The Private Patient, by P.D. James

March 7, 2009 at 4:48 pm (Book review, books, Mystery fiction, The British police procedural)


“Hurry up and read The Private Patient – I want to talk about it with you!” Thus was I recently exhorted by one of my most ardent mystery-loving friends. She added hastily that I should NOT read any reviews beforehand.

She needn’t have worried. There are certain writers of crime fiction whose books I read without first consulting critical opinion. Why? Because they have rarely, if ever, disappointed me. Examples are Ruth Rendell, Donna Leon, Peter Robinson, Peter Turnbull, Peter Lovesey (yes I know – a surfeit of Peters! ), Martin Edwards, Reginald Hill, Sue Grafton, Archer Mayor, Karin Fossum, John Harvey, and P.D. James. (This should give you a pretty good idea of why I am never caught up on my reading!  And BTW – if you scroll down, you’ll find a search box to the right of this text. Type in the name of any of the above authors and you’ll find reviews and/or commentary on this blog.)

Well, and so, I read Baroness James’s latest offering and enjoyed it enormously. In The Private Patient, she uses a device which has served her well in the past; namely, placing most of the action within an enclosed setting and observing the dramatis personae closely as events unfold. In this particular instance that setting is Cheverell Manor, a stately home in the English countryside which has been converted into a small hospital for patients undergoing  reconstructive surgery.  The eponymous private patient, an investigative journalist, has engaged the services of George Chandler-Powell, a renowned plastic surgeon, for the purpose of removing a disfiguring scar from her face. When he asks her why, thirty-four years after the injury occurred, she has decided to get rid of the scar, she gives him a strange answer: “Because I no longer have need of it.” He declines to question her  further.

In any event, what transpires is that the operation is a success, but the patient…you guessed it. I’m giving nothing away here. this is how the novel begins:

“On November the twenty-first, the day of her forty-seventh birthday, and three weeks and two days before she was murdered, Rhoda Gradwyn went to Harley Street to keep an appointment with her plastic surgeon, and there in a consulting room designed, so it appeared, to inspire confidence and allay apprehension, made the decision which would lead inexorably to her death.

(Before I forge ahead, let me praise this elegantly structured sentence. The precise, somewhat formal mode of expression is one of  the reasons many of us cherish this author.)

Here,  we see James employing a device she has used in at least one previous novel: that of informing the reader of the victim’s identity right at the novel’s outset. In the first paragraph of A Certain Justice, we are told that on a day in September, as barrister Venetia Aldridge rises to defend (the extremely unsavory) Gary Ashe, “she had four weeks, four hours and fifty minutes left of life.”

In the case of The Private Patient, it’s my feeling that this a priori “giveaway” diluted the suspense considerably. But – no matter; I still loved  the book. Few can match James when it comes to creating an atmosphere of menace, especially when the action takes place in an enclosed, even claustrophobic setting. Such is certainly the case once the action moves to the  hospital at Cheverell Manor. We may know who gets murdered, but we do not know when, how, or most crucially, why. The manor staff all become known to us, as does Robin Boyton, a young friend of Rhoda’s, who comes to stay in a cottage on the hospital grounds. There are anxieties and secrets aplenty even before murder takes place in their midst.

As for Commander Adam Dalgliesh, he enters the narrative at the beginning of Book Two, page 93;  he is on his way to meet the father of  his intended, Emma Lavenham.  This oddly anachronistic scene gets under way with this opener by Professor Lavenham:

“I feel bound to tell you that you are not down on my list of  eligible young men. However, I am quite ready to enter your name, should your answers be what an affectionate father requires.

Yikes – what century are we in??!!

Emma’s father proceeds to question Dalgliesh concerning his means and his living situation. For his part, Dalgliesh relaxes into the interview, thinking to himself that “they were to be indebted to Oscar Wilde for the dialogue of this personal inquisition.” (Personally I would have said Anthony Trollope or Jane Austen.) This is an old script being employed by the professor, one which is eminently familiar to Emma’s extremely literate and literary fiance.

As this scene reaches its conclusion, Dalgliesh receives a call on his cell phone (to the professor’s annoyance; he predictably loathes the devices). The Commander must gather his team of investigators and proceed post haste to Dorset: there has been a  murder.

I’d like to return momentarily to a point earlier in the novel. While driving to Cheverell Manor, Rhoda Gradwyn’s thoughts go back to a time six months previous when she attended her mother’s wedding. She and her mother had been estranged for some time, but the poor woman, who for years had been miserably married to Rhoda’s vicious tyrant of a father, was finally being offered a chance at domestic happiness. A rapprochement occurs between mother and daughter. At the reception following the ceremony, Rhoda gazes on the guests, all stolid representatives of the old  guard’s middle  class, and entertains the following sentiments:

“They had lived to see their simple patriotism derided, their morality despised, their savings devalued. They caused no trouble. Millions of pounds of public money wasn’t regularly siphoned into their neighborhoods in the hope of bribing, cajoling or coercing them into civic virtue. If they protested that their cities had become alien, their children taught in overcrowded schools where 90 per cent of the children spoke no English, they were lectured about the cardinal sin of racism by those more expensively and comfortably circumstanced. Unprotected by accountants, they were the milch-cows of the rapacious Revenue. No lucrative industry of social concern and psychological analysis had grown up to analyse and condone their inadequacies on the grounds of deprivation or poverty.

