A grief connection

Memoir: When Mary Loudon's sister, Catherine, died, the two had not seen each other for 12 years.

Upon her admission to Bristol Royal Infirmary with inoperable cancer, Catherine had stated that she had no next of kin. It was only when the authorities went through her apartment that they discovered the family's existence and informed them. By that time, Catherine was 11 days dead.

The sisters were 13 years apart in age and their paths could hardly have been more different. When Loudon finished her studies, she began writing books, bought a house, had nice boyfriends, eventually married a "lovely man" and had a baby. When Catherine left home, she travelled to India, suffered a breakdown from which she never fully recovered, then vanished. When she returned to England a year later, she was "broken".

A bedsit in Oxford followed, psychiatric hospitals, Holloway jail. Catherine was diagnosed with schizophrenia. She eventually settled in a council flat in Bristol, which the family was discouraged from visiting. So Mary Loudon never did. (The two exchanged letters, but nothing that, in retrospect, seems sufficient to Loudon.) Aside from trying to respect her sister's wishes, Loudon was also understandably unnerved by Catherine's "manic muttering, grinning, swearing and laughter". Now, in Relative Stranger, she recounts her attempt to find out who her sister became during those 12 years.

When Catherine died, presumably well-meaning people said to Loudon such things as "at least you won't have to look after her when she's old" and "thank God she didn't commit suicide".

Catherine's death, Loudon realised, was seen as less of a loss because she had psychiatric problems. The question arose: who, and according to what criteria, determines the worth of a life? Particularly a life which is not, in the sense in which we normally understand the word, "productive". Loudon notes that it is largely understood that "you are only worth your life as long as you are reasonably happy, well and rational" and that there will always be those who view her sister's life as a "waste" and a "tragedy". Ultimately, though, she concludes: "Catherine simply did what most of us do. She worked out how to live within her limits and she lived as fully as she could."

Indeed, Catherine did not live the isolated bedbound existence her sister had often feared she did. She had a lot of interests: Tibet figured hugely and she was a member of Amnesty International; she painted throughout her life; she made a lasting and positive impression on many people; and - as Loudon discovered early on in her investigations - she lived the last several years of her life as a man.

Relative Stranger, Loudon's fourth work of non-fiction, aims to clear up some misconceptions about schizophrenia. For instance, the disorder has nothing to do with a "split personality" but instead involves distorted cognitive processes and perceptions (including auditory and visual hallucinations), usually accompanied by inappropriate emotional responses. But at other times, Loudun clouds the issues, holding to a theory of predestination which is unsupported by the facts.

"Schizophrenia wasn't a car accident that happened to [ Catherine] when she was 18," Loudon writes. "It didn't . . . cut off her brilliant life . . . Catherine was never going to be anyone else." She maintains that it is fruitless to speculate upon an alternative version of her sister because "schizophrenia is not just what she was, it's who she was".

THIS LANGUAGE IS at odds with contemporary ways of talking about schizophrenia as a thing one has rather than a thing one is (and even the idea of "having" "schizophrenia" is far from clear-cut). It also presupposes that the illness is etched into a sufferer's neurological make-up from day one, something that has never been proven. (Schizophrenia's causes - or perhaps triggers - remain a source of debate. A recent issue of the respected journal of psychiatry, Acta Psychiatrica Scandinavica, for instance, was devoted to challenging the view that schizophrenia is "an illness like any other" - ie, one based on bio-chemical abnormalities - and focused on the link between early trauma and adult vulnerability to the disorder; meanwhile, the president of the American Psychiatric Association recently complained that his profession had "allowed the bio-psycho-social model to become the bio-bio-bio model".)

Loudon's assumption that schizophrenia was Catherine's fate discounts her sister's life experiences. While in India, for instance, Catherine was doing drugs, and Loudon herself cites the fact that it is now widely accepted that both hallucinogenics (such as LSD) and cannabis are capable of triggering schizophrenia, particularly in "vulnerable" individuals.

It would be surprising, however, if a book on such a complicated and contentious subject did not itself assume (even inadvertently) contentious positions. More problematic for me was the verbatim reproduction of lengthy interviews - with a nun, a priest, Catherine's local grocer, etc - detailing Catherine's daily habits. The information, while adding up to the sought-after "working knowledge" of Catherine's life, is simply not as interesting for the reader as it is for the author.

THAT SAID, THE book has many strengths. There is the diary Loudon's father kept when he travelled to a village near Dharamsala, where Catherine was falling apart amidst Tibetan monks and (perfectly captured) Western hippies - "pale, ill, hang-dog, unhappy, egocentric, with a touch of decayed arrogance about them". And there is the value of the search itself. Not because it enables Loudon to imbue her sister's life with meaning - her sister's life already had meaning; this is one of the book's insights - but because it reminds us that there are ways of connecting to loved ones (through narrative, for instance) with whom we were never able to manage the more banal methods of companionship, such as "Chinese takeaways and rented movies".

Loudon concludes her search both chastened and consoled. Consoled because the life she discovered her sister had led was - while often painful - anything but empty, and chastened because of the realisation that the judgments we tend to make about the emptiness or otherwise of lives are based on fairly limited, perhaps patronising, notions of what a "meaningful" life consists of.

The book ends with a single, startlingly beautiful page from Catherine's diary, in which she imagines a family gathering (including members no longer living), carefully arranging those present in a series of steps and concluding:

• Molly McCloskey's latest book is the novel Protection (Penguin Ireland)

• Relative Stranger: A Life After Death By Mary Loudon Canongate, 336pp. £16.99