And if we could please not speak of such things at the table,” Mr. Baltingham added.

“Hardly a shocking thing that women menstruate, I suppose. We’re not fighting for our food or being kicked at the moment. I’m happy to talk about it,” Mr. Moore said.

Heedson continued. “If I may go on—I’m confident that the group of you here are intelligent enough to understand what I’m about this evening.”

He snapped his fingers and more of the kitchen staff appeared, bringing with them food that the patients had not seen or smelled in a long time. Green beans, potatoes, gravy, warm bread, and a tray of real butter were spread before them.

“I want you all to understand one thing first and foremost,” Heedson went on. “I’m not a bad man. I’m a man of limited capabilities in a bad situation. This hospital holds hundreds of patients, many beyond any hope of recuperation. Old methods of bleeding and starvation are not means of a cure, but rather methods of weakening the patients so as to make them more manageable for the staff.”

“Well, cheers to him who’s not the bad man, then,” Mrs. Ubry said, raising her water glass in a mock salute.

“This hospital is unmanageable,” Heedson said as if she hadn’t spoken. “Many of Boston’s unwanted end up here; the difficult, the slow, the savage, and the truly insane all sharing space, and myself given the task of keeping the peace.”

“Can we eat?” Miss Holstein asked.

“When I’m finished speaking.”

“He’s cutting us a deal, missy,” Mr. Moore said. “There’s something he wants from us. And once we agree to it, we get to eat what’s been put in front of our eyes, though our bellies will be yelling louder than his words here in a minute or two.”

“As I suspected,” Mrs. Clay said.

Heedson polished off his wine, leaning across Grace and toward Mrs. Clay. Grace shrank away from his shoulder and the fumes rolling from his mouth.

“What I need is simple. Mrs. Clay and the group of you here are the sanest I’ve got. You’re the cleanest. You speak tolerably well and you can be reasoned with.”

“’Cept for Grace down there,” Mrs. Ubry chirped up. “She don’t speak none.”

Heedson turned to look at Grace, his elbow touching hers. She pulled it away quickly, skin crawling where it had touched his. The glassy tint of his eyes was too familiar, and she leaned back in her chair as he spoke, the sweetness of his wined breath choking her as he followed her movements.

“Ah, but our Grace here is such a sight. Don’t you think, gentlemen?”

Heedson rose somewhat unsteadily from his chair, running his hand up her arm as he moved behind her. “True, she doesn’t speak, but when the Board comes to inspect this place you’ll tell them what they want to hear, each of you with a sad story about your lives and how you’ve found refuge here. A new family, a home when you thought you’d lost anything of the sort.”

Grace’s hands were in her lap, pinching each other in their effort to keep still while Heedson ran his hand up her arm, to her neck, his thumb brushing over the burn Croomes had given her. Pausing. Touching it again, with the slightest bit of pressure this time.

“Grace won’t tell her story, but she hardly has to, does she? It’s right here in the wideness of her eyes, the innocence of her expression, and the bulge of her belly.” His hands cupped either side of her neck, and Grace’s breathing came in short gasps, even those tiny bits of air reeking of wine and his cologne.

“Dr. Heedson,” Mrs. Clay said. “I think you would do well to take your hands off the girl.”

“She inspires protection, doesn’t she?” Heedson leered toward Mrs. Clay, losing his balance slightly and bracing himself against the table with one hand. “The Board will take one look at her and say to themselves, ‘What’s the world to do with poor little birds like this one? Surely she’s better off here than in the streets.’”

The hand still covering her burn tightened and Heedson leaned against Grace’s back, his stomach pushing against her. “Someone knew well enough what to do with you, didn’t he, little chickadee?” Heedson whispered in her ear.

The smell of him, the maleness surrounding her, the wine-soaked words in her ear flowed through Grace, filling the gaping hole of herself that she had trained to become only a shell, a carrier for the life within. Horror filled the chasm that had been, and every word, every utterance, every time she had stamped down her own name or bit back a cry of pain came pouring out in an incoherent shriek as she grabbed her fork, slamming it through the web between his thumb and forefinger, straight down into the table below.