Whoa, thought I upon reading this. Strong stuff; I admit, it set me back on my heels. I was struck not only by the blunt resentment contained in this passage but by its bitter tone. I have read that P.D. James is quite traditional in her views regarding social issues. One gets that sense from her memoir, A Time To Be In Ernest. I have to say here that although she may be conservative, James is also a generous and compassionate person.  The Private Patient is, after all, a work of fiction, and Rhoda Gradwyn is an investigative journalist. The above ruminations are immediately followed by the thought that perhaps the plight of England’s downtrodden middle class might be grist for her reportorial mill.

In regard to the novel’s primary setting, James had the inspiration to place a prehistoric circle of stones just beyond the Manor’s walled garden. Before Rhoda’s surgery is to take place, in accordance with her doctor’s recommendation, she makes a preliminary visit to the Manor and spends a night there.  As she gazes out her bedroom window in the early morning, this is what she sees:

“A mist lay over the valley, so that the rounded hilltops looked like islands in a pale-silver sea. It had been a clear and cold night. The grass on the narrow stretch of lawn under her windows was pale and  stiffened by frost, but already the misty sun was beginning to green and soften it. On the high twigs of a leaf-denuded oak three rooks were perched, unusually silent and motionless, like carefully placed black portents. Below stretched a lime avenue which led to a stone wall, and beyond it a small circle of stones. At first only the tops of the stones were visible, but as she watched, the mist rose and the circle became complete. At this distance, and with the ring partly obscured by the wall, she could see only that the stones were of different sizes, crude misshapen lumps around a central, taller stone.

Everyone has heard of Stonehenge, but there are other stone circles found throughout the British Isles. Here, for example, is the Winterbourne Abbas Circle, a Bronze Age site located in Dorset and consisting of nine stones:


(In fact, the British edition of this novel features a stone circle on the cover.)


As for those black harbingers of doom upon whom Rhoda’s glance first falls, oh how the reader wishes that she had taken heed and fled from that place, never to return! But she is a modern woman, a citizen of the new millennium; she would not consider doing such a thing for such a reason. (Would we any of us?)

So then – what about those reviews? Before my friend warned me away from them, I had already gotten the sense that many were negative, with some critics claiming that The Private Patient seemed tired an unoriginal. But when I went back for a closer look, I detected by and large a more positive evaluation. Writing in the New York Times, veteran crime fiction reviewer Marilyn Stasio delights in finding  the ” traditional comforts of the British country house mystery — puzzling plot, attractive setting, brainy detective, interesting characters…” In the same paper, however, Janet Maslin’s take is more guarded: while appreciating the setting and atmosphere, she nonetheless feels that as a whole, The Private Patient is  not quite up to James’s usually high standards.

The reviewer in The Observer notes that while the conclusion is somewhat contrived – I would add, downright melodramatic – one forgives this flaw on account of the wonderful writing. The most negative review I found was in the Observer’s sibling journal The Guardian. That reviewer felt that while characterization of Adam Dalgliesh was too thin, the other characters were all too well fleshed out and so thoroughly unlikeable that “you wish someone would murder the lot of them.”  The Times Online takes the opposite tack,  praising the novel as a whole and in particular naming  Dalgliesh as ” one of the great police detectives in the history of crime fiction.”  The Washington Post’s review is likewise generally favorable, while   The New Statesman reviewer offers the provocative view that “the  real suspect to be cross-examined in this novel is not any one of the myriad potential murderers, but rather the status of detective fiction itself.”  The reviewer on the Eurocrime site declares that she did not care for the book, yet confesses that she “loved the experience of reading The Private Patient.” This sentiment exactly expresses my feelings: I lost myself in the text and was wishing the  book would never end.

I’d like to conclude with these gracious words from a profile of the Baroness in The Independent, August 2008:

When it comes to James’s own profession, she plans to stay an active member for a while yet. The Private Patient may have a “slightly valedictory” mood, but nothing is set in the Dorset stone. As for future novels, “This is going to be a matter of what happens to my heart, and how long it’s going to go on beating for me: I hope for some considerable time.” Meanwhile, this expert in sudden extinction rejoices in the present: “To live under the continual fear of death is to diminish the quality of life that you have.” Long may this patient, private icon remain a precious public asset.

P.D. James, in her home in west London

P.D. James, in her home in west London


  1. frances wang said,

    I read this when it first came out and enjoyed it immensely.


  2. Art and Intrigue II: The Gardner Heist, by Ulrich Boser « Books to the Ceiling said,

    […] In addition to the aforementioned mobsters, we meet members of various law enforcement agencies. My particular favorite among these was Charlie Sabba, a New Jersey police officer with a Bachelor of fine Arts degree from the School of Visual Arts in Manhattan.  A painter himself  and passionate about art in general, he put me in mind of Susan Hill’s Simon Serrailler and P.D. James’s Adam Dalgliesh. […]

  3. Best books of 2009: my own favorites « Books to the Ceiling said,

    […] by Archer Mayor Caravaggio’s Angel by Ruth Brandon The Listening Walls by Margaret Millar The Private Patient by P.D. James Blackout by Luiz Alfredo Garcia-Roza Wycliffe and the Tangled Web by W.J.  Burley […]

  4. Don Phillipson said,

    This is not a good book: better than many but obviously inferior to P.D. James’s best. She is getting old; it now shows in her prose, and it reveals the special difficulties of the autodidact in finding an authorial voice — as in a single sentence: “. . . drifting into sleep, she thought of the peaceful night ahead and of the morning she would never live to see.” This presents problems that do not advance either the narrative or the plot. P.D. James has done this before in other books, but more often here and it does more damage to The Private Patient.

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