The Air We Breathe by Andrea Barrett

I missed reading Andrea Barrett's The Voyage of the Narwhal when it was published years ago. I think it arrived in one of those cumbersome, stiff, spine-creaking paperback book club editions and I just never got around to it.
Then Andrea Barrett disappeared here until a copy of her latest book The Air We Breathe to be published by Hutchinson and in a nice soft, floppy, proof copy fell into my hands and begged to be read.
Autumn 1916 and an isolated TB sanatorium in the Adirondacks.
I rolled up my sleeves and prepared to get stuck in, there were sure to be blankets on balconies and they'd need a nurse.
Isolation hospitals I surmised might provide the same device as snow for suffocating action and all the more intense here as breathing is the biggest difficulty for many of the patients.
The war and social unrest might be in progress in the trenches of the Somme and in Russia but nowhere is impenetrable and the outside world soon starts to filter in around the edges of the sanatorium and in many ways the war is played out, in a mini-version within Tamarack Lake.The outcomes are just as cataclysmic and there are some passages that really do leave you gasping for air as events unfold.
The imagery of transparency struck me constantly as the experimental work of the radiographer comes into focus. Irene literally can see right through her patients, no secrets can be hidden in a place like Tamarack Lake where all the patients have been disempowered by their diagnosis and treatment. A weekly discussion group takes off and with it emerge all the thoughts and feelings suppressed by so much resting and gradually the inpatients rediscover their voices.
I had never really appreciated the thinking behind the TB rest cure.
TB was a disease of the past when I did my nurse training so I knew very little about it beyond the usual symptoms, associations with the consumptive in literature and the risk of fulminating and horrific haemorrhagic death, but why exactly the rest cure?
Call myself a nurse? Honestly, I'll be stripped of my letters next.
Thankfully I now know because Andrea Barrett weaves all this in and more as she recounts her story and I was quickly impressed with her peopling of this book. I'm not a writer of fiction but I imagine populating your book can be a tricky process because your reader has to be able to meet and greet and keep track of everyone quickly and decisively.
Here you've got a whole hospital full of patients, all on the same balcony as it were, to choose from, to try and make into individuals.The system has worked slavishly to depersonalise them and conceal them under identical blankets and somehow the reader has to be able to tell them apart. I took it for granted that I'd be able to and I could but it must be a huge challenge for a writer to sort it
There is a very clever little manoeuvre at the end of the book, an extensive family tree.
These are usually at the beginning surely? There to be constantly referred to?
Not this one. Take my advice, don't give it second glance until you turn the final page when you are then meant to look at it and the penny drops. Then you have a lovely surprise because you will carry on telling Andrea Barrett's story for quite some time after you have finished the book.Then I dig around and discover that many of these characters started life in a previous book Ship Fever and now I really do want to know more.
I don't think it's a spoiler to tell you but as I was reading I was gradually thinking 'who is telling me this story', it will rightly puzzle you mysteriously throughout the book.
No quotes from The Air We Breathe because it says I mustn't as it's not out until March here in the UK  (you already have it in the US I think) but all very clever indeed, a good read to watch out for and meanwhile it might be worth catching up on more Andrea Barrett if like me you've missed any or all of her five previous novels or two collections of short stories.