BOOK REVIEW / Repro Gothic, all mod cons: 'Dr Haggard's Disease' - Patrick McGrath: Viking, 14.99 pounds

THE GOTHIC mode which Patrick McGrath admires and advocates can only die out if people lose their fascination with the uneasy alliance, amounting to undeclared civil war, between the body and the dreams that drive it. The question, though, is whether the pastiche Gothic he turns out so skilfully (The Grotesque, Spider and now Dr Haggard's Disease) may not be missing out on an essential element of the genre: the disreputability that allowed it, in its time, to ask crude questions and play on basic fears. As McGrath refines his formula, he is in danger of becoming like a manufacturer of reproduction commodes, almost forgetting in his love of patina and craftsmanship that the originals once served a lowly function.

The central situation of his new novel lends itself with almost too much facility to the Gothic mode: a doctor in love, whose long training and sudden passion for a colleague's wife supply him with violently discordant definitions, often in rapid succession, of what a body is, or can be: 'Faced with a suppurating abscess, I saw the smooth white skin of your mother's breast. Removing a dirty dressing, and finding a black patch of necrotic tissue, I imagined placing delicate kisses on her belly . . .' Yet even here, themes and analogies that unselfconscious Gothic stumbled on, or fumbled for, are reeled off by a suaver author with a fluency almost self-defeating. There can be no such thing, after all, as a pat nightmare. In Dr Haggard's Disease the world divides with a starkness that is perversely reassuring into a part that smells of antiseptic and a part that smells of perfume. There is undoubtedly a drive in the book to show that these two parts of the world depend on each other, but it is relatively weak.

Dr Haggard has become a GP after the disastrous end of his love affair, and lives in the mansion (on a cliff) required by the literary genre which houses him. Houses in Gothic are routinely equated with their occupiers, and supply three handy metaphorical states: inhabited, deserted and haunted. Large houses have the advantage of suggesting an intermediate realm - unexplored spaces between the known self and the outside world, attics and basements of the mind.

Dr Haggard tells the story to his lover's son James, a Spitfire pilot (the present tense of the novel is the Battle of Britain, while the love affair took place in the period leading up to war). The novel's masterly first paragraph announces two violent climaxes, one that leaves Dr Haggard in constant pain, another that more mysteriously engulfs his listener. The body of the book never quite lives up to the bravura of this opening.

James the tragic Spitfire pilot is something of a stock character, but in fact the vagueness with which his mother is rendered - she emerges as an assembly of period props rather than a plausible motor for obsession - does the book more harm. A pastiche prose style dare not be too distinctive, and in his description of the affair McGrath sometimes capitulates to cliche: 'Time passed. Not a lot of time, by normal standards, but by the clock in my heart - ages, aeons, very eternities.'

By setting his novels before 1950 (a practice he has announced his intention of continuing), Patrick McGrath has created a safe haven for the Gothic in the imaginary past, but it may also be that he has turned himself into a curator, even a taxidermist, rather than the explorer he has it in him to become. The Gothic strain in our culture hasn't died out, but it has certainly mutated and migrated - to horror writing, to science fiction and, especially, to the cinema. And yet anyone who has read a neurological case-study has to see that the science that prompted Gothic in the first place, by considering the body in isolation from the mind, could do it all over again, if writers of sufficient talent would attend to it. Every brain is a mansion perched precariously on a cliff, and there is no shortage of secret passages, it turns out, within the skull.