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TraumaReview - Trauma
A Novel
by Patrick McGrath
Knopf, 2008
Review by Margaret Riley, MS, RN
Nov 18th 2008 (Volume 12, Issue 47)

When I made my request to review the book, Trauma, my preconceived notions directed my thoughts. As a nurse that has worked in a busy and acute Intensive Care Unit, with patients that have included various traumatic injuries and accidents, it was this sort of trauma that I anticipated. Physical trauma: from auto accidents and shootings; from knifings and falling from buildings. Instead, Patrick McGrath's novel is about psychological trauma. While I know a fair bit about physical trauma and the havoc it wreaks on the human body, I'm not very knowledgeable about emotional or psychological trauma. It was very interesting and actually educational, to read this story.

The main character of this novel -- Charlie Weir, is himself a psychiatrist. His first-person account includes tales of the long-past interwoven with recent-past and the present. He tells of his childhood -- a dysfunctional mixture of people including a slacker of a father, a depressed writer and heavy-drinker of a mother, and an overbearing artist older brother. Charlie apparently headed to psychiatry as a natural progression – he found himself trying to take care of people's emotional pain and problems even as a child.

Trauma makes its way along a path of milestones. Because of the mixture of past and present, the path is not always straight, but is intertwined, rather as memories and stories are: some past recollections and some present events and circumstances. Milestones include Charlie's mother's death and funeral. This funeral also brings Charlie and his ex-wife, Agnes together in an odd relationship of mutual support and a shared intimacy. His ex-wife has primary custody of their daughter; the relationship seems to have been cordial since their split, but after the funeral they share an increase in their relationship: filling a void they have apparently both felt, in spite of her remarriage.

Meanwhile, another relationship develops for Charlie: he sees a woman at a restaurant, and meets her at his brother's home. This quickly becomes intimate as well, and before long he and Nora are sharing his apartment. He continues also, with the relationship with his ex-wife, in occasional fashion, the timing of their encounters usually determined by her.

Mental illness is evident all around: Charlie is a practicing psychiatrist, with a private practice. Some of his patients and their illnesses are described. The attempted suicide of a current patient is detailed, as is visiting him in the hospital, and encounters with the patient's wife. Charlie's family alone is filled with DSM-IV diagnoses: depression and bipolar disorder are examples that come easily to mind. Agnes's childhood included abuse, and her adulthood included the suicide of her brother: a Viet Nam veteran that suffered Post-Traumatic Stress Disorder (PTSD) and alcoholism. Since his death, she has suffered at least depression, but also anger and blame, misdirected at Charlie. Their marriage broke up shortly after the suicide.

Charlie himself is probably depressed, at least sometimes. Because Charlie was Agnes's brother's psychiatrist, and the person who discovered his body after the successful suicide, he suffers guilt. Soon after Charlie and Nora begin living together, her mental illness becomes apparent. She is emotionally unstable, with mood swings, outbursts and heavy drinking. When this becomes unavoidably evident, Charlie tries to get her into counseling, but she's resistant.

As Charlie's world changes, especially through losses, the book comes to a surprising conclusion. I'll not provide details in this review, as I think it's important to follow the book in the way McGrath has designed it: not to read the last page or two first as some do with mysteries, but to read each page as it comes. My own awareness and knowledge of trauma has been enhanced by this novel. In my mind, the very definition of the word “trauma” has expanded to readily include emotional or psychological trauma as well as that physical trauma that I expected from the word before reading this. So many examples of the fragility of the mind, of the many ways that it can be injured and indeed traumatized, are hard to ignore and fascinating to read. Trauma allows for a definite appreciation for the whole and uninjured mind, and perhaps for its rarity, and a renewed empathy for the mind that has suffered trauma.

    

© 2008 Margaret Riley

Margaret Riley, M.S., R.N. -- has been a Critical Care nurse in a highly acute ICU in the Denver Metro Area since graduation from nursing school. She continues to work occasionally in that setting, but now works full-time as a faculty member at her Alma Mater.


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