Nelly's Version

Nelly's Version draws us into the mystery behind a woman's loss of identity. The novel is a fictional first-person account of a woman who awakes as if from a dream to find herself in a hotel lobby living a "pastless present." She signs herself in as Nelly Dean, and so begins her journey in search of an identity.

However, what at first seems like an amnesic disorder is illuminated just enough that we at times glimpse a darker pathology. Nelly's confused and disoriented internal world keeps us unsure of how much of what she experiences is reality and how much is paranoid delusion. A striking aspect of Nelly's character is her total lack of emotional connection to events and people that should have significance to her. Nelly recognizes her inappropriate apathy, and her narrative becomes a self-conscious character study. This complete self-alienation is illustrated in her description of her first encounter with the unknown middle-aged figure in the mirror. A reflection who possesses "regular features now partially obscured by skin and tissue which had lost its hold … hair streaked with grey, more than a hint of a double chin, a lined and sagging neck, and a thickened waistline."

Taken in a larger context, Nelly's confusion over her identity and sense of self embodies the conflicting roles of women in society. In the story we are acquainted firsthand with the subtle sexism that permeates Nelly's world and defines her identity. Nelly disavows the traditional female roles of wife and mother. While signing her assumed name at the hotel front desk as "Mrs. Dean," Nelly muses, "I ceased being just myself, by myself, I became a married woman in the looming protective shadow of a mythical husband who would shortly arrive to join her."

The sense of foreignness, isolation, and alienation experienced by Nelly is one that British author Eva Figes has personally experienced. Figes was born Eva Unger, a German Jew who narrowly escaped Germany with her family at the age of six after the release of her father from a concentration camp in 1939. She is known not only for her fictional works but also for her feminist writings. In 1970 she wrote the influential Patriarchal Attitudes, an examination of gender roles. The foreword to Nelly's Version, written by Susan Faludi, further enlightens us and reveals the true origin of Nelly Dean in Wuthering Heights. I suggest rereading the foreword after you read Nelly's Version.

Nelly's Version is a well-written psychological mystery and character study. Although Nelly does not fit a distinct DSM-IV diagnosis, she is an excellent study of the subtle pervasiveness of mental illness and its effects on relationships. This is a mesmerizing story that examines gender roles and the fluid nature of identity. The book is thought-provoking reading for any health care professional or layperson. The novel will have particular resonance for female health care professionals who are continuing to define their own identity and roles in what remains a male-dominated field.

Brief Reviews

• In sonorous prose Edna O'Brien tells the tale of Michen O'Kane's creation and demise. Based on a true story, In The Forest (New York, Houghton Mifflin, 2002) brings us to a predictable series of homicides through the voices of the perpetrator, the victims, and the observant but nonprotective community in a western Irish countryside surrounding the Cloosh Wood. Left behind at a young age by a beloved mother, beaten amidst family violence by a drinking father, and raised by a loving but unprotective sister, Michen is coined at an early age as the Kinderschreek, or someone whom young children fear. Prematurely labeled as dangerous, Michen grows to fill this reputation. This powerful, suspenseful, and psychologically sophisticated novel takes us between sanity and the darkness of psychosis with spellbinding ease. The characters struggle with responsibility and the arbitrary redirection of blame. Hope for redemption competes with fixed beliefs in immutable evil, and personal generosity happens alongside filial abuse for the sake of personal gratification. The novel's blurring of time, relationships, and trust parallels the common path of chaos and psychological disorganization that interpersonal violence can wreak on an individual and a community. This novel of desperation and loss amidst people who love but fail to protect is well worth a read.—Paula G. Panzer, M.D., New York, New York

• Second Glance, by Jodi Picoult (New York, Atria Books, 2003) is a confusing mix of fact and fiction. The scientific themes of the narrative include in vitro fertilization, preimplantation diagnosis and intervention, DNA typing, serotonin levels in the brain, WP disorder, and the world of eugenics. The story goes in different directions at the same time and is hampered by some stereotypical gender characterizations. The men are generally weak, flawed, and angry, and the women are strong, brave, and rescuing. It is difficult to know whether this is a story about the evils of eugenics in Vermont in the 1930s, an unresolved murder story, or a love story. The book has a Native-American spiritual theme, which underpins the book's title, as the central character, Ross Wakeman, falls in love with the ghost of a murdered woman of mixed race. The book's ending poetic paragraphs in many ways appear to capture the author's honest goals of portraying unrequited love and the light behind the shadow. Ultimately, this difficult-to-read book has all the right ingredients but tastes like an undercooked Irish stew.—Kieran D. O'Malley, M.D., Seattle

