FICTION REVIEW: "Turn of Mind"

This daring and confident first novel is a tour de force that takes us deep into heretofore unexamined psychological territory. It is the first-person account of a woman plunging rapidly into dementia. She is a retired hand surgeon who has posted a sign on the wall to remind her of basic facts: "My name is Dr. Jennifer White. I am sixty-four years old. I have dementia. My son, Mark, is twenty-nine. My daughter, Fiona, twenty-four. A caregiver, Magdalena, lives with me." Her husband, James, is dead, though she only intermittently remembers that.

She slips in and out of reality, back and forth from present to past. Early on in the book, she is institutionalized, though her children visit her almost daily. More and more often, she does not recognize them. When she goes off the deep end, into a private realm often shadowed by paranoia and fury, it is their voices that keep the reader on track.

The novel is a mystery thriller as well as a psychological study. A detective keeps visiting her to ask the same question over and over, one that will be answered by book's end. Her best friend and neighbor, Amanda, has been found dead, probably murdered. The grisly sign that points to Jennifer's guilt is that four fingers of her right hand have been neatly, surgically sliced off. The detective surmises that the killer wanted to pry something out of that hand. Jennifer struggles in vain to remember. "Something nags. Just out of reach. ...This dark shame. A pain too lonely to bear."

As Jennifer relives portions of her past, we learn some details of a wary marriage, marred by infidelity on both sides, plus a shocking secret that only Amanda was privy to, one that she held as weapon over her friend. For this was a fraught relationship, with large doses of rivalry and enmity mixed into the affection. As Fiona remarks, "It sounds like an alliance rather than a friendship. Like the treaties between heads of state, each with powerful armies."

The novel moves briskly, never flagging, the way that a good mystery barrels ahead. It never turns maudlin and even has flashes of humor.

After watching David Letterman, Jennifer devises her own Top 10 List:

"TOP 10 SIGNS YOU HAVE ALZHEIMER'S. 10. Your husband starts introducing himself as your caregiver." And so forth, hilariously.

This a wonderfully assured, absorbing novel, with each character finely imagined and a gangbuster of a plot. It is both literary and, as people like to say nowadays, "accessible."

Brigitte Frase is a book critic in Minneapolis.