In the first half of her 30-year career as a writer, Helen Garner was known primarily for her fiction. Yet in the 15 years since her last novel, Cosmo Cosmolino, she has won considerable acclaim for her engaging, controversial non-fiction. By this point, it’s hard to remember that she ever wrote anything else. In spite of her major journalistic talents, we can all be grateful that Garner has had another stab at her old form.

On first appearances, The Spare Room should be a difficult read. This is not for the words and sentences therein: it’s a short book and written in clear, simple prose. It’s more that the content appears heavy and rather bleak. The story goes something like this: an older woman provides her spare room to a friend with terminal cancer who is in town for treatment. “Not a barrel of laughs,” you would think.

There’s little about Helen Garner herself to suggest otherwise. Her non-fiction has dealt with heavy topics like murder and sexual harassment. She’s a feminist of the same vintage as Germaine Greer (even if a more moderate voice) and her public persona is austere to say the least. These appearances are deceptive, because the overwhelming impression The Spare Room makes is one of humour—frequent, black, and clever.

Humour is not just an occasional relief in The Spare Room, it’s actually the lifeblood of the book. The old cliché that “you’ve got to laugh” in the face of tragedy is given new meaning by Garner. For all the sickness and suffering and thankless service involved in the story, it’s only an acute sense of the absurdity of the situation that keeps the heroine (also named Helen) sane. Garner’s dealings with terminal illness are truly refreshing. Instead of focusing on the sufferer, Nicola, she delves inwards, exploring the impact on the carer. And she dares to express the unspeakable thoughts we often think when confronted by another’s illness.

The Spare Room is tragic in the classical sense: an oncoming train-wreck that the audience can see coming far in advance. In fact, Helen (the character) is with us in this dilemma. Nicola’s “treatment” is a ghastly charade of mock-science involving massive Vitamin C injections, electro-magnetism, and coffee enemas. The likely result is not promising, yet Nicola’s denial is monumental—she expresses complete conviction in her inevitable recovery. The toll this takes on the rational, grounded Helen is enormous.

As Nicola’s physical condition worsens, Helen is forced to provide greater assistance—and her pride is wounded by Nicola’s insistence that “it’s all nothing”.  If the quack medicine of the fictional Theodore Institute makes Helen’s (and our) blood boil, it’s Nicola’s denial that sends her into paroxysms. Helen’s help is willingly provided, but when Nicola seems to be doing herself no favours, limits are reached.

Nicola, an offensively self-involved but brilliantly charismatic woman, scarcely resembles the archetype of the noble cancer victim. And Helen is nowhere near our image of the saintly, self-sacrificing carer. They’re both tremendously flawed and equally likable. In fact, Garner has made them rather a lot like us or at least those we know.

This is not a conjuring act of literary imagination—Garner herself experienced the death of a long-time friend who formed the template for Nicola. Presumably her own reactions and self-disgust were mined for all they are worth. They are authentic and brutal enough to suggest as much. Yet even if the story were a note-for-note retelling of the true one, it would in no way diminish Garner’s achievement. Mere autobiographical faithfulness is not enough to make a great novel, and The Spare Room is an undeniably “great” novel. What Garner brings is a forensic self-examination and a dazzling ability to turn self-realisation into universal language—which in turn gives us a jolt of recognition, as the best fiction should.

Not only does she explore the darker human emotions, but Garner also manages to work in questions of faith. When confronted with death and suffering, it’s a common human impulse to reach for something transcendent. Helen’s rationalism may only be strengthened by Nicola’s treatment, but she is pushed towards her own quest for purpose and meaning in suffering. The Spare Room is a book that avoids easy answers throughout and it’s refreshing to see faith explored without either abrupt dismissal or simplistic epiphanies. When Helen prays “Lamb of God. You take away the sin of the world” with her devoutly Christian sister, it’s a powerful moment—even if we’re not entirely clear what Helen believes or what she’s seeking.

Life, death, sickness and friendship are big topics and it would be folly to try and tie up all the philosophical loose ends. The reason The Spare Room is so rich is because it tells a simple and honest story that forces us to confront our own lives and relationships. Garner may be leading the reader towards a particular viewpoint or outcome, but more likely she’s helping you to work things out for yourself.

If you’re game to confront your own mortality and weaknesses, The Spare Room is intensely rewarding. It’s a rare book that can make you laugh as much as this, while giving your head and your heart a workout.

Helen Garner, welcome back to the world of fiction. We need you here.