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Sat 17 Jan 2009 04:00 AM

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Mind-body problems

Maria Russo reviews the latest addition to the what women want genre.

Maria Russo reviews the latest addition to the what women want genre.

The unexpected misery of having it all - the husband, the baby, the wished-for fancy career - is a phenomenon with a growing literary trail. In the United States, the problems presented by the modern female high-functioner tend to be the territory of memoirists and manifesto writers: Leslie Bennetts, Judith Warner, Caitlin Flanagan, Linda Hirsh-man.

But in Britain, it's fiction writers who have been probing the situation. In a way that makes more sense: What ails the privileged contemporary daughters of feminism is so subtle and multifaceted, rooted in such a mash-up of internal and external forces, that the novel may be the ideal way to capture it.

The results can be humorous and slight (Allison Pearson) or humorous and deep (Helen Simpson) or visceral and disturbing (Rachel Cusk), but at the very least they omit the phrase "work-life balance."

To the list of fiction-writing British explorers of the modern feminine condition add Patricia Ferguson, a former nurse and midwife whose sixth book, Peripheral Vision, is both cheerful and emotionally wrenching.

Ferguson begins by introducing Sylvia Henshaw, an eye surgeon in her early 30s who is accomplished, attractive and at war with herself. In the aftermath of an emergency C-section, she finds she can't connect to her much older husband or her "unbearably fragile" baby.

"The glorious relief, two months later, of going back to work!" Diagnosis: Acute high-achieveritis, postpartum variety. Body torn in two, heart like a stone, future obliterated. Prognosis: Not fatal. So don't let on. Do you want them to think you're a freak of womanhood?

Sylvia's predicament is the heart of the novel, but it's just the entry point into an ambitious narrative that jumps back and forth in time, with a cast of characters, both men and women, whose connections aren't fully revealed until the end.

Back in the 1950s there's Iris, a beautiful young nurse whose capacity for nurture masks a crippling emotional wound from her childhood. There's Iris's patient George, whose eye was mutilated in a household accident.

There's George's mother, Ruby, who's pulled herself up after a deprived childhood and will never forgive herself for what she let happen to her only child. There's heedless Rob, training to be a surgeon and in love with Iris, though his snobbish mother is aghast at her commonness.

In the mid-1990s, we have Sylvia and Adam, who fell for Sylvia after his wife left him for a younger man. And then there's Sylvia's childhood friend Will, an actor whose best years appear to be behind him as he cares for his dying mother.

Ferguson uses her medical background not just to believably depict her characters' working lives but often to crawl inside their skin to the point of being on familiar terms with their livers, their spleens, the bloody pus that oozes out of their gashes. No doubt the eyeball and its ailments have never been presented in such smooth and friendly prose.

The same goes for Ferguson's straightforward and compassionate descriptions of maternity wards and aging and dying bodies. As horrific as some of her images are, there's no McEwanesque lurking revulsion.

The eye surgery play-by-play ends up being so absorbing that you're ready to forgive the obviousness of the novel's overarching metaphor: the contingency of vision, the trouble we so often have seeing what's right in front of us.

Clearly, Ferguson understands that our physical and emotional lives aren't separate. "All the while she is entirely absorbed," reads one passage, describing Sylvia's bliss as she operates.

"Her heartbeat is slow. All the processes of her body are calmed. Within she feels the great lively peace of creativity." Soon, though, she must face the long drive home - "which is not long enough" - and her waiting baby. For while Sylvia's work brings her immense satisfaction, she is a novice in the more inchoate realm of love.

In this at least, Ferguson suggests, the nurses have it all over the doctors. Iris, for example, moves easily between her love for Rob and for her patients: "Iris liked blanket baths... You could hardly help actually loving the person a little bit, by the time you'd finished."

In Ferguson's world, the love that comes from and is expressed through nurture - the passionate connection between parents and children, nurses and patients, even devoted friends - is the most powerful and enduring.

Mess with a child's right to parental care, and the person will never be quite whole. But it's romantic love that directs our adult destinies, and that's all mixed up with our primal, irrational sexual desires. If sexual love takes Iris's life toward a tragic turn while it only detours Sylvia's, that difference is mainly the result of the progress women made in the second half of the 20th century.

And if that progress has also created, in Sylvia, for example, new kinds of problems, Peripheral Vision makes it clear that compared with what women in the 1950s were up against, these problems are more readily solved.

It's something of a mystery that Ferguson isn't often mentioned in the top ranks of British writers. Equally strange is that this is the first of her books to be published in the United States.

Peripheral Vision has shortcomings, to be sure: For all the precision of its emotional insights, stylistically it can be slack. And given the unabashedly happy ending Ferguson bestows on her present-day characters, one wonders if a little more awareness of the irretrievable - of the injustice of so many of our losses - might have elevated this book into, say, the Pat Barker realm.

Still, Ferguson has done something significant: her characters live, and they have much to teach us.

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