In the novel-within-the-novel Bonds, Dr. Aftus is the doctor who Benjamin handpicks to oversee Helen’s care after he loses faith in Dr. Frahm’s methods. Dr. Aftus uses a kind of convulsive therapy—a progenitor of electroconvulsive therapy—to treat what he calls Helen’s schizophrenia. Benjamin sees the toll that the procedures take on Helen but tells Dr. Aftus to keep administering them. During one of those procedures, Helen’s heart gives out and she dies.