Summary:

This is the third novel in Pat Barker's trilogy about a group of shell shocked soldiers in World War I who are treated by Dr. William Rivers at Craiglockhart War Hospital. The protagonists include historical characters like Dr. Rivers (1864-1922), an eminent psychiatrist and anthropologist, and the poets, Siegfried Sassoon (1886-1967) and Wilfred Owen (1893-1918), as well as fictional creations, like Lieutenant Billy Prior, a working class man elevated to the position of British officer.

As The Ghost Road begins, Prior has been cured of shell shock and is preparing to return to the front in France. Rivers takes care of his patients and his invalid sister, amid memories of his experience ten years earlier on an anthropological expedition to Melanesia (Eddystone Island). He befriended Nijiru, the local priest-healer who took Rivers on his rounds to see sick villagers and also to the island's sacred Place of the Skulls.

Rivers entertains very un-British thoughts about the morality of these headhunting people, and about the power of symbolic healing. As these thoughts intrude upon his consciousness, Rivers is himself in the process of curing by suggestion a soldier with hysterical paralysis. Meanwhile, Billy Prior returns to the front. It is the autumn of 1918 and the last inhuman spasms of the war are in progress. In a futile battle that takes place a few days before the Armistice, Billy and his friend Wilfred Owen are killed.

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The action takes place in a mental hospital where Pythagoras is a patient. According to the medical authorities, Pythagoras is a small-time show-biz magician. The patient, however, believes that he is the REAL Pythagoras, the ancient Greek philosopher, mathematician, and mystic. It certainly SEEMS that Pythagoras may have magical powers: when he points to the telephone, it rings; when he raises his hand to the sky, thunder claps.

Dr. Aquillus, the superintendent, has no sympathy with these pranks. The patients believe in his power, but even they sometimes question Pythagoras. For example, in response to the Greek's boast that "I was philosopher, mathematician and magician," one patient says, "You shoulda specialized, buster. You won't get anywhere unless you specialize." At this point Pythagoras responds that it is "difficult to wear both the white coat of science and the magician's purple one. You have to be--very great!" In the end Pythagoras is reduced to Tony Smith and the truth is revealed. Or is it?

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The film opens with a short series of images of hospitals, dead bodies, landscapes, a hand impaled by a nail, and a bespectacled young boy lying uncomfortably under a thin sheet. (The shot of an erect penis was removed for distribution outside Scandinavia.) A young nurse (Bibi Andersson) is assigned to look after a great actress, Elizabeth (Liv Ullman), who had been playing Electra to critical success. Elizabeth is completely mute, but the psychiatrists cannot detect any discrete pathology and have no diagnosis.

At first the nurse worries that the case may be too complicated for her, because of the difference in age and experience. The pair are sent to the doctor's summer cottage by the sea. The actress remains silent, but her nurse chatters endlessly, trying to draw out the patient. Eventually, in a complete reversal of psychotherapeutic roles, she is compulsively confiding her fears and intimate secrets of sexual adventures.

To her horror, she reads a letter written by Elizabeth to the psychiatrist that describes the confessions as nothing more than amusing diversions. She is angered and deliberately tries to harm Elizabeth. Then she delivers a stern accounting for her patient's silence, as a rejection of her femininity, her marriage, and especially of her son. This scene is portrayed twice--once with the camera on the nurse; once with the camera on the patient. The irritated husband comes for his wife, they return to the city, where Elizabeth's future is ambiguous. But at the completion of their relationship the nurse has grown in wisdom and confidence.

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Dr. Ernest Lash, single and around 40, discovers his enthusiasm and love for psychoanalysis, the talking therapy, after several years of practice as a psychopharmacologist. As the novel opens, we meet a smart, somewhat smug and self-absorbed Dr. Lash who practices from his office located in the privileged community surrounding Sacramento Street in San Francisco. He has an active psychoanalytic practice, ambition for respect and notice by the seniors of his professional community, and some aspiration to greater success as a theoretician and writer on the subject of psychoanalysis. Central to his character is a love for his work, where it appears that pride in technique and outcome shadows genuine concern for his patients and their unhappiness.

