She rolled onto her back and closed her eyes. The newly sutured gash in her left arm throbbed with the bright intensity of a fresh wound. The partially healed burn on her right forearm alternated between an irritating feeling of extreme sensitivity and an itch that no amount of light scratching would vanquish.

  And she had a headache.

  She lay quietly for a moment, taking stock. The injuries were bad enough, but by now she had become used to dealing with a certain amount of physical pain. The headache was what concerned her the most. The headache was different. Something very odd was happening to her—the bizarre cranial pressure that seemed to come and go at random intervals, each occurrence accompanied by a bolt of extreme pain—and Cait’s initial fear was that this morning’s headache might signal the onset of another bout of that frightening sensation.

  It was the last thing she needed. She was nearly at the end of her rope. But after a moment of reflection, eyes closed, head resting on her pillow, Cait decided this morning’s headache was exactly that: a headache. Nothing more, nothing less.

  She could live with that.

  She rolled onto her side and opened her eyes to see her mother gazing back at her. Virginia looked wide-awake and alert, and Cait said, “Good morning. You were awake before the alarm went off, weren’t you?”

  Virginia smiled and said, “I told you I value every minute I get to spend with my long-lost daughter. Why would I waste any of my time sleeping?”

  “I hope you spent at least some of it sleeping!”

  Virginia winked at her but said nothing.

  Cait yawned. “Remind we why we decided eight o’clock was a good time to get up?”

  “Go back to sleep, honey. We can get a later start than planned; it won’t hurt anything.”

  “Nah,” Cait said. “That was more of a rhetorical question than anything else. I’m fully awake now. Besides”—she took another look at the cheap digital clock on the hotel’s nightstand—“we have to be at the hospital in less than two hours.”

  “We could reschedule. Milo’s not going anywhere.”

  “No. I don’t want to reschedule.” At the mention of her twin brother’s name, Cait felt a wave of despair wash over her, black and heavy, and she knew she was in for another long day. No surprise there. She was getting used to them.

  She sighed and climbed out of bed, feeling exhausted. “And I wouldn’t be so sure about your last statement,” she added.

  * * *

  Their destination was the town of Bridgewater, located roughly thirty-five miles south of Boston. The two women walked out of the hotel at eight thirty, having showered, dressed, packed their bags and checked out, and Cait asked Virginia, “What are we going to do when we get there? We’re probably going to be close to an hour early.”

  She had asked the question in all seriousness, but her mother seemed to find it amusing. “What’s so funny?” she said.

  “Honey, it’s obvious you didn’t grow up around here. The way the traffic is in the Boston area, we’re just as likely to be late as early.”

  An hour and fifteen minutes later, the massive Bridgewater State Hospital structure loomed in the windshield of their cab, appearing completely out of place in suburban Boston. Its dark brick and stone construction had the forbidding look of a medieval castle, but instead of being surrounded by a moat, the complex featured a double chain link fence topped by a snarl of intimidating razor wire.

  As they approached, Cait could see a series of guard towers spaced at even intervals between the fences. Security cameras were everywhere. The scene served to remind approaching visitors that, regardless of the facility’s name, they would not be entering a typical hospital. It was a correctional facility, and its “patients” were some of the most dangerous and frightening men to be incarcerated in the Commonwealth of Massachusetts.

  The cab eased through a wheeled gate that was currently open but could be rolled across the entryway at a moment’s notice, undoubtedly at the touch of a button by the officer manning a security booth just inside the hospital grounds.

  At the booth, the driver rolled to a stop at a lowered wooden security bar and buzzed down his window. A moment later a uniformed guard stepped out of the booth and approached, his face dour-looking and suspicious. “Help you?” he said.

  Cait lowered her own window and said, “Good morning, Officer. We’re here to see one of your…uh…patients.”

  The man was silent for a moment, his face impassive, as if she had spoken a foreign language and he was trying to translate her words. Finally he said, “Visiting hours don’t start until three thirty.”

  “I understand, but we have an appointment. It was set up through the warden’s office.”

  “Wait here.” The guard turned around and stalked into the security booth without waiting for a response. A moment later he returned holding a clipboard. He bent down to get a good look at the two passengers in the backseat of the cab. “Names?”

  “Cait Connelly and Virginia Ayers.”

  “I’ll need to see some ID.”

  The women fished out their driver’s licenses and passed them through the open window and the man disappeared again, returning after a short delay and handing them back.

  “Go to administration,” the officer said to the driver. “It’s straight ahead, at the end of the circular drive.” He looked into the backseat and continued. “When you get to administration, you’ll have to check in and pass through the metal detector. The admin folks will help you from there.”

  Then the guard turned around and reentered the small security building. A moment later, the heavy security bar in front of the cab lifted and the vehicle accelerated onto the prison grounds.

  They were in.

  Cait felt as though she could barely breathe.

  * * *

  The interior of the one-hundred-fifty-year-old structure was as drab as the exterior. Decades-old linoleum tile covered the floors, its finish long since worn away, the coloring faded and indistinct. The walls featured puke-green paint badly in need of a touch-up, and ancient doors creaked to an ill-fitting close behind Cait and Virginia as they were escorted to the warden’s office.

