Novelists are becoming increasingly adept at describing schizophrenia. A good example is to be found in Sebastian Faulks’s novel, Human Traces, a story of two ideologically divergent psychiatrists during the decades leading up to the climactic chaos of World War I. On the face of it, Dr Jacques Rebière and Dr Thomas Midwinter have a lot in common. They are the same age – both born around 1860 – and each feels strongly protective towards a vulnerable but profoundly influential older sibling. A more fundamental comparison lies, perhaps, in their shared curiosity about the workings of the human mind. Yet they are destined to fall out over their differing views of what it means to be human.

Their contrasting backgrounds are striking from the outset. Jacques, at 16, hails from a socially deprived rural community in Brittany, northern France. Coerced into leaving school prematurely to work as a labourer for his father, Jacques would not have studied medicine were it not for the encouragement of the local curé. The latter is a former medical student, who takes the young man under his wing and instils in him a thirst for knowledge.

But Jacques has domestic issues to contend with, principally that his brother Olivier is becoming unwell. Over the preceding years, Olivier has “started to drift away from his family; it began when, previously a lively and sociable youth, he took to passing the evenings alone in his room studying the Bible and drawing up a chart of ‘astral influences’”. His father now locks him in the stable with the horse. His appearance has become dishevelled, with “his hair uncut for more than a year, his dark beard reaching almost to his chest”. He has grown paranoid and agitated, on one occasion demolishing the collection of jars and specimens that Jacques keeps in his bedroom. “These are my instructions,” he insists. He is described harming himself, having “gauged a hole in his left forearm” because of a belief that spiders are laying eggs under his skin. And as if all this were not enough, Olivier appears to hallucinate, leaving his younger brother with “the feeling that, although there was no one else in the stable, it was not to him that Olivier was addressing his remarks”. 

It is with exceptional clarity that Faulks describes schizophrenia, not simply its signs and symptoms, but also the reactions of relatives and friends. Jacques is unique among his family members in not rejecting Olivier over the loss of his sanity. Indeed, Jacques’s very motivation is to find a cure for his brother.

Thomas Midwinter’s upbringing is an altogether more privileged one. Also 16 at the beginning of the story, he lives comfortably with his family in Torrington House, Lincolnshire, a respectable domicile provided for by a longstanding agricultural business run by his father. But Thomas has experienced his own share of psychosis. We learn that he has been hallucinating, hearing the voice of “a narcoleptic man” who has “spoken to him regularly since childhood”. This voice does not reflect his own thoughts, moreover. Instead, it is audible like the voice of his brother or sister, “outside him, not produced by the workings of his own brain but by that of another being.” In part, the experience explains his opting for the evolving but impoverished field of psychiatry.  

Human Traces is intricately plotted and extensively researched, while its descriptions of psychiatric illness are simply remarkable. We are provided with a vivid insight into the workings of a Dickensian lunatic asylum, with its grand classical façade and its six miles of corridors. Thomas is taken under the wing of the charismatic Dr Faverill, “a man of science and learning, rather grandiloquent, filled with the optimism of our time.” Yet, with 2,000 patients in the asylum the doctors are clearly overwhelmed by the magnitude of the task. Indeed, Thomas’s experience is contrasted sharply with that of Jacques, who witnesses the showmanship of Prof Jean-Martin Charcot, professor of anatomical pathology at the Salpêtrière Hospital, Paris, and a father figure in the study of neurology, hysteria and hypnosis. Thus Faulks sows the seeds of our two protagonists’ profoundly differing philosophies. 

In the end, Human Traces is a gripping story of two doctors whose fiery paths cross during the birth of an entire profession. From an academic perspective, it pits psychoanalysis against biological psychiatry; from a literary perspective, it is an epic journey filled with passion, friendship, loyalty and conflict, and a moving exploration of the inexorable passage of time. Alas, like any good novel, it simply tells the truth.