Although not timetabled into her induction, the wards for Ghyllside’s most severely disabled patients weren’t out of bounds. With a gap in her diary, Janice invited herself to the women’s continuing-care ward.

Ward 24 was on the first floor, above a similar facility for men. Plodding up the stairs, Janice pondered whether they were intended as a disincentive to the men from visiting the women or to the women from leaving the ward at all.

A corridor led to a large lounge bordered by stiff-backed chairs where old ladies sat in splendid isolation while, beyond their reach, a television chatted to itself. The afternoon sun spilling through the high windows could not dispel the gloom. Hunched figures paced the carpet while others, seated, snored or muttered witchy incantations. Some rocked and others contorted their lips and jaws like gurners at Crab Fair, except that these women didn’t twist their faces for a prestigious prize, but as a side-effect of antipsychotic medication.

In contrast to the rehabilitation wards, the staff wore the traditional nurse uniform, in deepening shades of blue spanning the hierarchy from nursing assistant to sister. Although the residents had no official uniform, they all wore shapeless floral dresses in non-iron nylon with thin cardigans, and slippers.

In a blue so dark it was a hair’s breadth from black, Sister Henderson occupied a desk in an office with an observation window into the lounge. As Janice took a seat by the open door, one of the pale-blue minions set down a tea tray with matching teapot, milk jug, and china cups and saucers, a lidded bowl of sugar cubes with filigree tongs. In addition to tea, Sister Henderson dispensed a slew of demographics: who was the oldest; who had been resident the longest; who had been subjected to the most courses of ECT. Her monologue was punctuated by a procession of old ladies to the door, whom Sister Henderson studiously ignored. Janice was becoming accustomed to the ritual when the nurse cut short her soliloquy on insulin coma therapy. “Matty Osborne! Away and meet the new social worker.”

Janice extended her hand. Instead of taking it, the patient curtsied.

“Tell our visitor about your mother,” said Sister Henderson.

“My mother married a prince,” chimed the old woman.

“What else can you tell our visitor, Matty?”

“Matilda told such dreadful lies it made one gasp and stretch one’s eyes …”

Janice recognised Hilaire Belloc’s humorous poem about the girl who cried wolf. When her father read it to her and her sister – pausing after Fire, fire! so they could shout Little liar! – the child’s death provoked fits of giggles. Now, prattled by the victim’s namesake, it seemed obscene. As Matty fixed her gaze on a smudged whiteboard and Sister Henderson looked on devotedly, Janice couldn’t decide which woman was battier. The poster in the social work office, of which she’d initially disapproved, struck her now as painfully pertinent: the passage from Alice in Wonderland where Alice tells the Cheshire cat, I don’t want to go among mad people. In her youth, Matty might have felt the same.

Her monologue complete, Matty bowed and left. Sister Henderson asked Janice to guess her original diagnosis.

“Mmm, I leave that to the health staff.”

The nurse leant forward, revealing fissures in her thickly plastered makeup. “Moral turpitude!”

Janice perused her mental filing cabinet for her psychiatry lecture notes. She found a reference to moral treatment from the early days of the asylum movement, but moral plus diagnosis had her flummoxed. Had Sister Henderson made it up? “Moral …?”

“Turpitude! Frightful, isn’t it, but this was the tail end of the thirties. Less tolerant times.”

Janice had studied labelling and stigma. She knew terms now deemed offensive had had their glory hours: lunatic; cretin; even mental handicap had recently been superseded by learning difficulty. Psychiatry was morphing into mental health, chronic patients into residents. “Was that another word for schizophrenia?” An advance on dementia praecox.

“They say you have to be deranged to have children.”

“Puerperal psychosis?” The ease with which the jargon tripped off her tongue would have pleased her tutors.

“Not necessarily. Imagine a lass, not much younger than yourself, drilled by parents and church to save herself for marriage. She’s stepping out with a local lad, thinks he’s the bee’s knees. With war on the horizon, she lets him go all the way. When the inevitable happens, her chap scarpers.”

“That can’t have been uncommon. If every unmarried woman who fell pregnant was diagnosed with moral-whatever the wards would be chock-a-block.”

“Most would’ve been packed off to the country,” said the Sister. “Once the child’s adopted, they’d slot back in at home.”

One woman’s loss another’s gain. “And Matty Osborne?”

“Mebbe her father smelt a whiff of scandal. Mebbe she’d been a bother and he wanted shot of her.”

“The family could determine the diagnosis?”

“I wouldn’t say determine, but they could influence. Especially if they had some clout and were pally with the medical superintendent.”

“But this was fifty years ago! In all that time no-one noticed she was sane?”

“Well, after a while, she wasn’t. When I met her forty years since she was as you see her today, only ten times as volatile. Mad as a hatter and supremely institutionalised.”

“And did her mother marry a prince?”

“Absolute codswallop. Or, if you want the technical term, delusions of grandeur.”

“So what’s next for her?”

“What do you think?” The Sister nodded towards the day room where Matty brushed imaginary dust from her lap. “She’d stick out like a sore thumb in the community.”

Out in the lounge, as if at the flick of a switch, the patients became animated, spines straightening and heads turning to the corridor beyond Janice’s view. She heard an orchestra of clinking crockery as a nursing assistant ferried an aluminium trolley into the centre of the room. “Is it okay for me to go and have a chat with her?”

“If you want, although it won’t be terribly illuminating. Our Matty’s no conversationalist.”

But a more congenial one than you! Janice humped her bag to a wipe-clean chair beside Matty. “Hello again.”

Matty didn’t speak until the nursing assistant brought her tea. “Thank you, dear, and one for my guest.”

“I don’t think our visitor would want this.”

The stumpy blue-green cups and saucers were the poor relation to Sister Henderson’s fine china. Janice felt outraged on the patients’ behalf. “I’d love a cuppa.”

The nursing assistant did some weird acrobatics with her eyebrows.

Matty drank. “Nothing beats a nice cup of tea.”

“I so agree.”

Stomping back to her trolley, the nursing assistant began to pour. Janice didn’t twig she hadn’t been asked how she liked it. At the first sip, she gagged.

The trolley was laden with cups and saucers and a gargantuan aluminium teapot, but no sugar bowl or milk jug. Not even a bottle. Had they set her up?

If so, Eyebrows seemed loath to participate. Janice refused to turn to check whether Sister Henderson watched from the window. She swallowed another sip, pretending it was Indian chai without the spices. If the patients stomached it, so would she.

Draining her cup, Matty broke the silence. Despite addressing the carpet, her enunciation was clear, her accent refined. “My mother takes Lapsang souchong with a slice of lemon.”

Under that unflattering outfit, beneath that crinkled-crepe skin, a young heart blazed. The hospital had stolen her home, her boyfriend, her baby. Her life. But fifty years’ segregation hadn’t erased everything. A spark of personality endured. It was down to Janice to blow on that spark and rekindle her fire.

Why shouldn’t Matty drink Lapsang souchong, orange pekoe or Earl Grey? Served with a sliver of lemon, a wedge of lime or a feast of seasonal fruit. Sweetened with honey, if she fancied it; coloured with Cornish clotted cream.