Cover Image: Inside the Bone Box

Inside the Bone Box

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Very different from any book I have read before. More than merely the story of an obese surgeon, this is the story of two people disillusioned by life who both escape into unhealthy habits.
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This was my third novella from Fairlight Moderns, who granted me a reader's copy. 

At least one star for that title, right?? The primary protagonist, Nicholas Anderton, is a brain surgeon and likes to explain that "the skull is like a bone box, with the brain trapped inside."

He and his wife Alyson, however, are each trapped inside their own heads with stress and some amount of grief and terrible events in their family's lives. She turns to alcohol, he turns to food, and neither of them turn to one another. 

Only a couple of minor quibbles with this one: sometimes the timeline was quite confusing, wherein it sometimes took me several pages (and in a couple of instances, never) to figure out whether the events described occurred in the current/"live" story or was a flashback. As well, I found the characters (primarily Nicholas and Alyson for a majority of the story) fairly intensely unlikeable and struggled for a while to keep reading. 

However, I'm glad that I did. Ultimately, this fascinating (and gruesome, sometimes) story of a dissolving marriage seen through the lens of practicing brain surgeon was just as interesting and engaging as I thought it might be based on the synopsis. I plucked up a couple of mirrored collations that I thoroughly enjoyed; Nicholas/the author described, in opposing terms, food as either really quite disgusting and off putting as he did delicious and savory and compelling. Equally and oppositely described was the brain - either beautiful and mysterious or a chunk of meat easily dissected and discarded. 

If you've the patience to suffer through a couple of insufferable characters for a bit, you'll be rewarded with an ultimately lovely story (especially once Sophie shows up).
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This was a quick and well-written novella. It is the story of a neurosurgeon whose marriage is falling apart. His wife turns to alcohol, while he uses food to soothe his emotional pain. The changes these activities cause in their behavior in turn wreak more damage to their relationship, in a sad downward spiral. His continued weight gain eventually causes him to have trouble performing his job, and he has to stop. 

Unfortunately this book was not one of my favorites. As mentioned earlier, I thought it was quite well-written, and I thought the author did a really good job of describing that emotional experience that comes when you realize that you have a certain vision of yourself, but that is no longer the way you are perceived by those around you...a situation that I think is probably endemic to reaching middle age. 

However, I was surprised when I came to the end of this book (something that only really happens with ebooks), feeling as if the book itself is only be partially complete. It is a familiar experience for me...one that I feel after reading the majority of short stories in The New Yorker magazine, or in many literary (read non-genre) short story collections. I feel that there is a style of short story that focuses on describing an experience, or an emotional revelation, and that is the sole purpose of the story. I am never satisfied by this type of story...I always feel a bit as if I was having some sort of very vivid hallucination that is suddenly cut short, leaving me wondering what I just experienced. 

That’s a bit how I felt reading this book, and so it was not among my favorites. But, if you like this type of literary storytelling, i think the quality of writing, and the carefully described breakdown of this marriage is wel, worth your time.
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Ruminations and torments of a brain surgeon
Nick Anderton is fighting to stay on top of the game as a neurosurgeon. His morbid obesity is raising serious questions about his professional abilities. His demons are rivals in his profession, being locked into a toxic marriage with his acerbic lawyer wife and, last not least, the “bone box”: This container of all that makes us an individual being, its fragile contents being an often unpredictable mix of neurons, blood vessels and tumours. In part human struggle, in part phylosophical treatise about surgeons in general, it is a blindingly candid view of a brain surgeon’s tribulations, torn between self-doubt and cockiness. But the bone box is also the prison that obese Nick and his alcoholic wife Alyson have build for themselves, that makes them react to trauma, grief and indifference in a car-crash way of cohabiting. Very thoroughly researched and very powerfully written, but one star less for intimating that weight loss will solve all your problems.
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I enjoyed this book for the writing, especially the little medical bits, and for the characters. I was put off by what felt was some pretty serious exageration of what it is like to be as obese as the main character. While the main character and his wife's feelings about his obesity are fairly believable, I can't help wonder if the author is perpetuating some harmful ideas about obesity and whether he truly believes something like weight loss surgery would solve all a persons problems.
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The Anderton's are two professionals that society tends to look up to, a doctor and a lawyer. However, in this story, the doctor is morbidly obese, and the lawyer is an alcoholic.  INSIDE THE BONE BOX is a unique novella describing the most private and painful aspects of Nicholas and Alyson Anderton's lives. 

