The Crimson Portrait

Jody Shields

Back Bay Books, 2008. ISBN 978-0-316-06718-8. 296 pages

Disclaimer: Pages 151-182 were missing from my review copy. From having read the rest of the novel I don't think these pages would have markedly altered my conclusions, but it's always possible.

The Crimson Portrait is set in a military hospital for soldiers with facial injuries in England in 1915. Two of the characters, Dr Kazanjian and the American artist Anna Coleman, are historical figures. The other characters are fictional.

In spring 1915, Catherine, a rich young woman whose husband has been killed in World War I hands over her grand country estate for use as a military hospital. Lost in her grief for her husband, Catherine cannot believe he is really dead and becomes obsessed with the idea that he is trying to send her messages or that he is one of the patients whose bandaged faces she cannot see. She becomes fixated on a particular patient, Julian, who reminds her of her dead husband. When the artist Anna Coleman is commissioned to make masks for some of the patients who are disfigured beyond hope of repair, based on photographs taken before their injuries, Catherine seizes the opportunity to re-make Julian in the image of her lost husband.

The quotes on the back jacket call this novel "a top-drawer literary thriller". Well, I agree that it's literary. I cannot, however, say that I found it thrilling. It seems to be a novel that takes itself terribly seriously. The writing style is opaque, elliptical and full of portentous references to light, mirrors, broken glass, reflective pools of water and the like. A sense of hopelessness and despair pervades everything and everyone. This may well be an accurate reflection of the subject matter - a hospital trying to pioneer plastic surgery for men with appalling injuries is never going to be a barrel of laughs, though I might have expected rather more gallows humour - but it doesn't exactly make for a light or even an absorbing read. Don't pick this book if you're looking for a diversion after a hard day at work.

The most interesting aspect of the novel for me was the background information on the techniques of early plastic surgery. Facial injuries are particularly difficult to repair, because (unlike the rest of the body) some of the muscles of the face are anchored only to each other, not to the bones. Severe facial trauma is no doubt as old as warfare, and could be repaired in some circumstances; for example, one of the skulls excavated from the mass grave at the site of the battle of Towton (1461) had a severe blade wound to his left lower jaw from some earlier violent encounter which, remarkably, had healed by the time of his death (scroll down to the photo at the bottom of the page in the link). However, the rebuilding of damaged muscle and skin is a comparatively recent technique that could only really be developed after aseptic surgery and efficient anaesthesia had been invented. I had an idea that a good deal of modern plastic surgery had been pioneered in the Second World War when burns and blast injuries were horribly common among aircrew, but evidently it has roots reaching back at least to the First World War. Techniques such as skin grafting and various ingenious devices for supporting damaged tissues are described in the novel in some detail, and made me want to go and find a book on the history of facial surgery to learn more.

The novel doesn't have much in the way of a plot (or perhaps it was too subtle for me), and the portrayal of the characters seemed to be me to be shallow and lacking in emotional impact. Despite detailed descriptions of various characters' innermost thoughts, feelings and philosophies, I never felt I really understood them as people. I took a particular dislike to Catherine, who seems to be so obsessed with her own misery that she will use and deceive other people in her attempt to get some of her old life back. I guess that's the point, as it shows how someone can be completely unhinged by grief, but as the novel doesn't show what Catherine was like before her husband died (except a slight hint of a none-too-bright debutante), she simply came over to me as self-centred. The surgeon Dr McCleary is a sympathetic and dedicated doctor overwhelmed by the enormity of his task, and the skilled anaesthetist Brownlow takes refuge from the strain in ether. Dr Kazanjian, a pioneering dental surgeon with a talent for improvisation, and the artist Anna Coleman are the most positive characters, able to find satisfaction in the practising of their craft. One aspect that I found especially disappointing was the absence of the patients' point of view. What was it like for them? How did they bear the unbearable? What did Julian think of Catherine and her attentions? Overall, the novel seemed to me to be shallow to the point of dullness, which is a great pity given its potentially dramatic subject matter.

Disappointing meander through the misery of bereavement and the hideous waste of war, with some interesting material on the early development of plastic surgery.