From the opening pages, the reader is plunged into the bitter cold of winter, near the Eastern Front during the First World War. We follow the story of Lucius, a young medical student whose devotion to medicine is such that he travels with a broken wrist to report at the hospital where he expects to be stationed with seasoned practitioners. Instead he discovers that he is now the ‘doctor’ in a field ‘hospital’ running from a converted wooden church near the Front in Lemnowice. The previous doctor fled, and Margarete is the only nurse left.
Over the years that follow, she transforms his incompetence and helps him apply his bookish knowledge to wounded soldiers who arrive from the Front. Some of their war injuries are familiar: stories of amputations, infections and dealing with the dreaded louse form a background to their work and to their growing romance that is tender and yet feels doomed.
It is the arrival of a new condition, ‘like an epidemic, a disease borne of war’ that alters the course of this love story set in a time of war.
‘Granatkontusion. Granatexplosionslahmung. Kriegszitterung. Kriegsneurose. Shell contusion. Shell-contusion. Shell-explosion paralysis. War-trembling. War nerves……And treatments….How do you treat something when you don't know what it is?’
Despite this, Lucius and Margarete attempt to treat the soldiers using kindness, bromides and improvised art therapy. For the psychiatrist, this novel offers a meditation on aspects of our art, such as what we do well despite the limitations of our knowledge and what we do badly, as well as how some of our patients affect our lives in ways that we never intended or expected. It also causes the reader to reflect on how far society's attitudes have changed around the care of people with mental illness when the suffering soldiers are ordered back to the front line.
Later, the doctor wonders whether his colleagues think he kept his patients at the hospital for too long. He waits ‘… to be told that he had committed one of the great sins of medicine, choosing to work a miracle over the mundane duty not to harm.’
Much later in the book, the young doctor wonders about asking an older Professor for a fleeting moment about ‘….whether if [he] had ever committed such an error – if he lost a patient, how he'd atoned.’. This is another meditation on an aspect of medicine that we do not always speak of aloud. The rest of the novel could be interpreted as one doctor's quest for atonement.
The author is a psychiatrist. As with his other two books, The Piano Tuner and A Far Country, the plot is simple and the characters are slightly over romanticised, but it is the clear attention to detail, both in the history of the war and in the vivid geographical setting, that gives Mason's writing such power. This power is used to conjure up scenes of love, war and injustice that burn in the mind, long after the phrases are forgotten.
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