Dr. James Blake, a highly respected chief medical physician at River Edge Mental Health Institution, wrestles with inner demons that would terrify the most dangerous patients on the dreaded fourth floor. Blake’s social and professional distance conceals grim secrets: a sinister past, scheming ambition, and a brilliantly concocted lethal plan to destroy his patients. There is no antidote. Its execution is irreversible. And at last, acclaim will shine in the eyes of his greatest love and tormentor. No one can stop him . . . until fifteen-year-old Franki Martin is admitted to River Edge and experiences his resident evil.