The apparent issue is Nicholas's morbid obesity.  He is a surgeon who needs to be clear-headed and physically active to perform the long, delicate brain surgeries he specializes in, but Nicholas has trouble walking from his car to the operating theater. Nicholas is still able to function with his team giving him their full support.  At home, the support level is entirely different Alyson is disgusted with how Nicholas looks and the lack of attention he gives to anyone but himself and his food.  Their two children are loving but barely hanging on with two dysfunctional parents.

A crisis takes the novel to its beautiful denouement, and I applaud this expertly told story of life in that part of society we think is perfect.  There is no perfection, we all live with a struggle.  The critical factor is how we handle those struggles.

Thank you, NetGalley and the publisher for the opportunity to read this E-ARC.
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Nicholas Anderton is a successful neurosurgeon, married to a lawyer, with two adult children. But he is also grappling with obesity after a series of crises in his personal and professional life. Now, his weight is threatening his ability to do his job. His wife, Alyson, is not inclined to be supportive and is dealing with issues of her own.

Nicholas is a complex and contradictory character. He is an accomplished neurosurgeon but has little time for philosophical discussions on the nature of the mind, preferring to see himself as more like his butcher father – good with his hands, with an instinctive understanding of anatomy. He has succeeded in a profession that requires great discipline and stamina but he is unable to stop himself from eating.

The story is told in alternating chapters from Nicholas and Alyson, though we only see Alyson at home, and hear about her life as it relates to her husband. Perhaps this reflects how Nicholas sees her, his curiosity limited to how she affects him.

Nicholas spends his day looking deep into the brains of others but his own remains mysterious to him. How far are we shaped by our minds, and how far by the confines of our body?

This slim novel asks some big questions, with compassion, wry humour and elegant, understated prose.
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Anthony Ferner's intense little novella is somewhat domestic in nature, exploring the deep feelings that run between a married couple. Those feelings are mostly hate and contempt, which might make Inside the Bone Box sound like an unpleasant but common experience, but Ferner's vivid writing and insightful ability to get 'inside the bone box', explores the deeper sentiments that lie behind the ruins of Nick and Alyson's marriage. Nick and Alyson might hate each other, but there's reason to believe that they hate themselves even more.

Nick Anderton is an eminent and well-respected neurosurgeon, but he is grossly overweight and aware that his health problems could start to have an impact on his ability to handle the delicate nature of his work and potentially lead to mistakes in the operating theatre. And indeed there already have been mistakes and indications that he could lose his position at the hospital and his licence to operate unless he takes steps to resolve his problem. He's thinking of going for an operation to insert a gastric band.

Nick's wife, Alyson has her own issues to worry about. She feels she has underperformed in her career as a lawyer and is dealing with her professional and personal problems by drinking heavily. She has even driven when drunk and recently knocked a man off his bike. Both she and Nick suffer nightmares, and their relationship with their children Ben and Sophie is difficult. They direct vicious barbs at each other at every opportunity, blaming the other for their condition, which is easier than facing up to their own failings.

As Nick's detailed observations on the nature of his neurosurgical work, Inside the Bone Box is about the fragility of the human body and the human spirit. It's about finding ways of coping with our personal flaws, issues and problems, and Ferner's writing finds several interesting ways of expressing that, never allowing his characters to wallow in self-abasement and become unsympathetic, but expressing their feelings in calm, measured prose that bristles with spikes of insightful observation as much as self-hatred.

