The Rack

by A.E. Ellis

A young English student, Paul, is sent to a Swiss sanatorium just after the end of the second world war. At a time when effective medication for tuberculosis was unknown, Paul undergoes an unimaginable regime of regimented medical intervention, both physical and mental. His fellow patients fare no better. Yet, as the poet Edwin Muir wrote in his original review in the 'The Rack does not deal obviously with disease and suffering; it describes, sometimes very amusingly, the life of the the sardonic professional kindness of the doctors, liable suddenly to break under pressure, the badness of the food, the endless pre-occupation of the patients with their symptoms, and the sexual promiscuity...Behind the book one has the impression of an unusual and powerful mind.' Graham Greene considered it a masterpiece; the Times Literary Supplement believed 'the book exercises a complete fascination...a deeply impressive performance' , and Time and Tide hailed The Rack as '...terrific. To read it is itself an experience.' Long out of print, the original Heinemann and Penguin editions cut out some 60,000 words of the author's original text. This Zephyr Edition will restore the complete text to provide today's reader with a chance to discover the definitive edition of one of the great English novels of the last century.

Genres: Fiction, Classics

Paperback

First published January 1, 1958

About the author

A. E. Ellis was the pseudonym of Derek Lindsay, who was born in 1920. Orphaned at the age of 3, he was brought up by an aunt. After serving in the Second World War, in which he rose to become a captain, he returned to England and attended Oxford University.

When he was stricken with tuberculosis, Lindsay was sent to a sanatorium in the Alps, where the years of his slow cure would provide the inspiration for his first and only novel, The Rack. This impressive work was published in 1958 to great acclaim from English critics; it went on to be included in the Penguin Modern Classics series and was reprinted several times in paperback.

Though he continued to write, including working on a sequel to The Rack, Lindsay never published another book. He died in 2000.

Reviews

[Canadian 135 · Rating 4 out of 5]

This is an almost unbearably intense book about pain - specifically, the agony of the protagonist, Paul Davenant, during his period in a sanitorium for treatment of tuberculosis. I first read the book as a teenager, when it made a tremendous impression on me. The futility of existence in a TB sanitorium; the endless treatments; the isolation; the sheer physical agony. First published in 1959 - the only novel by Derek Lindsay (writing under the pseudonym A.E. Ellis.).
Graham Greene reviewed it at the time, stating "There are certain books which we call great for want of a better term, that rise like monuments above the cemeteries of literature: Clarissa Harlowe, Great Expectations, Ulysses. The Rack, to my mind, is one of this company." High praise.
On re-reading, it is intense, and horrible. It is terribly dense; there is a constant sense of dread; you'll learn more than you could dream about TB treatments. The main character is a curious blank, without control or interest in control of his destiny. I did not like him, had no sympathy - other than some respect for his stoicism, I suppose. The relationship between doctor and patient is excellent - (not understanding, experimental treatments without adequate explanation or hope)- from that perspective, it is very interesting. Whether or not the physicians intend the result - it is evocative of the patient's perspective.
All in all - a very unusual, horribly depressing book.

[Mikee · Rating 5 out of 5]

This is a horrible book. It is one of the very BEST horrible books I have ever read. In its endless cycle of hope and despair it is a masterpiece of hopelessness and hopefulness. And the doctors.. ahh, the doctors! Amazing that it is so little-known and that it is the only novel that Ellis ever wrote.

[Ann · Rating 5 out of 5]

Heartbreaking

This is a hard yet beautiful book to read. It speaks of mans' capacity for pain and love. It describes in detail the tortures reserved for tuberculosis patients in housed in sanitariums yet also praises the courage and strength of those individuals. The end is heartbreaking.

[Barbara Scott-Emmett · Rating 4 out of 5]

Paul Davenant, a patient in a Alpine sanitorium, is gleefully told he's to be tortured by the treatment for his tuberculosis, and when he duly is, his doctors express little sympathy. Their bedside manner is severely lacking and Davenant must put up with the rigours of treatment as well as the medical men's insensitivity. The Rack reads like a black comedy at times; indeed the three doctors are like a music hall act.

The sisters who nurse him are no better - indeed all the women (apart from one or two exceptions) are presented as idiotic or incompetent. But then, so are the men.

The various other TB patients we meet - mostly young male students - rail against their enforced confinement with pranks and high jinks. They stage protests against the abominable food, get drunk, dress up, push each other about on trolleys, and generally carry on as if they are at a rag day parade. Paul, less well than they, suffers mostly silently and grows depressed.

