Season two episode four of TNT’s The Alienist begins on a macabre note. Laszlo (Daniel Brühl) pays a visit to a photographer who takes photos of people – mostly children – who have passed. Laszlo spots a picture of a child with the eyes painted on the eyelids and she explains she added them to the negatives. She reveals she’s only done two photos like that over the years, and Laszlo asks where those mothers are now. She says they took their own lives.
On the carriage ride over to the Lying-In Hospital, Sara (Dakota Fanning) and Bitsy (Melanie Field) go over their plan. Bitsy’s going undercover at the hospital and Sara reminds her to be safe.
Libby (Rosy McEwen) shows up at Sara’s office and asks for the file back. Sara wonders if Libby has read the file and Libby shakes her head no. Sara explains the aggressive nurse, Colleen, was the last nurse to check on Martha the night her baby went missing. Libby claims she’s not a gossiper, but Sara asks if she thinks Colleen is capable of kidnapping and murdering a baby. The action cuts to Bitsy at the Lying-in Hospital helping Colleen without showing Libby’s answer.
Bitsy asks where a patient’s child is and Colleen says it was stillborn. Colleen is lost in thought and mutters about him giving her a goldfish and a splash of greenery “which is more than he did for me – Richard.” Bitsy’s shocked by this revelation and Colleen’s not done confessing. “See, they like to get you pregnant to prove to their fellow financial types that their pecker still works,” says Colleen.
Bitsy questions why they aren’t bathing the woman and Colleen explains he’s had her fixed. She suggests they let her sleep as long as she can. The woman hears their discussion and begins to cry.
Libby sneaks into the matron’s office and is trying to put the file back when she suddenly hears the matron coming. She hides the file amongst papers on her messy desk. The matron questions what she’s doing in her office and Libby tries to act innocent. The matron sits down at her desk and picks up the stack of papers. She finds the file and now knows what Libby was up to.
Sara, Laszlo, John (Luke Evans), Marcus (Douglas Smith), Lucius (Matthew Shear), and Narciso Linares (Diego Martin) go over their findings so far. Sara says they believe the woman is a nursing mother and whoever it is is slow to kill. Angry, Linares yells at them about their failure to save the other baby. They remind him the police won’t help him because they view him as the enemy and think he kidnapped his own child.
Sara asks him to allow them to present their theories as well as the steps they’re taking to get his baby back. They’ve identified a poison that was used on the Napp baby. That baby and his child have been at the same hospital. They inform him they have someone working undercover there at this very moment.
Libby rushes in, covered in blood and with the matron hot on her trail yelling, “If the doctor tells you to administer more chloroform, you do it!” Libby says she doesn’t understand what she did wrong and the matron replies, “I know what you were doing in my office. NOW MOP THE FLOOR!”
John buys a copy of the Journal and shows it to his boss, Bernie (Demetri Goritsas). Just then Joanna arrives about a job and Bernie’s taken aback by the fact she’s Black. He asks if she really wrote the article and she says she did. He admits it was good. John ushers her off to show her where she’ll be sitting before Bernie can say anything else.
Sara and Bitsy meet secretly in a church to discuss what Bitsy’s learned about the Lying-In. She reveals the maternal research wing is where they keep the pregnant mistresses of rich men and what’s more peculiar is that there are no babies up there. Sara wonders where all the babies are and Bitsy explains they tell all those women their babies were stillborn.
Sara asks about Colleen and Bitsy confirms she’s a ward girl who started out as a patient after Richard Osgood knocked her up. She’s not sure if Colleen’s baby was stillborn but she can find out. Sara hands her a list of poisons and asks her to check at the hospital and see if they have a log of who signed them out.
Back at the hospital, Bitsy picks the lock on the cabinet where they store the medications. She spots one Sara asked about and begins to look through logs. She writes down what she finds. Colleen catches her and wonders what she’s up to. Bitsy claims it’s nothing and Colleen informs her she’s not allowed to be in there. “But you already know that, don’t you?” Colleen adds.
Over at Sara’s office, she fills the team in on Colleen and shares her thoughts on Colleen being the killer. Laszlo has doubts and Marcus questions if it’s the matron. She has access to everything and most likely oversees the delivery of medications coming into the hospital. Sara believes the matron gets off on the power of being in charge but doesn’t see her as being the murderer. Laszlo also does not want to lose sight of Dr. Markoe. (It seems he would really like to hang onto the notion it’s Markoe.)
Sara points out the profile points to a woman. Sara brings up that these two men – Dr. Markoe and Richard Osgood – will be at the big social event that evening, John’s engagement soirée.
Sara and Laszlo show up to the extravagant event together and when they spot Dr. Markoe they part ways. Laszlo decides to go observe the doctor.
The party’s going on as John speaks to William Randolph Hearst, advising him if he tries to link the kidnappers to Spain and Cuba, he could spook them. William asks if John thinks there are kidnappers and John admits not necessarily, not wanting to give too much away. William realizes John might have a story and John points out he knows he works for The New York Times. When William says, “The Linares are clearly guilty,” a shocked John questions guilty of what. William pulls stuff out thin air without any proof. He ends the conversation by pointing out Violet’s waiting to see John.
As John walks out, Thomas (Ted Levine) is walking in. He comes in with a gift for Violet and it appears William doesn’t want Thomas at his party. He suggests he grabs some hors d’oeuvres when he leaves through the kitchen. (This is a clear slap in the face to Thomas.)
