I mentioned Arthur Franks recently and his book The Wounded Storyteller, about the narrative of illness, where he suggests that to tell one's own story a person needs other stories, and perhaps it is books like The Dark Circle that do so because it has taken me to several places long-dormant in my memory. Arthur Franks, when asked to recommend books at that conference on narrative, fiction and medicine, where I heard him speak, suggested The Magic Mountain by Thomas Mann as a seminal text. There was much sage nodding in agreement around the room except from me who had barely heard of it. I still haven't read it and maybe, having read The Dark Circle, there is no need. It has told me, reminded me and taught me all I want to know and I am sufficed on the subject for now, and in the best possible way.
Set in London in 1949, post-war discontent, austerity and lack are the perfect setting for Linda Grant's latest novel. It is a monochrome world settling down after the hyper-excitement of the war into a fog of drear and monotony, and of course the dreaded scourge of TB has survived the carnage and remains a potent symbol of human vulnerability to assault from all directions. And so it is that twins Lenny and Miriam Lynskey are whisked from their adult lives in the East End of London to be coddled and swaddled like babies at the sanatorium in Kent and the transformation of a group of people begins.
The NHS is a mere babe-in-arms too and a private hospital is now having to open its doors to all. Unlikely friendships are made at the Gwendolyn Downie Memorial hospital, fondly known as the Gwendo and factions emerge. Groups that congeal in adversity and stick together for mutual support...the stoical and uncomplaining Mother's Union, the ex-servicemen and with it comes a hierarchy. Perhaps the liaison I enjoyed most that between the street-wise twins and the educated Valerie Lewis who has them all reading, enjoying and discussing the classics.
Moments of rebellion can prove costly in institutional life (for some reason girls and boarding schools come to mind) and especially when a limited number of courses of the potentially life-saving streptomycin become available, and the doctor in charge must make his God-like choices. In many ways, no one is who they seem in Linda Grant's book and there will be startling developments and revelations, unlikely liaisons, subterfuge and intrigue and repercussions which of course I won't spoil by even mentioning but plenty to make this an excellent read.
This is however soft imprisonment by any other name; isolation, enforced bed-rest (on balconies in blankets day and night) perilous operations to remove ribs even to remove lungs, induced pneumothorax (collapsed lung) all had even the nurse in me wincing ever-so slightly at the treatments that to our modern eyes seem so misguided. Yet prior to the arrival of antibiotics what else was there.
I couldn't help but compare my reactions on reading all that to my reactions for many years now on some early and experimental treatment that my brother had for leukaemia in 1974.
Calmette and Geurin had developed a non-virulent tubercle bacilli which became the standard immunisation that many of us would have had against TB. One BCG was bad enough (who can forget it and the months it took to heal) but in the fight against leukaemia, and in an attempt to see if it might somehow kick-start a beleaguered immune system that had turned in on itself, there were trials at the Royal Marsden that involved self-administering four BCGs a week. Proof positive that whether it is having a lung and ribs removed or whatever, a person will endure anything that might promise a cure. It now seems so far-fetched in this world of ever-advancing treatments, laughable almost, but I understood the premise of much of The Dark Circle in ways that I may otherwise not have done, and also the perceptive suggestion that the patients were 'old without the experience of life.'
And then I checked it out and to my astonishment discovered that BCG is now the standard immunotherapy treatment for several forms of cancer (though not leukaemia) and has been since 1977, so how many may have benefited from that agonising trial that my brother was part of...
There is much comfort in that now...and I wouldn't have known that had I not read this book and looked it up.
No book by Linda Grant is without its classic moments of wry humour and The Dark Circle is absolutely no exception. I can't quote because I don't have a finished copy, but there is so much that made me smile and on a few occasions laugh out loud.
But all this talk of TB reminded me (more reverberations) of something else I had completely forgotten...
With the arrival of streptomycin tuberculosis had almost been consigned to history when I was a child, so imagine the fright everyone had when my heaf test prior to BCG immunisation at school, when I was twelve, proved positive. There was me proudly showing off this raised circle of welts on my arm thinking this was what was supposed to happen whilst everyone else (and I mean everyone else, I was the only 'positive' in the school) had nothing to show, no reaction, not a sign.
My own dark circle if ever there was one and I remember feeling ever so slightly sick, and maybe for the first time in my life, slightly less than invincible.
I was immediately rushed off for chest X rays and another, different skin test and thankfully all was well but not before I had myself consigned, Heidi and Clara fashion, to the Alps for some bed rest on a balcony whilst wrapped up in a blanket and probably coughing for England...and heaven knows what my mother went through. A 1920's childhood in Liverpool, and diptheria as a child, had sensitised her health antennae to the merest hint of damp and infection, let alone a child with TB.
My close shave with consumption suddenly brought to the forefront of my consciousness, and with it the realisation that mine has indeed been a fortunate generation to have escaped the worst of its clutches.
The Dark Circle by Linda Grant is published by Virago this week, whether you buy or borrow, don't miss this one, and if you do read it I would love to know your thoughts...
Meanwhile TB recollections anyone...
I had to double check but I did look after several patients, both children and adults with TB in the 1970s.
Do any of you remember it as a scourge to be feared...