****They All Fall Down

caramelized sugar

photo: Serene Vannoy, creative commons license

By Tammy Cohen – Hannah is a new patient in a women’s low-security psychiatric facility called The Meadows outside London, the result of an incident Cohen takes some time to reveal.

In the several weeks before this new psychological thriller opens, two of the facility’s dozen or so patients have committed suicide. In fact, the first line is, “Charlie cut her wrists last week with a shard of caramelized sugar.” Hannah doesn’t believe Charlie killed herself. She believes both of the so-called suicides were murder. But who will believe her?

Most of the short chapters are told in either Hannah’s first-person point of view or that of her mother Corinne, in third-person. Corinne isn’t sure what to make of Hannah’s accusations. She wants to believe her daughter, but Hannah’s done some strange things lately that weaken her credibility.

At the same time, Corinne is desperate to believe her daughter is safe at The Meadows. And the director, Dr. Oliver Roberts, and the art therapist, the supportive Laura, as well as most of the other staff seem capable and conscientious, don’t they? Are these people who they say they are? Their contention that their patients are high-risk, with histories of suicide attempts, never quite reassures her.

Author Cohen has assembled an interesting group of patients: Odelle, thin as a stick with serious eating disorders; Stella, whose otherworldly appearance results from too many cosmetic surgeries, including removal of a rib to achieve a smaller waistline; and Judith, who says she’s just being “honest” when she makes her intentionally cruel remarks. As events unfold and confidences are shared, these patients form a kind of lamenting Greek chorus.

The characters are mostly well developed; however, it was jarring when the patients’ ages would be mentioned. They were in their mid-thirties or so (Hannah is 32), but they came across like teenagers. Perhaps this is because they are highly dependent, vulnerable personalities.

Throw into the mix a lurking filmmaker and his cameraman working on a “fly-on-the-wall” documentary. The filmmakers were a nice touch (with the director Justin “doused in self-absorption like cheap cologne”), since an underlying theme of the book is perception. What does the “neutral” eye of the camera perceive? What do each of the characters perceive about each other, and do they trust each others’ perceptions—they certainly share doubts about Hannah’s—and does she even trust her own?

In general, the writing style is effective and the pace is good and varied. Cohen uses cliffhangers to keep you reading “one more chapter”—mysterious items and messages turn up in the hospital, a red baby hat on Corinne’s doorstep. Eventually these are all explained, but the repeated technique begins to feel artificial. On the whole, an intriguing psychological thriller.

A longer version of this review appeared on CrimeFictionLover.com.

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