They All Fall Down by Tammy Cohen

Black Swan | 2017 (13 July) | 384p | Review copy | Buy the book

They All Fall Down by Tammy CohenThere was a time when everything was going well for Hannah – she had a happy marriage, a good job and with every hope of having a child to complete her life. But then she did something that shocked all who knew her and now she exists as well as she can in an expensive psychiatric clinic, The Meadows. The clinic is exclusive with few patients, all female. It’s taken a while but Hannah is beginning to form friendships but her progress is compromised when two of those closest to her commit suicide. She’s told that both were high suicide risks but Hannah is convinced that there’s more to it. She believes that they were murdered. But who would believe a woman regarded by doctors and family alike as mad?

Tammy Cohen has rapidly become one of my very favourite authors, thanks to the fabulous and original psychological thriller When She Was Bad and also the superb A Dangerous Crossing (written as Rachel Rhys), which will be among my top novels of 2017. They All Fall Down is another standalone psychological thriller with an unusual and captivating, almost claustrophobic, setting – this time a small psychiatric clinic. Our cast of characters is also relatively small but each of them is complex and holds our attention to the utmost.

At the heart of the novel is Hannah and this is reflected in the present-tense chapters that bear her name. But Hannah is the very epitome of the unreliable witness. We only find out slowly why she is in The Meadows but we can see some of the signs of her illness in her behaviour. I warmed to her immediately but I can’t say that I ever trusted her. But her story as it is revealed is fascinating and pulls us to her. It is even more difficult to know the other patients in the clinic. Each copes with what life has thrown with them and none can be relied upon.

We follow a small number of other characters, taking us outside of the clinic setting – Laura, one of the medical staff who works so hard to find the real Hannah within the damaged one before them, and Corinne, Hannah’s mother, who is determined to do whatever she can to help Hannah return to her old life. Each of these women brings a new perspective to Hannah’s story but, instead of stripping away the layers, they add to them. From one chapter to the next, we have little idea where we are heading.

They All Fall Down is such a fabulously twisty twisted tale. We expect this from Tammy Cohen and she most certainly delivers. I’m pretty good at working out psychological thrillers – I read so many of them – but this one surprised me continually and I loved that. But these aren’t shocks for shocks’ sake – they serve the story, the story of Hannah, and so we are emotionally invested in each of them. The relationship between Hannah and her mother is told so well and gives the novel such a punch that complements brilliantly the unravelling of the book’s mysteries, for there is more than one.

I thoroughly enjoyed the claustrophobic atmosphere and the world of secrets evoked by the clinic setting. It presents a sympathetic portrait of the clinic’s troubled and vulnerable patients and of the responsibility and duty of those who have them in their care. At times, we descend into horrifying territory but it is also an uplifting story in some ways as characters hold each other close. I might have imagined at the beginning that I knew where the novel would take me but I was so wrong and I relished each of its surprises while immersing myself in the gripping story of Hannah.

Other reviews
When She Was Bad
(as Rachel Rhys) A Dangerous Crossing

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