Onyx reviews: Trauma by Patrick McGrath

Through his protagonist, psychiatrist (don't call him a shrink) Charlie Weir, Patrick McGrath defines "trauma" as a horrible event that "is always happening now, in the present, for the first time."

Charlie is familiar with trauma—he has dealt with it all his life. He's the younger (and less favored) of two sons, the one who always had to look after his mother during her worst episodes of depression and alcoholism and placate his father during his rages. His brother Walt was gregarious, and his friends were always welcome in their home. Walt was allowed to make himself scarce anytime his mother was "ill" so he would be spared the sight of her "when she looks like death."

"How can any man see his mother in pain and not do everything in his power to relieve that pain?" From an early age Charlie thought he was the cause of his mother's illnesses, and no one ever disabused him of that notion. "It is the mothers who propel most of us into psychiatry, usually because we have failed them."

Being a mediator prepared him for his chosen profession. "It is the narcissism of the psychiatrist...to play the indispensable figure of succor and healing." Walt, on the other hand, becomes a successful artist. He's quick to remind Charlie that anyone can be a psychiatrist, whereas art requires talent. "The bond between brothers is often intense, but it isn't necessarily affection that unites them." Charlie resents Walt because his brother inherits the family apartment in Manhattan's ritzy upper west side (a departure for McGrath—most of his books are set in England) and relegates the furnishings he doesn't want to a musty basement.

Fred, Charlie and Walt's father, left after one of their mother's outbursts, seeking the solace and sanity of a much younger woman. Charlie delights in Fred's subsequent decline, though he's dismayed to observe that he resembles his father. All his life, he's had a recurring dream where his father threatens to shoot him. The only times his mother ever comforted him were when he awakened from those nightmares.

After getting his education in Baltimore, Charlie returned to a city that has decayed—at least in his eyes. His specialty became the newly identified syndrome of post-traumatic stress disorder in Vietnam War veterans. ("The irony," he muses, "was that fighting for your country rendered you unfit to be its citizen.") The plight of the war veterans and occasional glimpses of the World Trade Center under construction remind readers that things aren't much different today than they were forty years ago.

His patients refer to him as Captain Nightmare, because he listens to theirs. They don't know about his. "The most potent charge of emotion weakens over time, unless it's repressed. Then it can wreak havoc in the psyche for years to come....The buried material was throwing up nightmares and other symptoms and would continue to do so until the trauma could be translated into a narrative and assimilated into the self." Charlie is referring to his patients, but the words also apply to him.

Charlie's toughest patient is a recalcitrant man named Denny, through whom he meets his future wife, Agnes. She, too, survived an abusive childhood, interceding on behalf of her siblings when her father embarked on drunken rages, though she seems far better adjusted than Charlie. Still, he offers his shoulder and his ear to support her as she expresses concern about Denny's treatment.

They marry and have a daughter, but Denny's ongoing problems loom large in their otherwise happy lives. Readers learn early on that Denny died and that Charlie feels responsible, but McGrath is stingy in doling out the details. Charlie extrapolates Agnes's blame to its logical conclusion, so he leaves the marriage preemptively, though their daughter keeps them bound together over the years. Rather than risk another relationship, he visits prostitutes to satisfy his urges.

In later years, Charlie's mother becomes a moderately successful writer of popular novels, but she still has bouts of depression and needs him during her worst periods (when he hears the typewriter, he knows she isn't crying). Ultimately she has a stroke and dies. Understanding how badly Charlie will take this loss, Agnes renews their sexual relationship, though she refuses to discuss her new husband or her marriage with him.

In effect, Charlie's only bequest from his mother is her mental infirmity. He continues to treat his clients, but this physician can't heal himself. He understands that he has a problem but can't fathom what it is, and knows that no one is working on it. He develops a relationship with Nora, a woman he meets at his brother's house, but he continues his fling with Agnes even after Nora moves into his apartment.

Nora is damaged goods, volatile and fragile, with the tendency to self-medicate with copious amounts of wine. She's also beautiful and irresistible to Charlie, but he learned his lesson with Denny about the hazards of trying to treat someone he is involved with. Also, he suspects she's having an affair with his brother and wonders if their chance meeting was actually orchestrated by Walt for reasons he can't fathom.

Nora's nightmares increase in frequency, and their relationship disintegrates. Seeking relief from New York, he takes a routine job in a small town where a significant photograph from his past was taken. It's all very Freudian.

McGrath does a masterful job of distributing clues to Charlie's personal mystery throughout the book. "We...mistake for reality the fictions we construct from blueprints drawn up in early childhood." Upon review, all the evidence was there, both for the reader and for Charlie himself—he's just incapable of seeing the forgotten trauma that is the source of his distress.

However, when it comes time to rip the bandage off and expose the wound, the book becomes a sprint, wrapping up in a matter of a few pages that seem hurried and breathless. Perhaps self-discovery is like that, but it's too hasty and facile to satisfy after all the reader has been through up to that point.