Skip to content

PD James’ The Private Patient

November 15, 2012

NHS Hospital Ward in 1973

Sometimes we start reading the works of authors for unexpected reasons. I decided to read some of PD James’ novels after coming across a rather grubby letter a certain writer wrote to the Society of Authors claiming Baroness James should step down as the President of that organisation as she voted for the government’s controversial Health and Social Care Bill when it was brought before the House of Lords (perhaps he thought she had “unsuitable views for a woman”?)

Interestingly, from 1949 to 1968 James worked as an administrator in the National Health Service and she has drawn upon this experience for several novels such as Shroud for a Nightingale, The Black Tower, and A Mind to Murder. Although Philip Roth has just announced his retirement, stating that he has no more books left in him at the age of 79, it did cross my mind that Baroness James, now 92, published her most recent novel just last year and that her writing remains as sharp as ever.

The Private Patient (2008) explores the rather murky world of plastic surgery. It has a wonderfully grotesque and Dickensian cast of characters whom James spends more than the first hundred pages introducing before the appearance of her legendary detective and poet Adam Dalgliesh. Rhoda Gradwyn is a successful and unscrupulous tabloid journalist (the sort showcased recently by the Leveson inquiry). She checks into the fictional Cheverell Manor in Dorset, a magnificent country house transformed into a private clinic run by the arrogant and ambitious Dr George Chandler-Powell who is having an affair with the voluptuous Sister Flavia Holland, a nurse with a heart of stone. Gradwyn wants a scar, which she received from her abusive father during childhood, removed from her face: ‘Because I no longer have need of it’. Some of the staff are weary of a woman of Gradwyn’s reputation coming to the clinic, and, indirectly, Gradwyn contributes to the destruction of the clinic’s reputation when she is murdered within twenty-four hours of her successful operation. The newly engaged Commander Dalgliesh travels to Cheverell Manor to solve the murder case of a woman who was herself an enigma, thus the title carries a double meaning referring both to private healthcare (always a controversial subject in the UK as we have seen) and the mystery of the individual victim.

There are shades of Golden Age detective fiction in the novel as the characters are isolated in a remote setting and all possess plausible
motives for wanting to see the ruthless Gradwyn dead. The downside of this is that some of the characters’ portraits border on caricatures to the modern reader, such as the superstitious kitchen worker Sharon Bateman who is obsessed with the seventeenth-century  burning of a supposed witch on the grounds of the Manor. Bateman was a bit too parochial for my tastes. However, this is more than offset by the eloquent and often moving prose which, used as I am to a more hard-boiled American style, never failed to impress. As evidenced in the scene where Dalgliesh first set eyes on Gradwyn’s corpse:

Dalgliesh knew that speculative gazes fixed on a corpse – his own among them – were different from the gazes fixed on living flesh. Even for a professional inured to the sight of violent death there would always be a vestige of pity, anger or horror. The best pathologists and police officers, standing where they stood now, never lost respect for the dead, a respect born of shared emotions, however temporary, the unspoken recognition of a common humanity, a common end. But all humanity, all personality was extinguished with the last breath. The body, already subject to the inexorable process of decay, had been demoted to an exhibit, to be treated with a serious professional concern, a focus for emotions it could no longer share, no more troubled by. Now the only physical communication was with gloved exploring hands, probes, thermometers, scalpels, wielded on a body laid open like the carcase of an animal. This was not the most horrific corpse he had seen in his years as a detective, but now it seemed to hold a career’s accumulation of pity, anger and impotence.

Dalgliesh finally puts all of the pieces together, but with the solving of the case there always remains a void, as though the deeper mysteries of human existence can never be solved, not even by the most celebrated of detectives. And yet the final note is one of optimism, decent values have triumphed and life is worth living.

A superb novel.

6 Comments leave one →
  1. November 15, 2012 6:53 pm

    I’m amazed you’ve never read P.D. James before now. Do try “A Taste for Death” which caused quite a stir on first publication due to its pretty realistic descriptions of blood-letting. Though probably quite mild by today’s standards, it was a much-neededl kick in the pants for cozy British detective stories back in 1986 and you may disagree with Phyllis on politics and religion (as I do) but you can’t dispute that she’s a damn fine writer.

    • November 15, 2012 11:20 pm

      Thanks for the tip Mike. I’ve read an Unsuitable Job for a Woman and I’m looking forward to working my way through her back catalogue.


  2. May 30, 2018 8:40 pm

    I felt that The Private Patient had that leisurely, overly chatty feel that many Last Books have. I have gotten this impression from the Last Books of many authors, some of which I did not know were Last Books until after I’d read them. Ruth Rendell, Robert Barnard, P.D. James, they all could have used someone to rein in the inner monologues?punch up the action? a bit, in my opinion.

    • May 30, 2018 10:01 pm

      I think pacing can become a major issue when a writer, any writer, is getting on a bit and has two dozen or ore novels under their belt. I think PD James is the exception as the inner monologues are so beautifully written due to her complete mastery of the English language


  1. PD James | The Venetian Vase

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: