In the summer of 2016, Arifa Akbar’s older sister was admitted to the intensive care unit of a London hospital, suffering from a mystery illness. Akbar, the Guardian’s chief theatre critic, had no doubt that the doctors would be able to cure her, anticipating a second chance at life for gifted but troubled Fauzia, and a second chance for them both at sisterhood, a bond they’d once treasured but which in adulthood had become so strained, they were estranged.
It wasn’t to be. With crushing misfortune, doctors finally identified the illness that was ravaging her mere hours before she suffered a fatal brain haemorrhage aged just 45. Their diagnosis? Tuberculosis. Akbar had worried that it might be some deadly new virus, but while it wasn’t from the future, this ancient, sly scourge doesn’t belong to the past, either: it’s resurgent in contemporary London.
Fauzia’s death initially left Arifa numb. Then came horror, bitterness, outrage. There were questions, too – so many questions; having exhausted the ability of doctors to provide her with answers, she turns to paintings, plays and books.
Their very different experiences of the same parent would ultimately poison their sisterly intimacy
Her quest drives Consumed, a debut of fearless inquiry and astonishing emotional integrity. Contained within its pages is a history of TB, a disease that has, over the ages, been feared, glamorised, mythologised and stigmatised. It’s also about mental illness, and the painful challenges involved in merely being close to it. It’s about, too, the dynamics of one particular family, and how impossible it is to ever fully know those closest to us.
Akbar begins her story in Lahore, where her feuding, chronically mismatched parents attempted to resettle when Arifa was three. There, they lived in a large house teeming with extended family, cooks and cleaners, but when tensions between her father and his brothers forced them to return to London, they ended up sharing a single room in a squat in Hampstead.
It was winter. The girls spoke only Urdu and while their new brother took it in his stride, they were old enough to register the trauma and isolation of immigration, the grinding stress of poverty. But Fauzia had something extra to contend with: while Arifa was their father’s golden child, first-born Fauzia was bullied and subjected to daily verbal and emotional abuse. It even became physical at times.
Their very different experiences of the same parent would ultimately poison their sisterly intimacy, yet throughout their teen years, they were inseparable, even as depression and eating disorders began to consume Fauzia, whose artistic talent had until then seemed to betoken a bright future. When Arifa left for Edinburgh University, Fauzia slipped further away, leaving the younger sister burdened with guilt.
Their first real rupture came a few years later. Arifa was searching for a tin filled with teen diaries and sentimental childhood treasures; Fauzia, it turns out, had not only stolen it but picked the lock and pillaged its contents. That tin becomes a potent emblem, and not just of secrets and hidden meanings. In the wake of Fauzia’s death, Arifa is left wondering of her endeavour: “Is this the same raiding of her inner world as her prising open my locked box so many years ago?”
You’d be hard-pressed to find a memoir more scrupulous in its interrogation of its own motives. Again and again, Akbar questions her recollections and actions, fretting about straying into “the equivocal territory of interpretation” while poring over family photographs and her sister’s artworks. And isn’t there something “cowardly”, she asks, about trying to get close to Fauzia when she no longer needs to negotiate the “messy realities” of her sister’s struggles?
Akbar writes with such rigorous clarity that her recurrent doubts and regrets never feel self-indulgent. There is surely no real consolation to be gained from the loss of a loved one, and it’s refreshing to read a grief memoir that seeks understanding rather than solace. This she achieves via some astute, omnivorous cultural criticism, taking in works by the likes of Homer, Dennis Potter and Edvard Munch. She heads to Italy to see a production of La Bohème, pans the “genteel fantasies of suffering” peddled by the likes of Susan Sontag and Virginia Woolf, and chats with Paula Rego about learning to really look.
But there’s an additional strand to Akbar’s prose, one that both contrasts with and complements her intense rationalism. It takes the form of premonitions, hauntings and visions, such as the tiny black pearl her mother claims to see slip from under Fauzia’s eyelid on the day she died, to be caught along with her soul.
By the book’s end, Akbar has stilled her internal tumult, and yet she can’t help experiencing this “coming-to-peace” as a void. In a breathtaking closing paragraph, her sleuthing is rewarded with a radiant flare of hope that distils both the pragmatism and the mysticism that precede it. Consumed is a singular ode to a sister and to sisterhood, vividly accomplished in terms of its craft and its finely calibrated richness of feeling.
• Consumed: A Sister’s Story by Arifa Akbar is published by Sceptre (£16.99). To support the Guardian order your copy at guardianbookshop.com. Delivery charges may apply