A female psychiatrist at a state mental hospital finds herself at the center of a shadowy conspiracy in this dark and twisting tale of psychological suspense from the author of The Absence of Mercy.

Menaker State Hospital is a curse, a refuge, a prison, a necessity, a nightmare, a salvation.

When Dr. Lise Shields arrived at the correctional psychiatric facility five years ago, she was warned that many of its patients-committed by Maryland’s judicial system for perpetrating heinous crimes-would never leave.

But what happens when a place like Menaker is corrupted, when it becomes a tool to silence the innocent, conceal an injustice, contain a secret? Why is it that the newest patient does not seem to belong there, that the hospital administrator has fallen silent, and that Lise is being watched by two men with seemingly lethal intent? The answers are closer than she realizes and could cost her everything she holds dear.

In this chilling follow-up to The Absence of Mercy, author John Burley—a master at medical and psychological detail—showcases the many ways in which the dangers of the outside world pale in comparison to the horrors of the human mind.