Helen Garner’s The Spare Room (published by Canongate) is an exploration of the emotional and practical turmoil engendered by caring for someone who is grasping at straws to evade the terminal truth of their illness.

The narrative probes a friendship between two feisty women when it is taken to new levels of intensity by a clash in ideology. Helen (who deliberately shares the author’s name) starts off with noble intentions. She prepares her spare room with due consideration for longstanding-friend Nicola’s feng shui inclinations, hoping to strike just the right balance between practicality and homeliness. Nicola, riven with cancer, is coming to Sydney to spend a small fortune on alternative therapy at the Theodore Institute. Predictably, the Institute proves fantastically adept at sales talk but medically deeply dubious. Nicola emerges from intravenous Vitamin C treatment and ozone cupping weakened and wracked with excruciating pain, but she holds out against morphine until she – and, more particularly, Helen – can bear it no longer. Nicola is coaxed into reengaging with orthodox medicine by her outraged and exhausted friend.

Helen is not unsympathetic to alternative medicine, but she is driven to distraction by her friend’s vulnerability to exploitation – financial and emotional. Helen begins to think of herself in terms of being made ill with the burden of caring: ‘I folded my arms and closed my eyes. Let me pass out now,’ she pleads, ‘Please, Dr Maloney, take me to the hospital. Put me in a bed and spread a cotton blanket over me. Let me lie there alone in silence till this is over.’

Garner blends memoir with fiction with much of the book unashamedly autobiographical. In an interview with The Austrian Times (29 March 2008) she said that she felt alarmed by violent emotion that nursing sick loved ones evoked in her: “I was shocked by how much anger there is. I had an urge to own those feelings. I didn’t make them up. While I was writing The Spare Room I thought, ‘I’m going to look really bad in this book, there’s no redeeming this kind of awful, ugly emotion’, and I thought, ‘I’m not going to change it. I’ll call the character Helen and admit to those feelings.’” By rights this ought to be a morbid tale, but Garner’s mixture of wit and richly descriptive prose has a disconcertingly heartening effect.

This book has much to offer teachers and students of the medical humanities. For starters, it is a slim volume, making it an ideal read within a busy curriculum. It offers a startling and unsentimental insight into the implications of the role of the non-professional carer. Ethical questions are raised about a host of issues, not least the about patient choices with respect to medical intervention. The book facilitates debate about the boundaries between fiction and memoir, and where those margins should be drawn with respect to confidentiality. All in all, this book would be a worthwhile addition to the shelves of anyone interested in narrative approaches to illness.