As you might expect from the title, Inside the Bone Box also has recourse to plentiful metaphors on brain surgery as a way to express the nature of Nick and Alyson's condition and their marriage; a tumour that if you attempt to cut out the malignant parts, risks damaging good tissue. But there are also other more esoteric metaphysical questions considered on behaviour, whether we are at the mercy of chemical brain reactions or whether we truly have free will. But more than anything, Inside the Bone Box is a very human story, insightful in its observations, finding a humanity buried deep down in Nick and Alyson that you can't help but find warm and compelling.
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‘He walked slowly; any kind of exercise seemed a form of expiation.’

Nicholas Anderton is a consultant neurosurgeon.  He is morbidly obese and although he’s largely been able to ignore the impact of his obesity on his marriage, he can’t ignore the limitations it’s starting to impose on his professional life.

‘Operating was now the only thing, other than eating, that gave him a sense of purpose and identity, and if he continued to gain weight, he’d sooner or later be unable to continue.’

Nicholas is married to Alyson, a lawyer.  Alyson, who despises him for his weight gain, has an alcohol addiction.  Two unhappy people, each with addiction issues, each with security issues, each blaming each other (and others) for the problems they have.  Both Nicholas and Alyson are aware that change is needed, and while they work towards the what and the how, they reflect on the past.

It’s cleverly done.  Mr Ferner alternates chapters between Nicholas and Alyson.  Nicholas’s chapters draw their titles from events or memories largely external to Nicholas but in which he participates, while Alyson’s chapters have only her name. Nicholas as observer, perhaps, while Alyson is kept focussed by her anger.  Neither character is particularly likeable, but both are recognisable.  Each addicted to self-destructive behaviour, each aware of the risks.  Who knows what really goes on ‘inside the bone box?’  Nicholas can explain, from a neurological perspective, how the brain works.  Alyson can explain how she feels but I doubt that either could explain their own behaviour. Each is imprisoned by a mixture of emotion and addictive response.

But just as I begin to think that neither Nicholas nor Alyson will be able to step back from their personal abysses, there is a glimmer of hope.  A possibility that all is not lost.

Note: My thanks to NetGalley and Fairlight Books for providing me with a free electronic copy of this book for review purposes.   Thanks also to The Idle Woman, whose review intrigued me and led me to request this title. 

Jennifer Cameron-Smith
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It's nice to see literary fiction being marketed for busy people, but this one is not all that interesting and reads a bit like the down market slop that often tops bestseller charts.
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Nicholas Anderton is a neurosurgeon whose weight is becoming a threat to both his job and his marriage, this novella follows Nick as he reaches the pivotal moment of his professional capacity being questioned.   Each chapter alternates between the perspectives of Nick and that of his wife Alyson; and are either a continuation of the present or a flashback to an earlier point in their career or marriage which gives you a great picture of how the couple have got to where they are; one of my favourite things was how realistic these two characters in particular were, they're both flawed and while they do identify those flaws in themselves they're doing what most people do which is pretend is a much smaller problem than it is.  I think the book challenges a difficult topic to talk about, being set in the UK where obesity is continually becoming more of an issue the challenges Nick faces in the book must be a harsh reality for some and it's great that it's not shying away from things like this.   I gave this three stars as I thought a couple of chapters were a bit disjointed from the overall plot and I didn't get that 'must keep reading' feeling.
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In this day and age, with independent bookshops and small publishers closing in swathes, it's a joy to hear of a newly-founded enterprise: Fairlight Books in Oxford. At one year old, they're just about to release a series of five novellas in their Fairlight Moderns series and I was delighted to have a sneak peek. I decided to start with Inside the Bone Box, because it focused on a doctor and that appealed in the wake of Adam Kay's diaries. It's the story of consultant neurosurgeon Nicholas Anderton, whose burgeoning obesity has already threatened his marriage and now raises very serious questions about his professional capabilities. Meanwhile his wife, Alyson, has her own demons to fight. It soon becomes clear that the 'bone box' of the title isn't just the skull, within which the brain-self resides, but also the prisons we build for ourselves, trapping ourselves within excess flesh or addictions.

