Consumed: A Sister's Story

by Arifa Akbar

All happy families are alike; each unhappy family is unhappy in its own way.

When Arifa Akbar discovered that her sister had fallen seriously ill, she assumed there would be a brief spell in hospital and then she'd be home. This was not to be. It was not until the day before she died that the family discovered she was suffering from tuberculosis.

Consumed is a story of sisterhood, grief, the redemptive power of art and the strange mythologies that surround tuberculosis. It takes us from Keats's deathbed and the tubercular women of opera to the resurgence of TB in modern Britain today. Arifa travels to Rome to haunt the places Keats and her sister had explored, to her grandparent's house in Pakistan, to her sister's bedside at the Royal Free Hospital in Hampstead and back to a London of the seventies when her family first arrived, poor, homeless and hungry.

Consumed is an eloquent and moving excavation of a family's secrets and a sister's detective story to understand her sibling.

Genres: Nonfiction, Memoir, Biography, Pakistan

256 pages, Hardcover

First published June 10, 2021

Reviews

[Kerri · Rating 5 out of 5]

I actually listened to this, but there isn't an audio option yet.
I thought it was beautifully written. It first caught my eye when I was looking for books with a focus on Tuberculosis. It was certainly informative in that aspect, but I also greatly appreciated the detailing of the complex, sometimes fraught relationship between sisters, the insight into Fauzia's life and death.

I have a great deal of sympathy for her, and her family. It baffles me that Tuberculosis, which we are all at risk of contracting, since all you have to do is breathe to be infected, is so often misdiagnosed, or discovered too late. I realise it probably won't be the diagnosis in most people, but this is hardly something obscure! Fauzia and her family were let down that this wasn't picked up in time.
I can barely imagine how difficult it was to write about this, but Arifa Akbar has done so brilliantly.

https://www.theguardian.com/lifeandst...

[Rebecca · Rating 4 out of 5]

(3.5) I read the first 60 pages and had to skim the rest due to an impending library deadline with some holds after me; otherwise, I would happily have read the whole thing. There are compelling themes here: a life lived between two cultures, Pakistani and British; an autopsy of a family cursed by an unhappy arranged marriage and her father’s favouritism; and her artist sister Fauzia’s medical and mental health issues. There’s even an element of mystery to the book in that Fauzia’s condition was undiagnosed before her death in 2016. Soon after, the family learned that she’d died of TB, a disease that was almost in vogue in the 18th century but has had a resurgence in modern times, with South Asians at particular risk. Akbar wonders if her sister had been harbouring the infection ever since they lived in their first London home, a squalid squat.

As a theatre critic, she’s always looking out for resonances in culture, mentioning films, plays and literature (e.g. going to John Keats’ last abode as part of a trip to Rome). Sometimes I struggled to see the relevance of the film commentary. I was most interested in the sisters’ binge eating, a shared habit that became a lifelong eating disorder for Fauzia, and in Fauzia’s art. Colour plates reproduce a number of her artworks, most of which are based on embroidery (which explains the pink stitching on the cover), some with mixed media, and all rich in symbolism and self-portraiture. I wished some plates could have been devoted to family photographs, too. The book was written quickly starting in the first UK lockdown and while, ultimately, I think that shows, and the story might have benefited from more hindsight, the various elements are woven together well and the brevity creates an appropriate sense of intensity.

A readalike: Sick by Porochista Khakpour

[Maliha Tabassum Arna]

