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Title: The Shock of The Fall

Author: Nathan Filer

Genre: Contemporary

Diversity: Mental health / Neurodiversity

Format: Physical paperback

ISBN13: 9780007491452

Rating: starstarstar


Goodreads blurb:

‘I’ll tell you what happened because it will be a good way to introduce my brother. His name’s Simon. I think you’re going to like him. I really do. But in a couple of pages he’ll be dead. And he was never the same after that.’

Debut novel about one man’s descent into mental illness, following the death of his brother in childhood. Filer is a mental health nurse with a unique and startling insight into mental illness, and this book highlights a much-neglected subject.


Review: (no spoilers)

I went into this book kind of blind, thinking it might be about a kid with some sort of mental health issue due to a family member passing. Something similar to A Monster Calls, despite having bought this before Patrick Ness’ book.

The story is more character driven, and the book states so itself in the end. “Nearly every thought I have is about me – this whole story has been all about me; the way I felt, what I thought, how I grieved.” It was very much about the main character Matt and about his life having the mental disease. We also get to meet his older brother Simon, that has Down’s Syndrome, that dies when Matt is really young. Personally, I thought it was a very honest and unproblematic representation of mental health. The disease, that I won’t reveal, is presented in a way that defies common stereotypical tropes but gives an understanding for why most afflicted people end up in the positions they’re in. There isn’t much more to the plot than that.

There was one main character and the only character we got a real insight to. Unfortunately, this isn’t enough for 307 pages of reading. We get fleeting moments of people, we learn their names sometimes, but then they go away and we are back to being alone with Matt. And that’s partially because Matt is just that, alone. I understand that the author just wanted to write a book that represents the reality of mentally ill people. The only interesting plot was introduced in the last few chapters and should have been made that the core of the story. We would have been taken on a journey for Matt to achieve a goal as well as learn much about him on the way.

The writing was appropriate for the story. It wasn’t flowery or eccentric, it sounded like a normal teenage voice. Some pages also have small quirky line-drawings and other sentences are spread out over a page. The font varies from the standard computer-typed font to a typing-machine font to hand-written letters. This variation is refreshing and I believe one of the things that makes up for the complete lack of plot. One massive thing I appreciated was that the author never really tried to write how/what Matt was thinking when he was having the mental issues he has. He rather explained them as ordinary observations that occur to the narrator that make perfect sense. And that’s exactly how it is for most mentally ill people, to them it is real and that was never doubted or contested in this book!

I don’t think this would be the first book on my mind to recommend to someone but I do believe that it deserves recognition for how it portrayed mentally diverse people as well as how their inner monologue really sounds like. Having personal experience with mentally ill relatives/friends I believe this was a fair depiction.


Discussion: (with spoilers)

So, if you’ve gotten to this point and you haven’t read the book then close your eyes!

The first few pages I definitely thought that the mental illness was Simon’s Down’s Syndrome and was kind of upset because it is not a mental illness. But then I thought it might be about Matt’s grief depression and later on his mother’s Munchausen-by-proxy and lastly bipolar disorder before it said Schizophrenia.

In one bit he says, “I’m mental patient, not an idiot,” which really resonated with me as a medical student. It is very important to see people as more than their diseases, because they are more. Just like we are more than the pathologies we carry around, and everyone does, no one is completely healthy.

It made me think of something my bipolar friend once said, “You have a doctor’s gaze, you don’t see all of me,” and I have to argue against that. I think we, anyone in the medical profession, see people more than one disease. When I look at someone, when I’m doing a mock exam of a patient, I try to see everything. A patient that presents with a simple cold may also have mental health issues or a malignant disease or problems at home or anything else. Your mental health is as much a part of what the doctor sees as everything else.

But what that quote really did was remind me that not all people with a specific disease have to present all the symptoms or to the same extent. That’s called partial penetrance in genetics.

Schizophrenic people are usually thought of as drug addicted and homeless. This book did not follow that trope although it did give an insight to how that could become a possibility. When a schizophrenic person is in a state their grasp of reality becomes very real, even rent and cleaning become abnormal tasks. Usually it is not during a schizophrenic episode that a person starts using drugs but the opposite, whilst a person is using drugs their schizophrenia is elicited. With a loss of reality and a drug dependence it is hard to continue making money and maintain a home. This also depends on the type of schizophrenia and treatment plan.

Treatment is important. Matt says as much himself. He will let them in, he will take his tablets, he will also relapse and not take any medications, but then he will let them in. To relapse is not a failure, it is proof that you once got better and that you can do it again.

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