Early in the novel, a male patient, Justin, who has been working with Ernest for several years, announces that he is leaving his wife, Carol, for another woman. Ernest is pleased since he views the marriage between Justin and Carol as unhealthy, while a bit dismayed that Justin fails to acknowledge Ernest's contribution in helping Justin develop the confidence to take this step. Justin ends his relationship with Ernest Lash--feeling that he no longer needs his help--as the beginning of the novel takes an intriguing direction.

Justin's now abandoned wife, Carol, in a state of betrayal and desire for vengeance--she has a hateful attitude toward all psychiatrists after her psychotherapist of many years ago had an affair with her--decides to enter therapy with Dr. Ernest Lash in the hope of seducing him. She disguises herself with a name change and enough distortion of her past and present so that Dr. Lash will not be able to connect her to Justin. She wishes to expose him as a charlatan, and destroy his career.

Carol is an attorney, and smart. Dr. Ernest Lash is lonely and drawn to Carol. The therapy sessions and the progression of their relationship are central to Yalom's exploration of the intersubjective experience, where strangers struggle with the ambiguity of their own motives and intentions in the intimate world of psychoanalysis. Who is giving, who is receiving? Who is being helped, and who is helping?

Yalom weaves this central element of the plot with many other relationships. Dr. Marshal Streider is a senior psychoanalyst with ambitions for national recognition and a preoccupation with money. He is Dr. Ernest Lash's supervisor. He takes great pride in the fact that he treats many wealthy patients, and is engaged in his own boundary dilemmas when he invests, using insider information from one of his patients.

Dr. Seymour Trotter is a senior psychoanalyst who is condemned and removed from psychoanalytic practice after entering a sexual relationship with one of his patients. We learn that Seymour Trotter was once president of the American Psychiatric Association, and a mentor to Marshal Streider. His maxim, "My technique is to abandon all technique" (p. 7), both haunts and guides Ernest Lash throughout the novel as Ernest grapples with his own passions and temptations, while striving in his goal to achieve humane and healing therapy for his patients.

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Rachel is married to passive Leon who is utterly dependent on her care and organizational skills. They live in a vast, blanc-mange of a suburb where Rachel constantly looses her way while driving home from work. One night, she seeks direction from Wilkes. A strange recluse, he is obsessed with his teenage memory of the lost "girl on the bus" and leads a support group for agoraphobics.

Through contact with Wilkes, Leon gradually grows more independent and finds himself a job. Rachel becomes obsessed with the search for the meaning of "Harry," a mystery man who recurs in her husband's dreams and begins to take over her thoughts. She consults a psychologist, Alex Silver, who soon has Rachel enrolled in a study with two other women. Silver uses dream-deprivation with the goal of enhancing insight about her marriage, her life, and her friends.

Cameo appearances of three depressive, mid-life siblings, Dick, Jane, and Sally, with their dog, Spot, and cat, Puff, emphasize that life in modern suburbia can be a pathology in itself. In Jane, Wilkes finds his lost girl on the bus. Rachel dumps Leon and finds happiness with the agoraphobic developer of the aptly named "Arcadia Centre," where expense, space, light, greenery, and intimacy are employed unstintingly to create a non-pathogenic space for human collectivity.

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This is the story of a family struggling to deal with the accidental death of a teenage son. Calvin Jarrett (Donald Sutherland) and his wife Beth (Mary Tyler Moore) and their surviving teenage son Conrad (Timothy Hutton) live in a wealthy Chicago suburb. Some months before the time of the film, Conrad's older brother Buck drowned when the small boat he and Conrad were sailing capsized in a windstorm.

In the present we see Beth as cold, withdrawn from Conrad (Buck had been her favorite) and at times actively hostile to him and to her husband, too. Conrad, recently back home from three months in the hospital (including electro-convulsive shock therapy) after slitting his wrists, is between uneasy and agonized in his high-school and family world. Calvin remains emotionally open but is befuddled and often caught between his wife and his son, talking about things that don't matter.