একখানা বই-ই বটে। আর কথা না বাড়িয়ে নয়া দিগন্ত(১৮.০৬.২০২১) এর একটা প্রতিবেদন তুলে দিই।
" সাধারন থেকে অসাধারন হয়ে ওঠা এক লেখিকার বই 'কনজিউমড: এ সিস্টার্স স্টোরি '। এটি উপন্যাস নয়, সমালোচকরা বলছেন অটোবায়োগ্রাফি বা মেমোয়ার। তবে স্মৃতিকথা হয়েও এটি হয়ে উঠেছে উপন্যাসোপম। লন্ডন অব্জারভারে বইটির সমালোচনা লিখতে গিয়ে হেপজিবাহ এন্ডারসনও বার বার এর উচ্ছ্বসিত প্রশংসা করেছেন। বইটি লিখেছেন পাকিস্তানি বাংশোদ্ভূত ব্রিটিশ সাংবাদিক ও লেখিকা আরিফা আকবর। তিনি তার বোন ফৌজিয়ার রোগগ্রস্ত হওয়া ও মৃত্যুর কাহিনী বর্ণনা করেছেন বইটিতে। এ জন্যই নাম দেয়া হয়েছে এ সিস্টারস স্টোরি। পাকিস্তানের একটি পরিবারের অভ্যন্তরের বিরোধ, তার ফল হিসেবে আরিফা ও ফৌজিয়ার বাবার সপরিবারে লন্ডনে পাড়ি জমানো, দুই বোনের খুনসুটি ও এক সময়ে তাদের মধ্যেও বিরোধ সৃষ্টি ইত্যাকার ম্যানলি বিহেবিয়ারের চিত্র এতে উঠে এসেছে। কাহিনির সুচনা লাহোরে, যেখানে ছিল আরিফাদের আলিশান বাড়ি, সেখান থেকে লন্ডনের হ্যাম্পস্টিডের এক রুমের এক বাসায় আসা ও কঠিন জীবনের মুখোমুখি হওয়া। একসময় তারা দু বোন উর্দু ছাড়া কোন ভাষা জানতো না, পরে ইংরেজি ভাষা রপ্ত করে আরিফা সাংবাদিক হয়েছেন। তিনি এখন গারডিয়ান পত্রিকার চিফ থিয়েটার ক্রিটিক। টিবি রোগে তার বোনের মৃত্যু তার মধ্যে এক নতুন বোধের জন্ম দেয়। তারই পরিনতি এই বই। এটি আরিফার প্রথম বই, প্রকাশ হয়েছে এ মাসের শুরুতে। তার এই বইটি পাঠক্রা কিভাবে নেবেন সেটা দেখা যাবে আসছে দিনগুলোতে। তবে লেখক জীবনের সূচনায় একটি ব্যাতিক্রমি কাজ করে সবার কাছে প্রশংসিত আরিফা আকবর। বইটির প্রকাশক লন্ডন প্রকাশনা সংস্থা স্কেপচার। "

এর আগে কোন বই পড়ার জন্য এতো বেশি ডেস্পারেট ছিলাম বলে মনে পড়ছে না।

[Tilly · Rating 4 out of 5]

Consumed is a unique memoir that seamlessly shifts between a personal account of a family’s history, and expansive explorations of illness throughout history. The author’s sister, Fauzia, suffered from a mystery illness that left her in intense amounts of pain and confusion for some months, before she eventually succumbed to her illness. It was only after her death that the doctors discovered Fauzia had been suffering from TB, an illness much more associated with life in previous centuries than in modern day London.

The author is a journalist, which really does come through in her tone: often she refers to the arts in order to provide parallels between her sister’s experience with TB and how it is depicted in the cultural canon, be it through film, art, opera, or literature. I found some of her analysis enjoyable and eye-opening, but occasionally it was overwhelming and lacked in necessity. Thankfully, Akbar is equally able to reflect empathetically on her sister’s life, their mutual upbringing, and the scraps of memories that are left behind in the wake of her passing, which ultimately makes for some of the strongest and most moving writing in the book.

Fauzia, the author’s sister, was an artist, and the book greatly benefits from some stunning photographs of her embroideries and paintings- Akbar takes great care in dissecting her sister’s artwork and providing context for the reader, and I found those parts absolutely fascinating. It seemed very fitting that the sisters should complement each other in that way: Fauzia’s rich artwork is full of ideas to be admired and unpicked, and her sister writes of it so beautifully and sensitively, with a true critic’s eye, so that each sister’s talents benefit the other.

Overall, Consumed is a fascinating blend of wide-ranging and well-researched cultural analysis on the topic of TB, combined with a heartbreaking and unflinchingly honest account of grief.

[Annie Zaidi]

I really liked this book. It is a stunning account of a really difficult relationship. Although it is about consumption (TB) and the medical systems leading up to an untimely death, it is also about literature and art and migration and families and sibling love. Both Arifa and her sister Fauzia had a deep engagement with the arts, whether written, performed or painted/crafted, and this makes the memoir even more compelling for other artists and writers like myself.

