The Spare Room is driven by the increasing tension in their relationship and its eventual resolution, with Nicola coming to terms with the fact that she is dying and Helen with the limitations of friendship. The other characters are also nicely sketched: Helen's granddaughter Bessie and the various friends and medical specialists she consults, and Nicola's niece and her boyfriend, and the staff at the Theodore Institute which she is attending.
The plot is limited and has a didactic element that occasionally feels strained. Suffice it to say here that devotees of intravenous vitamin C as a cancer cure won't take to The Spare Room. This is only a minor concern, however, in a short, character-driven novel.
The Spare Room seems closely based on Garner's own experiences, as the first person narrator's sharing of her name suggests and as she confirms even in her insistence that it is fiction: "Even though it may be very close to real experience, I have taken the liberties I am allowed to take if I am writing fiction". This surely contributes to the total conviction of the story and characters.
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