For better or for worse, much of our knowledge of disease and medicine seems to come through popular culture channels rather than from more reliable sources. The effects of L-DOPA on patients with sleeping sickness, well-documented in Oliver Sacks’ Awakenings, were dramatically exaggerated for the film of the same name. Tom Hank’s Oscar-winning performance in Philadelphia positioned AIDS as a sociopolitical issue rather than as a condition that is both preventable and treatable. Multiple personality disorder (MPD), a disease that some physicians still dispute the existence of, was brought full force into the public eye via the best-selling book Sybil.
Unfortunately, when a disease becomes the prime focus of a story, it is often over-simplified to make for easier consumption by the reader or viewer. The difficulty lies in dealing with the intricacies of disease while still holding the interest of individuals who may be less medically inclined. This trend makes Matt Ruff’s success at presenting a full, nuanced portrait of MPD in Set This House In Order all the more impressive.
Fans of Ruff’s previous two novels, Fool on the Hill and Sewer, Gas, & Electric will notice a distinct departure from the unique blend of fantasy and reality that has become the hallmark of his writing. However, the same careful characterizations, dense plotting, and overall excellent writing remain.
House tells the tale of Andy Gage, a child abuse victim with MPD. The story is told from the point of view of one of the personalities (or “souls”) that inhabit Andy’s body, the 26-year-old Andrew. With the help of his doctor, Andy has learned to manage his disorder by compartmentalizing the his personalities into various rooms within an imaginary house in his mind. Through this structure, control of his body is voluntarily ceded to the various personalities for necessary tasks, such as self defense or enjoying a shower, though Andrew retains primary control.
This particular treatment for MPD is real, though controversial. Readers familiar with the well-known story of Sybil will recall that in the case of that book’s title character, the disease was treated by integrating the personalities into one functional consciousness.
While Andrew makes for a compelling narrator, the book doesn’t really take off until Penny, one of his co-workers, is introduced. Penny, like Andy, suffers from MPD. Unlike Andy, she is completely unaware of her condition. As such, she experiences lost time, finding herself mysteriously shuttled from place to place after extended blackouts during which her other personalities take over.
That Ruff can manage to make Andy and Penny’s various personalities distinct enough that the reader can keep track of them along with half-a-dozen other supporting characters is a testament to his skill as a writer.
An intense yet enjoyable read, Set This House in Order contains at least one shocking twist, though it is played so realistically and is so well integrated into the story that suspension of disbelief is not required. With his third novel, Matt Ruff proves his mettle as a serious writer and a deft storyteller.