Emma Healey: Elizabeth is Missing

This is a magnificent and moving work - and quite remarkable both for its accomplishment as a first novel and the wonderfully powerful, empathetic view of mind in terminal, decline created by a very young mind.

The narrator is the ultimate unreliable narrator, being 80-year-old Maud, in the throes of dementia, whose worsening throughout the novel is subtly and powerfully depicted. At the end, and particularly in the final scenes, she is almost completely removed from understanding reality. It really is a return to less than a second childhood and the last stage of the 7 Ages of Man.

Her obsession provides the title of the book but this is paralleled by a mystery in her earlier life concerning her vanishing sister Sukey and only at the very end are the pieces put together for us - and partially for Maud as well. In her mind although, she understands more but dares not say for fear of being disbelieved, as constantly happens to her throughout the novel. Her lack of understanding about what was happening when she was a child, because she was a child is very poignantly paralleled by her equal lack of understanding at the end of her life and story.

The writing is wonderfully vivid with some marvellous figurative language (a by-product of an MA in Creative writing?) and it is wonderfully appropriately chosen so that it completely fits the mind of the narrator - the puzzlement at seeing ordinary objects that are now unrecognised is one of the most effective techniques used.

It gives one a powerful and at times frightening idea of what it must be like to begin to lose ones mind in this way -and yet, to a degree also be conscious of this. The sense of frustration is the most powerful element in the emotional effect caused on the reader by this book and this is, according to those who know, one of if not the, key element of this terrible disease.

The conclusion is powerful -dramatically satisfying, sad - in a word a truly understanding and human conclusion.

I will be very interested to read what the author produces next. But this is a VERY hard act to follow!