"The Comforts of Madness" by Paul Sayer (Sceptre, 1988)

A 126 page first-person account by Peter, a mute, catatonic male patient whose voice is like this -

• They are often tarnished, given to disappearing before my eyes, and sometimes I wish they had not been disturbed but left to sink in the mud rather than come to light to mock and dismay me with their cheap appearance and unreasoned array (p.16).
• There you have it, then, this day I have described, confessed out of sight, the bauble broken, though it will always remain, hidden, its cusps and its brilliance embedded somewhere, above, below, in my liver maybe, nicking and scorching some secret part of me till i bleed, and am once more obliged to recognise its presence in my memory (p.37)

He's moved to an experiment clinic, "One World Rehabilitation Centre". He's told "you will not be a 'case', no, you will be, first and absolutely foremost, a human being, a living, feeling, thinking man capable of all the sweetness and essence that is given to mankind" (p.28). The methods include sensory deprivation. We learn that he's 33. His leg twitches.

In a 28-page section we're told about his childhood - a father who couldn't hold down a job, a suicidal mother who was murdered by a fellow mental patient. Peter was born mute but became motionless only after staying in bed for days waiting to die, his father dead in another bedroom (suicide? murder?). A letter of complaint about the Centre has his name at the bottom.

He's sent to a hospital, which he likes. Then he's returned to the original mental home. In the final chapter he's visited by Alison, his long lost older sister. But for some reason she decides that he's not Peter after all. He gets worse, can't be fed. He's given something to "make quick and light of your suffering".

I'm surprised it was a Whitbread book of the year.

Other reviews

• Kirkus reviews ( A decent first effort, but it would take the skills of a Beckett to dramatize successfully a state as inert as Peter's, so it's no surprise that Sayer largely fails here, or that his means of sparking a conflict (the rehab center) is excessively melodramatic.)
• Carolyn See
• Bruce Sarbit (Peter's condition and One World's response to it are so thoroughly plausible that we can extrapolate effortlessly from Sayer's fictional world to the real world of psychiatry and madness. In One World's treatment of Peter, we found direct parallels with York Retreat's practices as those were described by Foucault. We saw a corresponding use of observation, judgment and authority, the same requirement to work, an equivalent emphasis on objectivity, all despite the passage of time and many methodological changes. Foucault's Madness and Civilization primed our suspicions of apparent progress and also taught us to see that the rules of discourse governing the treatment of madness hadn't so much changed as been renamed.)