When he falls in love the tone changes. Paul now has something to live for but not the means to pursue it. His time in the sanitorium is ever expanding - another three months, by Christmas you'll be well enough to leave, by Easter, by summer, another three months; and so it goes on. His beloved, Michele, very young and rather irritating, is willing to wait for him. But how long can she put her life on hold? We cannot help falling into despair along with Paul at his lack of prospects, lack of money, and lack of health.

There are some beautiful descriptive passages, use of wonderful words and medical terminology, lots of untranslated French, and over it all a feverish, hallucinatory account of the indignities and privations of TB treatment in the fifties. This is a long book, at times repetitive, and with characters who are often barely believable. However, it is an astonishing account, and one to be savoured and reflected upon.

[Standish · Rating 3 out of 5]

Too, too Long

Brilliant writing with many, many words I've never heard of let alone know what they mean. Several words in French that I bypassed and not sure why they weren't footnoted for the reader. Story is one of unbelievable ongoing tortuous medical treatment and the perseverance of the patient.

[Giskin · Rating 3 out of 5]

Hmm... A less grandiose version of the Magic Mountain. Interesting descriptions of various TB treatments, but Paul is a bit of a drip really. Difficult to imagine why he inspired such loyalty amongst his friends. One of those books one feels relieved to have finished.

[Amanda · Rating 3 out of 5]

First published in 1958, this is the story of TB sufferer Paul Davenant and his treatment in a Swiss sanatorium.

The experimental treatment wouldn’t be out of place in a torture chamber, with the medical staff its sadists.

The inclusion of interstitial details, not something encountered (nor tolerated) in these days of rapid-access social media, gives the reading experience all the monotony and boredom of what life must have been like in a sanatorium.

Horrifying, yet hard to resist.

[Reet · Rating 3 out of 5]