  The trip through the metal detector had been uneventful. Cait had researched Bridgewater State Hospital online prior to the visit and had read stories—apparently inaccurate—of mandated strip-searches and lengthy questioning of visitors.

  They encountered none of that, although security was tight. Guards were uniformly tight-lipped and somber, exactly as the man at the gate had been. Cait had, of course, read news reports of the unexpected and violent suicide of Bridgewater’s previous warden—while locked inside his office at the hospital—and she assumed that horrific occurrence had much to do with the atmosphere of brooding negativity.

  Or maybe the place was like this all the time.

  At the warden’s office, their armed escort ushered them inside a small, marginally more pleasant suite. “I’ll leave you in the competent hands of the warden’s administrative assistant, Ms. Bickford,” the man said.

  Then he turned to the older woman—her hair had been tinted a vague blue and Cait had to stifle a smile at the sight—and said, “Give me a call when they’re finished here and someone will be back to escort them to the prisoner’s room.”

  Then the guard was gone. The elderly lady looked more like a retired librarian than the assistant to the warden at one of the most dangerous correctional facilities in Massachusetts. She was all business, though, and said, “Please take a seat. Warden Pend–”

  She caught her mistake and paused a moment. “I’m sorry,” she said quietly. “I worked a long time with Warden Pender and it’s very hard to get used to the notion that he’s gone.”

  “It’s no problem,” Virginia said kindly before Cait could answer. The look on her mother’s face told Cait to step back and let her do the talking, which Cait had no problem with. She was still feeling vaguely hazy and unsure of herself. “You were the one who found the warden, weren’t you?”

  “Yes, I was,” the woman said reluctantly. “It was one of the worst days of my life.” Tears filled her eyes and she dabbed at them with a tissue she had been holding, apparently for just this purpose.

  “Had Warden Pender been depressed prior to his…death?”

  “Why do you care about that?” the secretary said sharply.

  Virginia raised her hands in a soothing gesture and kept her voice low. “No reason,” she said, although Cait suspected that was not the case. “I apologize for upsetting you.”

  The woman nodded curtly and lifted her right hand, tissue still clutched inside it. She pointed at a bank of uncomfortable-looking chairs lining one wall—to Cait they looked exactly like a row of prisoners lined up for execution, but maybe it was just the setting—and said, “Please take a seat and I’ll let Warden Ciuffetti know you’re here.”

  * * *

  “You understand Milo Cain is comatose and completely unresponsive to all stimuli.” It turned out Warden Ciuffetti was a woman. She was dressed in a long gray wool skirt, a tan silk blouse, and low-heeled shoes. She had pulled her hair into the tightest bun Cait had ever seen and everything about her demeanor screamed “severe.” She reminded Cait of Nurse Ratched from the old Jack Nicholson movie One Flew Over the Cuckoo’s Nest.

  Cait waited for Virginia to answer and when she didn’t, said, “Yes, we understand.” Apparently her mother’s need to talk had been satisfied by her brief conversation with the emotional Ms. Bickford.

  The warden waited a beat and then spread her hands in a gesture of confusion. “Then why…”

  Cait shrugged. “I just needed to see”—she hesitated and gulped air—“my brother.” The words tasted bitter in her mouth.

  “You just needed to see him.”

  “That’s right.”

  Nurse Ratched drummed her fingers on her desk. A stain that looked a little like dried blood covered a large portion of the desktop. It had clearly been scrubbed and sanded, but no amount of scrubbing would ever eliminate all the evidence of the tragedy that had taken place on its surface. “You flew all the way from Tampa to see your paralyzed, comatose, incarcerated brother on a whim.”

  Cait pursed her lips. “I wouldn’t categorize it as a ‘whim,’ but I’ll admit to the decision being relatively spur of the moment.”

  “After not laying eyes on him for more than six months.”

  She felt a stab of annoyance, and like clockwork her attorney persona kicked in. It felt oddly satisfying to be back on territory she understood, even if the sensation was only temporary.

  “This visit was prearranged and preapproved,” she said. “In fact, I was told to arrive before the start of regular inmate visiting hours, so as not to upset the other visitors by exercising my right to see the notorious serial killer Milo Cain. I was told not to breathe a word to the media. I was told if I showed up here accompanied by a camera crew or any media representative, I would not be permitted on hospital grounds. I have honored all of your requests fully.

  “Now, after jumping through your hoops, I find myself undergoing some kind of interrogation. I don’t appreciate being treated like a criminal, Warden”—she craned her neck to read the woman’s name off a prison ID hanging from a lanyard around her neck—“Ciuffetti. I don’t appreciate it one little bit. What’s the problem?”

  The warden sat back in her chair. It was easily as old as the stained desk and it creaked with the motion as if lodging a complaint. Nurse Ratched’s angular face conveyed tightness and anger, but after a moment she spoke, keeping her voice neutral.

  “There’s no problem,” she said. “However, you must understand things have been strained and security’s been even tighter than usual around here since Warden Pender’s suicide. The warden was a generous, outgoing, friendly man—I knew him personally and professionally for over thirty years—and he never once exhibited any of the signs one would expect to see in a person contemplating taking his own life.”