Back at the party, John finds Sara and lightly teases her about her costume. She informs him she has much to tell him and says Dr. Markoe is there and they need to speak to him tonight. John reminds her they have nothing to confront him with and he doesn’t want her or Laszlo to embarrass him at his engagement party.
Actually, John doesn’t need to worry about his friends embarrassing him because William asks for everyone’s attention and begins to roast John for working for The New York Times. After he good-naturedly belittles John, he presents the couple with a gift – a brand-new carriage. Violet, who doesn’t seem to like her husband being around Sara, makes comments about how they’re dusting him off and he’ll no longer need rides from Sara.
Laszlo corners Richard (Ryan Ellsworth) at the party and gets to the point, revealing he knows about the girl in the research wing that was his doing. Richard threatens to have him kicked out of the party – and out of the country. Then, proving what a sleazeball he is, Richard says these girls are hardly innocent.
As Richard begins to walk away Laszlo stops him in his tracks by saying, “Tell me what you know about Colleen.” Richard questions if Laszlo thinks Colleen did this, explaining Colleen worked in sales and he wined and dined her. He describes her as spirited, hotblooded, and feisty, and says he broke her in. Richard says he believed her child died.
Sara and John find a quiet place to speak, and Sara admits to John she’s afraid he’s being bought while on the cusp of him finding his own powerful voice. He accuses her of behaving like a sister and thinks she should thank Violet for all that she’s done for the party. Sara believes Violet just humiliated him and when he tries to deny it, she points out she laughed at him in front of all his friends. Sara thinks he deserves better and he points out he asked her to marry him (in season one) but she said no.
Bitsy continues her undercover work at the hospital and thanks Colleen for not ratting her out to the matron. They seem to be bonding until Bitsy tries to ask about her and Markoe. Colleen seems stunned, then mad, and storms out. Libby overheard what happened and tells Bitsy that Colleen tries to pretend nothing goes on between her and Markoe. She also suggests she should apologize to Colleen.
Libby finds the woman Richard impregnated trying to get dressed. Libby questions what she’s doing and tells her she should be in bed. The woman believed all Richard’s sweet nothings and begs Libby to help her.
Once more to the party we go and Violet is jealous of Sara and John talking. John heads off to look for Violet and finds her in a locked room. She seduces him while the party’s still going on, just to make sure she has his attention.
Laszlo seems to be muttering to himself about the party-goers when it appears he meets his match. A woman begins to correct him as he mutters and it turns out she’s a professor. They know each other’s work. She offers him her card and walks away. He seems quite smitten.
The woman from the hospital shows up at the party in her fancy dress, looking for Richard. She spots him and begins yelling at him wondering why he didn’t come to her. She’s causing a scene and asks if he knew what happened to her. Dr. Markoe gets to her first and grabs her. Sara also runs to her, asking if she was just in Lying-In Hospital. The woman confirms she was and Sara tells Dr. Markoe to remove his hands from the woman or she’ll scream bloody murder. He obeys, and Sara continues to ask what happened. The woman explains they took her baby and then fixed her. Markoe jumps in, claiming she had an infection and he saved her life. He assures her he’ll have a carriage take her to Richard’s townhouse. (Right. She’ll most likely die for this outburst.)
Sara begs the woman not to go with him but she doesn’t listen.
Señora Linares arrives at Sara’s office to speak with Sara, Laszlo, Marcus, and Lucius. She remembers when she took her baby to the hospital there was a nurse who worked there who always stared at her. The nurse didn’t touch her or help her, but always watched her. She recalls looking back at her one last time as she left the hospital and, most importantly, she remembers her face. It’s the same person she saw outside the museum on the day her baby was kidnapped.
Milly joins the group in Sara’s office. She obtained the photos from that day and Señora Linares looks through them. She spots the nurse and points her out to Sara. Sara looks at the photo and exclaims, “My god!”
They all rush off to the hospital.
Meanwhile, Bitsy offers to help Colleen clean and apologizes for upsetting her. Bitsy wonders if Colleen ever had any children. She asks Colleen if she lost one and if she can still have kids. Colleen hastily explains she was going to bleed out and they had to save her. That’s what Libby told her, at least. In an accusatory tone, Bitsy asks what happened to Martha Napp’s baby and Colleen looks shocked.
Colleen becomes angry and slaps Bitsy. A bucket of water goes over as they continue to fight. Bitsy gets away and locks herself in a room, unaware Libby’s in there. Bitsy finally spots her and notices she has black residue on her mouth as she fills up a syringe. She tells Bitsy, “You sure do ask a lot of questions.”
With that, Libby stabs Bitsy in the neck with the syringe as Colleen witnesses it all from the other side of the locked door. Before passing out, Bitsy’s able to get to the door and unlock it while Libby runs off.
Sara’s group arrives and she and Lucius remain trying to help Bitsy while Marcus and Laszlo chase after Libby. Unfortunately, they lose her.
Lucius is able to inject an antidote and Bitsy eventually wakes up, but not before giving everyone a scare.
Libby runs to the matron’s house and barges in. The matron demands she leave and Libby slaps her across the face. Libby begins to cry and rambles on about how she wants to rest her weary bones. She then begins to choke the matron. Libby asks how it feels to rip lives away from the women at the ward. She produces a knife and stabs her repeatedly.
Libby draws eyes on the matron’s closed eyelids with her own blood.
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