• Tilt: Every Family Spins on its Own Axis (Naperville, Illinois, Sourcebooks, 2003) is the first novel of poet Elizabeth Burns. At 275 pages, the book is "a good read." I read it twice, the first time enthralled and unable to put it down, the second savoring the story and appreciating the author's ability to string together ordinary events to create an extraordinary story. The story is about a woman faced with a series of what we mental health professionals would call psychosocial stressors. Understood from the point of view of the heroine, Bridget Fox, the events are waves of cascading disaster; as her best friend dies, her daughter's development derails into autism, her father dies, and her husband is given a diagnosis of bipolar disorder, she is left juggling the increasingly unmanageable fragments of her life. One of the joys of this book is that it works. Whether Burns is describing the woes of a mother deliberating on how to use a few precious moments before her children wake up or the utter dismay of a wife unable to get help for her acutely psychotic husband, she writes as though she has been there. She describes coming onto a psychiatric ward: "There are a bunch of tables that recede down a hall. A skinny woman is leaning over one of these, doing a crossword. Her hair is different lengths. I guess it was hacked at. And a bald chubby man is pacing the hall by the tables. He seems to be engaged in conversation with himself. He's wearing a gown and no trousers." True enough, but then she goes on: "How weird is it in a mental ward? … this is actually what would scare you, that inside here, they're talking about what you're talking about at home … so you can't tell if you are really crazy." Tilt is a remarkable book because of its veracity. It is a story with nothing held back. It is not only gripping, it is grim. Tears streamed down my face as I finished it. Yet ultimately it is a tale of hope—not because the ending comes to some pat Hollywood resolution, but because in the end Bridget discovers that elusive quality we mental health professionals will never be able to package in a pill. One closes the book with a bittersweet sigh of satisfaction because Bridget has found resilience.—Margaret M. Chaplin, M.D., New Britain, Connecticut

• Inspired Sleep (New York, Scribner, 2001), by Robert Cohen, is a novel about Bonnie Sachs, a depressed and insomniac almost-40-year-old teacher and divorced mother of two boys. Years ago she spent her dissertation time never completing a thesis on Henry David Thoreau. She grew to realize that although Thoreau lived in seclusion on Walden Pond, he was only one mile away from his mother, whom he visited daily. Bonnie is pregnant and without a partner. The book is also about Ian Ogelvie, an almost-30-year-old brilliant but schizoid postdoctoral research fellow in psychiatry or psychology, I could never be sure, at a prestigious hospital in Boston. Bonnie ends up hearing about a miracle experimental drug—Dodabulox—that Ian is studying. He is a member of a high-powered research team that is studying the drug on a basic as well as clinical level. He has observed that this agent makes spiders spin perfectly symmetrical webs and causes fighting fish to kick back and spare themselves from the rigors of daily struggle. Bonnie learns about Dodabulox in a delightfully twisted consumer Internet listserv discussion in which her depressed punk baby sitter, Cress (coincidentally a member of the listserv), expresses her positive experiences with the agent. Meanwhile, Ian's boss, Dr. Howard Heflin, a shadowy, charismatic, and highly political department chairman, is helping the huge pharmaceutical manufacturer work around the Food and Drug Administration by developing Dodabulox for motion sickness: "Motion sickness is your Trojan horse, it gets you in the gate. In a few years, no one will remember what the original license was for." When Bonnie takes Dodabulox she slips into a surrealistic state commensurate with the epistemological imagery of the characters in the film The Matrix, whose subjective consciousness is controlled by computer (are my surroundings real, or do I just think they are?). In between all this are a myriad of social themes, including a vaguely insinuated conspiracy between the university and the pharmaceutical company, the modern-day complexities of the long-lost but visiting father-husband, and repeated references to pharmacologic chauvinism: analysis is dead; it can all be explained by neurotransmitters and hormones. At the end, Ian and Bonnie reach a modicum of resolution to their tensions. The writing ranges from brilliant to unnecessarily dense. The author lives amazingly at ease in the voice of Bonnie. Although the psychology of the human being is a never-ending inquiry, Mr. Cohen asserts, sort of, that it is the neuropsychology of the species that is relevant and, presumably not as elusive.—William M. Glazer, M.D., Boston

• The Happiness Code (New York, Penguin Putnam, 2003), Amy Herrick's debut novel, takes place "a few days or years into the future" and is replete with commentary on the biology of human nature. A series of scientific experiments has led to the creation of an infant with an altered genetic structure—one that allows an uncanny sense of well-being, including an absence of distress in response to commonly painful stimuli. The child is raised by a family in Brooklyn with a scientist father who is the only member of the family who is aware of the extraordinary set of circumstances that produced the baby. Marital struggles, parenting dilemmas, and slightly bizarre forays into the adventures of the family cat, Oedipus, form the structure of the plot. Although the story line becomes interesting and somewhat suspenseful at times, and the prose is often quite lovely, the novel seems contrived and not thoroughly developed. Some of the psychological insights bring to mind the term "psychobabble," and some are clearly derivative. The statement by one character, "I think happiness is just something that comes along now and then when you're busy working at something else," is an inversion of one of John Lennon's famous lyrics. On occasion the writing is more evocative, such as a description of the inner experience of a parent whose child is suddenly in the path of danger: "For a mother, this kind of time lies outside of the usual continuum … . Time jogs out of its usual orbit and the moment, which is generally tiny, no bigger than a marble, contains within it so much—a heightening of the senses and a straining of every ounce of willpower to return the child safely to the moment before and an odd assault of disembodied memories …—it threatens to collapse in upon itself and explode." Herrick flirts with futuristic and magical thinking, at times romanticizing the possibilities, but returns to fairly conventional solutions to the human dilemmas she poses. Warring neighbors find a way to get along, the ability to feel pain is seen as just as important as being capable of happiness, and the lost cat comes home. The author has received acclaim as a writer of short stories; perhaps this novel would have been more poignant in that format.—Jeanne L. Steiner, D.O., New Haven, Connecticut

Dr. Ruiz-Mellott is chief resident in psychiatry research at Cedars-Sinai Medical Center in Los Angeles.