I read Human Traces several years ago, and it is no less incredible on a second reading. Set in the latter half of the nineteenth century, the story begins when Jacques Rebière (from France) and Thomas Midwinter (from England) meet each other at the age of sixteen. They discover that they share a common fascination with the growing field of psychiatry and its quest to solve one of humanity’s greatest mysteries: the complex workings of the human mind.   

Jacques has a personal interest. His brother (Olivier) has become gradually more and more detached from the world around him, hearing voices and becoming confused. Despite Jacques’ protestations, Olivier has been sent to the local asylum, and Jacques is determined to one day find a cure for his brother. In the meantime, he works hard to qualify as a doctor, hoping that he can, at the very least, provide a loving home and sanctuary for Olivier.

Thomas, meanwhile, begins his work in an English lunatic asylum, intent on discovering the causes and potential cures for a whole host of problems. It is strange to hear these cases described in simplistic, all-encompassing terms such as ‘mania’, ‘melancholia’ and ‘hysteria’, and Thomas soon discovers that the vast number of patients and lack of medical staff make it extremely difficult for him to do anything at all. Many of the patients have no family, medical notes, or even a proper diagnosis. Some of them do not even have names.

Here is a conversation between Thomas and his colleague (Dr Faverill) in the English asylum. They are discussing Grogan (the porter), an ex-patient who has now become a member of staff:

‘…He came here fourteen years ago, raving and incontinent. He spent six weeks naked in the safe room, covered in his own filth.’

‘And how was he cured?’

‘My predecessor gave him henbane, camphor, morphine, I believe. I stopped that. I set him to work in the gardens and the farm. He revealed an extraordinary brain. He can calculate and keep records better than I can.’

‘Should he not have returned to his family?’

‘We did ask.’ Faverill coughed. ‘I am sorry to say that they declined. He prefers living in the asylum in any case…’

The Victorian attitude towards such individuals feels far removed from our modern understanding of mental illness, and it is unbelievable to consider just how much things have changed. But it is also interesting to see a snapshot of the change that was taking place, even then, knowing that, while this is a fictional account, it is based on historical research.

Eventually the two young men, now qualified doctors, embark on an ambitious plan to run a sanatorium in Europe, where they can study and attempt to cure both the wealthy and the less well-off. But they must not allow their ideas to get ahead of scientific fact. They are continually frustrated by their lack of progress and a growing awareness that they seem to be heading in different directions. There is also plenty of romance and frustration for several of the characters.

I like the fact that some of the story is told from the perspective of Sonia, Thomas’s elder sister. She suffers to begin with, constrained by the conventions of nineteenth century English society, and soon finds herself stuck in an impossible marriage, unable to see a way out. But eventually she is able to join her brother and his friend, able to play her own part in what becomes a large and complex enterprise, along with some of his former patients.

One small, extremely unnerving section of the book is narrated by Olivier, Jacques’s brother, and there are later sections that reveal the confusion of Alzheimer’s disease. We gain insight into the world of nineteenth century psychiatry from many angles, including the perspective of the patient. This is a moving, unsettling and thought-provoking novel.