In her debut novel, The Doctor, Laura Spinney marked herself out as a thoughtful, subtle writer capable of performing one of the most challenging of the writer's arts: stripping the human soul right back to its very core and uncovering the secrets and emotions we all do our best to hide in public.
Her second novel, The Quick, is a very different story but what it has in common with The Doctor is an uncompromising approach to the human condition. At the heart of the story is a woman trapped both in a hospital bed and in her own unmoving shell. She is totally paralysed, but perhaps, her doctors think, fully conscious, suffering from locked-in syndrome. But patient DL, tucked away in the remote corner of the top, almost forgotten floor of a London neurological hospital, is far from being the only character locked into a desperate condition.
The doctor that treats her, Sarah Newman, also the narrator of the tale, is an emotionally-repressed workaholic with no life outside her hospital. Patient DL's mother's life stalled on the day of her daughter's descent into immobile silence, while her blind father faces similar physical and emotional restraints. Her husband too, while following a somewhat mysterious course outside of DL's room, appears to have been all but crippled by his wife's condition.
All of which makes The Quick a difficult and often uncomfortable book to read. There is little warmth or emotion here to carry the reader through. The story is a reflection of the hospital itself: cold, drafty, austere and humourless.
But, save those occasions where Sid James is smoking under the sheets and Kenneth Williams conducting the ward rounds, hospitals are rarely joyous places, and there is an authenticity to the stark atmosphere and the crushing weight of helplessness and sadness felt by the visitors, and in this case, the medical staff.
And Spinney's refusal to dress her story in Sunday finery and cheer does her great credit. It is an honest and demanding novel, requiring a good deal of investment from its readers. It might have been easier, and perhaps more commercially-minded, to take the book down several other routes that open up during the narrative.
Patient DL's condition and story hold strong echoes of that of Terry Schiavo, a Florida woman who was diagnosed with a persistent and vegetative state after collapsing with repiratory and cardiac problems in 1990. Last year her life achieved notoriety as the desperately sad battle between her parents, who believed she was conscious and wished her to live, and her husband who did not, was used as a political football by US politicians on both sides of the ideological divide who shamelessly pushed their narrow, dogmatic agendas through her desperate plight.
Patient DL's story touches on this political opportunism and cynicism, but shies away from it, instead concentrating on the increasingly desperate search for life within her, analysing the line between dead and alive which seems to become finer and less-defined with every medical advance.
Dr Newman, and her mentor, the enigmatic Mezzanotte, introduce a new and revolutionary tool to try to uncover that life within patient DL and as they do The Quick becomes a race-against-time-near-thriller at the same time as it constructs a mirror in patient DL in which both the characters in the story and the reader can find reflections of themselves.
The Quick is no summer-on-the-beach mass market page-turner, but those who enjoy being challenged and surprised by their novels should be grateful for that. It is subtle and surprising, prickly and uncompromising. Give it a chance.
* One last word about The Quick. Fourth Estate, the publisher, have chosen to publish the book in paperback (what is known, I think as a "trade paperback") but for reasons best known to themselves have priced it, at £12.99, like a hardback. Is it just me or this insane? Who the hell wants to pay a hardback price for a paperback, particularly for an unknown author? Mercifully, the great discounter in the ether, Amazon, have taken a sensible approach and priced the book at £7.79, which is a much more sensible and appealing tag.