In her essay, “Love of Religious Practices,” Simone Weil addresses the condition of those afflicted by “the ugliness in us. The more we feel it, the more it fills us with horror. The soul rejects it in the same way as we vomit. By a process of transference we pass it on to the things that surround us.”  Persons in such conditon include prisoners in cells, drudge workers in a factory, and patients in a ward or care home. “In this exchange the evil in us increases. It seems then that the very places where we are living and the things that surround us imprison us in evil. . . this is a terrible anguish. When the soul, worn out with this anguish, ceases to feel it any more, there is little hope of its salvation.”

Such dark analysis might serve as a thematic statement for a worryingly good novel, The Rack, by the pseudonymous A. E. Ellis, published almost sixty years ago and at least twice reprinted. Graham Green hailed it as one of the great books, rising “like monuments above the cemeteries of literature.” And he suggested that the novel ranked with Clarissa, Great Expectations, and Ulysses.  My wife called attention to the title when she looked up the website of a favorite author and found the book listed as a shaping influence. “The Rack”? Curiosity (and humiliation – I’ve not heard of it, and Green liked it!) had me ordering a copy and then, slowly and painfully, as befits the work’s title, I read it.

Simply put this is the story of a patient in a tuberculosis sanatorium in the French Alps set immediately following the end of the Second War. Reviewers noted similarity in concept to Mann’s Magic Mountain. But this is not a novel of philosophical discourse. Rather The Rack is a novel of treatment, excruciating clinical procedures, recurring x-rays, painful and intrusive puncturings of the chest wall, and attenuated hope withered by signs of improvement dashed – again and again.

Paul Devenant, “a Cambridge undergraduate and sometime captain in an infantry regiment” has contracted TB and through a grant from the International Students’ Organization receives the funds to undergo a cure in an Alpine sanatorium, Les Alpes. His relationships with fellow student patients, the staff, and the doctors of Les Alpes focus the narrative at its start. The routine of “the cure” is established and the rules of the institution provide the young men with the authority to challenge and subvert – for life is endless rest and confinement. We have lengthy drama spawned by the poor and meager meals, the regular checks on the progress of the disease, the analysis of sputum, and the tortuous procedures such as those to relieve pneumothorax. Ellis spares us few details. The knife gleams, the blood and pus flow. In this rarified, isolated, and prescriptive world Paul is the point of consciousness. His drama is the novel’s conflict. And this is the framework that he lays out.

His sickness was of life, and he knew within him that that sickness had preceded the sickness of his body, rendering propitious the terrain of his lungs for the hosts of tubercles which they now pastured. And drenching his mind with the force of a cloudburst came the realization that in rejecting life he had of necessity chosen death, and that from death, when it is self-willed, there is no escape.

“Sickness was of life” and “from death . . . there is no escape.” As Simone Weil suggests this inner state is projected on Paul’s world about. Every consultation, conversation, suggested activity is tainted by the loathed self as in a mirror. Through many complications of plot, trivial but vast in the fore-shortened perspective, Paul at times chooses life and then chooses death – venturing even the act of suicide which is thwarted. The cast of characters, many of whom are vividly drawn, weird eccentrics, offer the reader, if not Paul, variety. Long discussion with the doctors, focusing on Paul’s treatment and his mental state explore the truly problematic situation of one who is chronically sick. Paul’s love interest in Michele, a fellow patient, seems to turn the screws of the rack even further.  He obsessively examines their relationship, driving himself into the terror of rejection just moments after he has heard her tell him of her love.

Why read this work, so clearly freighted with woe unto death? I think that the book’s importance lies in its ability to realize the state of the invalid. Ellis’s Paul is “a patient”. He so regards himself; he is defined as the inward looking, self-loathing being that finds disease and imprisonment mirrored in every article of furniture in the sick room and in the envy of every healthy person who possess what is never to be again for the sick.

Given such affliction, Ellis’ prose has to do double duty to capture the few piercing moments of Paul’s happiness:

In [Michele’s] face where all was perfection, all change must be decline; He wanted to possess her eternally, but eternally in the present. It was now which mattered. It was always now which mattered . . . And suddenly he knew with the force of revelation that his life had entered upon its optimum phase. This was both the meridian and the point of eclipse. In terms of time they could never again be closer.

Happiness here is fraught with the sense of its peak and its passing – indeed a foreshadowing of what must come. The passage also reveals the corresponding self-focus of the patient. The sense of sickness unto death makes sterile any intimacy. Paul is not loving Michele, he is lamenting his loss.

In one extended passage, Paul’s doctor, Dr. Bruneau, forces Paul to face his desire for death. He ventures rationalist arguments and considers religious prohibitions as he tries to probe his patient’s feelings.

I was urging you, monsieur, to consider that inability to adapt yourself to this world was perhaps not the best recommendation for prematurely moving on to the next. Can you not see that if there is a grain of truth in the Scriptures it is in the assessment of life as a test.

“Life as a test” - scarce consolation for one so depressed as Paul, and he has readied a cache of pills to act directly counter to the good doctor’s urgings. The ineffectual nature of wise speech to one so caught in affliction as Paul could not more clearly be shown. And only chance stops Paul from achieving that “consummation” in the moments after his talk with the doctor. 

One last somber quotation: this is Paul again racked by his isolation, the mental isolation of one dependent, fearful in anticipation, and worried with pain.

The moment when the crags and valleys of past and future are flattened into the infinite desert of the present; the moment that is company, in mirth or in grief, seems non-potential to the human condition; the moment when the soul looks at itself in the mirror and sees there is no reflection.

Happily, the era of TB sanatoria and the intrusive cures associated with mountain retreats are long past, but chronic, long-term pain, disease, and uncertain prognoses are very much with us. The Rack is an imaginative exploration of that all too familiar world that works itself out in care homes, rehab centers, and hospitals throughout the world. Ellis’ prose is taut, his dialogue at once lively and measured. He has constructed an instrument that furthers a true confession. Paul is the center of a vortex, so powerfully does Ellis turn him as we read. To render this experience is to immerse “in the destructive element” – as Conrad would say. To read the book is to know affliction in a salutary way.

Edward T. Wheeler, a frequent contributor, is the former dean of the faculty at the Williams School in New London, Connecticut.

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