In his final year at the Royal College of Music, star pianist Flynn Laukonen has the world at his feet. He has moved in with his girlfriend Jennah and is already getting concert bookings for what promises to be a glittering career. Yet he knows he is skating on thin ice - only two small pills a day keep him from plunging back into the whirlpool of manic depression that once threatened to destroy him. Unexpectedly his friends seem to be getting annoyed with him for no apparent reason, he needs less and less sleep, he is filled with unbridled energy. Events begin to spiral out of control and Flynn suddenly finds himself in hospital, heavily sedated, carnage left behind him. The medication isn't working any more, the dose needs to be increased, and depression strikes again, this time with horrific consequences. His freedom is snatched away and the medicine's side-effects threaten to jeopardize his chances in one of the biggest piano competitions of his life. It seems like he has to make a choice 

Shortlisted for the
Lancashire Book Award
Nominated for the UKLA Book Award

between the medication and his career. But in allthis he has forgotten the one person he would give his life for, and Flynn suddenly finds himself facing the biggest sacrifice of all. Told in alternating chapters from both Flynn and Jennah's points of view, this is the breathtaking, poignant sequel to A Note of Madness.
The efficacy of Tabitha Suzuma’s A Voice in the Distance extends from her richly detailed portrayal of Flynn whose loves, fears and losses are convincingly depicted. Use of the dual narrative device provides insight into the minds of the afflicted and those surrounding them. With studies showing one in ten children have a mental health disorder, this is a topical and reflective book with an emotional range that aids a breadth of understanding.' Jake Hope, The Bookseller
"A brilliantly crafted noveL. I would recommend this book to anybody interested in bipolar or other severe mental illnesses.' Rethink
‘Flynn!’ I throw open the bedroom door. He is still lying in bed, fast asleep, sunlight pouring through the thin curtains. I hesitate, wondering whether to wake him, then remember my train.
‘Hey, sleepy-head.’ I sit down on the edge of the bed. Stroke his arm. It’s not often that I see him sleep. He looks younger somehow, more vulnerable.
‘Flynnie . . .’ I give his arm a little shake. Bend down and kiss his cheek. He looks strangely flushed and his skin is hot and sweaty.
I straighten up. ‘Come on, wake up!’ I exclaim. ‘We’re all having breakfast and I’ve got to leave in half an hour!’
Nothing. I stare down at him. His eyes are tightly shut, his breathing loud and rasping. A cold hand creeps up and squeezes my chest. I can hear my heart.
I grab him by the shoulders and shake him, hard. ‘Flynn!’
His head rolls limply on the pillow. His eyes do not open. His breathing stops for a moment and then starts again, harsh and laboured. I leap away from the bed, a scream building in my throat. As I stumble back, something crunches under my feet. Blister packets, empty blister packets, all over the carpet. I hurl myself out of the bedroom door.
‘Help! Call an ambulance! Help!’ I scream at the top of my voice.
Rami reaches me on the landing. He is trying to restrain me, trying to pull me round to face him. ‘Calm down, calm down. What’s happening?’
‘No! No!’ I yell. ‘He’s unconscious! Call an ambulance!’
Rami grips me by the shoulders. ‘Where? Where is he?’
‘In the bedroom – the study!’ I scream. ‘He’s in there!’
Rami lets go of me and runs along to the room. I stumble in after him. Suddenly the small room is very crowded. I can hear the sound of a baby crying.
‘Oh God!’ a woman’s voice is moaning. ‘Rami, he’s all right – he’s all right, isn’t he?’
I am on my hands and knees, scrabbling through my coat pockets for my mobile phone. My hands are so clammy that it slips from my grasp.
‘Mum, Dad, it’s all right, it’s under control.’ Rami is trying to roll Flynn over onto his side, grunting with the effort. ‘Sophie – get them downstairs – ’

