Elizabeth Is Missing could have began as a bet Emma Healey made with herself, a challenge: Is it possible to write a mystery novel with a narrator who can’t recall its events? Maud, the elderly protagonist, has dementia so serious she can’t remember to drink the tea she’s just made or why she put on lipstick. So how can she tell a story, or crack a case?
Elizabeth Is Missing is a double mystery. Maud, who has dementia, believes that her friend Elizabeth has disappeared and that nobody is trying to find her. As Maud sets out in search of Elizabeth, she begins another, more important hunt: figuring out what happened to her own sister Sukey, who disappeared more than half a century ago. Part of the novel is told in the present, and the rest in the past, before Sukey vanishes. However, what matters most to the reader is not what happened to Elizabeth or to Sukey, but whether Maud can overcome her advancing dementia to find out.
Healey allows herself some fictional conveniences to protect her story from the disorganization of dementia. Maud can recount the past in detail, yet never remembers any trace of experiences that, when the reader learns about them from other characters, prove critical. Her small instances of forgetting are perhaps too well arranged. If Maud gives herself an instruction or receives one from somebody else, she inevitably forgets and then disobeys it within paragraphs, a strategy which the reader learns to anticipate too soon. Still, Healey’s portrayal of dementia rings true— in fact, she has said that her grandmother, who suffers from dementia, disliked reading the book because it felt painfully real.
Healey walks a fine line between the ironic and the pathetic. She avoids sentimentality, and she never mocks Maud, her narrator. This is especially true as Maud’s dementia worsens and Healey becomes more inventive. In one poignant moment, a small child in a doctor’s waiting room presents Maud with a jumping plastic toy. She cannot identify the animal it represents, which the child calls a “fog” and then she demonstrates: “He presses a little tab at the back and the fog jumps, not very sharply, as my hand is too soft a surface, but enough to bring the toy to life for a second.” He gives it to her, and of course the next time Maud reaches into her handbag, she tells us, “I find a little plastic frog.”
Healey’s sense of humor comes through in this scene, but often so does Maud’s. Her observations are acute—she describes one person as looking “like a Ken doll whose head’s been squeezed”—and she is noticeably accepting of her granddaughter’s pierced lip, her daughter’s short temper, even her caretaker’s tendency to tell stories about elderly people tortured by crack addicts.
The pathos of Maud’s personality slipping away keeps the reader emotionally engaged even when her fruitless search for Elizabeth loses its pull halfway through the novel. Maud’s search for Elizabeth, the reader comes to realize, is about holding onto her memory rather than finding her friend. This is well observed psychologically and makes for a satisfying conclusion to the story. Maud’s dementia can only go one way however, and sadly for the reader, we can only think that she, before long, will join Sukey and Elizabeth in the ranks of the missing.