Music Therapy 
 Many years ago, while a patient at one of those old English mental hospitals built like a huge country house in its large estate, I was asked to play the piano in some of the chronic wards. It was therapy for them; it was therapy for me. So I was immediately attracted to the character of Charles Fuller, who has scraped through his qualifications as a doctor, but finds fulfillment in playing for the patients at Sharston Hospital in Yorkshire and leading the band in the ballroom on Friday nights, the one occasion when selected male and female patients are permitted to mingle. The year is 1911. 
 Charles is one of three characters who get chapters to themselves on a rotating basis. The other two are patients: Ella Fay and John Mulligan. Ella, who has been working in a spinning mill since childhood and is still only in her teens, cracks one day in the noise and heat and throws a bobbin through a window. For this, she is committed to the hospital, and is eventually assigned to work in the laundry. John, an Irishman from County Mayo, has both lived more and lost more. But, as a strong and physically healthy man, he is employed outside the hospital building, first digging graves and then, as the seasons turn from seedtime to harvest, working in the fields. We will get to know him as something of a poet. 
 The novel has a fascinating shape of overlapping rise and fall. The first part resonated especially with me, echoing my own early impression of the hospital as a kind of Victorian workhouse, only to recognize it as a place of self-discovery and healing. Against the odds, it is also a place of friendship. John meets Ella at one of the dances, and begins smuggling her letters describing things he has seen on the farm. Ella gets has them read to her by her friend Clem, a bookish anorexic in whom the epistolary romance stirs needs she didn't know she even had. Despite its grim beginnings, the novel is soon rising into beauty and hope, a trajectory that takes it well beyond the halfway point. 
 Dr. Charles Fuller also has his epiphanies, but they are not ones he can handle, and in the second half of the book all his enlightened attitudes begin to curdle. It is a rather melodramatic shift, and I would have said an improbable one, had not some recent events shown me otherwise.* But Anna Hope does a brilliant job of tying together period details such as the General Strike of 1912, the force-feeding of suffragettes, and the growing Eugenics movement to create a potential for disaster that is even greater, because it affects people one has come to care about. I had intended this to be a two-day book, but could not put it down in the last hundred pages without knowing whether the forces of repression would triumph over those of freedom. 
 In her afterword, Anna Hope reveals that "Sharston" is merely the name she has given to a similar Yorkshire mental hospital, where her great-grandfather was confined at around this time. So she too has a personal involvement, and the story which emerges is both deeply felt and utterly absorbing. Only the tinge of melodrama keeps me from giving it five stars, but it is a very high four indeed. 
 [I received my copy through the Amazon Vine program.] 
 * 
 (view spoiler)[I was reading this just as the investigators of the Orlando nightclub shooting were speculating on the motives of the perpetrator. An extreme case, maybe, but a reminder of what sexual confusion can do. And despite his attractive qualities, Charles Fuller is a weak man, easily led into ideologies whose apparent clarity can assuage own self-doubt. (hide spoiler)]