I was also especially moved by the immense emotional and psychological work required to describe with honesty and openness the dysfunctionality and abuse that were part of the deceased sister's life, as well as her very difficult relationship with food. The 'consumed' in the title is as much about consuming (and being consumed by an unhealthy relationship to food and/or family) as it is about disease. I would unhesitatingly recommend this book.

[Sylvie · Rating 4 out of 5]

Unlike one reader who had to return this book to the library, I would not have regretted being unable to finish it. I felt there was too much repetition. A good part of it felt laboured and too inward-looking. I persevered, carried along in the hope that such an observant and clever writer as Arifa Akbar would land on some interesting topics as part of the story of her sister’s illness and death.

Her sister Fauzia was a troubled person. This was partly due to her father's inexplicable antagonism and his overt favouritism towards Arifa. The relations between the sisters was partly soured by that unjust treatment. The medical teams did not appear to discover the nature of the illness that plagued her and that eventually killed her - not until it was too late. All this produced a toxic mix of guilt and anxiety, which is examined in great detail. Nor does Akbar spare herself.

To work through it, and this comes further on in the story, she embarks on a journey of discovery of each work of art that her sister left, with the sensitive eye of an artist, and also as the sister who knew her and grew up alongside her.

The medical details are of course engrossing – most of us are intrigued by the mystery that is the human body, its failings and the assaults on it. What was also interesting were the various other topics she came across when thinking about the loss of her sister to such a disease – its history, its depiction in the lives of poets, the ideas conveyed in opera and art. Along the way, feminism is inevitably examined.

In La boheme
Mimi is dying and Rudolfo calls her beautiful as the dawn.”Leslie Jamison points out in her essay “Grand Unified Theory of Female Pain”. The suffering of women is often transfigured by “an old mythos that turns female traumas into celestial constellations worthy of worship” she argues, drawing a line from Anna Karenina’s suicide and Mimi’s consumption to contemporary narratives around women and self harm.

The passages devoted to artists saves the book from too much inwardness. In the chapter titled Sacrifice, she writes about Vincent Van Gogh. She watches Robert Altman’s film Vincent and Theo.

What is unquestionable is that Theo was the epitome of loyal self sacrificing brotherhood. Yet it did not save Vincent from his mental anguish. The bigger point is that Theo writes “it breaks my heart to know that now I’ll probably have days of happiness with my dear Jo ( johanna), you will actually have very bad days.” Theo had written that he was planning to marry Johanna Bonger. We can’t help someone we love beyond a certain point but we feel guilt all the same.

The other artist in focus is Munch. Arifa Akbar visited Norway as part of her research. Frode Sandvik who curated an exhibition of Munch’s work made several observations about the artist’s preoccupation with his dead sister in his art. Using such a subject is always a moral dilemma for the writer or artist and Akbar deals with that too. She writes:

He is the grieving brother but he is also the clear-eyed artist, depicting Sophie’s death as one part of a grander project to depict mortality and human suffering with himself at its centre.

I can see this would be a rewarding read. It covers much of the psychological pain that follows the death of a loved one, a death that occurs in such baffling and complex circumstances,

[Suzanne · Rating 4 out of 5]

A very intense and intelligent memoir about the loss of the authors sister and her struggle to make sense of her untimely death.

I found the beginning very engaging. The arrival of the family from Lahore and the struggle to adjust to a new culture. I did struggle with some of the passages on art and literature. There is no denying the author can write beautifully.

[Ross · Rating 5 out of 5]

Haunting! I loved reading this book. Il am going to go ahead and quote from a blurb on the back. Try and stop me! “Akbar’s sensibility turns what could be a misery memoir into a literary tour de force” (Yasmin Alibhai-Brown). Says it all.
Thanks for the recommendation Ingrid!

[Paws with a Book · Rating 3 out of 5]

This is a raw memoir, that conveys a real and honest sense of confusion, anger and grief around the loss of a sister and the relationship leading up to that loss.

Arifa Akbar takes the reader back to her childhood in Lahore, with tainted memories exploring the root causes of her difficult relationship with her sister. It is reflective, and explores identity, our human need to be loved, and the impact of trauma through the generations.

Akbar looks to the arts to explain a relationship she struggles to comprehend. I liked this aspect, but must admit I did struggle to engage with frequent tangents into details of paintings and works that were not familiar to me, and it would’ve helped for these images to be included in the photographed pages inserted.

