This first book in Barker's WWI trilogy is based on the real-life treatment of poet Siegfried Sassoon by psychiatrist and anthropologist Dr. William Rivers at Craiglockhart War Hospital. Sassoon has publicly denounced the war as a "senseless slaughter" and refuses to fight anymore. The powers that be assign him to Rivers' care as a victim of "shell shock" - a traumatic experience that leaves men unable to function. The hospital's aim is not so much to cure as to return men to active duty - an objective that leaves Rivers conflicted as doctor and a humanitarian.
In an era when treatment of mental illnesses was often barbaric, (as in a memorable scene near the book's conclusion), Rivers' treatment plan is to cure with compassion and respect for the patient. He allows these men the freedom to work through their experiences instead of repressing them. In doing so, he takes some of their suffering onto himself, and is changed in the process. The give and take between doctor and patient is the real meat of the story.
But beyond the plot, there's a lot to think about in this novel. In fact, the real genius of this work is not the plot or the characters or the setting, but rather the seemingly endless array of serious ethical questions that crop up as these men struggle with their situations. Was Britain justified in going to war against Germany? Can war ever be moral? Who is responsible for the actions of nations? Do soldiers abdicate their moral responsibilities when they don the uniform? How can a doctor cure a patient's infirmity only to send him back to the front lines to die? How does this apply to conscientious objectors? Is it enough to treat symptoms when the underlying causes are psychological? Barker doesn't provide answers, but wants us to look for them in ourselves.
This would be a terrific book for teaching an ethical philosophy course, and surely that's why this novel is so highly praised by reviewers. However, as an entertainment, this book is substantially less successful. One patient's brief dalliance with a factory girl provides almost our only glimpse of a woman, and even this episode seems tacked on, and is decidedly unromantic. And as one might expect, there is absolutely no trace of humor in this book at all - no one ever cracks a smile, let alone a joke. Less predictably, there's very little action in this book, either. The patients' tales of horrors at the front are powerful enough, but rarely run more than a page or two, and we don't get many of those. So while this is indeed a brilliant work of fiction, it should only be recommended to those who are deeply into ethical philosophy.