Novelist and playwright

Hamilton aspired to writing from an early age and was encouraged in this by his mother. Supported by his family, he settled down to writing full time, as well as becoming an expert on the inside of London’s pubs, which were to supply much of the material for his later books. Hamilton’s sister Lalla, an actress, helped him find employment in the theatre, though his experience was mainly backstage. The knowledge he gained of what was practical to stage and his talent for writing were a recipe for success, beginning with Rope, his story of two Nietzsche-obsessed young men who attempt to commit the perfect murder. His good fortune did not last long, however, as in 1932 he was hit by a car which left him badly disfigured and with a hatred of motor cars for the rest of his life.

Despite the success of his plays, Hamilton always believed himself to be primarily a novelist. Widely considered to be his masterpiece, the three novels that make up Twenty Thousand Streets Under the Sky (Reference HamiltonHamilton 1935) each tell the same story from the perspective of a different character. His writing matured greatly over the course of his career, but also became progressively bleaker. His final series (Reference HamiltonHamilton 1955) deals with the psychopathic Ralph Ernest Gorse as he swindles his way along the South coast. Gorse was modelled on Neville Heath, a psychopathic charmer convicted and hanged in 1946 for murdering at least one woman and who attempted to claim insanity under the M’Naghten rules (Reference ShewShew 1960). Hamilton originally planned further novels eventually bringing the protagonist to justice. However, this planned retribution was not to occur, as in 1956 he suffered a significant episode of depression which was treated with electroconvulsive therapy. His mood recovered, but he never wrote again. Despite attempts to cut down his drinking, his health declined steadily and he died at the age of 58.

A story of darkest Earl’s Court

In many ways, Hangover Square (Reference HamiltonHamilton 1941) shares common elements with other Hamilton novels – the oppressive atmosphere, hopeless obsession, gin-soaked characters and the location. Set in London and Brighton in the last days before the Second World War, the book follows George Harvey Bone in his hopeless pursuit of Netta Longdon,

As if to cement her unpleasant character, privately at least, Hamilton located Netta’s flat precisely where the car hit him in 1932.

Bone’s ambivalence towards Netta is manifested in two psychological states. In one, he worships her and can think only of finding ways to ingratiate himself with her, being hurt by the inevitable rebuff. In his ‘dead moods,’ however, he slowly realises that he has only one purpose – to kill Netta and to escape to Maidenhead, where he will be safe.

A heavy drinking man

One of the most obvious areas of interest for psychiatrists is the role alcohol plays in the book. Much of Hamilton’s adult life was spent drinking or trying to cut down on his drinking. He never considered himself an alcoholic, preferring the term ‘heavy drinking man’, the title he used for his unpublished memoirs (Hamilton unpublished). His novels, too, were ‘saturated with, almost drowned, in drink’ (Reference HamiltonHamilton 1972) and Bone is a heavy drinking man. Gin is his passport to interacting with others and the currency with which he purchases Netta’s favour. Some of Hamilton’s most engaging writing concerns the goings on in urban public houses. This reminder of the importance of the social world facilitated by alcohol helps one appreciate the difficult decision faced by someone encouraged to stop drinking for health reasons when their only social contact is in the pub.

Bone’s illness

Hamilton is unparalleled when describing his characters’ inner narratives – first-person descriptions of subtle shifts in mood from elation to envy and murderous feelings. Indeed, his depiction of jealousy makes his personal experience of this emotion clear and, at times, the intensity of the emotion approaches morbid. These almost imperceptible moment-by-moment shifts in mood are those that a good mental state examination attempts to capture, though few of us are as gifted as Hamilton in our descriptions.

In contrast to these smooth transitions, Bone’s ‘dead moods’ come on very suddenly (suggesting that they do not correspond to drunkenness and sobriety), without any warning, and often at rather tense moments of the book:

Hamilton’s description of these moods include some familiar symptoms. There are elements of derealisation and some of the lexical flexibility seen in schizophrenia, but his experiences retain a metaphorical quality rather than the symbolic equation of delusions (Reference SegalSegal 1957):

Each time Bone changes into this alternate psychological state, he experiences a prodrome-like period with a psychotic atmosphere before his resolve to rid himself of Netta crystallises:

The book’s epigraph implies that Bone has schizophrenia. However, it seems unlikely that he would attract this diagnosis today. On the other hand, it is well recognised that general usage of the word ‘schizophrenia’ diverges substantially from clinical descriptions (Reference WoodsWoods 2011).

Dissociative fugue

While in a ‘dead mood’ Bone walks long distances, once from Brighton to Portslade, and has no recollection of how he got there when he returns to his normal state. Such travels are strongly reminiscent of Albert Dadas (1860–1907), a gas company employee from Bordeaux who was the prototypical ambulatory fuguer at the beginning of the ‘fugue epidemic of the 1890s’ (Reference HackingHacking 1998: p. 10). Dadas was described in detail by Dr Philippe Tissié in his 1887 undergraduate thesis, Les aliénés voyageurs, and, more recently, by the philosopher–historian Ian Hacking:

Hacking’s thesis is that ambulatory automatism flourished in a particular ‘ecological niche’ and that examining such transient conditions might help us think about our contemporary classifications of mental illness (Reference HackingHacking 2013). Indeed, our taxonomies still include comparable, if seldom used, diagnoses. The ICD-10 criteria for dissociative fugue (F44.1) include

Concluding remarks

No one captured the drudgery and distress of day-to-day life in mid-20th-century Britain better than Patrick Hamilton. He is, in my opinion, one of the best writers of the past century and deserves to be widely read. Thankfully, owing to print-on-demand technology, almost all of his books are once again in print and one can only hope that his unpublished memoirs and other papers will soon follow.