Regeneration by Pat Barker

Jacalyn Duffin — Tue, 22 Jul 2025 23:34:08 +0000

The story opens in 1917, as the poet Siegfried Sassoon protests the war in a London newspaper. He is saved from court martial by a military friend who argues successfully for his transfer to the Craiglockhart War Hospital, Edinburgh, where he comes under the care of psychiatrist, William Rivers. Sassoon is not sick, but he and his doctor both know that the line between sanity and insanity is blurred, especially for a homosexual in wartime. The other patients, however, are gravely wounded in spirit if not body; sometimes they are tormented by uncomprehending parents and wives. Rivers’ efforts to unravel their nightmares, revulsions, mutism, stammering, paralysis, and anorexia begin to shake his own psychic strength and lead him to doubt the rationality–if not the possibility–of restoring them to service—a form of regeneration. Conflict is its own form of insanity. Rivers yearns for his pre-war research in nerve regeneration, the quixotic enterprise that serves as a metaphor for his clinical work.

This eloquent statement against the madness of war is the first novel in a trilogy that includes The Eye in the Door (1993) and finally The Ghost Road (1995), which was awarded the Booker prize. The story is closely based on the publications and annotated literary papers of three real men who met at Craiglockhart in 1917: psychiatrist W.H.R. Rivers (1864-1922) and two poets: Siegfried Sassoon (1886-1967) and Wilfred Owen (1893-1918). Owen wrote some of the most moving war poetry and the knowledge that he would be killed in action at age 25 simply adds to the poignant sense of futility.

Pat Barker (b. 1943) probed the tenacious role of class within the military hierarchy, while the society, which the military purports to defend, is rapidly being transformed by the converging lives of domestic servants and aristocrats. Her descriptions are powerful: the yellow skin of women who work in the munitions factory; the surgeon who can no longer bear the sight of blood; the young soldier who cannot eat because his nose and mouth had once been filled with rotting flesh when he was hoist by a grenade into the decomposing belly of a dead German. Rivers helps the men to recall and to understand the origins of their ailments by gentle, patient conversation–a treatment that he described in Lancet, 2 Feb 1918.

Regeneration
Pat Barker
London: Viking Press
New York: Plume
1991, 256 pages)

From the Vault: In these times, certain works of literature seem to be as relevant to us now as when they were published — possibly more relevant than the times that they depict. From the vault of the now closed Literature, Arts and Medicine Database, we will pluck a few items for their power and timeliness.

Web image by National Library of Medicine

Ward No. 6 by Anton Chekhov

Jack Coulehan — Tue, 11 Mar 2025 14:40:22 +0000

Dr. Adrey Yefimych Ragin has for many years been the superintendent of a provincial town hospital. Initially, he was energetic and enthusiastic. He made hospital rounds every day, worked long hours in the clinic, and tried to keep up as well as he could with the latest medical developments, but as time went on, he became less interested and engaged in his work, which he considers “palpable futility.” None of it makes any difference. The hospital is poorly equipped and out-of-date because of social forces beyond his control. Ragin has developed the philosophy that, since “dying (is) the normal and legitimate end of us all,” there is no point in trying to cure patients or alleviate suffering. The endeavor is futile. While he accurately observes deficiencies in the hospital and in the surrounding society, he does nothing to try to remedy them. Instead, he withdraws to his apartment and spends his time reading.

At one point Ragin accidentally visits Ward #6, the mental ward, where he encounters Ivan Gromov, a brilliant patient, and strikes up a conversation with him. Gromov, who carries a diagnosis of paranoia, loves life passionately. His passion attracts Ragin, whose sensibilities are blunted by the emotional numbness from which many physicians suffer. Ragin is attracted to Gromov like a moth to a candle. He begins to visit Ward 6 daily to debate with Gromov. Since the other doctors never visit Ward 6, this behavior is considered very peculiar.

Ragin yearns to feel something, anything, even to experience suffering, rather than to remain suspended in his emotionless cocoon. He develops an obsession that only suffering can redeem him. This obsession makes him even more dysfunctional, a situation which allows a junior doctor to have him fired as hospital director and, ultimately, admitted to Ward #6 as mentally ill. Once Ragin has become a patient, a “nobody,” the ward orderly hits him, thereby giving him the opportunity to suffer. Shortly thereafter, he has a stroke and dies.

Enormous demands and poor working conditions contribute to Ragin’s predicament, but Chekhov suggests that Ragin’s character is also deficient. Something is missing. He experiences a sense of futility and numbness. Is this an inevitable consequence of medical practice? Or is he particularly vulnerable to burnout? The deeper theme in “Ward No. 6” is Ragin’s failure to live an authentic life, to discover a sense of wholeness and meaning in his existence. It is possible that Ragin’s early enthusiasm for hospital practice disguised the fact that he never came to terms with his own needs and values.

Lady With Lapdog and Other Stories
Anton Chekhov
David Magarshack (Ed.)
London, Penguin Books, 1964.

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database (Litmed).

futility – medhum.org

Regeneration by Pat Barker

Ward No. 6 by Anton Chekhov

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Cold Eye, Warm Heart: Medicine and Anton Chekhov

An Awkward Business by Anton Chekhov

The Grasshopper by Anton Chekhov

Ward No. 6 by Anton Chekhov

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