Initially, when approaching it, I wondered if another biography of Queen Victoria was needed—there are no less than fifty. A quick scan of these accountings shows that her late-life decline was either ascribed to a relapse of her protracted mourning for Prince Albert, or just the decline of old age. Abrams, a geriatric psychiatrist with a deep knowledge of British history, lays out the case for a severe late-life depression.
This fact alone is of interest, but several factors makes this book unusually compelling: a closely observed end-of-life decline; the presentation of this decline in its historical context; and finally, a biography written with the utmost attention to language—sentence after perfectly balanced sentence flows.
The main material source is the Queen’s journals, which she assiduously wrote through her life. “The Queen’s accounts of her last five months of life present an often-moving ‘Book of Pain,’ in which her physical decline and person losses are described, elaborated, and lamented,” states Abrams. These last journals begin 17 August, 1900, ending on 13 January, 1901, nine days before her death. We learn of the day-in and day-out last concerns of the Queen. She struggles to maintain her official functioning, yet a lady-in-waiting returns to service after a two-month absence and notes, “The Queen is growing very old and feeble, and each time I see the change, even since August.”
The family made major edits to her writing. Abrams notes, “Whatever may have been lost the overall style and authenticity of the Queen’s writing are likely to have been preserved . . . and appear to have survived the conflagration of the original volumes.” He later writes, “Within the pages of her Journal she felt a freedom to express her genuine self . . . and in so doing she was able to find an authentic literary voice.”
The Queen’s decline is not without some rallies. She rises to official duties: “At that Council meeting, the Queen masterfully oversees the elaborate protocol involving the exchange of seals required by changes in the Cabinet.” Abrams notes this is not unusual for the course of a vascular depression, and moves between resurrecting the Queen’s history, as an historian, and understanding it as a contemporary geriatric psychiatrist. And in this, among many insights, Staring Night makes the case for the medical and/or psychiatric biography. While this genre of biography might maintain too narrow a focus, Abrams’s biography is justified on every page. He writes as if we were in attendance and witnessing the progressive demise. These five months are a window into a universal condition (late-life depression) and its “Victorian” presentation.
Abrams selects details that bring to life the court. Lady-in-Waiting Marie Mallet, a confidant of the Queen, brings her young son for a visit:
Victor danced by my side shouting, “Go to Queen, Go to Queen.” Once in the Queen’s sitting room he focused immediately on a portrait of the Prince Consort’s favorite greyhound, “Bootiful dog.” When he was presented with a small gift, he replied: “Thank-oo kind Queen.”
The documentary source for the last nine days become the notes of Sir James Reid, her physician. This material is more clinical and provides a transition to the final chapters, which include more contemporary science on late-life depression. Abrams notes, “Sir James Reid understood that Queen Victoria was depressed, but he did not fully appreciate the contribution of depression to her decline.” We are left with a glimpse into the doctor-patient relationship and the importance of positive transference and hope. Although the biography focuses on just five months, we close the final chapter as if we’ve lived through the saga ourselves.
I left this book saddened. The end of a life is difficult. That life has to end is difficult and must be confronted again and again. In hindsight we are often tempted to think—had a loved one died in a different medical era . . . This biography accomplishes something similar to Atul Gawande’s Being Mortal and Paul Kalalithi’s When Breath Becomes Air—all three express a profound experience of the end of life, a more deeply felt appreciation of life, and a sense of humility about medicine’s capacity, whether in the Victoria era or in our contemporary days.—Owen Lewis