As a Daughter Is Born, a Young Mother Dies by KATIE KITAMURAJAN. https://www.nytimes.com/2018/01/29/books/review/in-every-moment-we-are-still-alive-tom-malmquist.html?emc=edit_bk_20180202&nl=book-review&nlid=81975190&te=1

IN EVERY MOMENT WE ARE STILL ALIVE by Tom Malmquist

At a reading in Paris, Karl Ove Knausgaard was asked what made “My Struggle,” his six-part work of autofiction, a novel rather than a memoir. He answered that it was a novel because it used novelistic techniques. Tom Malmquist’s “In Every Moment We Are Still Alive” might lead some readers to ask the same question. The novel, we’re told, is “based on a true story.” It is narrated by a Swedish writer called Tom and recounts a scenario so devastating that the intimation of real-life parallels is both lure and distraction.

Autofiction has long picked away at the boundary between fiction and nonfiction, particularly in France (although the genre’s current English-language explosion has clear forebears in American writers like Chris Kraus and Kathy Acker). The term covers a multitude of approaches; here Malmquist sets his novel in opposition to the very meaning of “memoir,” which implies a recollection of something past. “In Every Moment We Are Still Alive” is narrated in a vivid present tense that collapses the distance between the time of narration and the harrowing events of the story.

The novel begins in a hospital at a moment of crisis. Tom’s partner, Karin, is 33 weeks pregnant and careering toward death. Within the first pages, she receives a diagnosis of acute myeloid leukemia and her daughter, Livia, is born via cesarean section. The subsequent deterioration of Karin’s health and the early days of Livia’s life in the neonatal intensive care unit are related in extreme, often technical detail: “The ECMO cannulas are transparent, one of them is hanging from Karin’s throat just above the collarbone, another is coming out of her groin, they’re as thick as garden hose, there must be many liters of blood flowing through them.”

Later Tom observes one of the members of the medical team: “I can’t see if Sax is yelling at the staff in Room 2 or into a telephone: Extraordinary doses of vasoconstrictors, acute circulatory instability, multiorgan failure, extensive bleeding from all orifices, membranes, infarcts, come on people, the patient is basically dying on us here.” As another doctor tells Tom, “We’re in proper hell now, you’re right in the middle of it.”

The reader is dropped into this abyss with little guidance. There’s almost no hierarchy of detail or information because Tom doesn’t know what’s significant and what isn’t. Everything is important, not only because the action is unspooling in real time but because in the first moments after his daughter’s birth and the final moments of his partner’s life, the most mundane detail is precious: “Her ears, eyebrows, eyelashes, nose, and that little indentation in her skin by her right nostril, that’s the only thing that’s still the same, but it’s enough, it’s Karin.”

This is narrative as raw material. In a powerful translation by the novelist Henning Koch, there are sentences of precise and subtle lyricism. Describing Tom’s newly born daughter, Malmquist writes: “The consultant is holding Livia by the legs, as if she’s bleeding prey.” Elsewhere the prose is unadorned, even blunt, particularly in the sections where the opaque languages of medicine and bureaucracy flood — infiltrate would be too weak a word — Tom’s voice.

A novel about permeability, “In Every Moment We Are Still Alive” captures the jumbled sensory experience of being profoundly, catastrophically overwhelmed. Malmquist achieves much of this through style. The linguistic contagion results in moments of deep pathos, as when Tom struggles to locate the language to tell her parents that Karin is dead, only to fall back on medical terminology: “I don’t know how to articulate it so I just repeat what Nygren said to me: The electrical activity in Karin’s heart has stopped.”

Tom is left with his grief and his newborn daughter. “Jersey Girl,” a heartwarming 2004 movie about death starring Ben Affleck and Jennifer Lopez, uses more or less the same setup. The comparison illustrates the degree to which this material risks cliché and sentimentality. But if sentiment is emotion’s easily digestible expression, simple to contain and designed not to trouble, it’s clear that Malmquist is explicitly interested in what can’t be contained, what continues to trouble.

This novel travels off the map and into that territory. It exchanges the schematic ease of the sentimental for the uncharted depths of the emotional. Toward the end, Tom says, “I miss Karin,” but until this point there’s virtually no mention of his feelings. At its conclusion, Tom hasn’t recovered, isn’t even bereaved, but instead exists in a pit of emotion so acute as to be without “meaning.” Watching his child at play and asleep, he confesses: “I have never hated as I hate now, it has no direction, no meaning, and every time I try to understand it, attach words to it, define it, control it, I start crying so violently that I am afraid of waking her even if I am in a different room.”

What kind of emotional experience do we expect from a work of art? Once upon a time, we turned to art in search of catharsis, submitting to a rite of terror and purification, the workings of which were beyond our comprehension. But in the age of psychology and self-help, our expectations have shifted. Increasingly, we seek narratives that guide us through our fear, language that diagnoses and renders transparent, a timeline of redemption and resolution that’s legible and coherent.

Malmquist denies us that timeline. Even as he depicts the unpromising start of Karin and Tom’s relationship, he utilizes the present tense: “Karin has a friend with her when we meet that weekend in a bar on Odengatan. Helena is as tall as Karin, but slender. … Karin is unremarkable in comparison, and when they stand next to each other at the horseshoe-shaped bar and I can see their hips, Karin looks ungainly.”

Over the course of the novel, Karin emerges as a complex character, and the representation of her relationship with Tom is undistorted by either hindsight or nostalgia. This temporal collapse captures the nature of acute grief and trauma: It’s not simply that Tom is unable to imagine a future without Karin, it’s that he’s unable to process the past as past. The effect is often jarring as disordered fragments from past and present are set against one another without signposts or connective tissue. In contemporary fiction, this technique is used infrequently enough for it to feel radical here, particularly in this sustained form.

Only in the novel’s final pages does time regain its full dimensions. Tom allows himself to address Karin directly and to dream of Livia’s future: “We’ll move away from Lundagatan to another street, another city, another country, she falls in love with an older boy or girl … over long periods she does not ask about you, she calls home while on a trip abroad, she misses home, I meet her at the airport, she says she thought she saw you, she loves your clothes, she finds a receipt in the pocket in your duffel coat from a shop that no longer exists. … She says: Sssh. And she says: I often dream about my mother.”

That a shift to the second person and a change in tense should feel so expansive and create such a rush of emotion is a testament to Malmquist’s extraordinary skill. As with “My Struggle,” it’s tempting to label this novel “authentic,” and therefore “artless.” The two are not always bedfellows, and, among other things, “In Every Moment We Are Still Alive” is a tremendous feat of emotional and artistic discipline. The novel doesn’t feel remembered, though of course it is. That’s where its craft lies, and its triumph — in the suspension of hindsight, in an act of recollection whose hand is perpetually guiding the text, but can’t be seen.