This is a rather depressing book, although I’m not honestly sure what else I should have expected from a novel set in an asylum. It sounded like it was going to be a romance. It was actually more about attitudes towards mental health patients in early twentieth century Britain, and, in particular, about eugenics. It’s easy to forget that belief in eugenics was widespread and quite “respectable” until the horrors of the Nazi period completely discredited them, and there are frightening stories of forced sterilisations being carried out on people well into the second half of the twentieth century.
The book’s set during the exceptionally hot and dry summer of 1911, and – as in The Go Between, set in 1900, and I’m sure there must be other examples but I can’t just think of any! – there’s a sense that the tension is going to keep rising for as long as but not after the hot weather lasts. There’s also a sense of the tension outside the doors of the asylum, with the railway strikes, and the Liverpool general transport workers’ strike and the riots which broke out during it. The location is the High Royds Asylum at Menston, near Leeds, but the author’s confusing renamed it “the Sharston Asylum”, making it sound as if it should be in Wythenshawe.
There are all sorts of horrifying and terrifying real life stories about people who were locked up in mental asylums for no good reason, such as women who’d had illegitimate children, or (although not so much in Britain, but certainly in a lot of countries) people who’d opposed the regime in power. There are even more stories of people who did have severe mental health problems but, instead of being given treatment that might have helped them, were, even in the twentieth century, very badly-treated. Even some of the treatments that were supposed to help just seem so barbaric now.
The main characters are Ella Fay, who’s been sent to the asylum because she broke a window at the textile mill where she worked, John Mulligan, who’s suffering from depression after the death of his child and the dissolution of his marriage, and Charles Fuller, a delusional doctor who thinks that he’s going to become a world leader in the field of eugenics, and that the patients are his to experiment on. There are various minor characters, including Ella’s best friend Clemency, who commits suicide after Fuller stops her from reading her beloved books, and John’s best friend Dan, who speaks Polari – a language usually associated with gay culture pre-1967, but also, as in this case, with travelling showmen, merchant sailors and various other groups.
Clemency is from quite a well-to-do family, who are genuinely concerned about her, which is interesting – it would have been far easier to have brought in a stereotype about a family wanting a “mad” child shoved away out of sight because of fears about “the taint of hereditary madness” damaging the family’s reputation. Clemency says that she actually prefers the asylum to life outside, because, in the asylum, no-one’s trying to push her into an unwanted marriage. It’s a shame that we don’t hear more about her, and about Dan – we never find out what happens to her – but the book is largely about Ella, John and Fuller.
Fuller’s focus through it all is on Winston Churchill, the Home Secretary, whose attention he hopes to attract, and the novel draws attention to how close Britain came to legalising the forced sterilisation of mental health patients – something which was legal in Japan, for example, until the 1950s. It could well have become part of the Mental Deficiency Act of 1913, although in the end it didn’t, and was proposed again in 1931. A lot of well-known names on both the right and left wings were associated with it – Churchill’s the one on whom Anna Hope concentrates, but others included Arthur Balfour, William Beveridge (of Beveridge Report fame), J M Keynes, and Sidney and Beatrice Webb.
This was just in Britain: the eugenics movement was far more popular in the US and in many other countries in Europe and elsewhere. Sixty thousand “mental defectives” were forcibly sterilised in the US, around a third of them in California, and many others were barred from marrying. It also happened in Japan, Norway, Denmark, Switzerland, Iceland, France, parts of Canada and elsewhere. And then, of course, there were, and these went on long after the Nazis, other eugenics-related policies, such as the “Stolen Generation” tragedy in Australia and the ethnic immigration quotas in the US.
So much for a romance! Well, there is a romance. Charles Fuller doubles as a musician, and the asylum holds weekly dances at which the male and female inmates, usually separated – men doing work such as quarrying and farm labour, women work such as laundry – were able to meet. John and Ella meet, and there’s an exchange of letters – facilitated by Ella’s friend, as Ella can’t read or write. Working outdoors, and the relationship with Ella, do a lot for John.
Ella becomes pregnant, and, as part of Charles Fuller’s strange scheme to monitor John, is released. In a rather bizarre sequence, Fuller decides that John will become the first patient in his unauthorised forced sterilisation experiment, and has actually got him anaesthetised, and the scalpel poised, when he’s called away to answer to Clemency’s family about why better care wasn’t taken of her. John comes round from the chloroform and is able to do a runner. That bit really was rather silly and OTT, which was a shame because the book addressed some important and very serious issues about mental health care.
The power of doctors is another issue – it’s not one which is discussed as much as the wider issues of eugenics and mental health “care”, but it’s certainly there: John’s future, and that of Clemency, the woman who killed herself, were in Fuller’s hands. I’ve seen interviews with people in Spain who had their babies stolen because they weren’t considered suitable parents by Franco’s regime, and many of them said that they never questioned what they were told about their babies having died because the word of a doctor was not to be questioned.
There’s no happy ending. Well, there is, sort of, but not for Ella. She and John are never able to find each other again, and eventually both give up trying. Their daughter eventually traces John a few years after Ella’s death, and is able to establish a happy relationship with him, so that’s a happy ending of sorts. But if you’re after a romance, don’t go for this. If you want to learn more about early twentieth century attitudes towards mental health patients – and, even now, attitudes towards people with mental health issues leave a lot to be desired, despite the various recent campaigns supported by members of the Royal Family and many others – then maybe try it. It’s not brilliant, but it raises some interesting points not often covered in novels … or indeed anywhere else.