A difficult read, partly thanks to the manifold thoracic agonies inflicted on its main character, a purposeless young Englishman called Paul attempting to rid himself of TB in an Alpine sanatorium, partly because hardly anything happens (other than the infliction of said agonies and a drippy love affair) in its 370 pages.

On the face of it it's like The Magic Mountain redux, drawing on many of the same absurdities of sanatorium life: communal indignity, bad doctors, worse food, the pan-Euro cultural mélange. But the focus here is much more intensely on the individual experience, on the dreamer, not the dream. We're drawn into Paul's private hell so effectually that by the end it's not entirely clear where he ends and reality begins.

Ellis achieves this interiority through pain. This is one of the great stories of pain, and the reason it's so painful is that he doesn't try to describe what it feels like to have your sternum punctured, your ribs creosoted, your pneumothorax pumped full of air every fortnight. Instead he describes the progress of the needle through the bruised flesh, the sounds of surgery, the bitter smell and colour of the bronchial sludge.

There are moments of comedy, usually dark: the deranged Belgian who is Paul's only true friend, the professional squabbles of the various doctors and staff, the Kafkaesque inevitability of Paul's vague plans being thwarted, his desires frustrated. The only annoyance is Ellis' habit of reverting to the local lingo for commonplace phrases that have perfectly normal English equivalents. It's not a dining room, for some reason, but always a salle à manger; never a maid but always a femme de chambre. There's also untranslated French dialogue strewn liberally about, which if your French isn't up to snuff will need to be run through Google Translate to avoid losing the thread.

This is a really unusual novel that goes to some pretty unfrequented places. But maybe don't do what I did and pair it with Tess of the d'Urbervilles. ( )

This novel is quite exceptional, a totally involving, emerging experience about life in the shadow of existence-threatening, debilitating disease. Try it, if you're feeling strong and not seeking a feelgood read. ( )