In Every Moment We Are Still Alive by Tom Malmquist and Henning Koch (translator)

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In Every Moment We Are Still Alive by Tom Malmquist and Henning Koch (translator)

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Category: Literary Fiction
Rating: 4.5/5
Reviewer: Rebecca Foster
Reviewed by Rebecca Foster
Summary: In this autobiographical novel from a Swedish poet, Tom has to face the loss of his partner and his father in quick succession while also adjusting to single parenthood. With its frank look at medical crises, this is a book I fully expect to see on next year's Wellcome Prize shortlist.
Buy? Yes Borrow? Yes
Pages: 288 Date: June 2017
Publisher: Sceptre
External links: Author's website
ISBN: 9781473640009

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Tom Malmquist is a poet from Sweden. Originally published in Swedish in 2015, this is his first work of prose. While it's being marketed as a novel, it reads more like a stylized memoir. Similar to Karl Ove Knausgaard's books, it features the author as the central character and narrator, and the story of grief it tells is a highly personal one.

The novel opens in medias res at Söder hospital, where Tom's long-time girlfriend, Karin Lagerlöf, has been rushed for breathing problems. Doctors initially suspect pneumonia or a blood clot, but a huge increase in her white blood cells confirms leukaemia. In addition, she has poor circulation, low pH, failing kidneys and heart problems. This might all seem manageable if it weren't for Karin, 33, being pregnant with their first child. The next morning she's transferred to another hospital for a caesarean section and, before he can catch his breath, Tom is effectively a single parent to Livia, delivered six weeks early.

Malmquist does an extraordinary job of depicting Tom's bewilderment. He records word for word what busy doctors and jobsworth nurses have to say, but because there are no speech marks their monologues merge with Tom's thoughts, conversations and descriptions of the disorienting hospital atmosphere to produce a seamless narrative of frightened confusion. It's no surprise, then, that Tom becomes rather paranoid: he pushes Karin's parents away and asks to be personally notified of every detail of her case, yet can't take all the information in.

There is an especially effective contrast set up between Karin's frantic emergency room treatment and the peaceful Neonatal ward where Livia is being cared for:

'The effect of the room seems to force itself on me, the burning surgical lighthead, the operation table lift, the pale blue walls, the floor pattern of rectangles and rhombi, the steel trolleys, infusion stands, monitors, and almost big-city feel of nearly twenty doctors and nurses getting themselves ready'

'The stillness in Neonatal, the slow movements of the midwives, the whispering voices, the milk replacement which they heat in microwave ovens and which smells like honey, the teddies, the dolls, the faint cooing noises from the incubators, the noticeboard by the entrance with photos of babies and parents, and the corridor decorated like a pre-school. All this space to breathe.'

After Tom loses Karin, the pace of the book changes. With her struggle over, the sense of urgency passes and we enter a more dreamy landscape where past and present coexist. If this is something of a letdown after the excitement of the first third of the book, it is also something of a relief: regular life can't be lived at such a lick. Tom moves in and out of his memories of Karin: good ones – meeting on a creative writing course, her collection of angel memorabilia, a New Year's Eve meal at his parents' house; but also bad ones – arguments over finances and her history of medical problems, including a brain haemorrhage.

In the present, Tom plans for Karin's funeral (a scene we never see, to my slight disappointment) but also adjusts to single fatherhood and deals with the unexpected bureaucracy involved in becoming Livia's official guardian: since he and Karin never married, though they lived together for ten years, only Karin's name is on the baby's birth certificate. Phone calls with Social Services and a welfare officer; conversations with the health visitor and a vicar: once again these other voices, by turns officious and compassionate, blend with Tom's narration to reflect his feeling of being bombarded by the outside world. 'I have learned to live in an expectationless coolness,' he describes his newfound detachment.

Cruelly, Tom must also face the final illness of his father, who has battled cancer for a decade. As with losing Karin, this second bereavement provokes bittersweet recollections: Tom's father was an alcoholic, and a gambling scandal he broke through his work as a sports journalist led to death threats and a tense time for the whole family.

In shortlisting this for the Nordic Council Literary Prize, the judges called it 'One of the most powerful books about grief ever written.' It is a fine entry in the canon of bereavement literature, conveying the lingering pain of loss and survivors' fumbling attempts to get back to some semblance of normal life. As Tom's father says to him, 'All you can do is fall to pieces and then come back.'

With its frank look at medical crisis, this is a book I fully expect to see on next year's Wellcome Prize shortlist. It reminds me very much of this year's winner (the first novel in translation to win), Maylis de Kerangal's Mend the Living, as well as Joseph Luzzi's nonfiction account of bereavement and single fatherhood, In a Dark Wood. Highly recommended.

Further reading suggestion: There is no shortage of touching autobiographical writing about grief, but you might start with H is for Hawk by Helen Macdonald and The Iceberg: A Memoir by Marion Coutts.

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