In 2016, Arifa Akbar's elder sister Fauzia succumbed to a mystery illness that for months had left doctors baffled. It was eventually diagnosed just hours before she died, and hours after she had suffered a catastrophic brain haemorrhage that had left her, writes Akbar, “not officially dead and not alive, either.” Not long afterwards her life support machine was switched off. She was 46 years old and had died, in a modern London hospital, from TB.
Up to a third of the world is infected by TB at any one point, although it lays dormant in most instances and manifests itself only in about five to ten percent of cases. It has an invidiously glamorous reputation: we associate it with tragic youth and creative genius – Keats; the Brontes –and with beatifically enervated young women: Mimi in La boheme. Yet it's a sly, slithery disease that disproportionately affects the dispossessed and, in the UK today, those of South Asian heritage. It's also extremely difficult to diagnose; of the 400 people who die of it each year in this country, most could have survived had it been caught early enough.
Akbar's memoir of her sister isn't an attempt to hold a fallible medical system to account, although there is a bit of that: just before Fauzia died a duty doctor pontificated on the number of composers who had featured TB in their operas, as if it “were a death of which to feel proud” she writes furiously, instead of one that could have been prevented “with a course of antibiotics”. Rather it is a love letter from one sister to another that seeks to understand a life that often felt horribly out of reach. Fauzia, a talented painter and embroidery artist, had battled depression and eating disorders throughout most of adulthood. While Akbar soared, studying at Edinburgh University then pursuing a successful career in arts journalism (she is currently the Guardian's chief theatre critic), Fauzia sank, abandoning an art degree at Saint Martins before sliding into a fog of anti-depressants and obsessive binge-eating that left her isolated and friendless. The pair were close in childhood but became antagonistic during their twenties and for years barely spoke, although they reconciled when she fell ill. Akbar writes to honour in death the sister who so struggled in life, but also to interrogate why her own journey has been so different and what, if anything, she could have done to help.
This is a scrupulously told memoir, exacting on the slippery nature of grief, memory and family history, but also on the rivalries and resentments that can stealthily accumulate between two siblings who care for each other deeply. Just as Fauzia wove multiple ideas and narratives into her embroideries (Akbar was amazed at the quality and quantity her sister left behind; several are featured in the book and are quite extraordinary), so Akbar weaves multiple stories into her writing.
She unpicks her Pakistani parents’ unhappy arranged marriage that at times cast a shadow on family life (Akbar also has a younger brother) and bravely confronts a paternal bias that cast Akbar as the favoured daughter over her sister. She travels to Rome and the Sistine Chapel to understand more about the Christian iconography that creatively so inspired Fauzia, brought up Muslim, and seeks understanding and solace in the ways writers and artists, from Louisa May Alcott to Edvard Munch, have explored sisterhood and memorialised siblings.
And she follows too the threads of uncanny and serendipitous connections. The impoverished Akbars lived for years in London very close to the site of the first hospital established to treat TB; as a teenager Akbar scrimped and saved to buy her sister a ticket for La boheme as a birthday present; as a critic Akbar finds herself confronted with artworks that probe the complexities of sisterly relationships: the contemporary artist Tai Shani and the ancient Greek playwright Sophocles.
If there is a quibble, it's that Fauzia feels defined rather too much by her suffering and unhappiness: one yearns to learn more about the sort of person she was when not lost to the clutches of mental illness, although Akbar proudly acknowledges her sister didn't “bear her suffering graciously”, refusing to play the “quietly ailing person that the world requires...ill women to be”. Yet Akbar worries about this too, questioning her own motivations in writing this book and wondering whether Fauzia “might want to have a hand in curating” its contents. Yet in the closing pages of the book she resolves to finally pass on to friends much of the work her sister left behind and to which she has been obsessively clinging. It is time, she realises, for Fauzia's art to go out into the world and be seen.
Consumed: A Sister’s Story by Arifa Akbar (Hodder & Stoughton, £16.99)