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For most of her childhood, Sarah Lippett was in and out of various hospitals. Her symptoms were pervasive and confusing, stumping doctor after doctor. She was misdiagnosed and prescribed pills that made her more ill. Weeks at a time away from school meant both her education and friendships suffered. In her worst moments, though she was only a child, the apparent hopelessness of her situation made her consider suicide. A Puff Of Smoke – a graphic autobiography written and illustrated by Lippett – chronicles these dark years.

But it wasn’t all dark. Although many aspects of Lippett’s childhood were truly miserable, her book is notable for a surprising amount of humour. Lippett was one of five children – she has three sisters and a brother – and she paints her home as a place of loving chaos. All of the siblings were close, and her mum and dad kept everything together despite the constant hospital trips and the more typical difficulties of corralling five children of varying ages through their day-to-day lives. And despite missing grand swathes of school, she still managed to make friends. Lippett’s childhood may have been heavily marked by her illness, but it wasn’t defined by it, and her autobiography is a testament to the fullness of her life.

Lippett’s illustration style is emotive and naïve, the whole book following the blue-pink-yellow colour scheme that you see on the cover. The naivety of her style is a perfect match for the subject matter of A Puff Of Smoke – it makes the panels grab you in an emotional, immediate way. There’s no polish, just pure feeling. The most wrenching moments come when she is still very young, and left on her own at the hospital for the first time. The vividly illustrated fear and horror on her face is devastating. As with everything else in Lippett’s book, however, there’s always an upside. One of the funniest panels is when she gets home from a hospital visit and is greeted with a heaving mound of fruit, a gift from the local grocers. Her face is a picture of pure, hilarious disgruntlement. ‘The fruit made me angry,’ she recounts, ‘why would someone give fruit as a gift to a kid?’ Why indeed.

A Puff Of Smoke ends with puzzling abruptness – the moment Lippett wakes from her pivotal operation, we are out of there. For a book that has been so diligent about sharing her emotional state through all the ups and downs of her medical journey, kicking us out of Lippett’s story immediately after she’s received her correct diagnosis feels like being cheated. It’s unsatisfying. Another chapter, or at least an epilogue, would have been nice.

Perhaps, however, it is a credit to Lippett’s creation that you want more of it. Intimate and deeply personal, with a healthy dose of humour thrown in, A Puff Of Smoke is a moving account of a childhood marked by love, pain and confusion. Vital reading for anyone who’s had their own tumultuous path towards getting an all-important diagnosis.

★★★★

A Puff of Smoke is published by Jonathan Cape on 7 November 2019

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