Measured madness

In Clare Allen's remarkable debut novel, two 'dribblers' at a London psychiatric hospital need to prove their insanity in order to escape. Review by Tom Barbash

Poppy shakespeare. By CLARE ALLEN. Bloomsbury, €19

'How do you prove you're mad?" asks one of the characters in Clare Allan's remarkable debut novel. "Well you do mad things, innit." But the line between madness and sanity swings unpredictably throughout this story about two patients at the Dorothy Fish day hospital, a North London institution for the mentally ill – one a 13-year veteran, the other a stylish and apparently sane single mother attempting to win her own release.

While Allan is hardly the first to explore this territory, in Poppy Shakespeare she creates a satisfyingly complex, darkly satiric and deeply claustrophobic world. Here the patients (called "dribblers") spend their days trading cigarettes for pills at a dribbler-run market, comparing their psychiatric assessments (27 different quotients, "from High High High to Low Low Low") and arguing over the literary roots of a suicide note. Doctors or administrators are scarcely seen, and unlike One Flew Over the Cuckoo's Nest – the novel with which Allan's is most likely to be compared – the book has no easily identifiable villain, no obvious Nurse Ratched.

Instead, Poppy Shakespeare sails on the strength of the slangy, profanity-prone and emotionally thwarted voice of its narrator, a woman simply called N, who knows virtually everything about the inner workings of the hospital and nearly nothing of the world outside, where street maps befuddle her and pop culture escapes her. She has no friends or family checking up on her, and no thought of ever abandoning the psych ward.

When Poppy Shakespeare arrives one morning, wearing "this little black suit, a lacy white blouse, black tights and snakeskin heels", N, who has been asked to serve as Poppy's guide, takes her for a pharmaceutical executive or a smartly dressed off-duty nurse. Poppy, in turn, mistakes N for a member of the staff. The two women promptly embark on an alternately farcical and hellish relationship as Poppy tries to burrow her way out and N tries to help her.

The conceit running through the rest of the book is that in order to secure the services of an attorney (a man with the Dickensian name of Mr Leech) to prove that she's sane, Poppy needs to gain access to the MAD (Ministry for the Advancement of the Deranged) law purse, which will pay his fee. As Mr Leech explains it, in a line straight from Catch-22, "You have to declare yourself mentally ill in order to prove you're not mentally ill, but there you are."

N becomes Poppy's tutor in proving her madness and, as might be expected, she does her job a bit too well. And yet, as fantastical as the set pieces become, and as limited in emotional scope as many of the imaginatively described supporting characters are – Verna the Vomit (who suffers from bulimia), Sue the Sticks (formerly known as Slasher Sue), Marta the Coffin, a woman so visibly depressed that "hearses used to toot her as they gone past down the street" – the novel never veers too far from the real.

Poppy Shakespeare is at least in part about a mental health system that has failed everyone, not through physical abuse from the priggish nurses and sadistic orderlies we've seen in other books but through nearly criminal neglect. It also provides a fun-house-mirror perspective on the madness of the bureaucracies even supposedly sane people are forced to live with. What's most startling about Allan's gift as a novelist is her ability to give us both the story N wants to tell and the one just beyond her comprehension.

Tom Barbash is the author of the novel The Last Good Chance and the nonfiction book On Top of the World. He is currently completing a collection of short stories

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