Through the bars on the windows they passed, Ruby could see the sun shining in a clear blue sky and her heart ached to be out in the fresh air. Already the bloom had gone from her cheeks and she had lost weight, but her resolve to escape was still strong. She had scratched four small marks on the wall in her cell with her fingernail – one to mark each day she had been there, and she had decided she would do that every day so that she would have some idea how long she was incarcerated.

As they were sitting waiting for the lumpy porridge to be served, Ruby glanced up at the ceiling. Whoever was in the room above was screaming loudly enough to wake the dead.

Dilys noticed where she was looking and whispered, ‘The really bad cases are kept up on the second floor. I’ve seen them occasionally when they’re let out into the grounds for a breath of fresh air, although that doesn’t happen very often and only when one of the kindlier nurses is on duty. Half of them don’t even know night from day and they drug them with laudanum to keep them quiet.’

Ruby shuddered at the thought. ‘And how often are we let out?’

Dilys shrugged. ‘Again, it depends on who is on duty. Nurse Downes will usually allow us half an hour when she can, although we only get to walk around the courtyard at the back of the house. Still, that’s better than nothing. At least you can feel the sun on your face and breathe clean air for a while.’ Sadly, neither of them had seen Nurse Downes that day. It was probably her day off and they both knew better than to ask Nurse Keen.

But despite all her new resolutions to be a model patient, by teatime Ruby was pacing up and down her cell again. The smell from the slop bucket was already overpowering and she knew there would be no chance to rinse it out until the next morning when she was allowed to use the washroom.

Even animals shouldn’t be kept like this, she thought as frustration rose in her like a tidal wave. And then before she could stop herself, all her good intentions were forgotten and she was banging on the door again, screaming at the top of her voice. ‘Let me out! Let me out!’

‘What’s all this racket?’ Nurse Keen said sternly when she finally opened the door, Bernard, the male nurse, right behind her. By this time Ruby’s eyes were red-rimmed from crying, her throat was hoarse from shouting and her fists were sore from pounding on the door, but before she could say a word, Nurse Keen nodded at Bernard and he strode forward and caught Ruby about the waist.