The Vanishing Act of Esme Lennox by Maggie O'Farrell

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Maggie O'Farrell revels in absences. She likes missing people, ghosts, gaps, any kind of void that lets her imagination have a free rein. Her hugely successful debut, After You'd Gone, was about a dead fiancé; her second let you think an ex-girlfriend was a ghost and her third played with coincidence, chances and the threat of missed opportunities.

The title of her latest novel should not be taken quite as literally as it appears. However, what has changed is O'Farrell's writing style; or at least she has shown a willingness to experiment with it. Here, O'Farrell marries the style and the content perfectly to give us a gently disturbing tale of family loyalty, what happens when it is mis-directed, and what happens when it is absent altogether.

Esme is the elderly inmate of a psychiatric unit in Edinburgh, where she has lived for most of her life. When we first meet her, she has fleeting memories of her childhood in India, where she lived once with her parents, sister Kitty and baby brother. But because something bad happened there, she has repressed her story and it comes to us only in jagged, fractured, doubtful paragraphs: "The seated girl is dressed in something pale, Esme forgets what, the other in a dark red frock that doesn't suit her. She has lost her gloves. It begins here. Or perhaps not. Perhaps it begins earlier..."

Esme's "home" is closing down and the authorities contact her great-niece, Iris, who has never known of Esme's existence until now. Iris runs her own business and lives in her own flat, but her love-life is complicated: she is embroiled in an affair with a married man, Luke, who wants to leave his wife for her, while secretly she still harbours a longing for another married man: her step-brother, Alex.

Iris is at first extremely reluctant to take Esme on but, after visiting a seedy hostel with her, feels she has no choice. Iris is also a girl from a fractured family, keen to protect herself from damage, but she begins to warm to this troubled, elderly woman to whom she bears little resemblance. Both women gradually tease those troubles out, without appearing to do so, and O'Farrell's subtlety and delicate touch have never been so finely demonstrated as in the scenes between the two women.

The question of what exactly defines madness and what defines sanity is central to the novel. Esme is damaged twice: by a tragic childhood incident and then by a violent experience in her teens, which taken together have had her institutionalised. Ironically, and unbeknown to her, her elder sister Kitty is now an old woman also in an institution, because she is suffering from Alzheimer's.

This triple-hander between Esme, Kitty and Iris's narratives could have become messy and confusing, but O'Farrell never relinquishes control, and her presentation of Kitty's voice, even more confused and fractured than that of Esme's, is a triumph. O'Farrell plays a delicious game between the two sisters, challenging her readers to decide just who is more sane than the other. It is almost too delicious at times: Esme and Kitty's stories are so fascinating that Iris is occasionally poor competition for them.

But Iris is there to help fill in the blanks, and that's exactly what this story is: an attempt to fill in those gaps and silences, the holes in a person's life, especially when that person is a woman locked up, forgotten about and ultimately silenced. It is also an exercise in narrative control that works beautifully, and sees O'Farrell raising her game considerably.