Will Self’s London is foul-humored, odorous, and greasy-streeted. It sprawls and heaves, enfolding upon its flyovers and two-up-two-down, red-brick, dendrite suburbs like a gigantic brain that must consume itself to grow. In the last decade, as he joined Britain’s new wave of psychogeographers with gusto, what Self hasn’t transplanted into fiction he walked with his own two feet: from the North to the Olympic-mangled East, all the way to Heathrow, and then from JFK into Manhattan just for the fun of it. To read his books, especially two recent works of nonfiction and the novel “Walking to Hollywood” is to realize this is a man with a destination.

“Umbrella” is his arrival point. Starting in Edwardian England and spanning a century during which mental-health care evolved from physical barbarity to chemical barbarity, the book, which was a finalist for last year’s Man Booker Prize, is a savage and deeply humane novel. It tells the story of Audrey Death, a woman diagnosed with encephalitis lethargica who spends nearly 50 years in the hospital in a state of increasing isolation from the world. As London is ravaged by war and time, and then a new kind of capitalism, Audrey remains locked inside herself without a key. Until a doctor named Dr. Zack Busner enters her hospital and regards her as a human being and treats her and fellow patients, as Oliver Sacks did, with doses of L-dopa and, like Sacks’s patients, they wake up.