Patricia Neary’s debut novel takes the reader into the harsh reality of streetwise runaway Franki Martin, a teenager forced into the foster care system and away from her sister after their parents die.
From her first day at River Edge Mental Health Institute, Franki is defensive and foulmouthed, figurative armor she built for herself while living hand to mouth on the streets. The nurses at River Edge have seen her like before—one, Gertrude, is mean and sinister. But Franki has less to fear from Gertrude than she does from Dr. James Blake, the chief physician. Behind the smiles and politeness is a man who suffered years of abuse at the hands of his mother. Dr. Blake has devised a plan which he begins to implement on the female patients, a plan he believes will make him famous. But it isn’t an experiment or new scientific insight he has in mind.
Franki is a seething ball of anger and fear covered by a tough exterior; to survive being committed to River Edge, she will do what is necessary to stay alive. No one can be trusted in Franki’s world, and the good people she has known are left behind so her presence won’t damage them. Yet, when the head psychiatrist Dr. Ellen Smith returns from her vacation, she carefully navigates the emotional minefield that Franki has created around herself. Franki desperately needs an advocate, and she slowly comes to trust Dr. Smith and Sandy, a nurse who has defended her more than once.
As Franki’s trust in Dr. Smith and Sandy increases, so does her loathing of Dr. Blake and his vile attacks on her under the pretense of routine exams. When she finally discovers what Blake is really up to, she puts her fate in Sandy’s hands—right before falling into a catatonic state. Dr. Smith investigates the unusual hatred between her young patient and her colleague, and what she discovers is an evil even she finds difficult to believe. For Franki and other female patients at River Edge, time is running out.
Breach of Sanity is indeed a page-turner. Neary’s plot is solid and believable, and the theme of control is threaded through the story as characters both lose and fight to regain it. However, the novel suffers from an excess of detail and dialog as well as questionable medical science and errors in verb tense and punctuation. These are problems that careful editing could easily remedy, especially because the novel’s structural elements are strong.
Neary tackles a difficult subject and tells a contemporary story of betrayal, friendship, and both the fragility and resilience of the human mind. Readers who enjoy medical thrillers will likely enjoy Breach of Sanity.