Wow! This was a tough read in lockdown. There was one point where I was really sweating because it was making me so anxious. Last week I went out for the first time in eight weeks. It was a beautiful sunny day. With the windows down and the music on, it felt like any other summers day. Then we reached the medical centre. The queue outside the pharmacy was ten people deep, all of them were wearing masks. It was so disorientating. Eve Smith creates a world like this. It’s ours, but not quite. There’s a sense of the uncanny. It’s familiar, yet changed completely. This is a world ‘post-Crisis’ and three different women tell the story.
Lily is an older woman, living in a nursing home facility. She is nearing her 70th birthday and this is a huge milestone. After the ‘Crisis’ an act was passed to reduce access to antibiotics for the over 70s. The world became overrun with a resistant form of TB, seemingly spread at a series of large concerts where thousands were exposed to the virus. Life has now changed completely. People no longer keep cats, just in case they are scratched or bitten. Pets were declawed or simply put down. If they have money, elderly people can be cared for well and in comfort. If not or if they get infection they can be bundled off to dormitories of the dying. The author’s description of these wards and how they treat those who die there had me in tears it was so powerful. This is what happens when certain groups in society are devalued. Our treatment of them becomes less humane. They become objects, not people capable of being loved.
Kate is a nurse, working within this changed healthcare system. She works with people who are terminally ill and palliative care is very different to what we’re used to. If someone is over 70 and has a terminal diagnosis they have a choice; they can take their chances in an imperfect system with no interventions possible or they can come to a room with their family and end their life. Again, the author describes such a powerful scene when a man comes with his daughter and son-in-law to die. Kate is so professional, talking his choice through with his devastated daughter and explaining why treatment isn’t available for his cancer. Once he’s ready Kate hands him a glass of whiskey flavoured drug and waits until he’s ready to drink it. Only minutes pass before his pulse slows down and he peacefully passes away. Kate carries this out efficiently and with empathy. In fact it’s preferable to the alternative. No matter how humane it seems, it’s still chilling and sterile. We find out that Kate was adopted, and since the death of her adoptive Mum she’s been looking for her birth mother in her spare time. She’s looking for a woman over 70, who knows if she’s still alive.
Mary takes us back to pre-crisis times and her post-graduate days in South Africa. Mary is a botanist with an interest in finding new species of plant that may have medical applications. She meets Piet in a close call with a rhinoceros and he introduces her to the growing TB crisis in South Africa. He explains that AIDS has suppressed people’s immune systems to the point that they’re vulnerable to other infection. This form of TB is resistant and American drug companies aren’t queueing up to help. Could her research help him find a plant suitable for TB drugs? Piet has talked about radical ways of making the world look at what is going on. They spend more time together and have a trip out to his lookout where you can hear and see incredible wildlife. This is where their affair begins.
Every single thread of this story is compelling. I knew they were connected, but kept reading to find out how and why they were all separated. There was the added mystery of who was targeting Lily with newspaper cuttings, and cards. The eventual reveal was a surprise, but it was the revenge that was particularly devastating. The research that must have gone into the medical and scientific aspects of this novel is staggering. The short, factual sections that are either news reports, or scientific articles feel almost real. Every so often I needed to take my head out of the book and see the world as it is, not that it was much better once I turned on the news. I had to take a few deep breaths in the garden from time to time. This author created a credible dystopia, one that’s closer to the truth than a lot of people would like to think. Within that world we follow three interesting and intelligent women, trying their best in an imperfect system. The cold, sterile present contrasts sharply with the lush descriptions of South Africa. It scared me, made me think about my old age and the way we treat those older and sicker than us. I think it is a staggering work of genius, delicate and detailed, but inside a huge vision. I found it incredible.