Happiness: The Crooked Little Road To Semi-Ever After

By Heather Harpham

Oneworld Publications, £14.99

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Reviewed by Dani Garavelli

THE title of Heather Harpham's memoir, Happiness: The Crooked Little Road To Semi-Ever After, sounds as if it has been stolen from a self-help manual, so I had braced myself for an onslaught of New Age introspection.

Sure enough, the first few chapters delivered much as anticipated. As the book opens, the US writer, forced to go through pregnancy alone, has just been told her newborn daughter Gracie suffers from a severe form of anaemia which will leave her dependent on blood transfusions.

Those passages in which Harpham writes about fighting to be allowed to ride in the back of the ambulance, or standing helplessly by the incubator, evoke a visceral panic; but they are interspersed with navel-gazing flashbacks to her early days with Gracie's father, the American novelist Brian Morton, their visits to a therapist and musings on the nature of contentment.

Though she refers to the pregnancy as "unplanned", it is clear Harpham – the product of a free-roaming Californian upbringing – was determined to have a baby against Morton's express wishes; and that Morton was so lackadaisical he couldn't be bothered making sure his express wishes were not ignored.

When Harpham finds out she has conceived, she expects him to embrace fatherhood and when he doesn't, she feels cheated. Morton is equally insufferable. When Harpham phones him on the other side of America to tell him about the central line in Gracie's torso, she can hear the "soft pencil scratch" as he takes notes.

As the pair slowly work their way back to one another, the reader is privy to every email, every shift of mood, every in-joke until Harpham feels like an over-sharing friend whose calls you are tempted to screen. Once the focus shifts from the couple's emotional travails to the fight to keep their daughter alive, however, the book improves.

Soon, Gracie's condition worsens until she requires to be hooked up to a chelating machine for 12 hours a night and her parents are told she is unlikely to live beyond 30. The situation seems hopeless, until one doctor suggests stem cells from a sibling's umbilical cord might cure her. Now the couple are faced with genuine quandaries: should they bring another child into the world in the hopes he or she will be a match? And how can they balance the possibility of Grace dying as a result of a transplant against the probability of her dying in early adulthood?

Harpham has a keen eye and a quirky turn of phrase. Newly-conceived, her daughter is "a grain of rice with a heartbeat", at birth she smells of "sliced apple and salted pretzels" and, emptied of blood, she is a "scarecrow girl".

Despite her emotional investment, she is able to give a forensic account of Gracie's reaction to her illness and its impact. The three-year-old's capacity to adapt to every new privation – to turn her IV pole into a character called Tough Guy and her chest tubes into puppets – is both impressive and pitiful.

The most powerful section of the book is that set in the transplant unit. Harpham's descriptions of the awkward dance between parents and doctors will resonate with anyone who followed the Charlie Gard case, and the interaction with other mothers and fathers with anyone who has spent time in a sick children's ward. "This is how we told each other our stories, in the margins, in the kitchen, over styrofoam cups, while washing our hands at the decontamination trough, at the snack machine, without ceremony," she writes.

When a child dies, Harpham stands outside the closed door, imagining the grieving family inside. "I want to look into their faces, to occupy them for a sliver of a second. To know if such loss is survivable," she writes. Bombarded with statistics, she rejects them. "F*** their arrogant razored corners, their cleaved sums. Their little stick-fingered hands rubbing out your odds."

These flashes of brilliance make it easy to overlook her occasional lapses into bumper-sticker aphorisms. And, ultimately, the happiness the couple realise is anything but trite. Harrowed by loss, their state of “dazed grace” is all the more precious for having been so precarious.