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A 1999 novel by James Herbert.

Alone in a murky, otherworldly cell, a deceased, unnamed man contemplates the depraved past life for which this "existence without hope" is his punishment. Two celestial visitors, dubbed Angel 1 and Angel 2, suddenly arrive with a proposition. He, and "one or two others" have qualified for a second chance at earthly life. Overcome, he tearfully accepts...

Thirty-two year-old Brighton-based private investigator Nick Dismas, "Dis" to his friends, is offered a case concerning a missing person; a baby who eighteen years ago apparently died, but whose mother, Shelly Ripstone, now intuitively believes him to be alive, a suspicion endorsed by local clairvoyant Louise Broomfield. Dis, deformed from birth with spinal curvature, an overlapping brow and a withered leg, as well as a missing eye lost in a childhood incident, goes about sundry duties with unflinching reflection on his lifelong rejection and humiliation.

Viciously mugged on the way home, a desolate Dis later sees in his mirror the reflection of a long-dead movie star whose name he can't quite place. A sudden visit from Louise Broomfield, who briefly takes away the pain of his mugging-induced headache, persuades him to consider the Ripstone case. The name of the missing boy's midwife, Hildegarde Vogel, leads Dis to Perfect Rest, a residential care home, one of whose carers, delicate-featured yet similarly deformed Constance Bell, seems strangely intimidated by the home's director, the coolly condescending Dr Leonard K Wisbeech. A nightly visit from numerous severely deformed apparitions heralds a shocking turning point in the troubled life of Nick Dismas…

The book closes with a note from the author of its inspiration by a true story, concerning a London children’s hospital.

"Well, who the fuck needs the tropes!":

