From the New York Times bestselling author of The Good House, the harrowing, gripping, and beautiful (Laura Dave, New York Times bestselling author) story of two friends, raised in the same orphanage, whose loyalty is put to the ultimate test when they meet years later at an institution based on a shocking and little-known piece of American history. It's 1927 and eighteen-year-old Mary Engle is hired to work as a secretary at a remote but scenic institution for mentally disabled women called the Nettleton State Village for Feebleminded Women of Childbearing Age. She's immediately in awe of her employer brilliant, genteel Dr. Agnes Vogel. Dr. Vogel had been the only woman in her class in medical school. As a young psychiatrist she was an outspoken crusader for women's suffrage. Now, at age forty, Dr. Vogel runs one of the largest and most self-sufficient public asylums for women in the country. Mary deeply admires how dedicated the doctor is to the poor and vulnerable women under her care. Soon after she's hired, Mary learns that a girl from her childhood orphanage is one of the inmates. Mary remembers Lillian as a beautiful free spirit with a sometimes-tempestuous side. Could she be mentally disabled? When Lillian begs Mary to help her escape, alleging the asylum is not what it seems, Mary is faced with a terrible choice.