Shutter Island

by Dennis Lehane

Shutter Island: Chapter 4 Summary & Analysis

Summary
Analysis
Teddy and Chuck step outside Rachel’s room and look for possible exit routes. Dr. Cawley explains that the only way out of the building is back the way they came. Rachel would not have had access to the roof, though Dr. Cawley and his team checked it anyway. They also checked all of the other rooms in the institution and could not find her anywhere. A table sits in front of the stairs leading away from Rachel’s room. Teddy asks Dr. Cawley whether someone watches the stairs at night. Dr. Cawley confirms that someone is always on guard. He also says Ganton was there on the night of Rachel’s escape.
As Teddy and Chuck’s tour of the facility continues, Rachel’s escape looks more and more impossible, assuming everything Dr. Cawley says about the hospital’s security is true. She would have had to break out of her room, bypass multiple security checkpoints, and fool multiple guards to get out of the hospital, all while barefoot. As such, something about the case is not adding up, and Dr. Cawley’s behavior suggests he knows something he is not saying.
Themes
Mental Illness and Delusion Theme Icon
Conspiracy and Paranoia Theme Icon
Teddy and Chuck continue following the path Rachel must have taken. They walk past the orderly table and down the stairs to the main living area, where the patients typically spend their evenings. Dr. Cawley explains that group therapy was held in the area the night of Rachel’s escape, and afterward, several orderlies stuck around to play a game of cards.
The orderlies are yet another group of people Rachel would have had to bypass to make her escape. The only other explanation, assuming Rachel escaped on her own, is that Dr. Cawley is mistaken—or lying—about the potential paths out of the building.
Themes
Mental Illness and Delusion Theme Icon
Conspiracy and Paranoia Theme Icon
Then, Dr. Cawley points out the building's various exits from the main living area. He assures Teddy and Chuck that they all had guards on duty the night of Rachel’s disappearance. Afterward, Dr. Cawley dismisses himself for a meeting. He asks that Teddy and Chuck find McPherson if they have any questions while he is away. As Dr. Cawley walks away, Teddy looks at Chuck and says everything about the situation feels like an inside job.
Given everything he has seen and been told, Teddy comes to the only logical conclusion. It looks like there is some sort of conspiracy going on at Ashecliffe that has Dr. Cawley at the center of it. However, the nature of the conspiracy is entirely obscure because the person seemingly at the center of it is also the most powerful person on the island.
Themes
Conspiracy and Paranoia Theme Icon
When the afternoon rolls around, Teddy and Chuck join the search party to help look for Rachel. During the search, Teddy spots a few cave openings and asks McPherson if his team has checked them. McPherson points out that there is no way Rachel could have made it down to the caves without shoes. There are plants full of thorns surrounding the entrance, and Rachel would have had to get through them after a long and strenuous hike. Teddy also notices guards with rifles posted outside of the lighthouse. He points them out to Chuck, who raises his eyebrows knowingly.
Although McPherson’s point about the rough terrain is valid, it isn’t clear how Rachel would have escaped in general—making it to the caves would be the least surprising aspect of her escape. Meanwhile, the guards posted at the lighthouse suggest that Dr. Cawley is lying about its true purpose. After all, one does not need to keep armed guards outside a sewage treatment plant.
Themes
Conspiracy and Paranoia Theme Icon
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Teddy and Chuck eat dinner alone and discuss the case. Neither has a sense of what is going on, though they sense Dr. Cawley and his staff have not been forthcoming with them. Next, Teddy and Chuck plan to question the staff, though they wonder how much help they will be. 
The problem with the case so far is that Teddy and Chuck cannot trust anyone on the island because they are all under Dr. Cawley’s command, and they do not know how far the conspiracy goes.
Themes
Conspiracy and Paranoia Theme Icon
Teddy and Chuck gather the staff and introduce themselves. They start to go over the facts of the case. One staff member suggests that Rachel could have tried to swim away from the island. However, another quickly shuts the idea down; if Rachel had tried to swim, she would have failed, and they would have found her body by now. As Teddy and Chuck speak to the staff, they notice the staff seems disinterested. Teddy is surprised; given that a dangerous patient is on the loose, he feels like the staff should care more than they seem to.
Rachel attempting to swim off the island recalls Dr. Sheehan’s description of the rats trying to do the same thing in the prologue. This suggests that the patients on Shutter Island bear some similarity to the rats—animals that are often used in scientific experiments. Additionally, the disinterested demeanor of the staff suggests they already know what happened to Rachel, so they have no reason to fear her.
Themes
Conspiracy and Paranoia Theme Icon
Teddy and Chuck question the staff but do not learn any useful information. One orderly admits that he stepped away from his post for a minute to use the bathroom, but that does not explain how Rachel could have slipped by everyone else. During the questioning, Teddy asks about Dr. Sheehan, who was on duty the night of Rachel's escape. No one from the staff says anything about Dr. Sheehan, so Dr. Cawley speaks up and says that Dr. Sheehan left on the morning ferry to go on vacation. Dr. Cawley promises to give Teddy Dr. Sheehan's notes, but unfortunately, Teddy will not be able to question him.
This is the first mention of Dr. Sheehan since his appearance in the prologue. The prologue heavily implies that Dr. Sheehan knew Teddy, so presumably they will meet at some point in the narrative. However, assuming Dr. Cawley is telling the truth about Dr. Sheehan’s departure—and that is a big assumption—then it is not clear how that is possible. Again, the official narrative Dr. Cawley and his team tell Chuck and Teddy fails to add up.
Themes
Conspiracy and Paranoia Theme Icon
Teddy asks McPherson why he would approve Dr. Sheehan's leave, given the circumstances. McPherson and Dr. Cawley downplay Dr. Sheehan's departure, but the breach in procedure appalls Teddy regardless of their responses. Teddy asks for a phone number and a phone so he can speak to Dr. Sheehan. Dr. Cawley promises to get both things for him. However, when he checks the phone, he discovers that the island's communications systems are down because of the storm.
Again, every piece of evidence lines up perfectly against Dr. Cawley’s official narrative. Though Dr. Cawley claims the communication systems are down because of the storm, it is hard to trust anything he says. He and his team do not appear to have a genuine interest in solving the case of Rachel Solando, meaning Teddy and Chuck are on their own.
Themes
Conspiracy and Paranoia Theme Icon
Once Teddy and Chuck are away from everyone else, they express their anger about the case. Both feel like Dr. Cawley and his team are lying about nearly everything. Additionally, the incoming storm will surely trap them on the island for some time without any access to the outside world. Chuck airs a theory about Dr. Sheehan taking Rachel off the island so they could live together as lovers. Teddy admits it is possible but wonders why everyone would help cover for Dr. Sheehan.
At this point, Teddy and Chuck can only throw out wild guesses because it is possible that everything they have seen up to this point is a lie. Additionally, they know nothing about Dr. Sheehan other than that he is supposedly not on the island, so it is difficult to make judgements on his character and intentions.
Themes
Conspiracy and Paranoia Theme Icon
Quotes