Not long after their marriage, Tom and Ally must spend several months apart. He goes to Japan to oversee the building of earthquake-proof lighthouses and falls in love with the culture. She, a newly qualified doctor, an unusual profession for a woman in 1880s Britain, stays in Cornwall to volunteer at the asylum until, unable to bear the gap between her own ideals and the often brutal treatment of the inmates, she flees to Manchester and the madhouse of her childhood home. She runs from there to her aunt’s house in London and wonders, with her mother’s voice chiming in her head, whether she will ever be fit to work again. When the paper she publishes on the possible social causes of insanity is well received, she’s invited back to Cornwall to serve as medical director of a new convalescent home to support women to make the transition from the hospital back to their communities. It’s just when she seems to have found her feet that Tom returns from his travels. He’s also changed and, like Kirsten and Rabih in The Course of Love, it looks as if their different ways of turning away from hurt will bring their marriage to an end before it’s properly begun.
I’m gradually building a collection of novels set in institutions, which will hopefully feed into my much-neglected WIP. Set around the time of Let Me Tell You about a Man I Knew, what strikes me particularly about Sarah Moss’s novel is the continuity between her dilemmas and those we grappled with a hundred years later discharging people safely from long term psychiatric care. In the Truro asylum, Ally finds compassion battling with the sometimes repressed fear of the patients and their states of mind, and the perverted pride of some of the attendants in their confrontational attitudes that serve to escalate the disturbance (and provide them the opportunity to feel skilled and sane and its management). It’s no place for an idealist, especially one whose mother considers her training and choice of specialism an indulgence.
Ally’s character is the perfect example of the type of person drawn to the self-imposed impossible task. Brought up by an emotionally cold mother, full of self-denial and hard work on behalf of the poor but with no love left over for her daughters, and by a father who’s absented himself from family life by absorption in his art, and still grieving her sister’s death ten years before, the concept of good enough is a complete unknown. At a time when it’s “not primarily medical care that is lacking but the most basic elements of public health” (p142) and in an area in which needs are infinite, she can’t easily find satisfaction in a job well done. As a child, her anxieties were met with cruelty (p158) (WARNING: you might want to skip this bit if you’re feeling fragile):
Words and a candle flame offered on her tenth birthday. Show me how you can bear pain, Aletha. Show me how you can choose to endure.
Lying hands at her sides with her skirts lifted for Mamma and Dr Henry to apply blisters. The best cure for weak nerves, Aletha. Pray refrain from that hysterical gasping.
so it’s understandable that, having made the mistake of returning to the place of torment, she not only blames herself for not coping, but causes herself further harm. That fear of a mother that complicates the process of leaving home to become oneself is the subject of my short story "Had to Be You".
Along with Playthings, another historical novel on the asylum, Signs for Lost Children well deserved its place on the Wellcome book prize shortlist. Thanks to Granta books for my review copy.