"The dark circle" by Linda Grant

An audio book. Flexible PoV.

In 1949 Lenny fails his medical examination for National Service. He and his twin sister, Miriam, have TB. They live in London, Jews, looked after by her East End uncle. They're taken to a distant sanitorium, nicknamed the Gwendo. They're one of the early patients funded by the NHS. He doesn't know that he's left an Italian girl pregnant.

Miriam shares a room with Valerie, who has an Oxford degree. She thinks of TB as working class and also as the illness Keats had. The place is still rather upper class. When young American Arthur Persky arrives, order is disrupted. We learn that years later, Lenny would tell his business associates that he learnt a lot for Persky. He has sex with a popular nurse at the first attempt, giving her, her first orgasm though she'd had many lovers before. He organises a little party for the children (whose presence hadn't been mentioned before), and introduces rock and roll.

We learn of the various treatments - isolation, a pint of Guinness a day, collapsing a lung - and of a promising new treatment. Doctors emphasise submission to regimes.

Hannah is a quiet German patient - a lesbian. Her lover Sarah who works for the BBC befriends Peter, a closet MP in his late twenties, and gets him to send a new drug to Gwendo, telling the boss to give one of the 6 doses to Hannah. The boss agonises over who to give the other doses to - himself? mothers? the worst cases? officers? agitators? When news gets out there are more protests. People no longer work through committees.

The uncle of Lenny and Miriam illegally gets the drug for Miriam. Arthur injects her but she ab-reacts and goes blind. Valery has an operation to remove several ribs.

In 1953 Hannah and Sarah are in an artists colony in Italy. Lenny and Valery are there too, with Miriam. Arthur, still feeling guilty, tries to visit but gets caught with a stolen dress.

Lenny and Valery work for the ITV, then try LA for a few years. They have kids. Mariam's not totally deaf. She marries, becomes a widow, moves to the coast.

In his mid-60s Lenny revisits the sanitorium. It had become a hotel, then closed. The locals are used to ex-patients revisiting. Independently, Mariam visits. She breaks into the abandoned building, wanders from room to room. She's always missed Arthur. Many people don't know what TB is any more.

When Valery dies, Mariam, 81, lives with rich Lenny.

Other reviews

• Christobel Kent (exhilaratingly good)
• Hannah Beckerman (Occasionally, the novel wears its social history too conspicuously on its sleeve: references to the early years of TV, issues with the middle classes, housing developments and debates about the NHS can at times feel pointed and do not fit entirely seamlessly with the narrative.)
• savidgereads (the more I read on the more bittersweet the humour becomes, after all the power with dark comedy is that it verges so close to the edge of tragedy the two can become entwined and the effect of that can be incredibly emotionally potent)
• goodreads