Architectures of Torment

The clinic in contemporary fiction

Maya Palit Illustrations By Mia Jose
01 April, 2024

HOSPITALS ARE STRANGE PLACES to look for linear stories. Their layouts compel you to think about the human body in a dismembered way—a floor for the heart, another for the kidneys, and so on. With death lurking everywhere you look, everyone lives in the eternal present, fighting tooth and nail for life. And then there is the lost time, spent waiting.

In fiction, the limbo that these spaces create offers authors a chance to flesh out the lives that have brought their characters there. Much of the Tamil novel A Woman Burnt, by Imayam, is set in the burns unit at a Puducherry hospital, where relatives of a young upper-caste woman, whom they had ostracised for marrying an autorickshaw driver, wait for her to recover after she attempts self-immolation. In Elias Khoury’s Gate of the Sun, partly set during the Israeli invasion of Lebanon, in 1982, a Palestinian doctor at a refugee camp in Galilee—who describes himself as “a temporary doctor, in a temporary hospital, in a temporary country”—tries to keep his mentor alive and recounts stories that make up a sprawling, epic history of his people, going back to the Nakba.

The mix of bureaucratic order and chaos, and the fact that everyone is in the same boat but in too much of a rush to engage with each other, means that writing about these spaces often contains flickers of absurdity, with which people are likely to be familiar. Psychiatric hospitals, however, tend to short-circuit this universality, because of the prevailing view of madness as an aberration, a social taboo, a space unfamiliar to the general public. C Ayyappan’s Malayalam short story “Bhranthu”—Madness—for instance, revolves around a Dalit teacher, living in an upper-middle-class neighbourhood, whose neighbours try to get him to institutionalise his sister. The thought terrifies him, because her condition could lead to intrusive questions that expose his family background to his neighbours. Since his wife detests his dark-skinned relatives, he also anticipates that she would refuse to visit his sister. Throughout the story, he wrestles with the dilemma of being unable to acknowledge her presence in the hospital.

Contemporary Indian fiction has explored notions of madness in stories set within the clinic as well. In these, a character often remains lodged within a ward, within a time warp of sorts, while the author chalks out crucial bits of the broader narrative. Sandhya Mary’s recently translated Malayalam novel Maria, Just Maria begins with its protagonist in a psychiatric hospital that she describes as uncommonly calm, just as she is provided with a television—a luxury afforded only to patients felt to be recovering. “Madness is often an easy solution for writers to conclude a story, especially stories with a hero or heroine in the grip of an existential crisis,” Maria says. “In real life, though, madness is boring.” It is hardly surprising, then, that, after the first chapter, the book abruptly abandons this setting, leaping into hallucinatory dreams; memories of her grandparents’ home, ghosts, ancestors and talking pets; a fragmented narration of the volatile childhood that those around her blame for catapulting her into madness; and an inquiry into what passes for sanity. The narrative captures the chaos of life outside the ward. The inside is tepid.


Maya Palit is the books editor at The Caravan.

Mia Jose is a non-binary illustrator and devourer of all things camp and horror, who draws from her Kerala roots to navigate the intersections of queerness and inheritance.