Healing the sick, and the self

WHEN I think of all the novels I've read set in psychiatric hospitals, they fall into two basic types.

There are those that argue psychiatric patients are really more perceptive and more imaginative than the people who look after them. Think of One Flew Over the Cuckoo's Nest or the French classic La Tete Contre Les Murs (Head Against the Wall). Then there are those soppier novels that depict sensitive psychiatric staff magically solving all their patients' problems. Think of the supposed case study I Never Promised You a Rose Garden which was immensely popular with teenage girls about 30 years ago.

Shira Nayman's The Listener is six of one and half a dozen of the other. The patients are imaginative and perceptive, but the novel is told in the first person by the psychiatrist, who is a complex character with problems and perceptions of his own. Maybe this is a way of saying the novel is more knowing about the nature of psychiatric hospitals than others in the field. The Australian-born American-resident author has worked for years as a clinical psychologist.

In the exclusive, expensive Shadowbrook sanatorium just after World War II, Dr Henry Harrison is caring for the battle-fatigued Bertram Reiner, who has been traumatised by what he has seen of Nazi atrocities. At least, that's what he claims. But as he's a psychiatric patient there's always the possibility that he's fantasising.

Bertram is charismatic. Other patients believe all his tales and he dominates their group-therapy sessions. He seems to have a strong moral sense. Or he could simply be a very manipulative psychotic.

As for the narrator, Dr Harrison shows distinct signs of having his own psychiatric problems. He obsesses about a female patient he was unable to prevent from committing suicide. His marriage is slowly disintegrating. As relief from the tensions of ward life, he is foolish enough to smoke opium. And he is intensely jealous of the attraction that his patient Bertram exerts over Nurse Matilda Willoughby, whom he himself fancies.

About halfway through The Listener, I had already picked one of its key themes as the biblical injunction "Physician, heal thyself!" So I wasn't surprised when Nayman quoted these words on the last page. At least part of her purpose is the very humane one of reminding medical people that they are not little gods and that their patients are fully human.

But there are difficulties with this tale. Nayman does very well with the masculine first-person voice she assumes, even in the male-viewpoint sex scenes. But the novel loses focus a little in its middle sections and drifts into passages dangerously close to soap. As for its ending, there's a soupcon of The Cabinet of Dr Caligari (have we really been told the story by a mentally unbalanced narrator?) and a genre-shift to something like a mystery story.

Solid work, but without the focus and intensity that could have made it great.

Nicholas Reid is an Auckland historian and reviewer.

Sunday Star Times