An Interview with Clare Dudman, author of '98 Reasons for Being'

Jonathan: I'd like to begin by saying that I enjoyed reading 98 Reasons for Being very much. I thought it very inventive in the way it combined fiction, historical research, biography and scientific thought about madness into a very readable novel. One of the reviewers quoted on the back of "98 Reasons for Being" mentions the "Teutonic intensity" of your previous book "Wegener's Jigsaw" which was about the German geologist Alfred Wegener. "98 Reasons for Being" takes up the story of Heinrich Hoffman, a physician living in 1850s Frankfurt. What is it that draws you towards German scientists in particular? And did one book somehow provide the seed for the other?

Clare: THANK YOU! That's very kind. I think the 'teutonic intensity' refers to my style of writing which I have also been told is ' literary' and quite passionate. I think I could quite happily take about ten pages describing the process of putting on a sock. There would be flashbacks to previous moments my character had put on the sock, what the putting on of the sock signifies for him today, why he chose that particular sock, how it reflects the weather and the state of his mind, and what he hopes to achieve now he has chosen this particular sock over others in the drawer. I like to get inside my characters' heads. I like to try and think like they think. Sometimes it slows things down and lovers of fast-paced books will probably not like my books. But I think anyone reading them will have an impression of what it would have been like to be one of my characters and have an impression of how I feel it must have been like to live their lives - as well as the ideas and thinking of the time.

I am not particularly interested in Germans, although I have grown to appreciate German people since writing my books. Without exception they have been helpful and friendly and keen to see their countrymen lauded. I was, however, interested in Alfred Wegener and his quiet heroism, as soon as I learnt about continental drift at school. He has been my hero ever since. It was through reading about the history of Germany in my researches about Wegener that I came across Dr Heinrich Hoffmann. I discovered that he was the superintendent of a lunatic asylum. Since I already knew about STRUWWELPETER, his book of cautionary tales for children, I thought it would be an interesting thing to link the events of his life with the tales in the book.

Jonathan: '98 Reasons for Being' is a book that is obviously the result of great research effort: one wonders at which point the imaginative process kicks in, especially when the principle character, in the shape of Heinrich Hoffman, is a real person. Hoffman seems a heroic but isolated figure, struggling with his own problems at home while also trying to cure his patients against the odds: failing with some and succeeding with others. He is also apparently attracted to one of his patients, Hannah, whom he tries to cure first with brutal methods such as a douche of freezing water and galvanism (electric shocks behind the ears) and later, with a more subtle 'talking cure'. Was it difficult to steer a path between fact and fiction? And do you see this conflict between fact and fiction as potentially bringing something new to the novel form in terms of style?

Clare: Yes it was a lot of research. The first thing I tried to do was to get into the way of thinking of a mid-nineteenth century psychiatrist. I read lots of papers of the time and many books. I also visited Frankfurt several times and examined things like photos, maps, portraits of people, museums, some of Hoffmann's memoirs, a biography and his casebook. I suppose I have developed a philosophy and it is like something I heard Pat Barker say: I find out as much as I can then feel free to fill in the rest. Usually this leaves a great deal. So I make my own interpretation of his character - and in Hoffmann the other characters in the book - which are completely fictitious - although there are records of patients like them, suffering from the conditions I describe, in the Frankfurt asylum at the time. The attraction between Hoffmann and one of his patients is fictitious, but it could have happened, and I think probably did.

The cures are based on the ones that Hoffmann outlines in his casebook. I think that the heroism required of the patient is something that can quite easily be overlooked. These are commonplace in nineteenth century literature. They are sometimes mentioned in passing, but to the patient concerned, especially if they were sensitive, they would probably have been quite terrifying. I was reading Emily Bronte's WUTHERING HEIGHTS recently and they are in there - bleeding, feeding bland foods, isolation and incarceration - Catherine is subjected to these with little comment.

I am sure these treatments would have sent some people mad (or made the already neurotic, psychotic) - and in fact Hoffmann records that some of them do. So I took the 'bare bones' of these cures - mentioned in his casenotes for one patient, just 50 words - and imagined how it must have been to have suffered these treatments. Hoffmann also records how he tried the moral therapy of the time (i.e. talking) so I felt at liberty to make my Hoffmann do this too. So from these small number of facts of how Hoffmann lived and worked I expended this into fiction. Since a lot of it is in Hoffmann's (and the other patients') heads, no one can argue with me.

I don't think this is particularly new. As I mentioned Pat Barker has done the same in her REGENERATION trilogy, and there are many other examples - Tracy Chevalier's GIRL WITH A PEARL EARRING is another, and Henry James was the non-fictional subject of at least two works of fiction recently (David Lodge's AUTHOR, AUTHOR and THE MASTER by Colm Toibin). Scientists are less studied I think, which is a pity because I think science is a rich field for fiction - and fascinating source of ideas.

Jonathan: Gender seems to play an important role in framing the novel. You concentrate more on the stories of the women inmates of the asylum, some of whom are there due to mistreatment at the hands of men. You also quote statistics which suggest that more of the inmates in the asylum were women, though I note there were less women than men who suffer from 'general confusion'... Is it generally true that the majority of asylum inmates at this time were women, and if so, why was this?

