With its solid grounding in the history of British asylums, Kelly's gothic tale centers on the wiles of men who bemoan the dangers threatening girls like Helen, who is confined by her wealthy parents to the sinister Nazareth Hospital in Nusstead, Suffolk. If one isn't mad upon admission to Nazareth, one certainly will be within days. Helen balks at the false choice she's given to marry a man who believed her to be mentally ill. An asylum of soaring Victorian dimensions, Nazareth has accrued its own reputation over the years thanks to its harsh conditions and unique location.
In 1988, Helen Greenlaw is about to do whatever she can to close the asylum down. Nazareth is crumbling yet remains an essential part of the Nusstead economy. But this hospital, seething with history and human stories, is destined to reveal itself. Nazareth is destined to have its revenge on Helen, punishing her for her defiance. In 1989, Helen--now a popular Tory politician--must finally face her fears that her old diagnosis might go public: "They knew about her past, and worse, what she had done to cover it up." Marianne and Jesse threaten to revealthe guilt and cruelty of what of what the three of them did that storm-drenched night when a three-way pact became "a sick little eternal triangle."
Now a married academic with her daughter of her own, Marianne returns to her childhood home of Nusstead. Despite everything, her thoughts turn to the intimacy she shared with Jesse. Something has been uncovered during the development of Nazareth, and someone has seen old records that implicate Marianne, Jesse and Helen. It is Jesse's lifelong dream to get revenge for being the most hated figure in the community. For years, obsessive and defensive Jessie has stewed over Helen's offhand remarks and imagined slights.
Kelly's narrative entangles us in the social and sexual mores of the 1950s, unfolding a generational mystery from multiple vantage points: Marianne's changing perceptions of Nazareth; the documents that incriminate Helen; and Jesse's hell-bent destructive path as he launches a blackmail campaign against Helen, jeopardizing Marianne's future as well as his own. Both Marianne and Jesse know that Helen's instinct for self-preservation means that she will go to any length to keep her past a secret. Staying with her sister Collette just three miles from Nazareth, Marianne recalls the asylum as "the local haunted house," where escaped lunatics were thought to run out across the fens with their manacles still around their ankles.
While Jesse's blackmail project accelerates the drama, secondary characters like Honor, Marianne's troubled daughter, compound Kelly's exploration of Britain's mental health, both in its past and its present. We feel the pain of a girl who must solve the riddle of her mother's past. We sense the slow burn of Jesse's anger and a relationship with Marianne cross-hatched with fault lines of money, sex, complicity and guilt. The novel culminates like a hammer striking when Jesse travels to London to confront Helen and "get his pound of flesh."
Helen, Jesse and Marianne's relationship fills the novel with long-buried landmines, the burdens of mental illness and the mystery behind what happened to Helen in the laudanum-laced hallways of Nazareth. Kelly creates a riveting, gothic portrait of three women and one troubled man, all touched and numbed, spiraling out of control by the mistakes of their past.