Love, loss and language are the themes of Anne MacLeod’s The Blue Moon Book. The story unfolds a cappella in a deft medley of voices and cameos charting a young woman’s year-long struggle towards recovery after a devastating accident. Bereft of memory, Jess is cut off from the past. Bereft of language, she is gradually released from her envelope of inarticulate pain into a dislocated world.
The patient’s role “with its inherent tensions” has always interested MacLeod. However, the Neurology Department of a fictional Edin-burgh hospital, ‘The Central’, provides a context quite different from her own speciality of dermatology, and while researching the book she became fascinated by the role of speech therapists, working as they do “at the cutting edge of language, encouraging speech where illness or accident has silenced the patient’s voice.”
She enjoyed creating the hospital setting, with all the “richness of community” that entailed. “So many voices. So many health-care workers giving generously, not only of their skills and knowledge, but of themselves. How much of their identity is invested in their work? How much is suppressed by it? This is the first time I’ve written a largely medical story. It’s unusual, I think, in that the patient is at once centre of the action and yet inactive. Both powerless and powerful. She’s the moving force, yet she may feel scarcely present.”
MacLeod is interested in the sort of event that disrupts relationships and expectations. This might be an accident. It might be falling in love. In The Blue Moon Book, it is both.
While covering a Pictish Conference in Edinburgh, Jess goes to bed with the star speaker. Casual sex is not her style but this encounter, passionate and tender, has seemed far from casual. The following day Michael is scheduled to go on a sightseeing tour of the city. After he leaves her hotel room, she decides to try to coincide with him on this jaunt. It is a fateful decision, in more ways than one. Spotting a tour bus he might be on, she makes an awkward leap for the platform. The bus suddenly lurches forward and she’s thrown back onto the road to be dragged along, “helpless, head raking the tarmac, left shoe snagged in the wooden deck”.
The driver eventually stops and the passengers exit at the front. Among them is Michael. With the efficacy of Puck’s Love-in-idleness, happenstance ensures that he continues in ignorance of her quandary.
Jess is rushed into casualty and her partner, Dan, comes through from Glasgow. The Festival is in full swing, hotels are full, and he ends up arranging to use the room she had booked. He goes there straight from the Intensive Care Unit and orders a large Lagavulin. Just as it arrives, he notices a piece of purple foil under the bed. Compulsively tidy, he picks it up and places it on the young porter’s tray. He is disconcerted by the response this provokes. Looking more closely at the scrap of foil, he realises it is a torn condom wrapper. To cover his embarrassment, Dan blusters aggressively about the hotel’s standards of cleanliness. It is only later when he is preparing to go to bed that he finally recognises “the latex shine of used condoms gleaming through the tissues in the bathroom’s overflowing bin”.
Dan is a sports journalist who knows all about playing away. Although he has his own hot dalliance on the side he can’t bear the idea of Jess doing the same but he’s enough of a realist to face the fact that the easy banter of their early years together has dried up and “their home had become the quietest, least conversational house he’d ever known.” And yet they have loved each other, once. When Jess emerges from her coma he is devastated to find that she has lost the power of speech, possibly forever. And what is worse, when he visits she “lies cowering, a lump of bruises, broken bones”, and screams the whole time he’s there.
Months pass. Winter is approaching. Jess, who has been moved from the high dependency unit, can now sit up in bed. She spends her time watching orange-breasted finches in the rowan tree outside the ward window stripping branch after branch of their red berries. Her only word is “no”, which she invests with an increasing range of expressiveness, sometimes giving a hint of her old self, sparky, mischievous, funny. Sian, a speech therapist, works painstakingly with her. One of her gambits is to make a portfolio of photographs that might trigger response in Jess. This “Blue Moon Book” is only one component in a healing process that is described with absorbing insight and very movingly.
