Barker maintains a high level of suspense throughout the book. The answers to all the questions don't appear until the final pages, but they are so well adumbrated that they come as no surprise and are fully consistent with the characters. A plethora of borders are crossed in this book: the border between illness and evil, or "mad or bad"; the border between classes; and the ocean between practice in England and in the United States. However, the most troublesome borders crossed are those of the therapist Tom and his patient Danny. Tom is a thorough practitioner, elicits painful information—or misinformation—from Danny, and is energetic in tracking down information from collateral sources. But he uses Danny to fill the loneliness in his life caused by the end of his marriage and to try to work out his own problems, and he makes little effort to separate his personal life from that of his patient.