Paul davenant, the protagonist of this story, is the autobiographical Stand-in for the author. He comes out of the British army with tuberculosis, and Is sent, along with other students, by the International student organization, to a sanitirium in the French Alps.
The treatment for tuberculosis at this time, after World War II, is torturous and Not A cure. They do things like puncture your chest and fill you up with iodine and oil, and then tell you to shake yourself all around like a dog getting out of water. Moreover, they leave an amount of oil in your chest. Can you imagine? I was horrified at some of the treatments. And they never got him better, they just kept him there, to keep their business going, I guess.
" 'Now I shall endeavor to make a little hole in your rib,' announced Dr Vernet. He inserted another and thicker needle into the track of the first. then needle followed needle with great rapidity, boring and enlarging..... And the whole time Dr Vernet sustained a commentary for the benefit of his assistants, with occasional asides to Paul. 'this will not hurt,' he would say, inserting another needle into the aperture, or dryly and with candor: 'attention! This will hurt.' he raised a lancet, and Paul objected: 'I won't have that in.' 'Ach, Ach,' replied Dr Vernet. 'no, you can put it down. I won't have it.' 'you have always murders in England because your policeman don't carry revolvers,' said Dr Vernet, plunging the lancet into the hole. With its progressive enlargements came the accompanying sound of the splintering of bone.
At last Dr Vernet lowered a thick needle into the aperture and it remained upright. To the free end he affixed a hypodermic syringe. 'now I draw out your marrow blood. It will hurt.' as blood gushed up into the transparent cylinder Paul's chest twisted forward despite the fact that both assistant doctors Had been securing his shoulders to the table."
In the course of this horrifying treatment, Paul becomes extremely ill, his temperature rising high, and going into a semi coma: "taking practically no nourishment, he soon became incapable of evacuation. periodically sœur Yvette would set him upon a chamber pot, aiding him to retain his position by supporting his shoulders. But her presence inhibited him. One morning, following the administration of an enema, he begged to be left alone. Such was his weakness, however, that after defecation he fell backwards onto his bed, the contents of the pot soiling his sheets and contaminating his flesh. Sœur Yvette came to his assistance, but found him mute and paralyzed with horror. Lying quite still, he made no effort to withdraw his limbs from their abominable contact.
He felt that there was nothing more; that life, engaged in his progressive humiliation, had overborne itself; that by this new blow its scope was not enlarged, but terminated, for his spirit was now dead and he could be tormented no further.
Sœur Yvette called for the assistance of another nurse, and with her help Paul was transferred to the Chaise lounge. He lay without movement where he was put, his genitals exposed, his head inclining backwards over a bolster. When Sœur Yvette had finished changing his bed, she bathed his limbs, but Paul remained limp, beyond protestation or cooperation."
One of Paul's fellow students, John Cotterell, is actually killed by the treatment. "the morning after the induction of the pneumothorax [this is where they would stick a large gauge needle into your chest wall, and blow it full of air.] the duty sister had found John Cotterell's bed to be empty. A search had been made of the sanatorium, following which the police had been notified. Then a cowman had reported that he had discovered a young man, half suffocated, on a mountain pass. John Cotterell had been brought back to the sanitorium. He was wearing flannel trousers, a pajama jacket and stockings which were shredded and stiff With blood. Under the pressure of the climb, his lung had perforated. He had been given oxygen but had lost consciousness and had died a few hours later."
Speaking of business, this sanatorium was saving money by serving the most atrocious food. Supposedly, customers could go to another sanitorium that had the same level of medical care, with better food, and pay more.
Things Were especially hard for our protagonist, Paul Davenant, because he was a vegetarian. Even though he still ate eggs and cheese, I liked him for this:
"Paul had his own food problems. For over 10 years he had eaten neither fish nor meat. (initially he had been unable to reconcile himself to the slaughterhouse. Later - when it had seemed to him that every principle was arbitrary - flesh eating as such had become repugnant).... Fresh vegetables were rarely served; a diffident request for a vegetarian diet had resulted in the substitution of a piece of cheese (always have the same indeterminate brand) for meat. For some weeks now he had received a twice daily serving of cheese, potatoes and gravy."
This was the craziest book. It lost one star from this reader because I don't read French. I do know a little French, because I took 2 years in high school, and also because I speak Spanish and the languages have many similar bases in the words, but what's up with this publisher that they couldn't add footnotes for the reader? Or was this book only meant for European audiences. In the United States, we don't need to speak French, we need to speak Spanish!
Also, I was not amused by the dumb little romance between Paul and a fellow patient. She's 17 and he's 27, and he wants to marry her? Grooming her 😡
At the end of the book, Paul is at his wits end. He's been at the sanitorium for going on 3 years now, and all that's happened is more and more torture. Moreover, his little girlfriend's mother has written him a letter telling him that he needs to forget about her, that it's taking him too long to get well, and she needs to go on with her life. This is where Paul really loses every hope.
One of the doctors treating him seems to sense what's going on in Paul's mind, and has a little talk with him about it:
"....'do you ever spare a thought for judgment day?' he added.
'judgment day!'
'I mean if you kill yourself. There is an old superstition, monsieur, that one is best advised to live out one's life. Or don't you mind running the risk of having it all over again? In any case why is it that when people think in terms of another world they always assume that it will be governed on different principles from those which God - if he exists - saw fit to establish in this one?' he paused for comment, but received none...."
" … o, let him pass! He hates him
that would upon the rack of this tough world
stretch him out longer."

And with that, Paul jumped out the window.

[Millicent · Rating 3 out of 5]

Three-quarters of the way in, I realised that this book is the overlooked sibling of existential classics such as Nausea, The Castle and The Trial. It's very well done, but definitely not the read for someone who's interested in plot or character development. The Rack focuses on the despair of the human condition, with tuberculosis as one ongoing metaphor of many (that I think I mostly missed). The sanatorium as life in a fascist state? It's also very post-war in its consideration of Europeans coming together and trying to heal.

I admired it more than I enjoyed it, but am glad to have read it.

[Fred Grogan · Rating 4 out of 5]

Very ponderous story of life in a Swiss TB ward. If you don’t know much about how tuberculosis was treated in the 1940s, you may be educated in these pages. Pneumo thorax and draining, application of asphaltum to lesions etc. All this is a regular part of daily life for these poor sufferers.
The protagonist is a sympathetic person, but only lives in these pages as a patient, no life beyond the ward is described. Long pasages of drinking cups in the canteen, and the subdued friendships to be had.
A lot like the experience lived by the residents. A bright, cold novel of a time and illness that no longer fills wards with doomed young men and women.

[Ian Hunter · Rating 5 out of 5]

One of the few books which I have felt compelled to re-read. There is something fascinating and compelling about Paul's story. A disease/condition that we hardly recognise today and yet so disabling only a few decades ago. Doctors who are either at the cutting edge of searching for a cure or treatment or are complete charlatans.

