A huge, bruising Soviet novel set inside a cancer clinic in Uzbekistan, where patients arrive with tumours, grudges, memories, political wounds, petty vanities, and whatever scraps of hope the state has not yet requisitioned.

On the surface, Cancer Ward is about illness; obviously, because Solzhenitsyn was not exactly known for subtle little metaphors in a cardigan, it is also about the moral sickness of Stalinism, bureaucracy, exile, fear, survival, and the intimacy produced when everyone in a room is waiting for news from their own body.

The ward becomes a miniature society: doctors, officials, ex-prisoners, workers, believers, cynics, cowards, and people trying very hard not to understand the full shape of what has happened to them. It is bleak, funny in that Russian “well, everyone is ruined but at least the sentence has architecture” way, and much more humane than its reputation as a Big Serious Soviet Brick might suggest.

For readers of Dostoevsky, Grossman, Shalamov, Bulgakov, Tolstoy’s later moral writing, or anyone who likes their novels politically radioactive and psychologically enormous.

Penguin paperback reprint, 1973. Originally published in Russian by The Bodley Head in 1968; English translation first published 1968/69; Penguin edition first published 1971.