A detective comes to the rehabilitation unit a month after the shooting. He does not want to be there any more than the patient’s mother wants him there. He pulls a chair up beside a young woman in a wheelchair, takes out a notebook and a pen, and asks what she can tell him about the night of December the ninth. She looks at the pen. The cap is red. Red is the colour her therapists put at the left-hand margin of a page so that she knows where the words begin, and so she watches it, and waits for it to move, and thinks only: don’t lose it. That is the interview. That is everything the police get. It is also the most efficient two paragraphs in Brain Damage by Freida McFadden, because it establishes in a single image that the witness and the evidence are in the same room and cannot be introduced to one another.
Freida McFadden Makes the Injury the Plot
Dr. Charlotte McKenna is thirty-seven, a dermatologist, comfortable, guarded, and privately convinced she is plain. A bullet passes through the right side of her skull in her own hallway. What follows is not a coma-and-recovery montage but roughly two hundred pages of ward life narrated by a woman who cannot consistently produce her own surname.
The damage she is left with is left-side neglect, rendered from the inside with a discipline most thrillers would not have the patience for. This is not blindness; it is a failure of attention so total that the left half of the world is not experienced as missing. Visitors materialise from nowhere. A tray arrives with only half a meal on it. A word on a name badge resolves into a shorter and much more frightening word, and a nurse has to talk her down from a panic that everyone else in the corridor finds hilarious. She fights the occupational therapist dressing her because when she is finally upright she feels herself falling.
Two things follow from this, and the second one is what makes Brain Damage by Freida McFadden better than its packaging suggests.
The first is that the reader is placed permanently ahead of the narrator without any of the usual cheating. Charlotte reports everything she perceives, faithfully and often comically, and the gap between what she perceives and what is happening does the work that an unreliable narrator normally does by lying.
The second is that the man who left her for dead crouched down and said one sentence into her left ear. The evidence is not lost. It is filed, precisely and permanently, in the one region of her experience she is neurologically unable to search. It is rare for a commercial thriller to build its central withholding out of anatomy rather than authorial convenience, and Brain Damage by Freida McFadden does it without ever announcing how clever it is being.
A Ward Written by Someone Who Works on One
The book carries a two-word dedication to the author’s own patients, and the closing pages hand the credit to the therapists and staff she works alongside. McFadden is a practising physician in this exact field, and the ward chapters read like it — not in the sense of being technical, but in the sense of getting the small humiliations right.
Charlotte is parked in a corridor at mealtimes so she can be watched. Her seatbelt is alarmed. She is promoted out of the group where the goal is knowing what day it is into one where the goal is thinking, and a single round of Taboo defeats all four of them while a retired psychiatrist of ninety-three complains the clues are too easy. The feeding tube comes out with a pop and she swears at the man who pulled it. She is in adult briefs because the gap between urge and accident is five minutes and the nurses change shift at eight and at four. Her insurance company is counting down, audibly, toward a nursing home.
What lifts this above documentary is that Brain Damage by Freida McFadden is genuinely funny inside it, and the jokes never come at the expense of the patients’ dignity — they come from the same place the patients’ own jokes come from. A man held to one litre of fluid a day finally cracks mid-session and puts his face under the hand-washing tap. A fellow patient smears an entire tub of cream cheese onto his face and blames the woman in the helmet.
The Cruelty in Brain Damage Is Administrative
The husband is where the novel makes its argument, and where the argument is stronger than the character delivering it.
Clark Douglas is handsome to the point of implausibility, which is the point; Charlotte spends the courtship unable to believe her luck and readers will spend it unable to believe anything else. He is a thin creation, and the moment he drops the mask he becomes a monologuing villain of the old school. But what he does with the mask off is very well observed. His menace is almost entirely clerical. He proposes an arrangement. He wants power of attorney. And he explains that his girlfriend will be moving into the master bedroom and can be introduced to visitors as the nurse. He vetoes a nicer pair of glasses on budgetary grounds. He tells his wife, calmly and at length, that no man will ever want her again and that she ought to be grateful to him.
This is the real subject of Brain Damage by Freida McFadden: the arithmetic performed on a person who can no longer do anything for anybody. Clark supplies one answer, and it is a market answer. The novel supplies another through Jamie Knox, a bar owner with wrecked balance and a six-year-old son, who works out for himself that if he turns her dinner tray around at every meal she will find the other half of her food, and then does it every night without mentioning it once.
What a book club will actually argue about: late on, Charlotte asks her doctor whether she could not see her left side because of what was standing on it — whether the neglect was conversion rather than injury. He tells her the lesion explains it perfectly well. The novel does not force the question shut, and the recovery, when it comes, is triggered by a pair of prism lenses so ugly she is ashamed to be seen in them. Miracle, medicine, or the mind letting go of something it was holding down? The text will support all three.
The weaknesses of Brain Damage by Freida McFadden are real and worth naming. The past-tense strand — courtship, wedding, betrayal — is a signposted domestic thriller with a firearm placed on the mantelpiece in full view of the audience. The mystery is not much of a mystery; there are two candidates and the field never widens. Charlotte’s running self-disgust about her body goes largely unchallenged for three hundred pages, which some readers will read as characterisation and others as the author’s own weather. And the 2016 vintage shows in the references. But a book that can hold a reader through a chapter about a woman failing to catch a beach ball has earned considerable latitude elsewhere.
For readers who want the marriage rather than the ward, The Divorce is the same author working the same material at higher speed and lower resolution, while Want to Know a Secret? is the closest cousin here for clinical texture and a narrator who cannot be trusted with her own account. Anyone who admired the sheer nerve of Jeneva Rose’s The Perfect Marriage will recognise the spousal calculus, though McFadden is after something sadder than a gotcha.
Where It Leaves You
The last page of Brain Damage by Freida McFadden delivers a diner, a thrown pea, and an ending so neatly tied that its own author seems slightly embarrassed by it — the acknowledgements are largely a comic transcript of her husband insisting the killer should have been an evil twin attached to the left side. It is a soft landing for a hard book.
What survives the landing is the corridor. Brain Damage by Freida McFadden is not remembered for its conspiracy, its stolen millions, or the twelve-year sentence handed down at the end. It is remembered for a woman relearning, in public, at the intersection of two bright white hallways, how to swallow, how to find her own arm, and how to be looked at. The thriller machinery is serviceable. The ward is the novel, and the ward is very good.