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‘Another World’ by Pat Barker – Review of a Novel at the Intersection of Medicine and Literature

Submitted by on October 23, 2017 – 9:41 PM

patLet’s dive straight into the subject of my blog: Pat Barker’s novel ‘Another World’. A family helter-skelter – a middle-aged professor, Nick, and his heavily pregnant wife, Fran. Their kid Gareth is the classic vicious bully and Miranda is morbidly apathetic. Fran is a harried bird just trying not to collapse. They have moved into a new house whose history is embedded in bloodshed and psychiatric illness, and where ghosts are sighted.

The novel’s protagonist is Nick’s grandfather, Geordie, who at the age of 101 is dying of cancer. Geordie is a World War II veteran who lost his brother Harry in the war. This is an unsettled memory, which is now roaring back to life, and old wounds are re-opening. The whole time we wonder how Harry really got killed. Why the guilt? Why the gruesome note as Geordie constantly wails, ‘I am in Hell.’


As Nick takes care of Geordie in the last few weeks up to his death, their conversations and shared moments provoke readers to reflect on the nature of memory, especially of wars and trauma. Do they shape our present? Does the present shape our memory of the events?
The lenses shift from one character to the next too swiftly in the narration. The language is in the present tense with bottled exasperation at the verge of bursting- a snapshot of a hassled modern-day middle class family in Britain. This in many ways makes it closer to life- a life just whizzing past and in the blur of events and thoughts tumbling in, we do not have the luxury for understanding all people, even us, or our pasts. Mysteries remain mysteries, the past has to be buried, and ambiguities fade eventually into the grey corners of our peripheral vision. And our eyes and life keep looking forward.
The prose becomes cathartically more coherent and fluid at the end. Grandpa Geordie has a ‘peaceful face’ at death. A sense of continuity is palpable- his perfume still lingers in his old room, a new baby is coming up. Gareth does seem to overcome his vindictive insecurities, the characters do not run away from their fears- rather, they explore. The ghosts stop appearing, the family holds on.
‘Treat not the disease, but the patient’- the patient that comes with a culture, with a history, with ‘another world’. This perspective, the motto of holistic medicine, is introduced in the book.
As doctors in a 70-year-old Pakistan, it is not too rare to meet patients like Geordie in our geriatric population. What did these people see, what horrors of the Partition of 1947 they had to face, what chapters of life they had to abruptly conclude? The collective society’s memory of a war or of treacherous losses aside, Geordie’s example illuminates the burden of individual memories leading to psychosis and dementia.


Recently, I came across an elderly Parkinson’s patient who vividly hallucinated about tigers emerging from woods to devour his little sister he had left behind in India. While dreaming, he would get distressed about the macabre chaos in the trains he fled to Pakistan in as a teenager. Beyond superficial sympathy, how can we begin to understand these patients and hence care for them more sensitively?


Geordie firmly believed that he was dying of an old bayonet wound. He hallucinated that it was getting bigger day by day, which we realize towards the end, is his way of reconciling with his guilt over Harry, his brother’s death on the battlefield. War and trauma are never really totally in the past. They live on in the memories, in the hallucinations, in our patients’ notions of death.
The book captures the complexities of fragmented families and explores how the past reaches into our present through identity-forging memories. These themes are common in all societies, and a nuanced awareness of them is particularly relevant in the practice of medicine, where a gaping divide may exist, not only in terms of the sick and the healer; but also in our capacities to connect with them intuitively on a personal level. It is for us also to recognize that the splendid Da Vinci’s Vitruvian man is rather a haze of continuities and echoes, not sharply drawn outlines of good and evil. He has regrets, sins and longings- ghosts in the mind. But despite all his vulnerabilities, his dignity is not any lesser and in the kingdom of Medicine; as the book ends aptly:
‘Let the innocent and the guilty, the murderers and the victims, lie together beneath their half-erased names, side by side, under the obliterating grass.’

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