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

The Eye in the Door, the second in the trilogy, turns its attention to the Home Front, and more specifically describes the rampant paranoia during the war, as the government targets two groups:  homosexuals and “conchies,” or conscientious objectors.  While it too is tethered to historical fact, it is more of a fictional narrative concentrating on the state-sponsored witch-hunt, refracted through the story of Billy Prior, a patient of Dr. Rivers.  Billy is bisexual; he also grew up with childhood friends who became pacifists and objectors, and who may or may not have been involved in a plot to assassinate the Prime Minister, and so he moves in both of these marginalized and persecuted worlds.  He also has fallen in love with a woman whom he wants to marry.  During his ongoing treatment of Billy, Rivers confronts his own repressed childhood memories.   

The Regeneration Trilogy has much to recommend it in considering works of literature in the area of medical humanities.  First—and obviously—it is about the psychological damage suffered by young men pressed into military service during wartime, and the way in which medicine approaches their resultant illness with the tools it has at hand.  Each one of these soldiers has a story, each one has a trauma, and there are no pharmacological options. Much like Freud (a contemporary whose work was well-known to him), Rivers felt that the way to treat the shell-shocked soldiers was a “talking cure,” making the traumatic events unrepressed and having the patients recognize and address them.  The stories of the soldiers’ treatments are engaging, Rivers’ warmth and compassion for his charges is unmistakable, and the nature of physician-patient interaction during treatment is explored.   

Barker also poses questions about gender; more specifically, about the nature of manhood and the role of women in a male-dominated society turned upside down by a cataclysm.  Being a man in England during the war means being in uniform and preferably fighting in France; the conchies and the gay men are seen by many, including many women, as being “less than” men, and in their otherness, as subversive.  Women, for their part, have had to step up and assume the roles in the workforce that men have vacated to go off to fight.   It is supposedly the love of their fellow men that allows the soldiers to fight as a unit, to want to enlist and to want to re-up after they are wounded, and this comradeship is trumpeted by those in command.  But it is crucial that everyone understand that this must be the right kind of love; the wrong kind of love is ferreted out and made example of. 

There are many paradoxes, and many instances of doubling or of opposites, in the novels.  Rivers wants to cure his patients, although curing them will render them fit to be sent back to combat and likely be killed.  Several bisexual men lead bifurcated lives.  And underlying all of it is a society rigidly divided along class lines, with the WC’s—the working classes—distinguished not only by their living and working conditions but also by the idiomatic speech put into their mouths by the author.   The war may be in some ways a great “we’re all in this together” moment, but it can’t erase class distinctions.   

It is worth noting that Barker’s style can range over to the gritty and realistic, as well as the graphic, whether describing the events occurring on a battlefield in Picardy or in a bedroom (or back alley) in London. The writing style is crisp, and the narrative moves along nicely.  The author’s characterizations are on point, especially William Rivers and Billy Prior.  Barker has a great feel for language, although some of the words and expressions several of the characters use are distinctly British and may be unfamiliar to American ears.  She conveys an England—or at least, a segment of England—tired of war, tired of being bombed, often living hand to mouth in cold water flats with faded wallpaper and trying gamely to carry on despite being ground down. 

And underlying it all, The Great War—its idealization, its senselessness.  The three volumes of this trilogy are beautifully written, hold the attention, and move quickly, and its relatively spare language has a lot to say. 

The Eye in the Door
Pat Barker 
Dutton: 1994, 288 pages 

Photo of Chester from  The Cleveland Museum of Art 

The Iranian-American author, Azar Nafisi (b. 1955), reminisces about her experiences teaching English literature in Iran before, during and after the revolution and the Iran-Iraq war (1980-1988). The book opens near the end of her sojourn in Tehran. A small group of young women, who have been friends since they were University students, gather in the author’s home to read and discuss English novels. They wear western clothes, remove their veils, and eat sweets. Some have been in prison. They conceal their simple purpose from fathers, husbands, brothers, because meeting to read Western fiction would be construed as an act of defiance.  

In four sections, two named for twentieth-century novels and two for nineteenth-century authors — “Lolita” “Gatsby” “James” and “Austen,” Nafisi constructs a series of flashbacks that describe the events of late 1970s to the 1990s in the inner and outer world of an academic woman. The books and writers used in the section headings have walk-on parts or starring roles that jar in this ostensibly alien context. Yet, they work surprisingly well for the women students, stimulating them to think in new ways about the situation in which they find themselves. Conversely, as the students assimilate the English and American writers into their world, we learn more about their Iran. 

Myriad details of moment, garb, color, and food, evoke the everyday “feel” of protests and atrocities that are known in the West only through journalist’s reports. The long descriptions contrast sharply with a relentless and probably deliberate lack of precision about several basic things. For example, the author withholds her age and the identity and the nature of her relationship with “my magician,” a greatly admired man –perhaps a lover or a teacher–who seems to exist on chocolate and philosophy.  

