Mother's Milk resumes the story of Patrick Melrose some time after the conclusion of the Some Hope trilogy. He has married, has two sons, and his elderly mother is about to leave the family's most valuable property to a New Age charlatan. The novel's four sections are set in the August summer holidays of four consecutive years, 2001 to 2004, and are mainly about the unravelling of the fabric of his life, relatively strong when the novel opens and on the point of disintegration in the novel's last section.
There is his mother's insistence on disinheriting him and his sons, for one thing; the near-total involvement of his wife in the nurturing of their second son, making her sexually unavailable, which precipitates Patrick's having a stupid and reckless affair; finally, his rapidly-declining, nearly demented mother's demand that he do whatever it takes to obtain legal euthanasia for her. Patrick starts drinking too much, and we wonder if we will glimpse again the Patrick of Bad News, three sheets to the pharmaceutical winds.
In the last few pages we have reason to hope he will recover his equilibrium -- there is his wife and children, for one thing. St. Aubyn is merciless on his fictional alter ego, Patrick (cf., again, The Ordeal of Gilbert Pinfold), but his wife Mary is as genuinely loveable a character as one is likely to meet in a novel, and the sons are a delight every time they appear on the page. I cannot think of another contemporary novelist -- hell, any other novelist -- who has St. Aubyn's ability to enter into a child's point of view or who has represented so much of how a father's love for a child feels. Patrick has Mary, Robert, and Thomas at least -- one hopes he doesn't blow it.