THE PRIVATE PATIENT is the 14th book featuring Commander Adam
Dalgleish of the Special Investigations Squad. The private patient
of the title is Rhoda Gradwyn, an investigative tabloid reporter
best known for her mud-slinging articles and secretiveness, perhaps
the result of an old, unforgettable trauma. When she was a child,
her father slashed her face with a broken liquor bottle, which left
her scarred and disfigured.

As the book opens she’s “celebrating” her 47th
birthday with a trip to Harley Street to keep an appointment with
one of the best plastic surgeons in England. After Dr. George
Chandler-Powell reassures her that he can remove the scar without
leaving more damage, he asks her why she waited so long to have
this work done. Her enigmatic response: “Because I no longer
have need of it.” None of the players in the plot learn any
more, and readers are also left to ponder her words.

Dr. Chandler-Powell offers to do the surgery at a hospital in
London or at his private clinic, Cheverall Manor, in Dorset.
Gradwyn values her privacy and chooses the manor house, hidden in
the country. She wants to have the operation and recover in
seclusion. Upon arrival, she removes herself to the bedsit
that’s been reserved for her and intends to remain there. The
wealthy women who come to this highly regarded facility are
obsessed over maintaining their anonymity. Their needs are
personal, and they expect their privacy to be the second most
important advantage the facility offers. The place itself is old
and not particularly welcoming but is run by a very competent
staff. Beyond tending to the patients, this crew takes no
particular interest in them. But over the years, they have
developed love-hate relationships with each other.

Gradwyn is murdered almost immediately after her successful
surgery, killed in her bed while she slept. Who committed the crime
and why remains a secret almost to the end of the novel. This
conundrum heightens the suspense and moves the plot along in a
timely fashion. With no shortage of suspects, Dalgleish and his
team --- Detective Inspector Kate Miskin and Detective Sergeant
Francis Benton-Smith --- have their work cut out for them,
especially since at a glance it seems that no one present has a
motive. Before they can really get going, they have to determine if
the murder could be an inside job or if some outsider did the deed.
Once this dilemma is solved, the interviews with the presumed
suspects can move on. Readers now have an opportunity to see just
who these people are, how they each operate and what their place is
in the clinic’s day-to-day functioning.

One of the most suspicious staff members is Sharon (Shirley
Beale) Bateman, a morose standoffish young woman who does the
cleaning and functions as a dogsbody. She rarely speaks to anyone
and can usually be found among a Stonehenge-like rock formation on
the property. Legend has it that a woman was burned at the stake
against the flat rock, which Bateman/Beale obsesses over. The staff
knows little or nothing about her, and she offers not a scintilla
of personal information. If asked a question, she simply stares her
interrogator down or turns her back and walks away. But as is true
of most of the secrets hidden in the narrative of THE PRIVATE
PATIENT, Bateman/Beale is about to be busted. The team discovers
that she is child murderer who bashed her younger sister’s
face in.

The backstory is full of coincidences and ironies. While in
college, a young man rents a room from the Beale family for a year.
The parents fight all the time, and the student, Stephen Collinsby,
is uncomfortable being there. But he can’t leave because the
younger daughter, Lucy, is a beautiful, good and loving child ---
the opposite of her disagreeable sister, Shirley. Collinsby takes
an interest in Lucy, they develop a lovely friendship and he loves
her. Then he must leave. The next time he hears anything about
Lucy, she’s dead.

Collinsby goes on to become head of Droughton Cross
Comprehensive. His progressive ideas about education and how to
motivate children become nationwide news. He is a husband and a
father, and is happy with his life. Then one day, Dalgleish shows
up and Collinsby is thrown back into the past. He’s afraid
that his life will be ruined if word of his association with the
Beale family turns up in the news. Nevertheless, he admits that he
was near the manor the night Gradwyn was murdered. He says that
Bateman/Beale traced his whereabouts and demanded that they meet.
She threatened to expose him if he was not there at a certain time.
Of course, even though he was guilty of nothing, he felt he had to
try to keep any slander away from himself. In the car,
Bateman/Beale told him that she loves him and always has, that her
sister said she was bored being with him and wished he would leave
her alone. The jealousy that fomented in the older girl erupted
like a volcano and Lucy died. When asked why she did it, her answer
was strictly in keeping with her personality: “she was too
pretty.”

Another “outsider” who was on the premises when
Gradwyn was killed is her friend Robin Boyton, cousin to Marcus
Westhall, Chandler-Powell’s medical assistant, and his sister
Candace. He was the one who recommended Cheverill Manor to Gradwyn.
He’s an annoyingly immature ne’r-do-well always looking
for an easy buck or handout. He has taken advantage of his Westhall
cousins by renting (for a fraction of the real price) one of the
cottages on the property. He suffers from claustrophobia and lives
like a slob. He’s very fearful of the world and not making
his way in it easily. Readers now have a second “real”
suspect in addition to the various staff members lurking in the
background.

Some readers may find themselves a bit disappointed with the
role Dalgleish plays in THE PRIVATE PATIENT, because we don’t
get enough of him. He’s on the job and we know he’ll
solve two murders, but he seems absent too much of the time.
Nevertheless, P. D. James weaves a narrative full of the themes she
has always intertwined in her work: the setting and atmosphere, her
characters are shaped in such a way that readers get to know them,
she uses psychological and literary devices because ultimately
it’s her characters and their motives that bring
verisimilitude to her books.

THE PRIVATE PATIENT can easily be read as a “locked
room” mystery that has grown up and branched out. But
whatever a reader’s interpretation, this is one of P. D.
James’s most complicated books and a deliciously challenging
read.