Toby's Room, By Pat Barker

Pat Barker creates an astute sequel about the loves and losses of a set of First World War soldiers, surgeons and artists

Toby's Room is a sequel to Pat Barker's previous novel, Life Class, but, as with each novel in her "Regeneration" trilogy, which closed with the Booker-winning The Ghost Road, it also stands alone. Life Class followed the lives of three students at the Slade art school: Elinor Brooke, Kit Neville, and Paul Tarrant. The first two were loosely based on the artists Dora Carrington and Christopher Nevinson; the third was a fictional character who had (like Barker) a working-class background, but who also displayed similarities to the artists Paul Nash and Mark Gertler. The latter competed with Nevinson for Carrington's affections, a rivalry reflected in Life Class.

A theme of Life Class is the way in which different people cope with devastating events. When the First World War starts, Elinor remains breezily detached, declaring that she doesn't want to involve herself in the war in any way. Both Tarrant and Neville volunteer for service, and Tarrant, while serving in the Red Cross, starts to draw some of the victims of traumatic injury.

Toby's Room continues the story, and focuses on the pioneering of plastic surgery, by the real-life surgeon Sir Harold Gillies, to reconstruct the faces of injured servicemen. Henry Tonks, a surgeon turned artist who taught anatomy and became Professor of Fine Art at the Slade, sketched these young men as an aid for Gillies, but did not think the misfortune of others should become public viewing. (Louisa Young's acclaimed last novel, My Dear, I Wanted to Tell You, also broached the topic of this surgery, which renewed hope in so many men.)

Early in Toby's Room, Elinor and her brother Toby share an experience which subsequently haunts Elinor. After Toby is reported as having been killed on the front line, the grieving Elinor finds herself unable to move on without knowing the exact circumstances of his death. She turns for information to Neville, who was in the trench with Toby when he died. But Neville is himself a casualty, and unwilling to relive events. So Elinor must therefore enlist the still-smitten Tarrant in order to find out the truth.

The book's title refers both to Toby's bedroom in the family home, in which Elinor sleeps when alone, and to the room in her mind in which, behind closed doors, she keeps her memory of the illicit event shared with Toby.

As in the "Regeneration" trilogy and Life Class, the details of the brutal reality of war are stomach-lurching: trench-foot and lice; crowded cattle trucks; the crawl across battlefields to retrieve the dead and wounded; young soldiers who shoot themselves rather than fight on, but whose self-inflicted wounds don't buy release unless fatal.

Back in England, Europeans are ostracised; their homes vandalised. Elinor's German friend Catherine is shunned, insulted and banned from her home in Lowestoft, while her father is interned as an enemy alien. In contrast, the relatively carefree existence of the Bloomsbury set is depicted during Elinor's socialising with Virginia Woolf and Vanessa Bell.

As well as the more monumental themes, Barker conveys ordinary lives with skill, and her characters are plausibly flawed. Elinor is selfish and has no qualms about using Tarrant and Neville to procure information, or lying to expedite her path. She lacks empathy or compassion for her wounded friends, but Barker hints that she may yet find these resources in herself. Neville is brash, while Tarrant feels frissons of Schadenfreude at Neville's fall, and dithers between Elinor and Catherine. In Barker's fiction, nothing is clear-cut – people are a mix of good and bad; destructive wars are fought for laudable aims. And facts – including the truth that Elinor craves – are multi-faceted and eroded by recall and subjectivity .

Barker is astute about emotions that don't conform to society's expectations. Elinor's initial response to the news of Toby's death is "a blaze of euphoria", capturing the surge of paradoxical energy that can accompany denial, and reminding us of the disparate forms that early grief may take. The housekeeper is "shamefacedly excited" when Toby's possessions arrive. Elinor thinks her mother is jealous of Elinor's relationship with Toby; this may partly be Elinor's projection of her own resentment at Toby's protectiveness towards their mother.

Barker casually drops in striking imagery: "black, leafless trees ... stencilled onto a white sky"; shuttered windows like "dead eyes"; blue lamps imbuing faces with "a cyanosed look ... the first darkening of the skin after death".

The novel's flaws are few. Fine wordsmiths such as Barker need not revert to empty clichés such as "for all the world", and especially not twice (on pages 125 and 259). Elinor's exhortation "Oh Toby, why did you have to die?" is superfluous. But this is insignificant nit-picking. Barker has shown again that she is not only a fine chronicler of war but of human nature.