I felt that whilst it was thought-provoking, a lot of the thoughts were fairly repetitive, and didn’t build as much as I’d hoped. I felt that the memoir built early and sustained…but that I was looking for more impact and this building could’ve been more gradual through the book.

There are difficult themes in this book, and I will highlight trigger warnings for: domestic emotional abuse, mental health including suicidal thoughts and actions, eating disorders and substance abuse.

This was a thought-provoking gentle exploration into a relationship through life, and also beyond. It must’ve been incredibly difficult for Akbar to write, and would like to thank Sceptre books for gifting me an advanced copy of this memoir, and to Arifa Akbar for opening herself up so beautifully in the pages.

[Hester · Rating 4 out of 5]

A memoir about tuberculosis . Sign me up . In all fairness TB , consumption , phthisis ( what an amazing word that is ) is the great ugly iceberg of infectious disease that The West , having dodged it's worst through a combination of improved welfare , drugs and vaccines now hardly gives a backward glance to .. Of course , those of us who value literature can name many lives cut short ...from Keats , through the Brontë sisters to Orwell and many others between . Sometimes the list reads like a railway timetable , morbid stations and halts , all potential and promise l, ike Adelstrop, as we pause and wonder what's beyond the platform, would that road we see have led somewhere extraordinary ..but we move on quickly enough , even as we briefly mourn the cruelty of their early deaths .

Arifa Akbar had a sister . An older sister . An artist..When she fell seriously ill , after a life marred by mental health problems, made manifest by eating disorders , no one even thought of tuberculosis . Numerous specialists at one of the best hospitals in London scratched their heads over her puzzling cluster of symptoms that any jobbing doctor practicing in any country where the disease still devastates would have recognised as miliary TB . Wrong place , wrong century .

Fauzia was a challenge, no doubt . Not just to the medics , who realised too late what had been staring them in the face, but also to her younger sister , the author . Her journey of grief, after long years of estrangement , is at the heart of this memoir as she too , like her sisters physicians and psychiatrists, searching the runes of symptoms and investigations , plunders memories of their childhood and tetchy adult encounters to try and grasp her sister again . To truly see her.

It's a courageous journey . Fauzia left a trail of crumbs in the form of fine art and , increasingly as she became ill , complex embroideries which Arifa interrogates over time with the detached eye of a critic . By doing so she is able to understand the awful binary of their sibling relationship , determined by a malicious good child/ bad child dynamic set ticking by their unhappy father . Arifa was the good child , increasingly able to frame her own story against her sisters chaos and inconsistency , but the legacy of her art and Arifa's ability to " see" helps her understand that her own hurts and stubborn adherence to the past has equally contributed to their divide..

In and amongst this we have wider stories about TB and the cultural luggage it has carried over the centuries ..there's Keats and Munch, Verdi and Puccini ...and insights into other sibling dynamics from Antigone to Van Gogh.

By the end I really felt the terrible loss of Fauzia, the hollow grief of her sister and the startling indifference we all show to a disease that is still reeking it's ugly havoc on many the world over. We just need to consider it .

[Nathan · Rating 3 out of 5]

Consumed tells the story of Arifa Akbar and her sister Fauzia - the latter of which died of tuberculosis in her mid-40s.
I'm not surprised to find out that Arifa Akbar is a theatre critic and reviewer, because i) she writes very well and ii) she consistently references how the arts have depicted TB, sisterhood and grief throughout history (she discusses film, theatre, literature, painting, embroidery - I think basically everything but stand-up comedy gets a mention at some point!) and she uses these references to look for synergies with her own sister's story to help the reader understand her points better. Unfortunately, I often struggled to see the relevance of these analyses because in many cases I wasn't familiar with the particular cultural reference she'd used. As a result, I was reliant on her descriptions of them to understand how they connected, which made the similarities feel a little sterile and too over-analyzed, lessening the emotional potential of her writing. The best way I can describe it is that it was like buying a ticket to an art gallery and instead of being able to view the art and experience the nuance and layered meaning of it in a simply instinctual and visceral way, the art itself is removed and there's a short written description in it's place of what it looks like and how you're meant to feel, had you seen it.
I was more interested when Akbar moved away from the comparisons with art and discussed their family background, the relationship between the sisters and their parents, Fauzia’s addictions and mental health issues, and the mystery of her illness and premature death. Although enjoyable, these segments felt, sadly, too brief, and occasionally as though she was on the precipice of an emotional breakthrough, before moving swiftly on. On the face of it, her personal story has enough ingredients to craft an incredibly emotional and affecting memoir - I've read brilliant memoirs of people who have gone through comparatively much less - but I ultimately ended up feeling that we were kept at arms length as readers and asked to intellectualize too much.
3 stars

