Francis King
The Agony of Alzheimer's
The Wilderness
By Samantha Harvey
Jonathan Cape 328pp

Whereas sufferers from diseases such as cancer, tuberculosis and multiple sclerosis have produced graphic accounts of their experiences up to only a few hours before their deaths, with Alzheimer's there cruelly comes a moment when the victim is literally lost for words. Fortunately, from time to time some writer—not a sufferer but possessed of exceptional intuition and literary skill, such as Norah Hoult in her 1944 There Were No Windows (reissued by Persephone four years ago) and now Samantha Harvey in this remarkable first novel, long-listed for this year's Booker Prize—manages to persuade one that, yes, this is exactly what it must be like to suffer this ghastly affliction.

At the beginning of The Wilderness, the still vigorous Jake, a successful Jewish architect, is travelling in a private plane to a retirement party given in his honour. He is already suffering a vague unease at his increasing difficulty in recalling a name or recognising a face. All too soon bewilderment and panic follow, as neurotransmitter loss becomes more and more disabling.

There are visits to a therapist, who sets him such tasks as remembering as many words as possible beginning with the letter D; but her effortful patience betrays her own realisation of her uselessness. There are visits to his son, incarcerated in a prison designed by Jake himself, during which the two men struggle to achieve some sort of rapport. Eventually Jake's condition drives his partner, who has always loved him far more than he has ever loved her, to such despair that she decides that she must have a holiday by banishing him, albeit temporarily, to a home.

As time and memory continue to disintegrate, Jake struggles to hold together the personality—intelligent, passionate and tough—of the man that he was once. In describing this futile process, Harvey shows her remarkable powers of empathy and her no less remarkable literary skill. To write about a disordered mind is to court the danger of creating a work that is itself disordered. But from start to finish her control is absolute, as she recounts how Jake keeps recreating his past—his marriage, an affair that survived geographical separation through a lifetime of correspondence, his relationship with his refugee Austrian mother, whose parents and siblings all perished in Dachau—in different and sometimes clearly imaginary versions. Does a daughter really visit him with a poet boyfriend? Or is that memory an illusion, since elsewhere he recollects her death in childhood? In his mental wreckage, these are the spars, some real and some phantasmagorical, at which he clutches to retain some hold on a world remorselessly drifting away from him.

This is not merely a profoundly disturbing book but also one that, so complex in its time scheme and so convoluted in its storytelling, makes onerous demands on the reader. But to persevere with it is well worth the effort. I can think of few more distinguished literary debuts in recent years.