Summary:

In this first person narrative, Dr. Edward Haggard addresses his story to James, the son of his former lover Fanny Vaughn. Haggard, once a surgical registrar at a major hospital in London, has isolated himself in a coastal town, where he serves as a general practitioner. The "present" of Dr. Haggard’s story is the early stages of World War II, when James Vaughn, a Royal Air Force pilot, lies dying in Edward Haggard’s arms.

The story’s "past" has multiple dimensions. The outermost, framing story recounts the relationship between James and Edward that began several months before the war and a year or so following Fanny Vaughn’s death from kidney disease. James sought out the reclusive Dr. Haggard to discover the "truth" about Haggard’s relationship with his mother.

The inner story consists of Haggard’s description of his reckless and passionate love affair with Fanny, an ultimately hopeless liaison between a young registrar and the wife of the hospital’s senior pathologist. Their few brief months of happiness ended when Dr. Vaughn learned of the affair, and Fanny made the realistic choice to remain with her husband and adolescent son. In a confrontation between the two men, Vaughn knocked Haggard to the floor, causing a leg injury that resulted in chronic pain and permanent disability.

Haggard resigned from the hospital and withdrew to a solitary life, in which "Spike" (the name he gives to his deformed and painful leg) is his only companion. He must constantly "feed" Spike with intravenous morphine to quell the emotional, as well as physical, pain. The situation only worsens when Haggard learns of Fanny’s death from kidney failure.

The obsession worsens further still after James Vaughn shows up at his door. As Haggard treats the young pilot for a minor wound (he has become the local RAF surgeon), he notices that James has a feminized body habitus--gynecomastia, lack of body hair, broad hips, narrow shoulders, and pre-pubertal penis. He interprets this as "a pituitary disorder" and attempts to convince James that he needs treatment. James is repulsed by these advances, which eventually escalate.

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Summary:

Stella is the wife of Max Raphael, the deputy superintendent of a maximum security psychiatric hospital near London (based perhaps on Broadmoor, where the author's father was medical superintendent), and mother of a ten-year-old son. She becomes involved in an obsessive sexual affair with one of the institution's patients, Edgar Stark, a schizophrenic sculptor institutionalized after murdering and decapitating his wife.

Stark uses his affair with Stella to escape, and she runs away to London to join him. After a few passionate but squalid weeks in hiding, Edgar's illness resurfaces, evinced both in the violence he shows to a sculpture he's making of Stella's head, and in his paranoid jealousy. She runs away from him and is captured by the police and returned her to her husband, who has been fired because of his wife's role in the escape of so dangerous an inmate.

The family moves to a remote hospital in North Wales, where Max has a minor position, and Stella becomes severely depressed, to the extent that she stands by helplessly as her son dies in an accidental drowning. As a result, she is institutionalized--she returns to the hospital, not as the superintendent's wife, but as a patient. Edgar has meanwhile been recaptured (in North Wales, seeking out Stella either to take her with him or to kill her), but they never meet again, for Stella commits suicide.

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