I’m sure it’s in the post, as they say, but I’ve always been uncommonly jammy with my health. Having lumbered around the earth for half a century now, I’ve never had a broken bone, a night in hospital or even a stitch. I can attribute much of this to the benefits of a resolutely risk-averse approach to life. (Just say no, kids.) However, the biggest factor is clearly a heapin’ helpin’ of good fortune.
One person who didn’t receive such a golden ticket is author and artist Sarah Lippett. In her whopping graphic memoir A Puff of Smoke, she chronicles a childhood and adolescence spent in and out of hospital, while doctors variously misdiagnose, mistreat or just plain miss a variety of ailments that blight her life.
The young Sarah’s odyssey through the hazards of the healthcare system starts at the age of seven. A series of crippling headaches is followed by her parents’ alarming discovery that she’s dragging her leg when she walks. As medical professionals struggle to identify what the problem is, she is initially (and wrongly) diagnosed with a brain tumour.
Later she suffers from kidney problems, prompting a regime of treatment that plunges her further into sickness and hair loss. And when that starts to wane, her neurology deteriorates again, leading to the belated confirmation that she had actually experienced a stroke.
The professional misjudgements continue until she is in on the verge of going to art college, when the truth of her one-in-a-million condition finally comes into focus and brings with it the most difficult of decisions.
Across nearly 300 pages, Lippett walks a tonal tightrope with great confidence. There’s no attempt to gloss over the pain of her various conditions, or the particular sadness of childhood illness more generally; one understated episode of tragedy in a children’s ward, presented without any kind of hindsight through the eyes of Sarah the child, is like a punch to the chest.
However, this certainly isn’t one for the ‘Misery memoir’ section. As you’d expect if you’ve read her previous book, Stan and Nan, Lippett also highlights the resilience and humour of family life – even if relations with her siblings aren’t always totally harmonious. Her dad spends much of the early part of the book as a fairly distant and peripheral figure, crowded out by the family’s expanding crowd of kids. However, he moves heroically to centre stage when one of Sarah’s doctors takes his pharmaceutical prevarication one step too far.
The delicate balance of the book is highlighted in the section where Sarah, unaware that she’s been prescribed way too high a dosage of drugs, entertains some (mercifully half-hearted) thoughts of suicide; the darkest of feelings give way to a comical vision of her family’s imagined responses at her funeral. Shortly after, playing with her little sister Samantha gives her an epiphany and a determination not to give up.
Despite her health issues, Sarah continues to throw herself into her young life as much as possible, while also acutely aware of the ways in which her ailments mark her out and hold her back. In one telling episode she is uninvited from a birthday party because her schoolfriend’s mum “just can’t be doing with illness in my house”.
However, her artistic and cultural horizons are particularly widened by her older brother and his university friends. As she jumps onto the carousel of young adulthood, she eagerly embraces a world of gigs, parties, hair dye, missed last buses and snogging the Jim Morrison-alike barman.
Lippett’s highly distinctive illustrative style may look a little loose, or even scrappy, on first appearance, but it has a real confidence behind it and seems more assured than in Stan and Nan. Her lines vividly depict the emotional cost of every episode etched on the faces of the characters.
My only whinge about A Puff of Smoke is a slightly peripheral one. The size of the book, plus the thickness of the paper and cover, make it a bit of a wrestling match to read. This isn’t a volume you’ll be whipping out on your crowded commute, and even if you’re just sat up in bed with it, it’s still a bit of a handful.
However, that’s neither here nor there. This is a thoroughly involving memoir in which laughter or tears are never far away. It’s also a powerful testimony to human resilience – both Sarah’s and that of the people around her.
Sarah Lippett (W/A) • Jonathan Cape £18.99
Review by Tom Murphy