The fact that very little is known about the author, who appears to have published no other work just adds to the strange attraction of this work.

I sincerely believe that everyone should read this.

[Paul · Rating 5 out of 5]

This novel is quite exceptional, a totally involving, emerging experience about life in the shadow of existence-threatening, debilitating disease. Try it, if you're feeling strong and not seeking a feelgood read.

[Virginia Rounding · Rating 5 out of 5]

Not for the faint-hearted or the hypochondriacal...

[Debra Davidson-Smith · Rating 4 out of 5]

When The Rack was first published in 1958 it was hailed as a literary masterpiece destined to take its place among the great novels of its age, and yet it’s author, Derek Lindsay never wrote another book, and today it’s a little known novel. So did it deserve such lavish praise? In a word, yes.
The novel is so immersive, telling its story with such a painful, brutal intensity and accuracy that it leaves you longing to escape the endless cycle of hope and despair, yet clinging, like the protagonist, to any chance of release.
The Rack tells the story of Paul Davenant, an unremarkable young man stricken with TB, who has arrived at a sanatorium in the Swiss Alps with high hopes of a full cure and a normal life. As the weeks and months pass interminably by, Davenant undergoes endless tests and torturous medical procedures, all the while facing the possibility that his case may be hopeless. Despite the pain, indignity, and tediousness of these brutal procedures before effective antibiotic treatments were available, Davenant never loses sight of the outrageous, absurd and farcical side to his situation. He never gives up.
I was not surprised to discover that the author bears many similarities to the hero of his book. Derek Lindsay who wrote using the pseudonym A E Ellis was born in 1920. He was orphaned at 3 and brought up by an aunt. After serving in the Second World War, he returned to England and attended Oxford University. When he became ill with tuberculosis, Lindsay was sent to a sanatorium in the Alps, where the years of his slow cure provided the inspiration for his first and only novel, The Rack. Happily, however, Derek went on to live a long life, and died in 2000.
It may be coincidental, but it feels like a timely re-release of the book because reading this in 2022, it’s hard not to see some similarities to the ups and downs, the fear and dark humour, the hope and despair, of Covid and its effect on the nation’s morale and mental health. One moment thinking we’re through the worst, only to be repeatedly hit with new variants and restrictions on our lives. A roller coaster of emotions which has really taken its toll.
This book is a powerful read. It can feel like heavy going in parts, thanks to the almost unbearably painful and detailed descriptions of Paul’s barbaric treatment, the repetition, and the bizarre editorial decision to include large sections of narrative in French without providing any translation. (Unless that’s just the ARC?) But, overall, these criticisms are minor, and the story of man’s capacity for love and hope against all the odds, sticks with you despite the bleakness of the tale.
With thanks to the publisher and NetGalley for an ARC in return for an honest review.

[Debra Davidson-Smith · Rating 4 out of 5]

When The Rack was first published in 1958 it was hailed as a literary masterpiece destined to take its place among the great novels of its age, and yet its author, Derek Lindsay never wrote another book, and today it’s a little known novel. So did it deserve such lavish praise? In a word, yes.
The novel is so immersive, telling its story with such a painful, brutal intensity and accuracy that it leaves you longing to escape the endless cycle of hope and despair, yet clinging, like the protagonist, to any chance of release.
The Rack tells the story of Paul Davenant, an unremarkable young man stricken with TB, who has arrived at a sanatorium in the Swiss Alps with high hopes of a full cure and a normal life. As the weeks and months pass interminably by, Davenant undergoes endless tests and torturous medical procedures, all the while facing the possibility that his case may be hopeless. Despite the pain, indignity, and tediousness of these brutal procedures before effective antibiotic treatments were available, Davenant never loses sight of the outrageous, absurd and farcical side to his situation. He never gives up.
I was not surprised to discover that the author bears many similarities to the hero of his book. Derek Lindsay who wrote using the pseudonym A E Ellis was born in 1920. He was orphaned at 3 and brought up by an aunt. After serving in the Second World War, he returned to England and attended Oxford University. When he became ill with tuberculosis, Lindsay was sent to a sanatorium in the Alps, where the years of his slow cure provided the inspiration for his first and only novel, The Rack. Happily, however, Derek went on to live a long life and died in 2000.
It may be coincidental, but it feels like a timely re-release of the book because reading this in 2022, it’s hard not to see some similarities to the ups and downs, the fear and dark humour, the hope and despair, of Covid and its effect on the nation’s morale and mental health. One moment thinking we’re through the worst, only to be repeatedly hit with new variants and restrictions on our lives. A roller coaster of emotions which has really taken its toll.
This book is a powerful read. It can feel like heavy going in parts, thanks to the almost unbearably painful and detailed descriptions of Paul’s barbaric treatment, the repetition, and the bizarre editorial decision to include large sections of narrative in French without providing any translation. (Unless that’s just the ARC?) But, overall, these criticisms are minor, and the story of man’s capacity for love and hope against all the odds, sticks with you despite the bleakness of the tale.
With thanks to the publisher and NetGalley for an ARC in return for an honest review.

