On October seventeenth, just before noon, Clemency looked at the mirror and asked whether I could do her hair differently. I told her there wasn’t another way to hide it. She turned red, stared at her lap, and said nothing. I knelt beside her chair and finally asked the question I should have asked months earlier.

“Clemency, does your mum know?”

She whispered no. Then she said something I have never forgotten: “That’s why I come here. You’re the only one who sees it.” She had been paying fourteen dollars every three weeks, partly to hide what was happening and partly because she needed one adult to notice.

She began pulling her hair the previous November, around the time her father moved away. He lived forty minutes away, saw the children every other weekend, and was kind to her. There was no obvious villain. She pulled while doing homework and lying in bed, sometimes without realizing it. What frightened her most wasn’t the patch. It was that she couldn’t stop and believed something was wrong with her.