Helen Fowler Writer

One of the worst things about long-term illness can be feeling you’re on your own, despite all attempts by well-meaning friends and family to persuade you otherwise. Hilary Mantel understands the isolation only too well, as she shows in Giving up the Ghost.

Bodily failure

Zoom and social media are, of course, helping; they connect us with each other and the various medics doing their utmost to care for us. But getting my head around the medications, appointments, bodily failures and – worst of all – fears of what will next go wrong has still often made me feel alone with my multiple sclerosis.

So, when I happened on Giving up the Ghost on one of our many bookshelves at home, I read its pages with a feeling akin to relief. That might sound cruel, which I don’t mean to be, since Mantel – or ‘Ilary, as people call her – makes for a likeable narrator as she recounts her childhood and the infertility that stems from abnormal menstrual bleeding. But her courage and skill in charting her experience of life-changing illness (endometriosis) has at least diminished my own self-pity, and I can imagine her doing the same for thousands of others.

Not a hint of self-pity

Giving up the Ghost manages to recount some of the bleakest episodes in Mantel’s life without so much as a hint of self-pity. While still in her twenties, and before she’s had chance to start a family, she is given a hysterectomy that of course leaves her sterile. Yet even here she manages to remain dispassionate and sardonic in her attitude to the medical bungling that is wrecking her life.

Her descriptions of the ghosts that feature in the title boast an insouciant physicality. She likes to acknowledge her stepfather’s ghost with a tilt of the head whenever she ‘sees’ him on the stairs in her home and is reluctant to move elsewhere because of him, saying: “I can hardly bear to sell the cottage and leave him behind on the stairs.”

Scant sleep

During her migraines she has visions that she likens to those of saints. “Scant sleep and lack of food increase the likelihood of these sightings,” she writes, prosaically. “Starving saints in Lent, hypoglycaemic and jittery, saw visions to meet their expectations.” Much of Mantel’s genius lies in her ability to combine the otherworldly and fantastical with text that is prosaic, embarrassing, bodily and matter-of-fact.

As readers we feel for Mantel when we learn of her pain at having to drop plans to become a lawyer because of illness. She’d have been good, I found myself thinking. Doughty. Combative. Clever. Driven. Impersonal. Perhaps if her life had gone a different way, she might have become a latter-day version of her own character, Thomas Cromwell, the son of a blacksmith from a rough part of London whose rise to high office is charted in her Booker-prize-winning novels. In Mantel’s hands, Cromwell transforms from the brutish, ruthless henchman of public imagination into a more nuanced figure.

Malingerer? No.

Mantel’s struggles at the hands of inept doctors rang plenty of bells with me; my Multiple Sclerosis wasn’t diagnosed until I was 46 though I’ve probably had it all my life. Like Mantel, I was dismissed as a neurotic, a malingerer. When I made the mistake of asking a London GP why I was so tired all the time, she replied, sighing: “Modern life just is very tiring. Do you think you might be depressed? We have medication for that.” It wasn’t depression making me tired, it was my brain-rotting illness.

Another reason I like Mantel so much is her non-conformism. Even when she becomes head girl of her school, she still manages to rebel by refusing to wear the regulation blue knickers most women of a certain age can remember having to wear at school too. She deserves commendation for this; at the primary school I attended, the PE teacher often made us pull up our gym tunics so she could check we really were wearing the prescribed underwear. It was humiliating. Nowadays such a practice would probably be prohibited for infringing our human rights. Personally, back then I was much too afraid of authority figures to risk breaking the rules, so just complied with all edicts on our underwear. But it makes me happy to think Mantel had the cunning and nerve to go her own way on that as on much else. She was a rare talent, our ‘Ilary.