[Lorraine · Rating 4 out of 5]

The Rack, the only published novel by playwright Derek Lindsay writing under the name A.E. Ellis, was first published in 1958 to critical acclaim. It has recently been republished in an attempt to restore its status as a classic. It’s not difficult to see why this has happened now, as The Rack captures a brief period in medical history when knowledge about how to treat a condition was evolving quickly. In this case, the condition was TB and the novel is set in the late 1940s.

Protagonist Paul Davenant and some fellow students are sent as a party to a sanitorium in the Alps to be treated for TB. While most of Paul’s contemporaries have straightforward cases and are able to move through the programme of treatment and return to their former lives, for Paul it is just the start of a long, frequently painful process.

Paul is treated by a succession of doctors whose primary aim seems to be the cementing of their own reputations rather than providing empathic patient care, and as well as brutal medical procedures he has to withstand numerous episodes of grandstanding by the medics, each of whom promises to have the solution to his health woes if he will just invest another three months.

There are also various friends who drift in and out of Paul’s life during this period, displaying a range of poor social skills. Paul tolerates everything placidly; at times it is hard to know whether he is a rather passive individual or just a man who has been driven to clinical depression by the endurance test he is on. Things pick up when he meets and falls in love with another patient, Michele, but even this relationship seems to bring Paul as much distress as it does happiness, as they navigate issues including Paul’s dwindling funds and Michele’s need to go back home to Belgium.

The Rack is a lengthy read at over 500 pages and, due to the subject matter, it is not an easy one. I am glad to have read it, as it gives a unique insight into patient care just before the corner was turned and effective TB treatments became available. The descriptions of sanitorium care were fascinating as well, giving many insights into the running of these large institutions that were once commonplace.

[zunggg · Rating 4 out of 5]

A difficult read, partly thanks to the manifold thoracic agonies inflicted on its main character, a purposeless young Englishman called Paul attempting to rid himself of TB in an Alpine sanatorium, partly because hardly anything happens (other than the infliction of said agonies and a drippy love affair) in its 370 pages.

On the face of it it's like The Magic Mountain redux, drawing on many of the same absurdities of sanatorium life: communal indignity, bad doctors, worse food, the pan-Euro cultural mélange. But the focus here is much more intensely on the individual experience, on the dreamer, not the dream. We're drawn into Paul's private hell so effectually that by the end it's not entirely clear where he ends and reality begins.

Ellis achieves this interiority through pain. This is one of the great stories of pain, and the reason it's so painful is that he doesn't try to describe what it feels like to have your sternum punctured, your ribs creosoted, your pneumothorax pumped full of air every fortnight. Instead he describes the progress of the needle through the bruised flesh, the sounds of surgery, the bitter smell and colour of the bronchial sludge.

There are moments of comedy, usually dark: the deranged Belgian who is Paul's only true friend, the professional squabbles of the various doctors and staff, the Kafkaesque inevitability of Paul's vague plans being thwarted, his desires frustrated. The only annoyance is Ellis' habit of reverting to the local lingo for commonplace phrases that have perfectly normal English equivalents. It's not a dining room, for some reason, but always a salle à manger; never a maid but always a femme de chambre. There's also untranslated French dialogue strewn liberally about, which if your French isn't up to snuff will need to be run through Google Translate to avoid losing the thread.

This is a really unusual novel that goes to some pretty unfrequented places. But maybe don't do what I did and pair it with Tess of the d'Urbervilles.

[Dominique · Rating 3 out of 5]

Paul Davenant's gruelling time in the Les Alpes sanatorium passed as slowly and tortuously as it felt reading it.

