Though Sybil has heard her own diagnosis, by the end of 1957, she still has not really accepted it. She has refused to hear about or come closer to her other selves, and refuses to listen to them on tape. She still thinks of her other personalities as “losing time,” and after every episode she resolves not to let it happen again. When it happens again, she blames herself.

The turning point in this attitude is the episode in Philadelphia, with which the book opened. Chapter 22 retells that episode from Dr. Wilbur’s perspective, a clinical perspective.

On January 3, 1958, after two months of having no “episodes,” Sybil does not show up to her appointment with Dr. Wilbur. Several days later, Dr. Wilbur receives a letter from Peggy Ann dated January 1946, reverting to her sessions with Dr. Wilbur in Omaha, asking why the doctor has given up on her–a sign of serious confusion. Dr. Wilbur traces Sybil to the Broadwood hotel and asks the matron to check on her patient. Wilbur determines that Peggy Lou and Peggy Ann together have assumed control of Sybil’s body. The matron says Miss Dorsett is doing fine, but Dr. Wilbur realizes it is no longer safe to let Sybil walk around on her own in the world and no longer enough to proceed gently.