The novel, the second of the two published this year by McCarthy after a 16 year interval since his Pulitzer Prize winning ‘The Road’, opens in October, 1972 with Dr. Cohen introducing himself to Alicia Western, described in the admission note to the eponymous mental hospital in Black River Falls, Wisconsin in the following way:  “Patient is a twenty year old Jewish/Caucasian female.  Attractive, possibly anorexic.  Arrived at this facility six days ago apparently by bus without luggage…Patient had a plastic bag full of hundred dollar bills in her purse—something over forty thousand dollars—which she attempted to give to the receptionist.  Patient is a doctoral candidate in mathematics at the University of Chicago and has been diagnosed as paranoid schizophrenic with a longstanding aetiology of visual and auditory hallucinations.  Resident of this facility on two prior occasions.”

With that intro and the first line, we launch into a 190 page dialogue between Alicia and Dr. Cohen presented in the form of a transcript of their weekly therapy sessions.  Cohen is committed to understanding Alicia’s world while she is committed to withholding the information that would enable that.  As the conversations unfold, we come to understand that Alicia is not only ethereally beautiful but has a brilliant mind and a deep knowledge of mathematics, physics, music, synesthesia, and her own illness all in service of trying to understand ‘reality’ and why this world is so sad, impermanent, and either critically important or totally trivial in the universe, if that even exists.

We have met Alicia in the first book of this diad, ‘The Passenger’, which opens with a hunter on Christmas Day discovering Alicia’s body hanging from a tree in the winter snow clothed only in a white dress with a red sash, so we already know the eventual outcome of these therapy sessions, but that didn’t alter my fascination with the dialogue written by McCarthy in his quirky, no apostrophes, no quotation marks style.  Sometimes it was difficult to know who was speaking, but the conversation moves along briskly filled with arcane references to physicists and mathematicians, Bach, Schopenouer, and Alicia’s ‘demons’ who speak to her, especially the Thalidomide Kid.

This is a strange book, deeply influenced by McCarthy’s connection with the Santa Fe Institute over the last 20 years. There, living and talking with eminent scientists for months at a time, he has wedded a complex scientific framework to his life long quest to understand the place of evil in the world.

I was quite taken with the esoteric references, though they were far beyond my ability to understand the math or the quantum mechanics or to recognize the theorists beyond the names of Wittgenstein, Russell, Durac, and a few others.  McCarthy is not writing for the same audience as Elin Hildebrand and her summer beach books about Nantucket, but if you’re looking for a fascinating insight into mental illness, the nature of reality, and the ultimately tragic life of one brilliant and beautiful young woman, here it is.