A. E. Ellis is quite a talent of projecting a vivid X-ray (forgive the pun) of Paul's condemnation over years in a TB sanatorium during questionable evidence-based practice. His descriptions and images of the patients, the scenery, and of the medical atrocities committed implanted my own perceived self as a patient, which was painful to say the least. He expertly moved through Paul's health and emotional faculties like the tidal waves of remissions and relapses of TB, which I give him the utmost respect for. He really made me sympathize with Paul during this stay, because there is no greater frustration than being physically ill then having to suffer sanatorium "care." The disgusting medical care and outright questionable moralities and ethics in this novel were so exaggerated, I debated on leaving this book unfinished multiple times and trudged through the novel as if I had climbed the Alps.

As much as I did not enjoy this novel from a consumer standpoint, I respect A. E. Ellis's ability to depict TB care and the mental, physical strain it had on these patients. Very intense themes of pain & suffering, morals in medicine, optimism, camaraderie & friendship, and death were as omnipresent and powerful as Mycobacterium. Paul's perspective and experiences were probably a sum of what various TB patients experienced, and it made me more grateful for today's advances in medical care and ethics.

[Laura Spira · Rating 2 out of 5]

I had to stop reading this book halfway through. The story of Paul Davenant, a tuberculosis patient in an Alpine sanatorium, makes for very difficult reading, especially the painful treatments he undergoes which are described in minute detail and based on the author's own experience.

My mother contracted tuberculosis in the 1930s, spent a long time in a sanatorium and thankfully recovered to live to a long and happy life. She didn't tell me much about it, although the medical vocabulary in this book was instantly familiar, but any mention of the name of the place where she was treated (now famous for heart surgery) upset her, so it must have been a very traumatic experience. One aspect that she did talk about was the camaraderie among the patients - she made good friends there and there were lots of jolly pranks - so that part of the book resonated for me.

This book emphasises that we have much to be thankful for in the development of medical science which has provided drug treatments for this disease, which carried not only physical threats for patients but also social stigmatization arising from fear of infection. But it is a very hard read. Netgalley provided me with an ARC.

[Trevelyanwright · Rating 3 out of 5]

Can a novel be excellent and yet also barely readable? That's perhaps the central question of this classic of medical fiction. For the first fifty pages The Rack provides the reader with some conventional entry points. A motley group of English young men diagnosed with TB arrive at a Swiss sanatorium for treatment in the late forties. There’s an exotic locale, there are quirky secondary characters and a sympathetic protagonist in the shape of ex-Oxford and ex-army student Paul, with a packing crate full of books and a damaged lung.

But as the second act gets into its stride it becomes increasingly focused on Paul’s suffering. The operations go on and on, the doctors change as another new medical course is proposed. Different drugs, different regimes, but the same cycle: treatment, recovery, hope, relapse, despair. One by one Paul’s comrades fall away, their place taken by a teenage girl Michele whose relationship with the quintessentially diffident and reserved Paul dominates the last third of the book.

The insight and focus this book has into the suffering of chronic disease one can only marvel at, and one which is clearly borne of personal experience. It might be glib to say that it’s gruelling experience for the reader, but that;s clearly what the writer intended.

[Sarah Hudson · Rating 5 out of 5]

We meet Paul Davenant in the interwar years of the early twentieth century, as he and some fellow university arrive at a TB sanatorium in the Alps. Having never undergone treatment at a sanatorium before, Paul’s new friends as well as his doctors take great delight in informing him of the varied and gruesome “treatments” that might await him, should his illness progress. What follows is the story of his stay, his treatments, and his interactions with his doctors and fellow patients, including the woman with whom he falls in love.

This is a brutal, beautiful book, and I loved it. The descriptions of the treatments were so incredibly graphic that I could barely look at the page, and yet the relationships that develop are described with such intimacy and humanity that I couldn’t put it down. The story speaks so much about the human capacity for pain, hope, and friendship, and was, unexpectedly, darkly comic throughout. This truly deserves its status as a classic, and is one that will stay with me for some time.

My thanks to the author, NetGalley, and the publisher for the arc to review.

