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.


In this modern Gothic novel, the romanticism is, in many ways, over the top. The image on the front cover is of a man standing with a cane on a rocky cliff, staring away from the reader into a stormy sky, reminiscent of 19th century romantic novels, like "Wuthering Heights." The publisher’s blurb describes Edward Haggard as "a tragic figure on a tiny scale." It is probably more accurate to view him as a neurotic figure on a mammoth scale.

Nonetheless, this is a fascinating novel about a man for whom erotic passion becomes a progressive and incapacitating disease. Bit by bit, Dr. Haggard falls apart, both professionally and personally, and eventually winds up an egregiously impaired physician, destroyed both by his addiction to morphine and his neurotic obsession with Fanny/James Vaughn.

Two medically-related features play important roles in the story. The first is Haggard’s detachment from, and personalization of, his injured leg. Throughout the novel he refers to "Spike" in the 3rd person, making comments like, "Spike was having a bad day." He attributes his own increasing need for morphine to Spike’s need, as if Spike were a demanding patient rather than his own leg.

The other peculiar feature is Haggard’s obsession with James’s feminized body. His differential diagnosis includes Froehlich’s syndrome, a condition characterized in males by feminine obesity, sexual infantilism, and atrophy or hypoplasia of the testes and penis. Froehlich’s syndrome is usually caused by hypothalamic tumors. Haggard eventually concludes that James has a "pituitary condition." However, the reader (at least, this reader) wonders how much of James’s bizarre bodily transformation occurs in James’s body, and how much of it occurs in Haggard’s mind.



Place Published

New York



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