Within that setting, the film tells the story of Conrad's attempts to deal with the guilt he feels after his brother's death. A series of psychotherapy sessions with Dr. Berger (Judd Hirsch) plays a crucial role. Seeing Dr. Berger also helps Cal understand some things, and when in a midnight confrontation he tells Beth of his sorrow that she has substantially changed for the worse, she proudly packs her bags and leaves. The film ends early the next morning, with Conrad and his father in an emotional embrace on the front steps of their home.

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Dr. Tom More, from Love in the Ruins (see this database), now middle-aged, returns to Feliciana after spending two years in prison for selling prescriptions of Dalmane and Desoxyn at a truckstop. On his return to his psychiatric practice, More observes that two of his former patients are acting strangely. In his own words: "In each there has occurred a sloughing away of the old terrors, worries, rages, a shedding of guilt like last year's snakeskin, and in its place is a mild fond vacancy, a species of unfocused animal good spirits." (21)

More observes that his wife Ellen and his children have also undergone some mysterious personality change. More, the scientist-physician, with the help of his cousin Dr. Lucy Lipscomb, launches a search for the cause of these and other observations. More and Lucy discover that John Van Dorn, head of the computer division of the nearby Grand Mer nuclear power plant and Dr. Bob Comeaux, director of the Quality-of-Life Division of the Federal Complex overseeing euthanasia programs, are involved in social engineering, releasing Heavy Sodium into the water supply to "improve" the social welfare.

Throughout the novel, Dr. Tom More returns several times to evaluate and talk with Father Rinaldo Smith, a parish priest who has exiled himself to a firetower overlooking the vast pine forest of Feliciana. More has been asked by Comeaux, who sits on the probationary board overseeing More's return to practice, to declare Father Smith crazy, so that Comeaux can take over Father Smith's hospice and put it to better use. The conversations between More and Father Smith contain the philosophic and moral themes that support the plot and action of the novel.

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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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In 1984 Handler was a moderately successful 23 year old New York City actor, when he developed acute myelogenous leukemia. Strongly supported by his girlfriend and family, Handler underwent induction and, later, consolidation chemotherapy at Sloan-Kettering Memorial Hospital, where he also began his long experience (the "comedy of terrors" or, perhaps more appropriately, the "tragedy of errors") of a harsh, hostile medical environment populated by arrogant physicians, condescending nurses, and a host of unhelpful minor characters.

Handler carries us briskly through his first remission, the impact of his illness on his family and personal relationships, his experience with nonconventional healing (Simonton Cancer Center), his return to work on Broadway, his relapse, and the agony of a second round of induction chemotherapy at Sloan-Kettering.

Subsequently, he goes to Johns Hopkins Hospital to undergo the rigors of an autologous bone marrow transplant. At Hopkins he discovers to his surprise a medical setting far different from Sloan-Kettering: communicative, compassionate physicians and a patient-centered healing environment. Even the two hospitals' sperm banks reflect this radical difference in approach.

After surviving his transplant and a subsequent round of serious infections, Handler resumes his life. He realizes that most of the time nowadays he is not in touch with the sense of joy and gratitude for each moment that the illness taught him. Yet, these feelings exist below his consciousness; sometimes he steps through "a little doorway near the floor of my consciousness" and experiences his life in a simpler, more profound way.

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A 17 year-old boy, Alan, is brought to a psychiatric hospital because he has blinded several horses with a hoof pick. A psychiatrist, Dysart, works to "normalize" the boy, all the while feeling that though he makes the boy 'safe' for society, he is taking away from him his worship and sexual vitality--both of which are missing in the doctor's own personal life. He actually envies Alan the sexual worship he has experienced.

In spite of his own hang-ups, though, the doctor does help the boy work through his obsession, which identifies the horse Equus with God. But the doctor comments that "when Equus leaves--if he leaves at all--it will be with your intestines in his teeth. . . . I'll give him [Alan] the good Normal world . . . and give him Normal places for his ecstasy. . . Passion, you see, can be destroyed by a doctor. It cannot be created."

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