IS it possible for a novel to be a thriller, comedy and tragedy and teach us about dementia too? Elizabeth is Missing by Emma Healey manages to do just that — and do it so well. This perhaps explains why it was the talk of so many book fairs last year, and at the centre of fierce bidding wars by nearly 10 publishers falling over themselves to get it.

We follow the story of Maud, an 80-years-plus old woman who suffers from dementia; her memory falters — she has cupboards full of canned peaches for example even though she carries notes telling her not to get anymore. She is still mobile, albeit at a slow pace, and dislikes being fretted over by her caregivers, including her daughter Helen. But how can they not worry for, if left alone, she’ll wander out and then what?

While she has gaps in her memory there’s something Maud is dead certain of: her dear friend Elizabeth is missing. And she wants to find her because Elizabeth is the only friend whose company she enjoys, and the only one who, like her, is living independently, i.e. not in an old person’s home.

So while Maud is not always lucid, drawing blanks for words, she’s determined to find Elizabeth. Herein begins the thriller, the piecing together of clues, in this case by a woman with very little memory — often doing things like showing up at police stations several times with no recollection of having done so earlier — but you admire her steely will. Even though Helen struggles with it, as does Elizabeth’s son. As we progress into the story, we are told a back story: that Maud lost her sister Sukey and her husband Frank during the war and was never found; Frank is found shortly thereafter but not Sukey. Maud and her parents are devastated, confused as to what could have happened, and a week after the couple’s disappearance initiate a police case.

Sukey’s disappearance changes the family: when the police return Sukey’s suitcase that they have found, her father cries, her mother thinks immediately of washing her daughter’s clothes, almost as if emptying the contents of the bag would prolong the inevitable from happening — realising that Sukey was gone for good. Maybe Maud was thinking the same.

“I kept my eyes on the suitcase wondering how long it was since Sukey had touched the things inside. This was all we had left of her. I wanted to curl up in the case and shut the lid, not take everything out and wash her away.”

So now, we have two mysteries, two stories, and two personal bonds, working side by side. And we’re gripped because we want to know whether Maud can solve them both. She may not be able to remember things but she can grasp the sense of loss she feels for Elizabeth and Sukey.

We get an insight into what it must feel like for a person who is afflicted with dementia and what it’s like for the family caring for them and it is told with aplomb. When it is realised that Maud cannot live on her own, Helen and her brother who lives in Germany, Tom, decide that their mother will move in with her daughter after selling her home. However, Maud has no memory of the house sale or who Tom is. This is particularly frustrating for Helen who has to constantly contend with being on repeat mode, day in and day out with her mum, a déjà vu loop if you will:

“[Tom] flies in from Germany once a year and flies out again and you think he’s wonderful. But he’s not here day after day arranging your appointments and talking to your carers, checking your cupboards and taking you out shopping, buying you new underwear every time you lose yours and picking you up from police stations at two o’clock in the morning.”

There’s no pity here for the elderly, certainly no boredom — two words one tends to associate when one thinks of the aged; especially the former if they’re losing their memories, the latter if they’re invalid. It’s told entirely from Maud’s perspective yet one can still empathise with her loved ones, like Helen who has to contend with being asked the same questions again and again.

When awarding Healey’s novel the Costa first novel prize the judges said: “This outstanding debut novel gripped us from the very first page — once you start reading you won’t be able to stop. Not only is it gripping, but it shows incredible flair and unusual skill. A very special book.”

That it is gripping is certainly true but it is also special for its deft handling of Maud. You can’t help but feel very affectionate and protective towards her, and then find yourself reflecting on the aging process itself: how will you be when you age? What if you (or a loved one) are afflicted with dementia, or memory loss? How will you handle them? Hopefully with more patience, as Elizabeth is Missing teaches us.

A word must be mentioned about the story itself. We’re gripped because we’re committed with Maud to finding Elizabeth and wonder whether, as the reader, she could be at an old person’s home or dead and if our lovely heroine a) has been told and doesn’t remember or b) hasn’t been told as a way to protect her from the harsh reality of it.

So we race through the novel, at times wondering why so much of the story is about Sukey — Maud is able to remember conversations with her parents, their lodger, her brother-in-law Frank. But then when the novel approaches its end, it does so in a surprise — I promise I’m not giving anything away, so no hate mail please. Until you pause and do a rethink, and remember all the little clues that Healey left for you.

And therein lies the cleverness of this delightful novel that you’re likely to put down and then recommend to all your friends. It lives up to the hype you’ve heard and don’t let the hype turn you off. This isn’t that book to hate. It’s a good story to boot that’ll leave you questioning an old person’s mortality — I foresee a lot of hugging of grandparents here, and nothing bad can come from that. 

Elizabeth is Missing

(NOVEL)

By Emma Healey

Penguin Books, USA

ISBN 978-0241-968185

288pp.