After serving in the Civil War and witnessing the devastating effects of privation and war on fellow soldiers' physical and mental well - being, he shifts his clinical interests to diseases of the mind. He's now an alienist - a doctor to the mad - with little time for frivolity. He agrees to invest in the opera, in the memory of his sister, Sarah, who was murdered by a yet nameless killer. When he catches Emily Forbes prying into the past, his life is upended again.