VISUAL ARTS/Aidan Dunne (Having. By Susan Tiger): A little over a year ago, Susan Tiger was artist-in-residence at The Coombe Women's Hospital, in Dublin.

Before that, the American had experienced a different kind of residence at The Coombe, first when she was there for an operation and, subsequently, when she gave birth to her daughter, Sophia.

Having, her limited edition book of drawings and writings, in a way results from all of those residencies. It is as if she used the third to retrace her steps during the first and second, to produce a meditative reflection on her experience of surgery, pregnancy and birth at the hospital.

Having is a narrative, of sorts, in pictures and text. But in keeping with the general tenor of Tiger's work, it is a gentle, oblique narrative, built from the accumulation of countless matter-of-fact details, of tiny but telling observations. It is intensely personal and even poignant, but never sentimental. In fact, there is a distinct rigour and toughness, a flat commitment to relating things as they are. Although it clearly draws extensively on Tiger's experiences, it reflects the experiences of many, and her careful management of point of view unobtrusively manoeuvres the reader into a subjective position.

As she says: "Sitting in on support groups during the residency, you quickly realise that, though at first you think it's just you, everyone has similar experiences. I think any woman who's been through it could identify with finding such a route through the hospital."

Each reader in a way becomes the protagonist in a first-person story.

This is all the easier because of the accuracy of Tiger's observations of the texture of institutional environments, of what might be described as the brutal impersonality of functional rooms and objects and furniture.

We see things as we would if we, too, were thrust by circumstance into the hospital environment. Figures are viewed fragmentarily. We hardly see identifiable faces. We encounter the physical fabric of the hospital in terms of strangeness; we try to get a handle on its topography. There is a great deal of waiting, of nervousness. As an American thrust into the midst of the Irish healthcare system, Tiger says frankly: "I was frightened. Particularly because I'd been spoiled in the American system, because my family has a medical background."

To say this is not to take from the warmth and care dispensed by the hospital's staff, its nurses, midwives and doctors, something that also comes through vividly. But an edgy impersonality is an inevitable facet of hospitals. In fact, Tiger's experience of The Coombe was extraordinarily positive. "I developed a love for the place through dealing with the people there. Really, you could not buy the level of care I received."

The idea for the book came from Dr Sean Daly, master of The Coombe, who early on remarked that Tiger was going to know the hospital as well as anyone by the conclusion of her pregnancy. Her drawings conceptualise things beaut- ifully. That is to say, when she draws a waiting-room chair, she doesn't aim only to capture a momentary impression of a chair glimpsed in a room. The chair she makes is both abstract, a Platonic ideal, and concrete, physically there. Spaces are envisaged in the same way, not as atmospheric impressions but, more, as labyrinths to be negotiated. Patterns of corridors, staircases and doorways are recalled in the form of mental maps, inscribed with the imprint of repetitive negotiation. There is a sense of the world as a durable background across which we flit like ghosts, a sense heightened in the space of hospital, in which so many cruxes of life and death are encountered.

Several books and documents feature in the drawings: Tiger's medical file, contraction times noted on the back of an envelope, a diary, books. Books were important to her during her times at the hospital. She could, she observes, have finished the book she was reading the night before her operation, but it was better luck not to, to have it to go back to - "books being time markers", reads one overwritten note, like so many things associated with hospital, even cups of tea with biscuits or toast.

Tiger draws in pencil, building up her images in tentative sequences of making and erasing. Exceptionally sensitive and responsive to draw with, graphite is notoriously difficult to reproduce faithfully. Usually the tonal delicacy of the line is coarsened in the process. But Language, which designed the book, has worked with Masterphoto and Printstone to produce images that capture the soft greys of the graphite line and the faint underpinning of erased marks. This works incredibly well in relation to some drawings, including that of the diary, with its almost flickering impression of turning pages, embodying the idea of duration. There is colour, incidentally, which is used sparingly and well.

Visually and psychologically acute, Having is both a personal chronicle and, as Tiger says, one that relates to universal areas of human experience.

• Having is available in a limited edition of 1,000 copies. Proceeds go to The Coombe. Inquiries to Fiona FitzGerald (01-4085280 or ffitzgerald@coombe.ie  or Caroline Woods (01-4085644, cwoods@ coombe.ie)