Bernlef’s most important themes – forgetting, vanishing, remembering – have an important place in the novel that marked his 1984 breakthrough to a broad readership. Out of Mind is the first-person account of a Dutch immigrant in the snowy landscape of North America whose dementia is steadily worsening. ‘Memories can sometimes be temporarily out of reach, just like words,’ thinks Maarten Klein at the beginning of the story, ‘but surely they can’t disappear completely while you’re alive.’

It is of course a vain hope. Alzheimer’s disease is inexorable, even if it rarely takes effect so rapidly as in Bernlef’s central character and even if few patients remain so eloquent. His illness takes him into a swift descent that begins with ordinary moments of forgetfulness – the time of day, someone’s name, a misplaced item – and spirals into the ultimate terror where he cannot trust his perceptions any longer and is left spinning in a whirlpool of fragmented images.

He tries to fight his disorientation by seeing it as normal for his age, tries to link it to childhood experiences of waking up when ‘the walls of your room were all wrong around you. In your mind you had to swivel the room around…’ Though his link to his world has been severed, he survives on internal monologues that are fed by surprisingly rich images.

In his effective choice of Maarten’s present-tense perspective, Bernlef forces his readers to participate in Maarten’s terrifying journey through an unfamiliar landscape. Maarten’s bewilderment mirrors the confusion he felt when he and his wife, Vera, first arrived in Gloucester (Mass.). Like all immigrants, they were confronted by the different language, the unknown region. But in this internal terrain of chaos, any adaptation is deceptive: moments shift, rules change and language ultimately fails. ‘I seem to lose words like another person loses blood.’

Bernlef has written a dark book about irreversible loss – loss of self, of language, of relationships, of memories. Although the voice at the end of the novel suggests hope, the situation is bleak: Maarten is removed from his home and taken to a hospital where he lies nearly incoherent, ‘hidden from the eye of the world.’