He shrugged again. She wanted to scream, not from annoyance but from anguish. Nathaniel was supposed to be the strong one, the person who didn’t falter or panic and who never surrendered. Now he didn’t even have the energy to lift a bite of food to his mouth. She picked up the plate and set it on the sideboard, then returned to him.

“I’ll ask the cook to leave that there for you. It will be waiting for you when you’re ready.”

As will I, she silently thought as she returned to work.

Caroline stood beside Ida’s wheelchair as Dr. Tisdale administered another injection of sedative. Since the president’s death, Ida had become overly reliant on this nerve medication, and it didn’t seem to be helping much anymore. While sometimes the injections calmed her, at others the exact same medication caused her to become angry and paranoid.

Dr. Tisdale noticed the same thing as Caroline escorted him down the staff staircase. “If she shows no sign of improvement by tomorrow, I shall adjust the amount of bromide in the dosage,” he said.

Dr. Tisdale had treated all of Ida’s many nervous conditions over the years. He surely had more experience with disorders of the mind than anyone she knew. They were alone in the stairwell, and she needed his insight, even if she felt awkward asking for it.

“Some of the people on the president’s staff are taking his death badly,” she began.

“To be expected,” the doctor replied as he adjusted the sit of his eyeglasses. “Is there anyone in particular you are concerned about?”

It felt terribly intrusive to go behind Nathaniel’s back, but he wasn’t going to reach out for help on his own.

“Nathaniel Trask,” she said quietly. “He is completely despondent. Not angry or despairing, just . . . blank.”

“It sounds like a nervous breakdown, a form of neurasthenia. An overstimulation of the nervous system leads to a breakdown of the mental systems. Just like a machine can break down from overwork, so can a man.”

“Is there anything that can be done?” she asked.

“Keep him busy, engaged in the world. If that is too much for him, institutionalization can be an effective—”

“Short of institutionalization,” she said.

Dr. Tisdale lifted his medical bag. “I can inject him with the same sedatives I use with Mrs. McKinley. It will only dull the effects, but it won’t cure him.”

She blanched at the suggestion that the doctor would resort to the same medications that now held Ida captive to his treatments.

“Nathaniel would never permit it,” she said.

“Well, then.” Dr. Tisdale took a heavy breath and looked her straight in the eyes. “I suspect you will like my final suggestion even less.”

None of his other ideas sounded palatable, but she was at her wits’ end. “Let’s hear it.”