Umbrella

"A brother is as easily forgotten as an umbrella."--James Joyce,Ulysses

Umbrella, the latest novel by the cuttingly intelligent Will Self, arcs between pre-World-War-I London and a mental hospital in 1971. The title refers to a recurring motif in the book, which appears most notably in the sections that take place at the mental hospital, where the nurses call for an "umbrella” when they need to inject a patient with a sedative. The book challenges the institutional treatment of the mentally ill from the Victorian asylums to the "care in the community” that is the touchstone of contemporary mental health care.Umbrellais a complex narrative peppered with Self’s wit, dark humor, and stylistic idiosyncrasies.

The work is written as a single uninterrupted stream of narrative, without any chapter breaks and with paragraph breaks only rarely. The book is told in the third person, but includes italicized lines in many sentences that relay the characters’ thoughts or speech. The setting shifts between a coherently advancing central plot in one timeframe and flashbacks/memories of earlier periods in some of the characters’ lives, which initially makes for a (deliberately) disconcerting reading experience. However, as the reader becomes more familiar with this narrative strategy, the changes in narrative perspective become second nature. This shift in narration, far from alienating the reader, keeps the book’s narrative in constant flux, and makes the work gripping and engaging.

The book’s protagonist is ZACHARY BUSNER, known to Will’s fans from his appearances inGreat Apes,The Quantity Theory of Insanity, and other books. Busner works as a psychiatrist at a mental hospital in London’s northern suburb of Friern Barnet. The time period in which the book is set is not immediately apparent, but it can be worked out as 1971. Busner is a complex character: hardened by his career, indifferent to his wife, and rather self-absorbed, he nonetheless takes his duties as a psychiatrist very seriously and attempts to analyze and determine the underlying pathologies of his patients. As he tours the ward of the hospital at which he has recently begun working, he notes a group of patients who exhibit a very peculiar type of physical tic: extremely quick but very precise movements, that seem to be very controlled in nature. These patients are extremely mentally unconscious--they do not react to outside stimuli and are trapped inside an internal world. Their atypical symptoms arouse his interest.

One such patient is Audrey Death (variously De’ath, Dearth), who is an elderly woman, born in 1890 in Fulham, in south-west London. Through a narrative that slips into Audrey’s mind and recounts her memories in the present tense, the reader learns that Audrey is one of five children; her father SAM is a gambler and small-time businessman, and her mother MARY JANE, a housewife--both are native Londoners, and much of their speech is written in a Cockney dialect. Audrey lives with her sister ADELINE, and her brothers, including STANLEY and ALBERT, the latter of whom is extremely intelligent, and is given patronage by a gentleman, who, it is suggested, is interested in Albert not only for reasons of philanthropy. Lines of Cockney songs mix with descriptions of a bygone London, where horse-drawn buses roamed the streets, and costermongers dotted every corner, selling food, household goods, and so on. The vivid, bustling, lively London of Audrey’s memories contrasts absolutely with the clinical, institutional mental hospital in the central narrative.

It quickly becomes clear to the reader that Busner himself seems to hear voices in his head, or at least become fixated on certain phrases, snatches of songs or poetry, which echo in his mind. His closest associate at the hospital is a nurse of Kenyan origin, called Mboya--he is calm, knowledgeable, and hardworking. Busner and Mboya investigate Audrey Death and the other patients who are exhibiting strangely precise, most of whom have been incarcerated in the hospital since the 1930s. Busner looks into Audrey’s records and goes to meet the psychiatrist who was in charge of the hospital before he arrived, DR. MARCUS. Dr. Marcus tells Busner something which he already suspected: that Audrey and the other patients on the ward whose strange behavior Busner has noted, are not suffering from mental illness per se, but from the after effects of encephalitis--brain fever. They were hospitalized following an outbreak of viral encephalitis, exhibiting symptoms initially thought of as indicative of schizophrenia or the catch-all diagnosis of 'hysteria’. Dr. Marcus tells Busner of how they probably would have endured sexual advances, possibly rape, from their former warders, and how they would have initially been sedated with opium and even henbane, the use of which was common at the time. Schizophrenics were given sex hormones, and patients at one point had to wear colored cards around their necks if they were suffering from a communicable disease such as diphtheria or tuberculosis. Having confirmed that the patients are post-encephalitic (i.e. their symptoms arose from encephalitis rather than underlying mental illness), Busner resolves to attempt to treat them. If he can control their tics and their catatonia, he may be able to help them.

Passages told from Audrey’s perspective trace her teenage years--how she lost her virginity to a young man with socialist politics, GILBERT, who jilted her soon afterwards, and how she found work as a clerk at a shop that sold umbrellas and canes. She then worked in the workshop of the same company, turning lathes to shape umbrella handles and operating these complex machines with great grace and speed. It is clear that the precise, mechanical tics she exhibits relate to this work--she is operating an umbrella lathe in her mind. Then Audrey lost or left that job, and begins working as a munitionette in a factory after the outbreak of World War I. Meanwhile, her brother Stanley goes off to fight in the trenches, and the intelligent Albert has since joined the Civil Service and is making his way in the world.

At the hospital, Busner begins a torrid affair with a dispensing nurse, Mimi--their jerky sexual movements are likened to the tics of the mental patients. Busner prepares to conduct a study on six of the most extreme post-encephalitic cases (or "enkies” as he and the other staff call them)--including Audrey Death. The others include the disgustingly obese Leticia Gross, and Helen Yudkin, whose tics echo the work she did as a bank teller. As Busner investigates the various histories of these patients, the language Self uses invites the reader to make a comparison between their horrendous institutional treatment and that of Jews in Nazi Germany--there are references to 'railway spurs’ and 'putting on a show for visiting Red Cross delegations’. Later in the book, when Busner thinks to himself about how the hospitals used to use electro-convulsive therapy, the question of his guilt in being implicit in this horrific treatment again invites the reader to think of greater questions about human guilt. The drug that Busner gives the post-encephalitic patients, L-DOPA (a real drug featured prominently in Oliver Sacks''sAwakenings), immediately improves their condition. Audrey begins to focus lucidly on Busner and speak to him in a way that shows she knows who he is, and understands that she is in a mental hospital. The other patients show similarly dramatic progress. While they all express varying degrees of shock and surprise at the triumphs of modernity that greet them when they "awake”, they seem to adjust to their ne