Clare: Gender was, and still is, an important issue in terms of madness. For a long time women were thought to be especially susceptible to going mad, particularly at certain times in their lives - during puberty, pregnancy, and especially at the critical period - the time of the menopause. This idea arose in the times of the ancient Greece - hysteria was thought to be an exclusively feminine condition, due to the womb wandering around the body (whereas hypochondria was thought to be exclusively male) and prevails even in the modern day. In fact there is some scientific basis - when you read the clinical handbooks of the end of the eighteenth century of people like ESQUEL who was an early psychiatrist working in Paris - it is clear he has identified some of the clinical conditions we know today - post-natal depression, and anorexia nervosa - although he calls it something different of course - monomania was a common term.

Women were susceptible not just due to their hormones but also due to the stresses that society put upon them. Sometimes they wanted to marry, but could not afford to do so and so were forced into poor spinsterhood. Sometimes they were forced into a loveless marriage. They had little power - and I think it is lack of power that drives people mad. It is the reason that soldiers started to go mad in the trenches of the first world war, when in previous wars nothing like shell-shock had been encountered. They were forced to sit there day after day waiting for something to happen to them and unable to do anything about it. It may sound over-dramatic but I think many women in the nineteenth century experienced a similar sort of shell-shock in their ordinary lives.

There were men in the asylum too of course and large numbers of them were there due to tertiary syphilis - which manifested itself as general confusion or more often general paralysis of the insane. They didn't realise this at the time - syphilis is an interesting disease. It can lie dormant for many years after the initial infection - only manifesting itself as madness when it attacks the brain. Syphilis was rampant at the time due to the overcrowded social conditions - and it was generally men that got it after visiting the prostitutes.

Jonathan: Heinrich Hoffman was, by your account, a self made man. His 'Struwwelpeter' poems for children are quite macabre: like the tale of the boy who sucked his thumb and so had it chopped off. At some points in the book, when he is talking with Hannah, you portray him as quite sensitive. However, this sensitivity is undermined by his insistence on applying what seem like rather barbaric and sadistic healing techniques on Hannah. Your portrayal of Hoffman at times seems to underline a sort of confusion between a motivation to cure, a scientific, cerebral motivation and a sexual motivation. Do you think scientists have the right to try out things which the person in the street might find unacceptable, or do they need to be closely regulated?

Clare: Yes, he was self-made. He was the first member of his family to be a member of the new middle-class and he was proud of this. The macabre nature of his work is probably due to his occupation - at one time he was a pathologist - and what may seem normal to a pathologist may seen macabre to everyone else. Doctors, I have noticed (my brother is one) do have a macabre sense of humour. I think it helps them deal with what they do in some way.

I believe that Hoffmann was sensitive. He was an artist and he wrote satirical works. He cared very much for his patients. Part of the reason he wrote his book of cautionary tales was because he cared. As a family doctor he had many young patients - and in order to put them at their ease (if the doctor visited you were very likely to end up suffering some painful treatment) he used to invent tales and draw funny pictures. These he made into a book for his son as a Christmas present when he could find nothing in the shops that he liked.

As for the barbaric treatments he was trying to do good, and thought he was doing good. He had to steel himself and carry on, although it was all a bit experimental. But his main aim was to cure, and I suppose that would justify the means even to a sensitive doctor like Hoffmann. And yes, there is also an intellectual side to all this, an idea that he must be learning - because so little is known - part of his sensitivity is to find out, and thereby cure and do good. The sexual motivation is something he can't control. Something that comes in despite himself. That is also due to his sensitivity. He feels misunderstood and dismissed by his wife - especially in terms of how they deal with their problematic son - and because of that he feels drawn to one of his patients who seems to listen to him, and seems to regard him highly. He knows it is wrong, but he does it anyway. I suppose he is a little confused and fallible - like most people.

This was in the nineteenth century when things were not regulated - and of course worse things, much worse things, have happened since in the name of science. I do not think that scientists 'have the right' to do anything - they must be regulated, just as the man who services the gas meter and the dentist must be regulated. But I do not think the man in the street (or a politician) is necessarily a good judge. I suppose the best regulators would be an informed 'think-tank' - intelligent people able to understand the science and morals involved. It is quite a difficult task.

Jonathan; In 1817, Mary Shelley published 'Frankenstein', a fiction which used the new practice of galvanism in an imaginative way to suggest that it was possible to reanimate dead bodies using the power of electricity. Your book takes a historical perspective and a modern understanding of the effects of electricty on the brain. Shelley's novel is the science fiction of its day, and yet had a metaphorical warning for scientists against becoming too entranced by the wonders of science and trying to 'play god'. Today we seem to be closer than ever to the point where scientists can 'play god'. What do you think about this, and are you attracted to the idea of taking an aspect of modern science and writing a more fantastic fiction that depends less on historical research and more on "what if?"

Clare: Yes, I do feel attracted to investigating the idea of 'what if' - less of a fantasy, but closer to exploring the social effects of what might happen if the technology we almost have becomes more widespread and usable. In fact that is what I am thinking of doing next. I have been invited to become 'writer in residence' at the University of Oxford's Institute for the Future of the Mind. I am going to shadow surgeons and scientists in neurology with a view to writing some fiction based on this.