“I did not recognize the sound at first. It arrived as nothing more than a subtle incursion: something seeping between the accumulated layers of silence.”
One of the benefits of experience is that we grow to know what we like, so while after reading some plot outlines, I tend to steer away from certain books, I am attracted to others. The Sleep Room had an unappealing cover, but the storyline checked a lot of boxes for me:
- written by a psychologist
- set in a mental hospital/asylum
- treatment/therapy for mental problems
- anything to do with sleep and dreams
British author F.R. Tallis was new to me, and in spite of the fact that the book had its attractions, I approached it still with some doubts because, after all, you never know just how well written a book will be until you take that chance and open it.
The Sleep Room is outstanding. Suspenseful, compelling, and atmospheric, this has to be the creepiest book I’ve read in a long time, but far more than that, this is also a very intelligent story which questions the validity of medicating mental problems, which is, as it turns out, a preferred method in this tale, over the snidely dismissed ‘talking cure’ of Freudian therapists.
It’s 1955, and the novel opens with James Richardson, a young psychiatrist working in London, interviewing for a job with Dr. Hugh Maitland. To Richardson, Maitland is a hero of sorts–an eminent psychiatrist regularly published and the head of “psychological medicine at Saint Thomas’s.” Richardson is particularly interested in sleep studies, so he leaps at Maitland’s offer of a job at Wyldehope, a remote hospital located in Suffolk for ‘special’ cases. This sounds like a dream job: 24 beds “two wards and a narcosis room,” supported by nine nurses, a caretaker and his wife. In addition, Maitland in vigorously opposed to Freudian methods:
Freudian techniques are hopelessly ineffective. All that talk. All those wasted hours. Three hundred milligrams of Chlormazine is worth months of analysis! Don’t you agree? Dreams, the unconscious, primitive urges! Psychiatry is a branch of medicine, not philosophy. Mental illness arises in the brain, a physical organ, and must be treated accordingly.
Maitland’s anti-Freudian stance matches Richardson’s beliefs, so he takes the job, agreeing with everything Maitland says, thinking that this will be the first step in a brilliant career. Apart from occasional relief from local doctors, Richardson will be the only doctor on staff–a situation Richardson initially questions, but then he’s reassured by Maitland, who’s a rather domineering character, and after all a senior doctor, that all of the treatments are handled expertly by the nurses, and that the work load will not be unmanageable. While the patients are divided into male and female wards, Maitland is obsessed with the patients in The Sleep Room:
I will always remember entering the sleep room for the very first time: descending the stairs that led to the basement, Maitland at my side, immaculately dressed, talking energetically, cutting the air with his hands, the door opening and stepping across the threshold that seemed not merely physical, but psychological. The nurse, seated at her station–a solitary desk lamp creating a well-defined pool of light in the darkness–the sound of the quivering EEG pens and, of course, the six occupied beds. All women–in white gowns–fast asleep: one of them with wires erupting from her scalp like a tribal headdress.
The six patients are undergoing Narcosis (deep sleep) treatment with the goal of keeping the patients asleep for about 21 hours a day. Each patient is woken up–but perhaps it’s more accurate to say each patient is ‘disturbed’ every 6 hours and taken to the toilet, washed, fed, and given more drugs. Enemas are administered in case of “falling bowel activity.” One of the arguments for Narcosis is that patients could be given more ECT (Electroshock) therapy when they are asleep, and Maitland’s patients receive weekly ECTs with the controls set “at their uppermost limits.” Maitland sees little difference between the patients, is disinterested in the details of how they became damaged people, and describes them collectively as schizophrenic.
“Of course,” Maitland continued, “the great advantage of administering ECT while patients are asleep, is that they experience no anxiety–which means one can prescribe longer and more intensive courses.”
Maitland returns to London leaving Richardson in charge. For the most part, the patient care–especially for those in the sleep room–is on auto pilot with Richardson monitoring the sleeping patients and their bodily functions. The patients who are not undergoing narcosis are also bombarded with medication, and any failure to “respond” leads to a doubling of medication, so even those not asleep are like zombies. Richardson is naturally curious about the patients and the circumstances that brought them to Wyldehope, but this is not a subject up for discussion, and ”case histories were entirely irrelevant.” It’s not so much that it’s a secret as much as it simply doesn’t matter, but then neither does a “cure” seem to be part of the agenda. In fact, as time goes on, Richardson, who is plagued by headaches and disturbing dreams, begins to suspect that Maitland’s goal is to see how long people can be kept in this vegetative state.
Richardson isn’t exactly comfortable with his duties, but his doubts and questions are answered or dismissed so smoothly by Maitland, that he bows to his authority and reputation. However, once Maitland is gone from Wyldehope, Richardson is left in charge, and some bizarre things begin to occur. He feels a presence in his isolated room, items disappear, a patient complains that his bed moves back and forth making sleep impossible, and a nurse is terrified to stay in the Sleep Room alone at night. Since the patient population is delusional, perhaps some of this can be explained away. Richardson’s discomfort grows even as he attempts to quell his growing alarm, and he is forced to acknowledge “the idea of the dead returning to annoy the living.” Yet as a doctor, he knows all too well that if he begins to acknowledge any supernatural presence he places his professional standing in jeopardy.
A psychiatrist cannot admit to seeing things that cannot be explained. As soon as he does so, he crosses the line that separates himself from his patients.
As events spiral out of control, Richardson wonders what happened to his predecessor. The atmosphere at Wyldehope, a rambling mansion, glows darkly with the sense of impending doom–especially so when Richardson, continually observing those in the Sleep Room, discovers that the sleepers are dreaming in synchronicity.
The Sleep Room is an entertaining, suspenseful page turner which questions the poisonous structure of professional hierarchy, the prevalent attitudes towards female sexuality, and the power of dreams. This well-crafted book, told through Richardson’s eyes, moves smoothly from skepticism and the solidity of scientific facts to sheer terror of the unknown and the unexplainable. There are some real names here, and the treatments, as outlandish and barbaric as they seem to the modern reader, were the MO of the day, and the character of Maitland appears to share some basic commonalities with Dr. William Sargent. We may finish the book and reassure ourselves that mental patients in the western world fare better these days, but an uneasy feeling remains that pills have become a replacement for therapy. Author F. R. Tallis, a psychologist, certainly seems to know how to push those reader buttons, and the narrative moves along very cleverly by feeding with hints such as “it is ironic–given what happened next” which left this reader eager to continue and very annoyed by any interruptions. Some of the issues raised by the plot are left unanswered, but it’s easy to connect the dots and come to one’s own conclusions. The final chapter overworked the book’s premise, but in spite of that minor flaw, this is a helluva creepy read.