Review published on June 3, 2016.
A mother recounts the five years following an accident that left her son in a minimally conscious state.
In March 2006 Lu Spinney’s 29-year-old son, Miles King, was on a snowboarding holiday in Austria with friends. On the final morning of the trip they’d planned the most challenging jump of all. Miles purchased a crash helmet specifically for the purpose. What irony: the first time he wore it he took the fall that would leave this athlete, intellectual and entrepreneur with a traumatic brain injury. Back in London, Spinney was planning a special meal; when Miles arrived she’d have all four of her grown children back with her and their stepfather, her second husband Ron. She got the call as she was preparing dessert. “Too terrible to think of myself vainly crushing peppercorns at the moment that he stood, thrilling with adrenalin, on the top of that ski slope, unaware he was poised on the threshold of consciousness.”
The family rushed to Innsbruck, where the beauty of the quaint town in springtime contrasted cruelly with their torment as they waited to learn what Miles’s future held: “Below us the river Inn flows busily, people stroll past or sit at pavement cafés chatting in the sunshine, the mountains continue to sparkle under a cloudless Alpine sky. The serenity is monstrous.” Miles was in top physical condition, yet received the lowest score on the Glasgow Coma Scale. “What does that actually mean? What is happening in Miles’s head? Can he dream? Can he feel pain? Can he think?” Spinney wondered.
They brought Miles back to London via an airlift, and over the next five years he would be passed between various brain injury units and care homes. Eight weeks after the accident he opened his eyes and seemed to be attempting to speak, but given his minimally conscious state his only communication would ever be facial expressions and roars of frustration. Despite Spinney’s unfailing role as advocate and cheerleader, the family gradually came to realise that Miles would not make any more progress – “Modern medicine and technology saved him from dying but it could not give him back a life worth living.” More than that, they could discern that he was miserable and no longer wished to continue. But when the UK’s legal system only allows those in a vegetative state to die, what choice did they have?
Flashbacks to Miles’s childhood and adult life give glimpses into his character. Although she pays faithful, nearly daily visits to his care home and brings him home every weekend, Spinney recognises that post-accident Miles “is a myth of my making, necessarily” – based on memory rather than on his present life. She illuminates the small things that keep a caregiver going: a nice outfit, a perfect cup of coffee or a glass of wine. Regrettably, she also documents the ways that patients who cannot speak for themselves are sometimes neglected, as when Miles was left without pain relief after surgery on his arm.
Pointless to mention just how sad this book is – and Miles’s condition isn’t all there is to it. In the midst of all this struggle Ron was diagnosed with cancer and died at home roughly two years after Miles’s accident. You might say Spinney’s experience is unimaginably hard, except that readers don’t have to imagine: she has lived to tell the tale and tells it remarkably well, in a consciously literary style. With no speech marks and present-tense narration, thought and action flow lucidly into dialogue and daydream. Spinney always chooses just the right metaphors, too, as when describing how people treat the bereaved: “I could be a foul black crow. Limping with my scabbed feet, dragging a broken wing behind me, eyes glittering, my wound an open gash; I leave a trail.” It’s hard to believe this is her first book.
This is a book about life and death, but it’s also mostly about love. How much can love achieve? How far does it go and when does it ever stop? I would highly recommend this to readers of other illness and bereavement memoirs written in a literary style, such as Paul Kalanithi’s When Breath Becomes Air or Marion Coutts’s The Iceberg.
Beyond the High Blue Air by Lu Spinney
Atlantic Books 9781782398875 hbk May 2016
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