The Sanatorium by Sarah Pearse
Book summary - Spoiler alert
Protagonist Elin Warner, a young police detective, travels to Switzerland for her brother Isaac’s engagement party at Le Sommet, a luxury hotel built on the site of an old sanatorium. Her sense of unease about the hotel is soon justified when a snowstorm traps the guests, and Isaac’s fiancée, Laure, goes missing.
The Murders and the Killer’s Identity
An employee, Adele, is found dead, and Elin is forced to investigate. When CCTV footage shows that Laure is still alive and hiding in the hotel, Elin’s suspicions shift. However, a meeting with Laure in the penthouse ends in tragedy: Laure is murdered in the elevator by a masked assailant. The same assailant attacks Elin, but her boyfriend, Will, rescues her. Elin and Will overhear a suspicious conversation between the hotel owner, Lucas Caron, and his sister Cecile, leading Elin to believe they’re involved.
When another employee, Margot, goes missing, Elin and Will find her in a maintenance room, where she attacks them. She confesses to her part in the murders, revealing her motive is revenge for a relative who was tortured at the sanatorium. She stabs Will and escapes. As Will recovers, Elin confronts Isaac, believing he killed their brother, Sam. Isaac reveals that Elin had witnessed Sam’s death but blocked it from her memory, a revelation that deeply affects her.
The Final Showdown
Convinced that she must find Margot to avenge her loved ones, Elin and Lucas discover a secret tunnel where they find Margot’s body, tortured to death. Lucas then locks Elin in the tunnel, leading her to believe he is the killer. She texts Isaac, who rescues her. When Elin goes to Lucas’s office, she finds a black mask and a suspicious smell of chlorine, which makes her realize that Cecile, an avid swimmer, is the true killer.
Elin finds Cecile holding Lucas hostage near the pools. Cecile confesses that she orchestrated the murders to get revenge on the hotel’s original architect, Daniel Lemaitre, for sexually assaulting her as a teenager, as well as on everyone she felt had failed her. Elin saves Lucas, and both Carons are arrested. The novel ends with Elin’s relationships with her brother and boyfriend strengthened, but a mysterious man watches her as she leaves, hinting at an unresolved element to the story.
Character analysis
Elin Warner
Elin Warner is the protagonist and narrator of the novel, a young British police detective on leave to cope with the trauma of a past case. She suffers from panic attacks and feelings of incompetence and guilt after an on-the-job assault. The story is told from her perspective, giving us insight into her anxiety and her struggle to trust people.
Elin’s core motivation is a deep-seated guilt over her failure to save her brother, Sam, a trauma she has buried. This guilt has led her to an obsessive career, pushing her to solve the hotel case as a way to atone for her past helplessness. She is also convinced that her anxiety will eventually drive away her boyfriend, Will. Throughout the novel, however, Elin’s journey is one of healing. By confronting her past, saving Lucas, reconciling with her brother, and committing to a future with Will, she ultimately finds growth and a path toward recovery.
Isaac Warner
I
saac Warner is Elin’s older brother and a former computer science lecturer. He is engaged to Laure, and the novel’s events are set in motion by their engagement party.
A Strained Relationship
From Elin’s perspective, Isaac is guilty of their brother Sam’s death because he left home and never returned, even for their mother’s funeral. This belief has created a deep rift between them. In reality, Isaac is just as traumatized as Elin, having desperately tried to save Sam after he fell.
Initially, Isaac also holds a negative view of Elin, seeing her as controlling and exhausting. However, as the mystery unfolds, his actions reveal his true character. His reaction to Laure’s disappearance and his eventual reconciliation with Elin show that he is not the heartless person she imagined. Their journey to repair their relationship is a key part of the novel’s emotional arc.
Laure Strehl
Laure Strehl is Isaac’s fiancée, Elin’s childhood friend, and the assistant manager at the Le Sommet hotel. She seems to be organized and confident on the surface, but her mysterious disappearance and murder suggest a hidden life. The novel hints at her unfaithfulness to Isaac, adding to the layers of secrecy surrounding her character. Her disappearance is the inciting incident that sets Elin’s investigation into motion.
Lucas Caron
Lucas Caron is the wealthy and famous owner of the Le Sommet hotel. He’s a real estate superstar, following in his great-grandfather’s footsteps. Despite his success, Lucas has a deep-seated need to prove himself, stemming from a childhood heart condition that made him a target for bullies.
Lucas is obsessed with his public image and goes to great lengths to protect it. He hides the truth about the murders at his hotel to save his business, a deceptive practice that mirrors how he also concealed the dark history of the sanatorium the hotel was built on. Just like his hotel, Lucas is all about the public image, even if it’s a mask hiding an ugly truth.
Cecile Caron
Cecile Caron is the manager of Le Sommet and Lucas’s sister. On the surface, she seems like a meek sibling, always trying to please her brother. However, this facade hides a ruthless, revenge-driven killer.