Possessives and the first-person singular are used liberally (“my students”) to remind us that this is one woman’s story—notwithstanding the solace, but barely developed presence, of a husband, two children, and a mother. The decision may have been made to protect personal privacy. But the result also conspires to build a narcissistic tone, as if the author marvels at her own creativity, attractiveness, resilience, survival, and escape.  

Some of the most engaging passages describe the male students’ difficulty with literature that they perceive to be immoral (for its sexual content or for the agency it assigns women). In the social climate, the young men are utterly unable to accept great writing on its own terms. One wonders how they would react to Nafisi’s own book and her portrayal of them. The wonderful device of a mock trial of Gatsby (pp. 120-136) challenges the students by going to the heart of the conflict of politics, religion, literature, and justice; it would work well as an excerpt and is worthy of emulation in our classrooms. The work deepens our understanding and complicates the impressions of Iran that are generated by a steady diet of news reports. 

In 2024, Reading Lolita in Tehran became a film directed by Israeli filmmaker Eran Riklis. 

Born into a privileged, Iranian family and educated in both England and the United States, Nafisi saw the great changes in her beloved country as the encroachment of a retrograde, unthinking tyranny, hostile to women and to reason. She moved to the United States in 1997 and became a citizen in 2008. She has served as a professor of English literature in several universities, holds at least nine honorary doctorates and numerous awards and prizes for her creative work. 

Reading Lolita in Tehran
Azar Nafisi
Random House, New York 2003
347 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 photo by  ariyan Dv 

He was wrong.  

In Nazi Germany, sleep was a poor protection from the horrors of the external world, as Charlotte Beradt, a Berlin journalist, found out. Beradt, a Jew and a Communist—and thus an ultimate outsider in Hitler’s state—began having unsettling dreams shortly after the Nazi takeover of the government in 1933, dreams of being “chased, tortured, shot at, [and] scalped,” from which she awakened drenched in sweat. Wondering if others might be having similar experiences, she began collecting dream reports from neighbors, friends, and acquaintances, aided in some cases by a friendly physician who would ask his patients about their dreams in the context of their office visits. She recorded them in her notebook or on scraps of paper, often in coded language so they would be unrecognizable to prying eyes, especially of the police. This project engaged her from 1933 until she left Germany in 1939, ultimately winding up in New York City and settling among a community of German expatriates and refugees, including Hannah Arendt. She originally published her dream reports in 1966; this new English translation by Damion Searls appeared in 2025. 

The book is divided into eleven chapters, each reporting several dreams that are linked by a common thread. Patterns emerge and are echoed: initially, the loss of privacy and the intrusion of state policies into everyday life. There are dreams in which the dreamer is under surveillance or feel they must conform to state policies; Goebbels and Hitler appear in several of these, or exist in the background. There are Kafkaesque nightmares where household items like stoves and pillows become monitors of activity or nagging and accusatory voices (Beradt refers to the “Orwellian” sense of being watched, noting that the dream content prefigures Orwell’s 1984 by many years).  

Interestingly, after 1935 (and the passage of the notorious Nuremberg Race Laws) dreams show up in the text characterized by a preoccupation with the wish for the ideal Aryan body type (blonde, blue-eyed, tall), or, more commonly, the preoccupation with the dreamer’s falling short of this ideal and being singled out for it. Non-Jewish Germans have dreams in which their noses are too prominent and “the authorities” accuse them, directly or indirectly, of having Jewish ancestry. And in her final chapter, “Jewish Dreamers, or, ‘I’ll Make Way for the Trash, if Needed,’ ” Beradt catalogues the dreams of Jewish Germans, dreams of exile, loss, hounding and pursuit, and self-abnegation. 

The book is a relatively brief (122 pages) compendium of nightmares, some of which have the feel of surrealistic short film clips, which catalogues the increasing encroachment of a totalitarian state on the lives—and into the unconscious worlds—of its subjects. The author’s analyses of dreams bespeak her familiarity with dreamwork concepts (she is referred to in several biographical sketches—not part of the book—as a “member of the Berlin psychoanalytic community,” although she was not a trained psychoanalyst), and many of her interpretations are sophisticated and suggest significant familiarity with Freudian concepts.  

It is worth noting that Beradt has probably surveyed a skewed population; her subjects are mostly people she knows, or referred by people she knows and presumably trusts, and there is a selection bias, in that she has probably not approached, say, Nazi Party members or sympathizers for their dreams. A large number of the dreams seem to date from the early years of the Third Reich, 1933-1935/6; it is possible that in the later years it was just too terrifying to talk about one’s nighttime visions…or that the dreamers had started to leave the country. 

The Third Reich of Dreams makes absorbing and chilling reading. It is fascinating to see how dreams, the realm of the personal unconscious, become infiltrated by and reflective of societal change in real time. Sometimes “the royal road to the unconscious” leads straight to the dreamer’s front door.  

The Third Reich of Dreams  
by Charlotte Beradt, translated by Damion Searls 
c. 1966, 2025 
Princeton University Press 
122 pp. 

Web photo by Ed Wingate