This dystopian novel is set in the near future, in 2023. Barry James is being quarantined in a secure facility located in the hot, arid Karoo desert of South Africa. He and his fellow patients are suffering from pulmonary nodulosis, a lethal disease called the “new plague.” Barry has been confined there for over three years; in that time he has cut all ties with the past because “looking back is madness.” He is just waiting to die.

After Barry attempts suicide, a psychologist suggests that he keep a journal. His notebooks form the narrative core of this novel. In a preface, the editors/compilers of these notebooks suggest that they be read “as a meditation on the psychology of illness.”

This is not an action novel with a lot of suspense. Barry describes his daily life which is a routine of eating, sleeping, taking medications, and staring out the window. He is very lethargic so it is obvious that he is struggling with depression. Occasional visits with Ms. Van Vuuren, the psychologist, or chats with Dr. Von Hansmeyer, the resident physician, provide some relief from the monotony.

Barry’s only escape is dreams: “They are the only way out of here – in those dreams anything is possible, any horror, any one, any thing, even snow.” He sleeps so that he can dream: “Dreams. What bliss to close your eyes on this carnage, to slip into blackness and be swept away to another world.” Barry describes his dreams in great detail; in all of them, snow is falling, as if he wants to inhabit a world that is a total contrast to his reality. He comments, “even in the most bleak of worlds we’ll find something to hold on to . . . even if that is something as impossible as snow in this god-forsaken wasteland.”

Barry is an unreliable narrator. The effects of his medication often leave him unable to distinguish between reality and delusions. Likewise, he is not above fabricating stories to tell the psychologist. In the preface, the reader is told that the journals are “in effect an internal monologue that straddles the precariousness of what are essentially two worlds – one real and one imaginary.”

The book is an examination of the psychological effects of a terminal illness and isolation: “We are sick and therefore we are isolated, locked up. We must wait out our days here, and then die – so that the healthy ones, the ones we have forgotten about, may live.” And the world outside the facility is not a haven either; there is a suggestion that the outside world is falling apart because of climate change: “’The whole country is now nothing but army and private contractors protecting the rich. And as long as they have these droughts and floods, nothing will change. All downhill from here.’”

I cannot say that I found this book unputdownable. At times, it is tedious. But, of course, that tediousness is a reflection of Barry’s daily existence. It is thought-provoking and suggests that there may be no true asylum (shelter and protection) for us in the near future.

Note: I received a digital advanced reading copy from the publisher.

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