My second granddaughter (aka GD2) is a midwife in Cambridge. There she has access to spotless facilities, the latest technology and the extensive expertise of a big teaching hospital. “You should read this memoir, Granny,” she said to me soberly the other day. “It’s astonishing.” So I did.

Anna Kent, a qualified nurse, was uneasy working in the comfort of the UK and vaguely dissatisfied with her very promising relationship with an eminently likeable and decent man. Although she has grown up in a comfortable, loving, supportive home in Shropshire, there are incidents in her past which haunt her. It’s the early 2000s. So she volunteers with Médicins sans Frontières (MSF), is accepted and, eventually, after some training, sent to the war-torn country we now call South Sudan for a nine month placement.

What she finds there is almost unbearable and she is plunged in at the deep end – sleeping in a tent and dealing with tragic, desperately serious medical issues every day as people come from miles around to access the pretty basic MSF clinic. Despite having no midwifery training she has to deal with women in labour, pre-eclampsia, retained placentas, sepsis and other things which fill her with anxiety and horror although she is actually good at what she does.

The trouble is that Anna is not strong mentally and very quickly gets bogged down in what she regards as her own inadequacy despite the warm support of her fellow nurse, James who becomes a lifelong friend. James has a long history of issues in his life (alcohol, drugs, failed relationships) but has come through it all to become a wise, kind adviser – and a fine nurse, now a gently un-judgemental Buddhist with a sense of humour. Perhaps we all need someone like James in our lives to be the still, small voice of calm. Another nurse, Anita becomes a wonderful long-term quasi-sister too.

As the months go by, Anna, to whom sharing problems doesn’t come naturally, becomes ever more distanced from her life in the UK. Only the here and now seems real. The horror can be discussed only with those who have seen it with her. It doesn’t take an psychiatrist to spot PTSD – it’s what left millions of men who fought in World War One unable to talk about what they’d experienced other than to former comrades. War zones and frontlines come in many different forms.

Once back in the UK Anna, still beset by guilt, trains as a midwife and then goes  to Bangladesh with MSF to serve a huge refugee camp. Her accounts of the women she helps are very painful to read. And the ones she can’t help, obviously, are even more agonising. They haunt the reader as much as they do Anna. She’s a fine, graphic writer (she always wrote diaries) and her account of how, utterly terrified, she has to break up a dead baby to get it out of the poor woman’s body will stay with me for a very long time.

By the time she finally gets back to the UK her mental illness is severe and I couldn’t help wondering, despite all she achieves, whether she was ever actually cut out for field work. Her stress levels have made her physically ill and recourse to heavy drinking and smoking do nothing to help. Moreover, as a youngish woman, she craves for the “right” relationship (she details several failed ones) and children of her own. None of that goes well either although she does eventually find a settled life of sorts. And her daughter Aisha is, she says, the best thing which has ever happened to her. Not for nothing is the book subtitled: “My story of survival and keeping others safe.”

Published in 2023, this is one the most excoriatingly and powerfully truthful books I’ve ever read. Kent bravely and casually shares, in some detail, personal matters which most of us would hesitate to confide to our closest friends. Somehow, that simply adds to the authenticity. We believe every word she writes. And we are right to do so because she is no Raynor Winn. Her afterword carefully explains that she has changed details to disguise identity where necessary and that’s fine. Every writer of memoir (and I’ve done it so I know) has to do this. Moreover because she has, as far as possible, consulted  the people she writes about, there are of course, some who asked to be omitted and she has respected that.

As any reader knows, some books disappear from consciousness almost before you’ve reached the last page. Others get right under your skin and stay with you permanently. This is going to be one of those. So thank you, Jasmine, for alerting me to it.

Next week on Susan’s Bookshelves: Eleanor of Aquitaine by Alison Weir

My friends fall into two main camps: Reading Friends with whom I discuss books continually and Non-reading Friends who chat to me about other things.  The RFs and the NFs don’t seem to have much in common if they meet.   RFs, six of whom share the dedication in my own latest book Unheard Voices: Tales from the Margins of Literature, often suggest titles for this blog.

And that was how I stumbled across Marianne Cronin’s moving, compelling debut novel which was published in 2021: one of my RFs spotted it in her local library.

It tells the story of two lonely women, both terminally ill in a Glasgow hospital. Lenni is seventeen and Margot is eighty-three so between them they have a hundred years of memories. When they meet, and hit it off, in the hospital art room, they decide to record their memories in paintings as a shared project. It’s a simple enough plot and yet in Cronin’s hands it has more layers than an onion – and nearly as many tears. It isn’t a gloomy book, however. In places it’s very funny.

Lenni, who is half Swedish and therefore bi-lingual, has a troubled background. Her parents aren’t around and she’s a loner though no choice of her own. Her voice is sharp, sardonic and her personality is prematurely aged by her predicament. Her burgeoning friendship with the patient, bemused hospital chaplain, Arthur, is skilfully nuanced as she wickedly challenges his Christian conformity and uncovers his vulnerability. In an interview at the end of the novel Cronin reveals that Lenni’s very distinctive voice came to her fully formed in the middle of the night quipping about the difference between being “terminal” and passing through one at an airport. It provided the novel’s opening chapter.

Margot’s roller-coaster life meanwhile has brought her a bereavement from which she has never recovered, two very different husbands and a woman named Meena. All this is gently and gradually unfolded in a mixture of first person “present day” narrative by Lenni interpolated with recollections which they both narrate. The story telling is complex but beautifully controlled, complete with one or two satisfying twists.

Other engaging characters we meet along the way include sympathetic, decent Pippa, who runs the art class, New Nurse who is Lenni’s main carer, Margot’s fabulous second husband, Humphrey (oh my, that account of the initial onset of Alzheimers!) and the ebulliently attractive Meena. There’s a lot of caring humanity and benevolence in this uplifting story.

It’s obvious, or at least the reader assumes it is, how a novel about two dying people has to end. Actually Cronin springs a surprise. Yes, of course some things are inevitable but sometimes there are unexpected developments and a glimmer of hope even in the grimmest of situations. And I wasn’t remotely surprised to read that Cronin herself had a brush with potentially life-limiting illness which provided the stimulus for this novel.

I recommend it warmly.

Next week on Susan’s Bookshelves: Frontline Midwife by Anna Kent