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“In your circles? No. In mine he’s a miracle, but I shall have to acquaint you with him. Some forty-odd years ago Phineas Gage was a railroad worker. His specific job was a blaster, which means that he would drill holes into bedrock, fill them with gunpowder, add a layer of sand, and then press the charge down into the rock with his tamping iron before igniting it. Now, a tamping iron is—”

“Doctor,” Grace interrupted, “I have to struggle for every word I speak and only wish to know what you’ve done to the others. Must you tell me these things?”

“No, but I’m answering questions you haven’t asked yet. If I do it in a circuitous manner you’ll have to suffer through it. I only have a short time to inform you about the history of my medical practice and then offer my services to you, should you be so inclined.”

Grace wordlessly settled back into the chair, crossing her ankles beneath the filthy dress, a mannerism that had been ingrained in her by her governess, which the doctor’s quick eyes took in.

“As I was saying,” Thornhollow said, his tone warning her not to interrupt, “Phineas worked with a tamping iron, a long metal rod with a sharp tip. Something like a spear, but a heavy one at that. Phineas had his made to order, and it weighed about thirteen pounds, which you’ll understand why I make a note of its heft in a moment.”

Thornhollow laced his hands behind his back, his feet wandering the stones as his story flowed.

“One day, his fellow workman failed to put the sand on top of the gunpowder, which is why anyone even knows the name of Phineas Gage. He struck with the dull end of the tamping iron directly onto black gunpowder, triggering an explosion that drove the tamping iron through his skull.”

Thornhollow’s steps brought him behind Grace. “It entered here,” he said, suddenly jamming his fingers under her cheekbone below her left eye. She jumped at his touch, but he casually traced his finger along her head as if she hadn’t moved. “It passed through the roof of his mouth, behind his left eye, and exited through the top of his skull, here.” He tapped her hairline, but she sat still this time.

“Amazingly, the man didn’t die.” Thornhollow’s hands spread out, framing her face, his own lit with the excitement of his tale. “Gage was thrown onto his back, but only a minute after the explosion he was up and speaking, despite the fact that the tamping iron had passed cleanly through his brain.

“Luckily for Gage, the nearest doctor actually knew something about treating head wounds, and his injured brain had room to swell thanks to the opening in the top of his head. With a little time Phineas healed completely, and yet those who knew him said that Gage was . . . no longer Gage.”

“What do you mean?” Grace asked.

“Gage was a kind, well-mannered man before the tamping iron passed through his brain. After his recovery he was rude, ill-tempered, and vulgar with women. The man who struck that tamping iron was not the same man who left the doctor’s office healed. The injury to his brain had altered his personality.”

“Altered,” Grace echoed, thinking of the shrieking men who had passed by her cell hours before, only to leave this room tame as lap kittens. “And so you’ve done something similar, haven’t you? But in reverse. You’ve found a way to . . . to . . .” Her gaze slipped to the apple corer, and her stomach rolled.

“Don’t leap to conclusions yet, though I see Falsteed was right in calling you clever. It’s not a simple chore, and I’m sure you’ve noted by the size of my valise that I’m not driving thirteen-pound tamping irons into people’s skulls.”

“I’d imagine not,” Grace said, but her eyes were still on the apple corer.

He followed them and picked up the tool. “What I did was combine the knowledge of what we learned from Phineas Gage with the common practice of trepanning. As I said before, Gage was lucky in that his wound was an open one, allowing his brain to swell. Most patients with injured brains don’t know they’re in danger until it’s too late. A kick from a horse or a fall from a ladder may jar them, but they don’t realize that their brain is swelling inside their skull, pressing against the bone and cutting off blood flow.

“It’s long been a common practice to cut a hole in the skull of such a patient, allowing the brain to swell as it needs, then closing the wound. Different doctors use all manner of different things to pack the wound with, but I prefer lint soaked in—”

“Oil of roses,” Grace interrupted again, rolling her fingers together, still coated in the residue from the table. “And the eggs?”

“I’m guessing you’ve never had to wash your own breakfast plate. If you had you’d be well aware that a dried egg is almost impossible to remove from anything it’s adhered to. I’ve not found its equal for closing up wounds that shouldn’t be stitched.”

“So you . . .”

“It’s quite simple,” Thornhollow said, advancing on her again. “I make two triangular incisions on the forehead—here and here.” He tapped her sharply on the temples right at her hairline. “Cut through the dura to the skull.” He increased the pressure on her temples from both sides, his fingers digging into her scalp.

Grace stiffened. “And then?”

“And then”—Thornhollow released the left side of her skull to reach for his bag, producing a blade and a circular tool—“I cut to the bone on both sides of the temple and punch through the skull with a trephine, which leaves a neat little circle in the bone. The apple corer is to destroy the frontal lobe of the brain. This is where you live. Every gesture, every skill you’ve perfected and experience you’ve had is wiped clean, like my breakfast plate once I managed to get the damn egg off of it.”

“And memories?” Grace asked, refusing to smile at his joke. “What of them?”

“Gone, I suppose,” he said, his eyes no longer jesting. “I don’t know for sure. Most of them lose the capacity for speech and can’t say. For all we know they’re living in their own private hell that I delivered them into.”

“They’re not,” Grace said swiftly. “Their eyes tell the story. They’re calm and contented.”

“But”—Thornhollow raised a finger in warning—“I would never claim they are happy. I think they lose the ability to feel anything. I’ve only been experimenting with this for a short while, but the asylum administrators thank me for it. They believe I’m doing them a favor by turning violent patients into timid lambs. But in truth I do it for the afflicted, to ease their suffering and the weariness of the world they’ve been born into, where we have yet to understand or truly help them.”

He fell silent, his eyes on his hands, now balled in his lap. Grace watched without speaking, willing him to come to the same conclusion she had hours before.

“This is what you ask of me, then?” He raised his eyes to hers. “You want me to cut into you, tear away your skin and your brain, and leave you a desolate, incoherent mess that feels no more?”

“Yes,” she said, the one word heavy in her throat as a tear slid down her cheek. “Yes, I would have that.”