[cailleach · Rating 4 out of 5]

I had this book on my wishlist for a long time as it won great critcial acclaim when it was pucblished and Graham Greene compared it to writing by Camus, Mann and Proust. So, I have to say I was quite disappointed. The book isn't bad it is just a well written account of a WWII soldier who returns from the war to restart his studies at Cambridge but develops TB. The Government has a scheme sending groups of students to a sanitorium in the Alps for a cure. and we follow Paul as he reaches a crisis, is subjected to various horrible treatments, gets used to life on the wards and starts to meet the private patients who reside on a lower floor and get served much better food and one of whom gives him a reason to wnat to get better and live again. It was all told nicely and makes for an interesting "historical" read of the treatment protocls for TB in the late 40's. It was okay but didn't blow me away.

[JK · Rating 3 out of 5]

Drawing on his own experiences within sanatoriums, Ellis delivers us a macabre and unsettling account of tuberculosis treatment in the years following WWII.

The book was agonising for me in a variety of ways. Our protagonist suffers a multitude of treatments which made my teeth clench - the experimental nature of which was enough to make me feel sick. There’s little to no hope, the feeling of isolation ripped through the pages until it instilled claustrophobia, the density of the text, the sheer length of the thing, everything contributed to me feeling as Paul would’ve felt - trapped, helpless, and desperate to escape.

Although I feel this is an important account of the treatment of tuberculosis after the war, this story is something to enter into with hesitant resolve - so very bleak, and seemingly unending, it will hold your mind in its hands for quite some time afterwards.

[John Fullerton · Rating 5 out of 5]

An extraordinary novel, presumably based on the author's personal experience: vivid, bitter-sweet, extremely funny and poignant, redolent of a certain type of Briton now sadly extinct - the war generation - desperately inhibited, sensitive, brave, stoical, selfless, fully aware of the absurdities, indignities, follies and pains of this short life. One can do no better than to quote what Graham Greene said of it, faithfully reprinted on the cover of the 1979 Penguin paperback reprint:
'There are certain books which we call great for want of a better term, that rise like monuments above the cemeteries of literature: Clarissa Harlowe, Great Expectations, Ulysses. The Rack to my mind, is one of this company.'

[Lucy · Rating 4 out of 5]

I'm not sure I'd consider this book a masterpiece, but I have enjoyed it, and welcome its republication.

Set in a Swiss sanatorium, the story concentrates on the life of Paul, a student with TB, and details the medical procedures he undergoes in the hope of a cure. (Warning, the medical bits can get fairly descriptive, so avoid if you don't like that sort of thing).

Sometimes normal life seems just around the corner, other times Paul finds himself at death's door. As the months go on, a new patient provides a love interest for Paul, and he starts to dream of the future he could have.

Set in a beautifully described mountain setting, this is an interesting read.

[Anthony Weir · Rating 2 out of 5]

I remember from my childhood in the late 1940s or early 1950s that one of my aunts was actually cured of TB by collapsing her lung and removing at least one rib during a fairly short stay in an NHS hospital. She lived into her eighties with a single functioning lung.

This book is horrific, grotesque - and tedious. An exaggerated (and self-indulgent) denunciation of the essentially cruel - if not psychopathic - behaviour of some people employed hitherto in the medical industry.

Nowadays, the cruelty has been transferred to laboratory animals - in their millions.

[Jim Woolwine · Rating 3 out of 5]

I plowed through this book to the end - the kind of read that I treat myself to Starbucks if I hang in there to the end.

I found Paul an unsympathetic character. I missed/never understood why he remained at Bisset. His love affair was completely, selfishly, one-sided.

As for the physicians - quacks all. "Oh, we all know that the information provided by any little gadget or magic box is worth its weight in gold to the modern practitioner as long as it saves him the trouble of thinking." Have times changed?

[Aria Harlow · Rating 4 out of 5]

This book was both really hard to read and really hard to put down. The experiences that the patients went through in the Sanatorium to help their TB was barbaric and chilling and even more so as you know that it could all of happened and more behind closed doors in the time it was set in.
It was well written with an engaging if not horrific storyline and well developed characters. It was a hard read but one that I am glad that I got to read.

[Roger · Rating 4 out of 5]

I have no idea why I requested this book, but I'm glad I did. It is hard to believe the mumbo-jumbo medicine that was practised only 80 years ago in treating TB patients (although I suspect in 80 years time we will look back at some of the responses to Covid in a similar way).
Not what you'd call an enjoyable read, but very well done..

[Annette Kane · Rating 4 out of 5]

DNF, good book but needed to crack on with other reading