[Hafsa Lodi · Rating 4 out of 5]

I was so captivated by the cover, coupled with the Pakistani author name, that I immediately ordered a copy of "Consumed" without even reading what it was about.

It’s taken me some time to get through, but what a brilliant story and tribute from one sister to another. Arifa Akbar’s sister Fauzia died tragically after battling a long-term “mystery illness” and in her book, Arifa investigates the cause of her sister’s death while trying to get to know her better, to grow closer to her, and ultimately, to gain closure.

“Looking for clues to questions that can never be answered,” Arifa reflects deeply on both her own upbringing and her sister’s, which were surprisingly extremely different. The duo had a tumultuous relationship, and as Arifa looks back with fresh and thoughtful eyes, she starts to understand more about her sister’s rage, hurt, eating disorders and mental health issues. She also reveals the ultimate cause of Fauzia’s death, and goes into depth researching this disease (I won’t give spoilers), its symptoms and prevention.

Arifa started writing this during the first COVID-19 lockdown in 2020 in London, and “embroiders” a memoir-style story framed around both her and her sister’s lives. “Of course I could be wrong with all of these half-formed theories,” she admits at one point, and in another, states, “it's all a matter of looking - the more you look the more you see.” My favourite parts were Arifa's childhood memories of Fauzia, and her present-day analysis of Fauzia's artwork, which combines paint with embroidery and mixed media.

Arifa Akbar is a British-Pakistani journalist and currently the chief theatre critic at The Guardian and as such, Consumed is a blend of personal anecdotes, opinions, recollections, facts stats and research. The story is interspersed with many art, theatre and mythology references, which at times can be tedious for readers who do not share these interests, but aside from that, this book is an excellent deep-dive into one family’s tragic loss, and the challenge of drawing acceptance, meaning, purpose and closure from that loss.

[Bethany Reaney · Rating 3 out of 5]

Picked up this book in a bookshop, read the blurb and first page and instantly had to buy it.

A book about a sister's experience of losing her sister to tuberculosis in 2016. Of losing her fascinatingly enigmatic sister to a historic illness, in a modern London hospital with modern medicine which /should/ have been capable of curing such a disease.

The premise was utterly captivating. And when I started reading the book; learning about the sisters lives in Lahore and their relationships with each other and their parents, learning about Fazia's illness and death, I was completely enamoured. I couldn't put the book down.

Unfortunately after the first few chapters, the author continues to trail off into uninspiring tangents about historical figures or theatrical representations of tuberculosis. I was so frustrated by the constant tired references to Keats because I felt like it detracted from the far more interesting and novel account of tuberculosis that I bought the book to read.

I was here for Fauzia and Arifa's story, not his.

In the moments where Akbar is talking about her sister or her family; when she talks about the challenges of getting a diagnosis and how her sister was let down by the system of medicine; when she talks about the modern challenges with TB; all of these moments are absolutely 5 star worthy and make it worth reading. I just wish that made up the whole book.

[Ged · Rating 3 out of 5]

“Consumed” is a sometimes anguished reflection; a hopefully cathartic processing of a younger sibling Arifa Akbar on the troubled life and premature death from tuberculosis of her elder sister Fauzia. Tuberculosis plays the role of villain but the sub-plots are the internal dynamics of a British-Pakistani family and mental illness and eating disorders.

The book explores the historical, medical and cultural context of tuberculosis contrasting its somewhat romanticized and mythologized reputation with the catastrophically destructive reality. Tuberculosis is at once familiar and yet so unexpected so as to evade diagnosis until too late. The author’s skills as an arts critic are used to great effect in the cultural analysis…passages on visiting John Keats’ lodgings in Rome and the performance to La Boheme at Torre del Lago are insightful without forced pretension.