A Quest for Revenge
Cecile’s murderous spree is the result of a traumatic past. As a teenager, she was a sexual assault survivor, but her family, including Lucas, dismissed her claims to protect their reputation. This lack of support led her to become withdrawn and antisocial. She justifies her crimes as a righteous act of revenge, seeking to punish those who she felt failed her. Her respectable and well-put-together appearance is the perfect cover for her murderous side, highlighting the contrast between who she appears to be and who she truly is.
As a teenager, she was a sexual assault survivor, but her family, including Lucas, dismissed her claims to protect their image. This lack of support led to her antisocial behavior. She justifies her crimes as a righteous act of revenge for her brother’s failure to protect her. Her respectable and well-put-together appearance is the perfect cover for her murderous side.
Will Riley
Will Riley is Elin’s boyfriend and the voice of reason in the novel. He is a pragmatic and logical man, a stark contrast to Elin’s impulsive and anxious nature. Coming from a close-knit family, he represents the stable, loving life that Elin has always yearned for.
Will consistently tries to protect Elin, prioritizing her safety and health above all else. While he is supportive of her career, he becomes frustrated when her anxiety and obsession with her brother’s death threaten to pull them apart. Despite his fears and frustrations, he remains a patient and unwavering presence, trusting Elin’s instincts and refusing to abandon her, even when the situation becomes dangerous.
Margot Massen
Margot Massen is an employee at the Le Sommet hotel and the accomplice of the killer, Cecile. She is driven by an obsession to uncover the truth about her great-grandmother, Bette Massen, who was a patient at the old sanatorium where the hotel now stands.
After discovering the horrifying truth about the experiments conducted there, Margot’s desire for justice leads her to demand that Lucas, the hotel owner, acknowledge the injustices done to her great-grandmother and other women like her. Margot’s mental health struggles make her vulnerable and a perfect target for Cecile, who uses her need for answers to manipulate her into becoming a part of her murderous plot.
Important subjects
Mental Health: A Recurring Theme
Mental health is a prominent and recurring theme in the novel, explored through a cast of characters struggling with trauma and its consequences. The book challenges the stigma surrounding mental illness by contrasting different responses to trauma and exposing historical prejudices.
The Stigma of Mental Illness
From the outset, the novel introduces the theme of mental health through protagonist Elin Warner, who suffers from panic attacks and post-traumatic stress. Despite her own struggles, Elin, and other characters, often view mental illness with suspicion. For example, she questions the reliability of her brother’s fiancée, Laure, simply because she is on medication for depression. The novel highlights how mental health is often used to question a person’s competence and stability. Her own struggles lead others, including the police, to doubt her judgment and ask her to stop investigating.
The book delves into the historical and social stigma of mental illness. We learn that Laure’s depression was kept a secret to avoid judgment. Margot, who suffers from psychotic depression, becomes a vulnerable target for the killer. The most powerful example of this stigma is the history of the old sanatorium, where women like Margot’s great-grandmother were tortured. They were deemed “useless” and “disposable” due to their mental illness, illustrating how people with mental health issues have historically been stripped of their humanity.
Two Sides of Trauma
The novel contrasts two different responses to trauma through the characters of Elin and the killer, Cecile. Both women have unresolved trauma, but their reactions are polar opposites. Elin deals with her pain by withdrawing from her loved ones and obsessively throwing herself into her work. This introverted response is a common way people cope with trauma.
In stark contrast, Cecile responds with extreme violence, justifying her gruesome murders as a form of righteous revenge. This contrast between Elin’s and Cecile’s actions challenges the harmful stereotype that people with mental illness are a danger to others. The novel suggests that, in reality, as shown by the victims from the sanatorium, those with mental illness are far more likely to be victims of violence themselves. Elin’s more common and introverted response stands as a stark contrast to Cecile’s violent actions, highlighting the truth about mental illness versus the stigma surrounding it.
The Systemic Abuse and Dismissal of Women
The systemic abuse and dismissal of women is a central theme in the novel, highlighting how women are often silenced, exploited, and disregarded by those in power. This is explored through several characters and historical events within the story.
Abuse and the Dismissal of Women
The novel reveals a cycle of abuse that connects the past with the present. The women from the old sanatorium were not only tortured and experimented on but were first committed by their own families. They were seen as a burden and were essentially discarded, much like how Cecile felt after her sexual assault. Her family, driven by a need to protect their reputation, dismissed her trauma, forcing her to endure it alone and in silence. Just as the doctors at the sanatorium disregarded and abused the women in their care, Cecile felt discarded and silenced by her own family.
Power and Vulnerability
The abuse suffered by the women from the sanatorium is a powerful example of systemic abuse. These women, who were in a vulnerable position, were treated as if they were disposable. They had no control over their situation and were dehumanized even in death, buried in unmarked graves.
This history created a cycle of generational trauma that affected Margot, her grandmother, and her mother. When Margot tried to get help from Lucas, a man in a position of power, he chose to protect his business and his image rather than acknowledge the suffering of these women. He valued profit over their lives, perpetuating the same systemic dismissal they had faced. As Cecile tells Elin, this was simply “the age-old abuse of power; it was an exploitation of vulnerable women.”
