I’ve struggled lately with my blogging. Not the actually writing, but more the content. I’ve got a folder full of half-written posts that all seem ridiculously pointless when I revisit them to tweak for publishing.
One of those posts is about the TV series, The Alienist. Well sort of. It’s about things that meandered around my little mind as I watched The Alienist and that’s partially to do with the subject matter – namely the way in which we treated clients of mental health services. It’s a long time since my undergraduate psychology degree, but… I currently work in a health service so my colleagues deliver mental health services and I’m vaguely connected to some planning around a new inpatient mental health facility.
Which is why books like Kathryn Hughes’ The Key – about archaic medical practices – are of more interest than they may otherwise have been. (Plus, and as an aside, I’ve remained a little perturbed about that stuff since seeingĀ An Angel At My Table, about the life of NZ author Janet Frame, a few decades ago!)

by Kathryn Hughes
Published by Headline Review
on April 26th 2018
Source: Hachette Australia
Genres: Historical Fiction
ISBN: 1472248856, 9781472248855
Pages: 416

Goodreads
1956
It's Ellen Crosby's first day at work as a student nurse at Ambergate County Lunatic Asylum. When she meets a young girl committed by her father, and a pioneering physician keen to try out the various 'cures' available for mental illness, little does Ellen know that a choice she will make is to change all their lives for ever...2006
Sarah is drawn to the abandoned Ambergate Asylum and whilst exploring the old corridors she discovers a suitcase in an attic belonging to a female patient who was admitted to the asylum fifty years earlier. The shocking contents of the suitcase lead Sarah to unravel a forgotten story of tragedy, lost love and an old wrong that only Sarah may have the power to put right.
We spent a bit of time with Sarah as the book opens and I was interested in the story around her parents’ relationship, her own marriage breakup and young Nathan, a homeless boy helping her rummage around the old asylum.
However we then flick back 50-60 years and spend a long time with first year student nurse Ellen who’s very much thrown in the deep end on arrival and learns the hard way how cynical / disillusioned / uncaring some of the older nurses – and the system in general – have/has become. (Indeed, there’s a patient there who’s been there 40-50yrs and no one remembers why she was admitted in the first place.)
The ‘long stay’ ward is exceedingly depressing so Ellen is happy (after a couple of months) to be rotated through to the acute-admissions ward where the new residents at least have the chance of release.
It’s there we (properly) meet a new arrival Amy, who features briefly in the book’s opening scene. She’s not the usual type of patient seen at Ambergate, and attracts the attention of a physician with an interest in Freud and psychoanalysis – something beyond restraining the patient and offering the occasional ECT. Dr Lambourn tries to get Amy to talk about what’s mentally ailing her and it’s something she initially rails against.
I wasn’t sure I’d find the theme of this novel interesting (given what I mentioned earlier), but I found myself quite intrigued by the suitcases of those who never made it out of Ambergate and the stories of Sarah and Amy. Interestingly, though it’s kinda implied Ellen is a focus, she isn’t really. She’s a narrator and bystander, and holds the key to a secret but doesn’t really feature as prominently as one would expect.
We’re actually in the head of Amy as much, or at least more intimately. And it was an interesting place. On one hand she’s a sympathetic and seemingly guileless character, but on the other she seems far more scheming than one would expect. Or perhaps we should expect it… given where she is, and why.
It felt like it took a long time to get to Sarah but we eventually loop back, though in some ways she’s (ultimately) more on the periphery; also more a narrator than anything.
I think the lack of focus characters was a little off-putting for me and I was less engaged with their plight than I could have been.
I enjoyed the plot itself and loved the kinda fatalistic twist Hughes throws in at the end, but she could have possibly avoided Ellen completely with minimal impact. The book’s pacing was also a little off for me. Months would go by in a page and I felt jolted about time-wise a little and as if I’d been cheated out of part of the story. Of course, the fact I thought that is an indication I was enjoying the events unfolding before me, so despite my whingeing there’s a lot I enjoyed about this book.
The Key by Kathryn Hughes was published in Australia by Hachette and is now available.
I received a copy of this book from the publisher for review purposes.
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