I key in too many nines and have to find the clear button and try again. Sophie is attempting to get Matias and Maria out of the room. Maria has gone white. Matias sounds panicked. ‘What’s he done? What’s he gone and done?’
‘Rami needs space,’ Sophie is saying desperately, ushering them out. ‘It’s under control, but he needs some space. Please come downstairs with me – we need to open the door to the paramedics . . .’
‘Emergency services. Which service do you require?’ comes the voice over the phone.
‘Ambulance,’ I say desperately.
‘Just putting you through.’
‘Emergency ambulance service. What’s your name?’
I stutter in reply.
‘Your telephone number?’
I give them the number from my mobile.
‘Your address?’
‘Eight Rose – uh – Rosewood Drive,’ I stumble. ‘Angmering, West Sussex.’

Rami has got Flynn into the recovery position and is kneeling astride him on the bed, taking his pulse and peering at the back of one of the empty blister packs.
‘The ambulance is on its way,’ the woman says. ‘What’s the problem?’
‘He’s taken an overdose.’ My voice sounds weird, as if I am being shaken. ‘There are a lot of empty pill packets. He’s unconscious.’
‘Is he breathing?’
‘Yes, I – I think so. Rami, is he breathing?’
‘Laboured,’ Rami grunts.
I repeat this into the phone.
‘Is he lying on his back or on his side?’
‘He’s – he’s on his side, Rami’s moved him – ’
‘The ambulance!’ Rami shouts. ‘Have they sent out the ambulance?’
‘Yes, it’s on its way!’ I yell back
‘And are his airways clear?’ the operator asks.
‘Yes, I – I think so!’
‘Can you read what’s on the pill packets? Can you tell me how many pills are missing and what it says on the outside of the packets?’ the operator continues.
I squat down and scrabble round on the floor, almost dropping the phone. ‘Five, ten, fifteen, twenty, twenty-five, forty – I mean thirty – and then there’s two more – forty – and it says fluox — I’ll – I’ll spell it . . .’ My mouth feels as if it has gone numb. I can hardly get the words out.
‘Benzodiazepines,’ Rami barks. ‘Tell her he’s taken a massive overdose of benzos and ADs.’
I repeat it into the phone. I can feel the sweat running down my back.
‘What dose does it say on the packet?’ the woman asks.
‘Two milligrams. No, I think it’s ten . . .’ I am seeing double as I try desperately to read the faint type on the sticky label. ‘Yes, ten of diaz – ’
Rami snatches the mobile away from me. ‘Four hundred milligrams of diazepam,’ he barks down the phone. ‘And six hundred milligrams of fluoxetine. Maybe more. When will the ambulance be here?’
Sophie appears in the doorway. She waits until Rami hangs up. Then she asks, ‘Is he stable?’ Her voice is eerily calm.
‘Pulse fifty, pupils non-responsive,’ Rami replies. ‘Oh Jesus, Sophie!’
‘He’s still breathing on his own, Rami. Shall we try and get him downstairs ready for the paramedics?’
‘No, it’s better not to move him.’
‘Right. Just keep tabs on his airways and his pulse. That’s all you can do for now.’
The wail of a siren suddenly blasts up from the street below. Sophie disappears. Moments later the bedroom is full of people with walkie-talkies and green overalls, crowding round the bed. Everyone is talking very fast. Flynn’s nose and mouth are covered with an oxygen mask and a needle is inserted into his arm and taped down. A blood-pressure cuff is attached to his other arm and a thick white neck brace is fitted around him. Then he is lifted onto some kind of chair and covered with a salmon-pink blanket and strapped into it. On the count of three, they lift the chair and manoeuvre it through the bedroom door, jolting it against the door frame. The chair disappears and the room is suddenly empty. I can hear the paramedics grunting and giving instructions to each other on the staircase outside.
I will myself to move, to run downstairs after them and follow Flynn into the ambulance, but nothing happens. I don’t seem to be able to get up from the floor. A few minutes later, the sound the siren wails into life again, sending blue waves of light crashing through the empty rooom.
© Tabitha Suzuma