The demise of well-to-do bohemian England must be one of the longest terminal illnesses on record. It was dying in the fiction of Evelyn Waugh and of Nancy Mitford, and yet sixty years later, in Edward St Aubyn’s new novel, we find it gamely dying still. This time, however, things finally seem to be critical.

Mother’s Milk is plotted with deliberate minimalism. Its subject is not a set of events but rather the states of mind of its characters, and in particular that of Patrick Melrose, around whose mid-life crisis the novel turns. Patrick, who appeared as a younger man in St Aubyn’s first three