  • Ambiguously Gay: Henry Solomon, bookkeeper for Dismas Investigations.
  • An Aesop: "Learn to see with generous eyes."
  • Angelic Beauty: The two angels who briefly visit the deceased actor in Hell have movingly "serene" and "pure" countenances.
  • The Apprentice: Nineteen-year-old Philo Churchill, Dis's newest recruit.
  • The Atoner: Dis comes to realise his impediments, and implicitly, Constance’s, to be a redemptive “test,” as part of a mission to atone for the iniquities of a past life.
  • Aroused by Their Voice: On first hearing it over the phone, Dis is entranced by Constance's voice.
  • An Astral Projection, Not a Ghost: The deformed apparitions who visit Dis are mental projections of living people, sent by a psychic amongst them.
  • Aura Vision: In Dis's aura, Louise senses the residual shock from when he lost an eye.
  • Axe-Crazy: Beneath the wing of Perfect Rest which holds numerous severely deformed youths and children are inmates known simply as "others": severely deformed people who also happen to be homicidally insane.
  • Bar Brawl: On search of a gay bar for traces of a missing youth, several patrons took offence at Dis's appearance. Timely intervention from part-time bouncer Ida averted a two-on-one brawl.
  • Battle Amongst the Flames: In the rear wing of Perfect Rest, a studio in which Dr Wisbeech allows production of lavish pornographic films of copulation between his deformed test subjects, catches fire. On defensive eye injury from Dis, Wisbeech's ferociously powerful, insanely vicious "beast" seeks revenge, and hinders the escape of Dis and Constance.
  • Big Fun: Theresa, a jolly nurse.
  • Bitch in Sheep's Clothing: Sharply dressed, impeccably cordial Dr Leonard Wisbeech, with calm callousness, probes Dis's life perspective, and conducts brutally unethical studies in deformity.
  • Black Site: A secret wing of secluded retirement home Perfect Rest houses numerous children with extreme deformities, on whom Dr Wisbeech conducts brutally inhumane tests.
  • Bloody Horror: In the agency office, Dis finds Henry's eyeless, castrated corpse.
  • Born in the Wrong Century: Dis has a comprehensive affinity with films from before 1950.
  • Broken Tears: After his mugging on the beach, Dis, bruised, bloodied and devastated with humiliation, returns to his basement flat and sobs.
  • Bruiser With A Soft Centre: Ida, whose formidable bulk once aided an outnumbered and very grateful Dis.
  • The Brute:
    • Perfect Rest orderly Bruce.
    • A ferociously powerful, insanely vicious deformed man, known only as "the beast," is directed by Wisbeech to scare off Dis, but instead finds Henry.
  • Child Prodigy: Twelve-year-old Joseph, born with progeria, has a precocious vocabulary and grasps Dr Wisbeech's studies.
  • Closet Gay: Henry, seemingly terrified of upsetting his loving yet overbearing mother, refuses to openly admit his homosexuality. Under the pretence of working late, he secretly meets a rent boy in the agency building.
  • Council of Angels: "The Uppermost Level" apparently hosts discussion, with "The Final Arbiter" having made the decision to give several damned souls a second chance.
  • Crusading Lawyer: Etta Kaesbach, having helped Dis set up office, consistently supplies the agency with work.
  • Disabled Snarker: Dis's first person narration is replete with witheringly grim witticisms. With the bruises of his mugging still in evidence...
    Shelly Ripstone: Your poor face!
    Dis: Kind of spoils my looks, doesn't it?
  • Don't You Dare Pity Me!: Dis laments his reception of conspicuous gestures of acceptance or sympathy.
  • Doorstep Baby: Shortly after birth, Dis was left on the steps of a convent.
  • The Dragon: Brusquely supercilious senior nurse Rachel Fletcher, whose loyalty to Wisbeech extends to complicity in funding his inhumane researches by allowing snuff films to be made of his test subjects.
  • Drowning My Sorrows: Dis does so keenly.
  • Eye Scream: Quite a bit of this. Aged eleven, Dis accidentally stabbed himself in the eye in self-defence against an attempted molestation, Henry's strangled corpse is found with the eyes gouged out, mercifully after strangulation, and the culprit, Dr Wisbeech's "beast," gets a bit of this from Dis.
  • Friend on the Force: Dis and Detective Chief Superintendent Oliver Macaroon, having helped occasionally helped each other on their respective cases, share a mutual respect.
  • Friend to All Children: Deformed babies secretly brought to Perfect Rest were devotedly cared for by midwife Hildegarde Vogel. Constance later took up the position.
  • The Grotesque: The severely deformed apparitions initially terrify Dis until they're revealed to be psychically projected images of harmless people who desperately need his help.
  • Handicapped Badass: Despite appearances, Dis can handle himself, as Bruce learns the hard way.
  • Healing Hands: As well as clairvoyant reception of distant thoughts, Louise Broomfield can psychically relieve pain.
  • Hell: A murky, timeless realm of solitary remorse.
  • He Knows Too Much: Elderly midwife Hildegarde Vogel, as well as Dis, although in his absence, Wisbeech’s “beast” brutally murders Henry instead.
  • Holy Halo: "Interesting how the ancient artists intuitively got it right when they depicted bright auras enveloping the holy spirits on their sojourns into the infectious world of mankind."
  • I Hate Past Me: Dis, in a near-death vision, is appalled by the deeds of his previous incarnation, though recognises his occasional redeeming features.
  • Jewish and Nerdy: Henry Solomon, bookkeeper for Dismas Investigations, is jealously proud of his authority on movie trivia.
  • Knight Templar: Dr Wisbeech takes great pride in his study of bodily deformity. Having covertly stolen severely deformed newborn babies, he justifies his incarceration and brutal study of them by having saved them from early death, and seems to have no qualms about using coercively produced porn films and murder to finance and protect his studies.
  • Mama Bear: Despite a fire raging through the secret wing of Perfect Rest, Constance is determined to save Michael, a deformed patient in her care; Dis just as much so.
  • Meaningful Name: Nick Dismas was named after the caretaker who found him as a baby on the steps of a convent, and after Saint Dismas, the crucified thief who repented to Christ.
  • Mirror Scare: Investigating a vandalised house, Dis hears a suspicious sound from upstairs, where, in a heavily cracked mirror, he sees the anachronistic reflections of numerous people with facial deformities.
  • My Beloved Smother: Henry's mother, Evie Solomon, to whom he's very close, is protectively possessive of him.
  • Nice Character, Mean Actor: Dis's previous incarnation, to tragic extremes.
  • No-Holds-Barred Beatdown: On a walk home via the beach, a gang of drugged up teenage girls hurl pebbles and insults at Dis, knock him to the ground, relentlessly kick and punch him, and steal his cash.
  • Ocean Awe: An evening walk home past crowds of staring, taunting revellers drives Dis to the solitude of the beach.
  • Pet the Dog: The unnamed movie star, from whom Dis is reincarnated, while an unashamedly ruthless, selfish, unscrupulous hedonist, had a blindness-threatened young boy flown to New York for surgery.
  • Politically Incorrect Hero: Henry is known for petty, institutionalised but ultimately harmless bigotries.
  • Psychic Powers:
    • Clairvoyant faith healer Louise Broomfield.
    • Michael, the deformed lost son of Shelly Ripstone, whose mental projections reach Louise and Dis.
  • Rape as Drama:
    • When Dis was eleven, a "pervert, who wanted sex with a freak" tried to molest him.
    • In the secret wing of Perfect Rest, Dr Wisbeech, to fund his studies, oversees lavishly produced footage of drug-coerced copulation between deformed test subjects. In these, he includes his ward Constance.
  • Reincarnation: The Five Hundred Year Plenary Indulgence offers earthly rebirth into circumstances to morally test the participant.
  • Shout-Out:
  • Snuff Film: Secretly filmed footage of copulation between severely deformed patients is used to fund Dr Wisbeech’s studies in deformity. They occasionally include Snuff.
  • Social Climber: Shelly Ripstone, bereaved of wealthy fridge exporter Gerald Ripstone, tries to disguise her estuary accent. Dis finds the gesture endearingly vulnerable.
  • Stepford Suburbia: Averted. In Ramble Avenue, which Dis finds pleasantly relaxing, widower George Wilkins, while somewhat bluff, is genuinely helpful, and, in memory of his wayward son, sports a "Never Mind the Bollocks" tee-shirt.
  • Teens Are Monsters: The girl-gang who rain physical and verbal abuse on Dis.
  • There Are No Coincidences: In Shelley's recommendation to Dismas Investigations, Louise apprehends Dis's innate vocation to take the case. On so doing, he reveals Perfect Rest's inhumane confinement of numerous severely deformed people. On a near-drowning in the nearby river, a sudden memory of his previous life indicates his bodily inhibitions, and rescue of others with similar affliction, to be part of a redemptive test.
  • Together in Death: Having completed his life's mission of atonement, Dis, on discovery of a brain tumour, is overjoyed soon to be reunited with the recently deceased Constance.
  • True Companions: Dis and friends, particularly Henry, who lends a sober ear to Dis's unique isolation.
  • Turned Against Their Masters: When several "others" escape into the studio where Dr Wisbeech and Head Nurse Rachel plan to oversee production of a Snuff Film, the two meet a sticky end.
  • You Are Number 6: The deformed young inmates of the secret wing of Perfect Rest are marked with registration numbers.