Dear Reader: a letter from Emily Koch

Dear Reader,

The idea for If I Die Before I Wake came to me on my morning commute. I clearly remember pulling up to the big roundabout next to the newspaper offices where I worked, and as I sat waiting for the traffic lights to change, I thought: what would you do if your boyfriend had been in a coma for a few years?

That’s how the novel began. It was Bea’s story, all about her loyalty to and love for Alex being challenged, and about her, unwittingly, getting herself into more and more danger as she found out the accident which put him into a coma was not an accident at all. Someone tried to kill him.

But then I got it into my head that I wanted to tell the story from the point of view of her comatose boyfriend, Alex. This seemed like a crazy idea, but I was determined to make it work, playing around with a very weird, almost supernatural voice. And then, there was that magic moment when this really started to become the book that is in my hands now. Someone mentioned Locked-in Syndrome to me, and everything – Alex’s voice as well as the whole plot – fell into place. I knew about Locked-in from the stunning memoir The Diving Bell and the Butterfly. It is a terrifying condition, with patients experiencing it in different intensities. Some can communicate with their loved ones and doctors, but not Alex. I discovered through my research that people can be totally locked-in, unable even to blink.

This was the stuff of nightmares, and the perfect territory for my psychological thriller.

Alex is at the mercy of his doctors and nurses. He can feel pain but isn’t able to tell anyone when he does. His family are considering putting an end to his treatment and letting him slip away – but he doesn’t want them to. He likens it to being buried alive. One Locked-in patient whose memoir I read, Julia Tavalaro, wrote: “No one knows how dark the night is until you can’t speak into it.” I think that just about sums it up.

There were times, as I wrote the novel, that I felt being in this state was enough to put Alex through. I felt guilty about piling more upon him. But (sorry, Alex), I did it anyway. With Bea’s help he remembers strange things that had been happening before his climbing “accident”, and tries to piece together how he ended up in hospital.

He can only see very occasionally when his eyes open spontaneously, and even then, his head injuries have left him with visual impairments. So he has to use his remaining senses to solve the mystery – piecing together his patchy memories and the clues he gets from his hospital visitors. But therein lies another problem. He doesn’t know who he can trust. Do all of his visitors really believe he is in a vegetative state and unable to hear him? Are any of them feeding him incorrect information, just in case he does wake up one day and remember what they said in his presence?

Alex’s existence sounds incredibly bleak, doesn’t it? But, as his creator, I have to say I don’t see it that way. He tackles everything thrown at him with courage and a sense of humour. He escapes into his imagination – into beautiful memories re-lived, and colourful daydreams. And he finds a certain amount of peace and acceptance.

Bea’s experiences are still key to the novel, but I’m glad I had that crazy idea to make Alex the narrator. As I wrote and edited his story, I laughed with him, cried with him, and felt his fear intensely. I hope you do too.