  Cait nodded, prepared to accept what seemed to be meant as an apology, but the woman continued to talk. “There has even been speculation that the warden was murdered, despite being found in an office locked from the inside and having received no visitors that morning.”

  The new warden blinked and shook her head. Her angular face now looked pinched, like she had just bitten into spoiled meat. “I don’t share that view, of course. The physical evidence was clear, and it all pointed to only one thing: suicide. It’s just that the way it happened was so…”

  “How did it happen?” Cait asked softly.

  “He sawed through his own throat with a letter opener.”

  Cait couldn’t help reacting. She swiveled her head to look at Virginia and discovered her mother was staring back at her. It was obvious they shared the same thought: Milo. The use of a sharp-edged tool to maim and kill could not possibly be coincidence.

  Could it?

  If the warden noticed their shared glance, she made no mention of it. “Anyway,” she said, blowing out a breath. “I apologize for giving you the third degree. It’s just that the timing of this unusual visit, coming right on the heels of Warden Pender’s bizarre death, caught me a bit by surprise. I wouldn’t want to see you or anyone else hurt.”

  “I understand,” Cait said, although she didn’t.

  Warden Ciuffetti pressed a button on the old-fashioned console telephone on one corner of her desk. “Have Officer Caldwell escort Inmate Cain’s visitors to his hospital room now, please.”

  * * *

  The confidence that had come from pushing back against the warden leached out of Cait almost immediately. It was replaced by a bleak foreboding that she realized had been steadily building from the moment their plane touched down in Boston.

  The feeling of hopelessness continued to grow as they wound their way through a maze of dusty and mostly empty corridors. Officer Caldwell was not the same guard who had escorted her and Virginia to the warden’s office upon their arrival, but he was no more talkative and no friendlier than the first.

  Cait wasn’t sure what she had expected Bridgewater State Hospital to be like, but this wasn’t it. The place seemed uniformly silent, almost as if it were empty except for them. There were no shouted curses from inmates, no banging on cell bars. Hell, as far as Cait could see, there were no cell bars to bang on. Only an endless array of winding corridors and office doors, all closed and, presumably, locked.

  We must be in an administrative wing, she thought, wondering what all of these empty offices might be used for. The silent guard continued to lead them along dimly lit corridors and through locked double doors, stopping each time they arrived at a set and waiting to be buzzed through by other unseen guards monitoring their progress on an endless array of CCTV cameras.

  At the end of a long hallway they moved through one last set of doors and then down a stairway, arriving at what looked more like a hospital, circa the 1950s, than the prison cellblock Cait had been expecting. Then it occurred to her: of course Milo would be in a hospital room and not a cell; he was paralyzed and in a coma.

  Officer Caldwell—Cait had dubbed him Silent Cal in her head—led them down another long corridor. This one was filled with closed doors, just like the administrative wing, but on the other side of these doors were hospital rooms, most of them empty.

  At the end of the corridor, Silent Cal gestured to a closed door on the right and said, “This is Inmate Cain’s room.” The disdain in his voice was obvious, and Cait assumed he had meant for it to be. “I’ll be right outside the door if you need me.”

  “Thank you,” Cait said, her voice sounding small and insignificant, seeming to struggle into the dense Bridgewater State Hospital air and vanish. Her heart was racing and she felt jumpy and afraid. If she could have managed it without getting lost, she thought she might have sprinted outside to the cab, which was waiting in front of the complex with their luggage.

  She glanced at her mother. Virginia seemed unruffled. She still looked frail and ill, but Cait thought she could have passed for a woman strolling through the neighborhood grocery store rather than waiting to be allowed inside the room of one of the worst mass murderers in the history of Massachusetts.

  Cait paused at the door, assuming it would be locked like all the others had been. Officer Caldwell stood six feet behind them in the hallway examining his fingernails, making clear through his posture he had no intention of putting forth one ounce more effort than the absolute minimum required of him.

  She reached out and turned the handle and to her surprise the door opened. She turned to Virginia, who offered a small smile of encouragement, and then entered Milo Cain’s room.

  * * *

  A grimy window, too small to accommodate even the tiniest of human beings, sat high on the far wall. Despite its miniature size, the window was covered with steel mesh on both sides and a set of iron bars. As a result, only a minimal amount of daylight was able to fight its way inside, and the room was dim almost to the point of darkness.

  And it was practically bare. No curtains adorned the little window. A single plain wooden bureau stood against one wall, its top bare. A bedside table, as plain and unadorned as the bureau, was the only other furniture in the room.

  Against the wall to her left a standard-looking hospital bed jutted out into the middle of the small room like an extended middle finger. Lying in the bed, covered with a single ratty prison blanket, was Milo Cain.

  The notorious murderer.

  Her nemesis.

  Her brother.

  He lay unmoving, of course; eyes closed, of course. Cait hadn’t seen him since that terrible afternoon inside Virginia’s tract house in Revere last summer, not once, and he looked much smaller than she remembered. What she could see of his muscles appeared shriveled and atrophied.

 

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