It starts with a scrap of paper. "Elizabeth is missing," it says. But the woman holding the note, 82-year-old Maud Horsham, can't remember writing it. She can't remember where she put her tea, either. Or why there are fifteen tins of peaches in her pantry. This is the heart-wrenching, often darkly funny, and deeply frustrating world of Emma Healey’s debut novel.
Elizabeth is Missing isn't your standard detective story.
Most mysteries rely on a brilliant mind. Think Sherlock or Poirot. Here, the "detective" is losing her mind to dementia. It’s a bold choice. Honestly, it’s a terrifying one for a reader. You’re trapped inside a brain that is literally dissolving, yet you're tasked with solving a seventy-year-old cold case.
Emma Healey wrote this book over five years, often during her lunch breaks at a London art gallery. She was only in her late twenties when it was published in 2014. How did someone that young capture the internal monologue of an eighty-year-old so perfectly? She looked at her own grandmothers. One of them actually kept saying her friend was missing. That real-life spark turned into a story that has now sold over a million copies and basically redefined how we write about memory loss.
📖 Related: Mikaela Hoover Guardians of the Galaxy: The Evolution of a Sci-Fi Secret Weapon
The Double Mystery: Sukey vs. Elizabeth
The book works on two timelines. In the present, Maud is convinced her friend Elizabeth has been kidnapped or worse. Her daughter, Helen, is exhausted. The police are dismissive. "She's just a confused old lady," they seem to think.
But Maud has another ghost.
Back in 1946, just after the war, Maud’s older sister Sukey vanished. She went out and never came back. No body. No explanation. Just a husband who might be violent and a lodger who seems a bit too interested in the family.
As Maud’s short-term memory fails, those 1940s memories become hyper-vivid. A broken compact mirror found in a garden today triggers a flashback to a fight decades ago. A tin of peaches isn't just a snack; it’s a clue. Healey uses these "triggers" to bridge the gap between a post-war Britain of rationing and the sterile, confusing modern world of doctor appointments and social workers.
Why Maud is the Ultimate Unreliable Narrator
We talk about unreliable narrators a lot in fiction. Usually, they’re lying to us. They’re hiding a secret or they’re sociopaths.
Maud is different.
She isn't trying to trick you. She is desperately trying to be honest, but the tools she has—her memories—keep breaking. You feel her panic. You feel that "silent scream" that Glenda Jackson captured so hauntingly in the BBC adaptation.
The brilliance of Emma Healey Elizabeth is Missing is that the reader becomes the detective. You have to sift through Maud’s confusion. When she describes a "mad woman with an umbrella," you have to figure out if that’s a real person or a distorted memory of someone from 1949. It’s active reading. It’s exhausting. And it’s incredibly rewarding.
That Ending (No Spoilers, But Let’s Talk About the Impact)
People often ask if the mystery actually gets solved.
Yes. Both of them.
But if you’re looking for a "CSI" style ending where everything is tied up with a neat bow and a confession, you’re reading the wrong book. The resolution is messy. It’s tragic. It’s "Gone Gran," as some critics called it, but without the Hollywood glitz.
The real resolution isn't about the crime; it’s about the loss. By the end of the book, you realize that the title doesn't just refer to a friend. It refers to the loss of self. As Maud finds the truth about Sukey and Elizabeth, she loses the ability to understand what that truth means. It’s a gut punch.
Critical Reception and the BBC Adaptation
The book didn't just sell well; it cleaned up during award season. It won the Costa First Novel Award and the Betty Trask Award. Critics like the late Ruth Rendell—a legend in the mystery genre—said they’d never read anything quite like it.
Then came the 2019 BBC film.
If you haven't seen it, find it. Glenda Jackson returned to acting after 27 years in politics just to play Maud. She won a BAFTA and an International Emmy for it. The film is shorter than the book, obviously, but it captures that "Munchian scream" of frustration perfectly. It’s a tough watch if you’ve cared for someone with Alzheimer’s, but it’s an essential one.
What Emma Healey Gets Right About Dementia
A lot of fiction treats dementia as a plot device or a "sad grandma" trope. Healey avoids this by showing the specific, weird, and sometimes funny details of the disease.
- The Mints: Maud stuffs her pockets with mints to "leave a trail" like Hansel and Gretel so she can find her way home.
- The Notes: Every surface in her house is covered in Post-it notes. "Don't buy peaches." "Elizabeth is missing." "Tea is in the pot."
- The Aggression: Maud isn't always "sweet." She’s often rude to her daughter. She’s stubborn. She’s irascible.
This is the E-E-A-T (Experience, Expertise, Authoritativeness, and Trustworthiness) of the novel. It feels real because it is based on the granular, painful reality of caregiving. It acknowledges that love and exasperation live in the same house.
How to Read (or Re-read) Elizabeth is Missing
If you're picking this up for the first time, or maybe looking back at it after the TV show, here are a few ways to get the most out of it:
- Watch the triggers. Pay attention to the physical objects Maud touches. A piece of soil, a certain melody, a brand of lipstick. These are the "keys" that unlock the 1940s chapters.
- Look at Helen. While Maud is the narrator, her daughter Helen is the unsung hero. Notice the toll the "mystery" takes on her. She’s mourning a mother who is still sitting right in front of her.
- Don't rush the ending. The clues for the Sukey mystery are scattered much earlier than you think.
Emma Healey managed to take a terrifying medical reality and turn it into a gripping piece of art. It’s a book about what remains when everything else is forgotten. It’s about the fact that even when we lose our "selves," our loyalties and our loves can still drive us to do incredible things.
If you’re interested in how memory works in fiction, your next step should be to look into the "unreliable narrator" technique used in other 2010s hits like The Curious Incident of the Dog in the Night-Time or Before I Go to Sleep. Comparing how these authors handle "broken" perspectives will give you a much deeper appreciation for the technical skill Healey showed in her debut.