The story is about surgery, of course, and there are several intriguing accounts of operations on the brain, which fascinated me because it's something I know nothing about and neuroscience still has an almost mystical quality for me. Ferner has done a phenomenal amount of research into brain surgery and writes with an authority which completely convinced me, as a layman. Yet there's another kind of surgery in the novella as well: the diagnosis and (premature) autopsy of Nick's and Alyson's marriage: its current failings arising from the issues of the past, and the petty spite of a union dragged through the wringer by infidelity, trauma and growing indifference. It's a story about how we present ourselves to others, and the grief that arises when there's too great a gulf between others' understanding of ourselves and what we feel to be our true natures.

Neither Nick nor Alyson are particularly pleasant people. They have both done terrible things, to themselves and to others, and yet they feel gut-wrenchingly believable. You feel that you might well know couples like this: two deeply mismatched people, who are nevertheless trapped by the bond of long cohabitation. They've both allowed stress or unhappiness to goad them into unhealthy behaviours: now Nick finds that everyday tasks grow harder as his girth expands, layering tiers of fat around his body which make it hard for him to see certain parts of his anatomy, let alone use them. Alyson has come to rely on alcohol, which gives her the sense of gaining control over her brittle, unhappy emotions while also undoing her physical self-control. Neither of them are healthy; but dare they admit it? Dare they combat it? If they tried to change, how would this affect their identity? What would existence be without the pleasures of good food or good wine, which make up for the dismal lack of joy elsewhere in their lives - never mind that their pleasures might be slowly be killing them along the way?

The novella alternates chapters between Nick's and Alyson's perspectives: I thought it interesting that Nick's are given fragmentary titles excised from the text of the chapters, while Alyson's are only ever titled with her name. We see Nick out in the world: at foreign conferences; at work in the hospital; dining expansively in a favourite restaurant. But we also only ever see Alyson at home, trapped within the confines of the walls, aggressively nursing her habitual glass of wine. I don't know to what degree this was deliberate, but it gives extra force to Alyson's sense of being belittled, ignored and overlooked, even though we're told that she has a (presumably demanding) job as a solicitor. It also emphasises the claustrophobia of her chapters, a tight and tensely-wound anxiety, which goes well with her nervous alcoholism.

I really enjoyed Ferner's flair as a writer. He can give you a strong picture of a character in just a sentence or two of elegant prose, and combines precision with just the right amount of ornamentation. Predicated on questions of identity and the loss thereof - through brain damage, perhaps, or the renunciation of a quality that we feel defines us - it's a little book that packs a punch far greater than its size.

I can't wait to dive into the rest of Fairlight's new releases, so watch this space...

For the review, please see my blog:
https://theidlewoman.net/2018/06/13/inside-the-bone-box-anthony-ferner/
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4.5 stars
This book is different from anything I’ve read recently and I loved it. I adored the whole world the author created around the hero being a neurosurgeon, how operating patients’ brains is so much part of himself and so much ingrained in himself that his actions and how he sees life and the world are completely contaminated by his craft.
Nicholas Anderton, an almost fifty-year-old British doctor, is not your typical hero. He could be handsome but he’s too fat, and and perhaps a bit to be appealing. Yet, the author’s candid and rational approach to the harsh realities of neurosurgery successes and failures and his passion about it make him a rather honest, matter-of-fact and attractive character, in spite of all his non-romantic features.
His relation with his obesity and with food is amazingly explored. I found this part a bit hard to read sometimes, because of its crude authenticity. The realities of the operating room are also realistically depicted here but somehow that didn’t shock me as much, perhaps because of some familiarity with it. And all these dimensions seem very well researched and put together, creating an engaging story.
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