State of Happiness by Stella Duffy

I've thought so long and hard about this book and how to share my thoughts on it that it's been three weeks between finishing it and posting here.This is challenging reading and I desperately don't want to upset anyone who may be going through serious illness or perhaps acute grief and loss of their own, so if you are and this jars a nerve please just stop reading.
Having discovered an affinity for a writer it always feels incumbent upon me to read the whole lot and so the minute I had turned the final page of Stella Duffy's The Room of Lost Things and I'd let those thoughts settle I immediately picked up State of Happiness. Different yet in some ways not so different as I quickly slipped into Stella's real-time writing. I can't quite describe this but it is as if you live the book minute by minute.
Five years on from an initial meeting that quickly becomes a permanent relationship, Jack and Cindy have relocated to California from New York to enable Jack to grasp a brilliant job-opportunity making his own current events TV programme, whilst Cindy will continue to pursue her own succesful career as a cartographer and author of a best-selling book on map-making. This is a couple who know where they are going and how they will get there, life is good and full of promise and Jack and Cindy embrace it all to the full, until one day just before the move Cindy collapses in excruciating pain whilst lecturing a student class. NAD (Nothing Abnormal Detected) on examination and after a battery of tests and a tentative all-clear it's off to the sunny climes of California and a new life together.
Except it isn't long before Cindy's symptoms recur and this time the news is not so good and this is where Stella Duffy's real-time writing steps up and delivers an extraordinary reading experience. If you've encountered it then you'll know all about the excruciatingly long-drawn out process of tests,scans, biopsies, and the interminable waiting for the results and a diagnosis. I was almost screaming along with Cindy by the time we got  to sit in Dr Neil Austin's office to hear the verdict, in fact I was feeling sick and a bit wobbly along with Cindy truth be told and I was the lucky one.
I could close the book, take a deep breath and go and empty the washing machine.
Cindy and millions like her in life can't do that and Stella Duffy pins this down to perfection as Cindy now has to map a new journey for herself. As Jack and Cindy sat there in front of Neil Austin my anxieties were somehow compounded because Stella never actually gives a named diagnosis, Jack and Cindy know what they are dealing with but we don't. It's almost like a patient confidentiality issue and I was desperate to be told.
I sensed the fear that gripped Jack and Cindy's stomachs
I watched with Cindy as all her healthy parameters were swept to one side and she was imprisoned in that strange, unmapped land of illness.
I listened with them as they weighed up the options, helped them make the percentage treatment decisions about chemotherapy and watched Jack watching his wife as her battle for life begins.
By now I think you'll have gathered that this is a tough read but the repercussions of serious illness are tough, there's no way to avoid that fact and it is with a 'tenderness and unflinching honesty' that Stella Duffy tackles a subject of which she has personal experience.
We're back on the 'witness' trail again and whilst those who may be experiencing anything like this right now might find the book and its outcomes too emotionally demanding, I think this makes State of Happiness one of those books it feels vital to read, but perhaps at a time when you don't have that sort of thing going on in your life or with those close to you.
I'm now reading a book from the Orange longlist, The Household Guide to Dying by Debra Adelaide, same theme, very different approach and in her author interview (you know those things I hate at the back of books, except this one's good) Debra says,

'Fiction is - in part anyway - the place to confront things and explore ideas that in your own life you are too timid to do. Dying tends to confound most of us, frighten us, make us literally lost for words. We have a lot of trouble finding the the right things to say and do when we're required to cope with death'

Serious illness seems almost unavoidable. someone usually knows someone, the degrees of separation are usually very few and though many might not even want to consider it, there seems little point in ducking the issue when you can safely explore the subject third-party and fictionally through a great novel if you choose to.
I've come away richer for the reading of State of Happiness.
I'll never forget Cindy and Jack or how they deal with this, and with that knowledge Stella Duffy conveys a profound understanding of the effects of life-threatening illness.
It's perfectly possible (once you've recovered from the reading) to use this remarkable book as a resource and have some coping strategies in the knowledge store because Stella Duffy made me think quite clearly and lucidly around what would I do, what would I feel, how would I deal with it, would I be like Cindy?
I spent the latter chapters of State of Happiness in my own state of permanent welled-up-ness but ultimately I feel very privileged to have read this book. If that all feels too much to take on board then just shelve the book, it is fiction after all and this is supposed to be good for reducing stress, but don't forget it, save it for another day perhaps.