Adulthood has its advantages. You can decide when to go to bed, where to go on vacation, and what to read. Unlike those years of high school, college, and medical school, during which teachers and professors had the right to assign reading lists, when we are "grown up" we can read the first few chapters of a book and, if we become bored, frustrated, or simply uninterested, put it down. One of the great exceptions to this freedom is when one has agreed to review a book for a journal!

Had I begun Bedlam Burning in the absence of a commitment to write this review, I most certainly would have put it down well before I had read the first 100 pages. Although the book is promising in its beginning, the bulk of it is a foolish, absurd, offensive, and boring piece of writing. Although, admittedly, there are chuckles to be had here and there—and even some reasonable wordsmithing—the price of plowing through the rest of Geoff Nicholson's novel is hardly a price worth paying for these (rare) pleasures.

Initially, I thought I might be in for a clever treat. Bedlam Burning opens at Cambridge University in the early 1970s, where two undergraduates are invited to attend a book-burning party thrown by one of their professors. At the climax of this festivity, each of those present is expected to throw a book into the fireplace. Mike, the primary protagonist, throws in one of the host professor's critical works. His author friend, Gregory, disposes of the manuscript of an unpublished novel he has recently completed. Okay, so the metaphor is a bit hackneyed, and the outcome of this "little act of symbolic literary criticism" is possibly predictable, but one does become engrossed in the characters and their misadventures.

From this point on, however, we begin a disappointing downhill slide. Mike graduates and takes a job in a rare book dealer's shop, into which his undergraduate pal Gregory later stumbles. Gregory asks Mike to pose for the author's photograph on the book jacket for a novel Gregory has just completed. Through a series of contorted, improbable, and often absurd coincidences and unlikely events—neither interesting nor consequential enough to bother enumerating here—Mike soon finds himself as the "writer in residence" at a psychiatric institution, the Kincaid Clinic, run by Dr. Eric Kincaid and his sidekick, Dr. Elisa Crow. Here the alleged comedy begins.

Kincaidian therapy involves depriving the patients of any exposure to representation of reality: nonabstract paintings, photographs, movies, and television are all banned. But Dr. Kincaid values literary work and asks our protagonist to "help the patients use language as a bulkhead against madness." Mike begins a class for the ten patients of the asylum, asking them to produce their own writings, which he then intends to be read by the patients and critiqued by him. He soon finds himself overwhelmed by hundreds and hundreds of pages of the patients "literary productions." Everything from entire treatises made up of anagrams to blow-by-blow accounts of soccer games to sadistic and sexualized material appears under his door. Each patient presented is a shallow caricature; few have redeeming characteristics, none have more than a hint of humanity, and all are portrayed with little understanding of the nature of mental illness and the pain, anguish, and torture from which such individuals suffer. The proprietors of this august establishment fare no better. Kincaid is a self-absorbed foolish buffoon, and Dr. Crow engages in regular sexual orgies with Mike—but only under the agreement that he will constantly bombard her with vulgarity, sexually explicit epithets, and play-by-play descriptions of the commingling. Believe it or not, the book goes even further downhill from there.

I am sure that well-intentioned literary critics will hail this as a thoughtful, farcical look both at the writer's craft and at institutions for the mentally ill. Its portrayal of the clinical staff at Kincaid Clinic is at best shallow and at worst appalling. Nicholson is an equal opportunity satirist: literati, consumers, and mental health professionals are all treated with equal contempt.

Although I was not spared myself, I hope that this review will help protect you from purchasing—let alone reading—this dreadful work.

Dr. Goldfinger is professor and interim chair in the department of psychiatry at the State University of New York Downstate Medical Center.