Toby Litt

Galley Beggar Press, £15

THIS astonishing novel is difficult to discuss fully because, in addition to its many other fine qualities, it is a cliffhanger – one of the most perspiration-inducing ever written. So much tension gradually builds that at times it's positively excruciating.

You can't build tension without an interest in the principal characters in a novel, their hopes and aspirations. Sympathy and empathy swirl like smoke through this story; they enter your nose and your mouth as you read it and threaten to choke you. And yet it is entirely unsentimental, and on almost every page blackly and deeply funny.

The point of view of the whole narrative is that of a young man in a wheelchair. As with James Kelman's How Late It Was, How Late, one can scarcely believe the narrative flights Toby Litt achieves for his hero, Elliott – and it is even more moving and meaningful when we discover that only recently has Elliott been able to tell his story, having been "unlocked", finally, by a medical procedure.

After an opening which is the closest thing to a sunrise you will ever read, we are gradually acquainted with Elliott's environment, a late-1970s ward for disabled children in an asylum run by nuns. What's interesting about Patience is the lack of all the usual clichés about closed, locked-up environments like hospitals, prisons and submarines. Elliott's mind is crystal clear and it roams the earth and heavens; what he doesn't know he invents, and his inventions and terminologies are enthralling.

Principally they are about his fellow sufferers. There's Lise. Elliott is in love with her knees, not because they're cute, but because in their changing shapes and colours they are a barometer both of her personality and events to come. Lise's brother Kurt, it would seem, does nothing but bang his head against a metal file cabinet all day. But Elliott shows us this is just the outward manifestation of Kurt's being a king, the leader of an invisible but very real land, its people constantly and unfairly beset by invasion.

When Jim, a new blind boy arrives, he and Elliott become friends. Ultimately Jim, Elliott and Lise attempt something that is the source of the sweat mentioned above.

One of the most impressive elements of Elliott's consciousness is his awareness of music, to which he is very alive, and about music he is nobody's fool. Much of the music he hears is liturgical, of course, some of it pop-liturgical. Some of it he likes and about some he is killingly sarcastic. Most of the other music he has obtained has come through Radio 3, about which itself he has some unerringly satirical thoughts. Radio 3 should take heed. But what arrests you is the articulation, the feeling of musical thought and experience in this unfortunate boy: "A devoted opera-lover like myself knew at this moment of her emotional and religious life Lise could be no one but Maria Callas impossibly singing Wagner in German singing Isolde singing from the third act of Tristan and Isolde singing the world towards death so intensely because life could never be lived more intensely than in that direction and so death met its defeat even in its embrace."

You could say that we are living in the era of the Novel of Hurt. Sometimes it seems that writers have nothing left but to crybaby their way out of illness or ill treatment toward "redemption", whatever that is. This novel puts the lie to all that. What carries Patience is Elliott's unique personality and Litt's perfect craftsmanship, a mixture of high and low language reminiscent of Beckett in Murphy. Elliott can say one moment that he was "rent in twain" by discord between people he loves, mention Steve Reich in passing, and in the next he refers to the sister who cleans out his "yucky crevices". So there you are. It's about all of us.