Reviewer: Ian Freckelton

The Spare Room, by Helen Garner: 2008, Text Publishing, Melbourne. Pages 1-195; Price: $25 (pb).

Helen Garner’s The Spare Room is her first work of fiction for 15 years. However, while nominally fiction, it is a novel that resonates deeply of personal experience and of the reality of predation by cancer quacks that, unfortunately, is all too real a phenomenon in the contemporary health care environment.1

In an essay, “Woman in a Green Mantle”, in her earlier book The Feel of Steel (Picador, 2001), Garner stated: 

“I think, that at least now there exists a developed awareness of something honourable to offer in [the novel’s] place – I mean the dangerous and exciting breakdown of the old boundaries between fiction and nonfiction, and the ethical and technical problems that are exploding out of the resulting gap.”

One of the signature aspects of The Spare Room is its authenticity and its verisimilitude, born out of experience. Thus the book lives and breathes in the interstitial space between fact and imagination. The Spare Room is about death and not coming to terms with it. The plot centres around a three-week visit by Nicola to the author’s house. Nicola is an old hippy of 65 from Sydney. She is experiencing severe pain from advanced cancer in her neck and back. She has come to Melbourne to receive ozone and vitamin C therapy from an alternative health practitioner in Collins Street who has assumed the appearance of scholarly respectability as part of a scam. “Professor” Theodore operates from a dingy set of rooms that he has named “The Theodore Institute”. The descriptions of the operation of the Institute and those working within it are chilling, memorable and confrontingly realistic. What is even more disturbing are the unreasonable hopes created by the Institute in patients desperate for any possibility of survival not provided by mainstream medicine.

A person purporting to be a doctor at the Institute explains to Nicola (p 36):

“High dosage vitamin C will kill off lumps of cancer and boost the immune system. And our ozone sauna treatment is based on the old natural-therapy approach to cancer – sweating out the toxins. Most doctors don’t know about this stuff. But it’s good science.”

 Nicola is completely convinced by the young doctor and even the author is taken aback (p 37):

“What did I know about cancer? Maybe there was something in these cockamamie theories. Maybe they were the future. Maybe [Dr] Leo was wrong when he stated that vitamin C did not shrink tumours. Maybe it was unfair that these pioneers had fallen foul of the authorities and were obliged to treat their patients in shabby private clinics.”

Nicola suffers adverse reactions to the high doses of vitamin C, sweating profusely during the night, and gradually becoming weaker and more afflicted by increasing levels of pain. Yet she persists in refusing to abandon trust in the clinic, leaving her friend in an ethical dilemma: should she take away the last vestiges of optimism that Nicola has by confronting her with the harsh realities of “Professor” Theodore’s charlatanism or should she continue to support her in an unconditional way? As the days wear on, the latter option becomes more and more difficult as the sheer physical demands of looking after Nicola and her nightly travails and then transporting her back the next morning to the clinic start to wear her down. All the while Nicola’s pain is intensifying.

The Spare Room is an intriguing study of Nicola, whose self-absorption in her terminal illness is far from edifying. At the one time there is an element of the inspiring in her determination not to give up but at another her quickly formed dependency on the author and her preparedness to make inordinate demands bespeak difficult aspects of her character which have been of long standing. Dealing with reality has been an ongoing issue in her life. When the author confronts Nicola with how she can keep going with the treatment, her response is (p 77): “Helen … it’s the same with chemo and radiation. Nobody knows how they work, either, but people still do them.” But she is persuaded out of necessity to commence morphine to deal with the pain that is starting to overwhelm her.

Toward the end of her time with Helen, Nicola starts to reflect on her life, acknowledging that she had “wasted her good luck” and “made nothing of myself” (p 107). Such conversations are not easy to participate in if one is to do more than utter comforting platitudes. They torture Helen.

The inevitable eruption occurs when Helen confronts “Professor” Theodore. It starts with her saying to him: “I need you to tell me why you keep brutalising [Nicola] like this.” The “Professor”, though, is untroubled by her reproaches and calmly, vacuously, responds to her complaints, even retaining composure when she informs him that she will report him to the Health Services Commissioner.

The final parts of the book should not be fully revealed in a review. Suffice it to say that they are raw and that there is no Hollywood ending or an easy death after a cathartic acquisition of insight and a resolved calm. Helen is left with mixed and confused emotions. These include a recognition of the toxicity of anger. She gained little comfort from her report to the Health Services Commissioner. It was months after Nicola’s death that she came across the valedictory letter addressed to her which Nicola had carefully hidden (p 193): “I was racked with weeping, with harsh sobs that tore their way out of my body, as she had fancied her toxins would rush from hers.”

The Spare Room is a work of genius and maturity. It is manifestly deeply autobiographical. It is raw, real and without cosmetic rendering. It cannot but prompt emotional responses, at times deeply sympathetic to Nicola, at other times repelled by her narcissism and her inability to come to terms (as society unreasonably expects)2 with her terminal illness. It gives an understanding of how unscrupulous practitioners such as “Professor” Theodore can prey upon those desperate for hope, at almost any cost. But it does more: it communicates memorably how the experience of death radiates out beyond the individual concerned. It affects all those who care about the person who is suffering and, ultimately, dying. The greatest attribute of The Spare Room is its emotional complexity and, in this, its uncensored empathy with the pain, joy, ambiguity and sense of loss that is part of the dying experience. It is a wonderful and memorable book that all who have an interest in health, law, living and dying should read and reflect upon.

1 See Freckelton I, “Unscientific Health Practice and Disciplinary and Consumer Protection Litigation” (2011) 18 JLM 645.
2 Parker M, “Not So Great Expectations: Why We Should Accept and Respect Hopelessness and Futility” in “Bioethical Issues”