Consumption is a haunting story of a woman’s life marked by struggle and heartbreak, but it is also much more. It stunningly evokes life in the far north, both past and present, and offers a scathing dissection of the effects of consumer life on both north and south. It does so in an unadorned, elegiac style, moving between times, places and people in beautiful counterpoint. But it is also a gripping detective story, and features medical reportage of the highest order. In 1962 at the age of ten, Victoria is diagnosed with tuberculosis and must leave her home in the Arctic for a sanatorium in The Pas, Manitoba. Six years will pass before she returns to the north, years she spends learning English and Cree and becoming accustomed to life in the south. When she does move home, the sudden change in lifestyle leads sixteen-year-old Victoria to feel like a stranger in her own family. At the same time, Inuit culture is undergoing some equally bewildering changes: Cheetos are being eaten alongside walrus meat, and dog teams are slowly being replaced by snowmobiles. Victoria eventually settles back into the community and marries John Robertson, a Hudson’s Bay store manager, and they raise three children together. Although their marriage is initially close, Robertson will always be Kablunauk, a southerner, and this becomes a point of contention between them. When Robertson becomes involved in arrangements to open a diamond mine in Rankin Inlet, the family’s financial condition improves, but their emotional life becomes ever more fraught: their son, Pauloosie, draws ever closer to his hunter grandfather as their daughters, Marie and Justine, develop a taste for Guns N’ Roses. Several other richly imagined characters deepen Patterson’s unsentimental portrait of both north and south. They include Dr. Keith Balthazar, a flailing doctor from New York whose despairing affection for Victoria leads to tragedy, and Victoria’s brother, Tagak, who finds that the diamond mine allows him a success and maturity he could never attain within his traditional culture. The novel deftly tracks the meaning of “consumption” in both north and south. Consumption is tuberculosis, an illness previously unknown among the Inuit that wrenches Victoria from her home as a child, changing her family relationships, her outlook on the world and her entire future. As such consumption is a harbinger of the diseases of affluence, such as diabetes and heart disease that come to afflict the Inuit over the four-decade span of the novel. Consumption also defines the culture of post-industrial, urban North America, captured here through Keith Balthazar’s troubled relatives in New Jersey. And when the diamond mine opens in Rankin Inlet, its consumption of northern natural resources seems to symbolize Canada’s relationship with the Arctic and southern encroachments on the Inuit way of life. Consumption is a sweeping novel, of the kind one rarely encounters today: it is an essential book for Canadians to linger over, learn from, and remember.