Following Dr. Poirret's dismissal, the young and handsome Dr. Patrick Rowland is hired as his replacement. During a rainstorm, Gertrude witnesses Jonathan, an elderly male patient, having sex with a young female orderly outside. Later, she awakens from a nightmare in which she suffocates Jonathan, though she is unable to discern whether it was merely a dream or if she might have actually committed another murder. Jonathan's corpse is found the following morning lying in the grass. After leading a prayer for Jonathan, Gertrude has a nervous breakdown. Shortly after, Janet, another patient, is bound and gagged by an unseen assailant before being ritualistically stabbed in the face with needles and slashed in the head and neck by a scalpel.