Book review: In Every Moment We Are Still Alive, by Tom Malmquist

Tom Malmquist has an eye for small details and significant words
Tom Malmquist has an eye for small details and significant words
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The Scotsman’s monthly review of a book about health, promoted by Wellcome

Swedish poet and author Tom Malmquist’s In Every Moment We Are Still Alive is a work of autofiction – that is, a fictionalised autobiography. It tells his own story, though in the style of a novel, and it begins when his wife Karin is admitted to hospital in Stockholm with what at first appears to be pneumonia. She also happens to be 33 weeks pregnant. Very rapidly her condition deteriorates and it becomes clear that she is suffering from a recurrence of her leukaemia. She is moved to the Central Intensive Care Unit at the Karolinska University Hospital, and there her baby is delivered by emergency Caesarean Section.

Sadly it seems that Karin never woke up to hold her baby, or even see the picture of newborn Livia that Tom taped above her bed – though she may well have done. With memoir-as-fiction you never quite know where you stand, which could perhaps be seen as its chief drawback.

I began reading In Every Moment We Are Still Alive cold, as a work of fiction, not scanning the blurb or press release and knowing nothing of its background. Being slow on the uptake what struck me first was the research Malmquist had put in, and all of it meticulously incorporated and ringing true on some fundamental level. Surely the author had to work in intensive care? Was he a nurse, or a physician? Eventually though (still slow on the uptake) I Googled Malmquist’s name to find out he’d lived it. At one point Tom even describes himself, the main character, sitting in ITU, writing in his notebook – caught in the act, as it were.

Tom’s experience is described first-person and present tense; dialogue is free of speech marks and isn’t always paragraphed or attributed, which enhances the story’s immediacy and adds to the overall air of confusion, the sense that the protagonist just-about-understands what’s going on. The narrative is highly restricted, confining itself in the opening third to snatched conversations in and fleeting impressions of a large, busy hospital. We see Tom jealously guarding access to Karin, even from her mother and father. There’s a poet’s eye for small details and significant words: in a waiting area Tom sees “chewing gum pressed into the leaf of a yucca plant,” and Karin is not to be moved to an intensive care bed, but “installed”. The overall effect, disconnected from any thoughts of past or future, adds to the sense of this person not really grasping what’s going on; to an air of claustrophobic disconnection. “I feel as if I’m wearing a diving helmet,” Tom says at one point, and the reader does too.

After Karin’s death, the pace of the book changes. Tom has to deal with the bureaucracy of becoming sole guardian to Livia, then with his father’s own death from cancer. The present-day is intercut with the past, and this works well: it is arresting to have Karin alive then gone in everyday moments, just as she would be in Tom’s own thoughts. As the book progressed, however, I began to find its autofictional cloak distracting. What was real and what wasn’t? I wondered if I would have accepted all the everyday details and medical abbreviations in an unambiguous work of fiction, and began to wish that Malmquist had just set out his stall on the biographical side of the market. For my money, fiction reaches highest in creating realities which could exist, but likely haven’t or even couldn’t: you admire how far up the garden path the author has led you, while still suspending (or even subverting) your disbelief.

As for the translation, Henning Koch has done a fine job, though in my proof copy on the very first page BP (Blood Pressure) was rendered as “BT (Blod Tryck)” and “...it’s just a dry retching” should perhaps have been “...I just dry-retch.”

Whichever way you read it, In Every Moment We Are Still Alive is both a poignant memoir and a fine first novel. I just wish I could have switched off the part of my brain that wanted to know where the best-told truths and best-told lies were.

In Every Moment We Are Still Alive is published by Sceptre, £14.99

Rob Ewing is an Edinburgh-based GP. His debut novel The Last of Us is published by Borough Press and he was shortlisted for the 2016 Costa Short Story Award.