I wonder whether her highly-tuned artistic receptors make the task of reviewing Fauzia's portfolio more distressing than would be the case with the more attenuated senses of the layman. Such a subjective critique might not be conducive to definitive closure.

[Rachel · Rating 1 out of 5]

It’s rare I “DNF” a book (and trust me I feel terrible about doing so) but this just wasn’t for me at all and it was a struggle to get through. I read a large chunk of it, don’t get me wrong, but then I just thought to myself “why am I making myself do this?”

I even put it down three times and tried to re-read over the course of six months! I was committed, ok.

I usually love memoirs but honestly this story of loss was just depressing. Even in the hardest and most difficult stories, I like to find hope and joy and there was just none at all to be found. It was dreary and depressing page after page. I wanted to hear nice stories of her sister at a young age as she reflected, and maybe that would have come along in the last few pages of the book, but the vast majority was just sullied with impenetrable depression.

[Sue Merrick · Rating 3 out of 5]

This book was not for me, of course I understand that Arifa must feel devastated at loosing her sister to TB and that the TB was not picked up until it was too late.
I just found the continual search within her sisters artwork and going over their relationship felt like we were stuck in a loop that never reached it's conclusion and maybe that is the life that Arifa was living at the time she wrote the book. I just wanted her to stop writing so I could finish the book. It was certainly a very uncomfortable read.
Also I understand that her fathers treated of her sister was abominable, but I wonder if this and her mother and fathers relationship is not their affair and not for sharing with the reader? I wonder how the rest of the family feel about this being shared with the world?

[The Contented · Rating 5 out of 5]

Wow! This was a very fine book - moving, disturbing, original, impactful. The writing style had similarities to Hisham Matar - maybe it was the discussion of art? - but this was very different to anything I’ve read.

An author telling her own story. In her words. Not trying to be what someone else perceives her to be.

Definitely recommended

[Carolyn Drake · Rating 3 out of 5]

Powerful memoir detailing the grief, anger and anguish of losing a sister, and the complicated nature of family relationships and dynamics. Arifa Akbar is a sensitive writer, and her thoughts on art and its relation to the mental states of both those who create it and those who experience it, adds a fascinating existential layer to the tough reality of what happens to her sister.

[Amal Hamid · Rating 2 out of 5]

I wanted to like it, I really tried. It was interesting in the beginning but really dragged, the comments on the art that touched her sister or that she found connected the author to her sister sometimes were written in a really long winded manner, other times there was just too much detail that didn't need to be there. Was not a fan of the writing

[Rebecca Wilson · Rating 3 out of 5]

The book varied wildly from disturbing insights into family dynamics (the father's behaviour was atrocious) into detailed, fascinating description of operas, exhibitions and the history of TB. It sometimes felt like I was reading different books. Despite the emotive topic, I found the tone quite cold.

[Linda Fallows · Rating 3 out of 5]

Although interesting, I found this to be a rather rambling memoir about the author’s relationship with her late sister. Jumping back and to from accounts of her sister’s mental health struggles and her feelings about her sister’s death. I am sure that if I read it again in the future I will gain more from it. It seems like a book you need to savour in your mind and that you will find more understanding with each reading.

[Michaela · Rating 5 out of 5]

I cannot give this any less than 5 as it is someone’s life story. A story of sisters and all they shared.

This is a dark dark story. Fauzia suffered so much in her short life. The treatment by her father sounds horrific even if it wasn’t physical violence.

I found this hard to read in parts because it was so raw and so real.

[Laura · Rating 3 out of 5]

3.5 stars.

[Ellen · Rating 4 out of 5]

Searing grief. Reminded me a little of Justine Picardie.

[✰matthew✰ · Rating 4 out of 5]

a complex book discussing so much in a short number of pages. i found every topic was intertwined really well and it never felt rushed.

[Amna Khawaja · Rating 4 out of 5]

Very unfamiliar subject matter but I connected with the author so much

[Laurie · Rating 5 out of 5]

Excellent book! A memoir about family, siblings, illness, death, grief, and much more. I highly recommend it.

[Hadiya Arif · Rating 4 out of 5]

SO good!

[Allison · Rating 3 out of 5]

I need to go to my sister and apologize for every bad thing I’ve ever done to her