“Jess’s dilemma is that nobody’s quite sure who she is,” says MacLeod. “In a very heightened way, her quest for identity reflects the fact that there are always uncertainties in how we see ourselves and how other people expect us to be. That’s partly what makes life so wonderfully varied and colourful, quite apart from possibilities of sadness.” Relationship provides more than emotional texture. MacLeod refuses to be categorical about the destiny of her characters, showing them in different lights, refracting personalities through the impressions they make on others. She often turns a phrase that crystallises common experience in fresh terms. For instance, describing Sian listening to approaching footsteps: “She had not known she knew them. She had not known how completely you could deduce living flesh from the simplest sound.”
Working most of the week as a doctor at Raigmore Hospital in Inverness and with a busy family and social life, it’s no mean feat to wrestle the necessary solitude for writing. Lack of continuity means that MacLeod often has to “read back” in order to reconnect with the atmosphere and mood of the work in hand before she gets back down to writing.
“I don’t necessarily have a plot right at the beginning,” she says. “I tend to let the characters have their head.” She sees people as “interplays” of personality and expectation. She enjoys a broad linguistic palette. “While I was writing, it was lovely to hear all the different accents, though that’s not something you can necessarily put on the page.”
Tuesdays find MacLeod in her study, a conservatory-like extension off the generously proportioned kitchen of her home in the Black Isle, set on the top of a hill above Fortrose. A wall of windows allows natural light to flood in. It would be impossible to ignore the elements here, which suits her earthed, poetic style.
Born in Aberfeldy in 1951, she was brought up in Inverness, second child of five. Her parents were “natural storytellers”. Both had been obliged to leave school at the age of fourteen. Her mother came from Northern Ireland to the Highlands to find work.
“She became a bus-conductress on the Inverness-Buckie route till she was old enough to join the WAAF (Women’s Auxiliary Air Force), which is how she met my newly demobbed father. We grew up benefiting from their combined determination that their children would have the education that they never had. We always had books, always, even when money wasn’t plentiful. I read anything I could get my hands on. I was a particular fan of Beryl the Peril, the Four Marys and the Incredible Wilson.”
When she was ten she decided to give up doing homework, sloped off to Inverness Library instead, and spent the rest of the evening lost in a book. “This went on for months. Then the teacher, Sister Vincent, wrote to my mother to complain. I’ve never quite forgiven her.”
She intended to study maths at university, then changed her mind at the last minute, influenced by a charismatic physics teacher who emphasised how important it was to do something useful in life. No longer quite so clear that maths isn’t socially useful, she has no regrets that she set her sights on a career in medicine. But her early years at Aberdeen University were a stultifying slog, choked with rote learning.
“I hated anatomy. That year they didn’t put the clocks back in winter, and we’d walk to Marischal College in darkness and come home in darkness. From third and fourth year on, we had more contact with patients. People were always what I was interested in.”
Curiously, the decision to recognise writing as being central to what she is about came much later. Married and with the second of her four children eighteen months old, she stumbled on a poetry reading by Ian Abbot in Eden Court. “It was an epiphany,” she says. By this time, her younger sister, Ali Smith, had also discovered in herself a dedication to being a writer.
MacLeod’s first collection of poems, Standing by Thistles, appeared in 1997. Just the Caravaggio followed in 1999. “At that stage I hadn’t written any prose for about two years. I took myself on a couple of screenwriting courses and the plot for my first novel came to me.” This was The Dark Ship, set in the aftermath of the sinking of the Iolaire off Lewis at the end of the first world war.
Until now MacLeod has been reserved about setting a novel in her professional milieu, but she has found a way of doing so without exploiting information given in confidence. She is inspired by ‘Narrative in Medicine’, a movement that harks back to oral traditions for skills of listening, appreciating and interpreting what patients say. “Modern medicine is a discipline that straddles both science and the arts,” says MacLeod. “While we must offer the best scientific knowledge we have, we also have to find illumination in the patient’s own story.” In the face of narrow didacticism, The Blue Moon Book is gently, firmly subversive.