‘All day, all night the body intervenes,” wrote Virginia Woolf in On Being Ill. It “blunts or sharpens, colours or discolours, turns to wax in the warmth of June, hardens to tallow in the murk of February. The creature within can only gaze through the pane – smudged or rosy; it cannot separate off from the body.”

On Boxing Day 2022, in Rome with his Italian partner Isabella, Hanif Kureishi felt dizzy while sitting at the table. He fainted, landing on his neck and becoming tetraplegic as a result. He spent 2023 in Italian and English hospitals, being prodded, rearranged and invaded while sending dispatches to his fans (dictated to Isabella and to his son, Carlo) via his popular Substack. “I will never go home again. I have no home now, no centre. I am a stranger to myself. I don’t know who I am any more. Someone new is emerging.” Now, those dispatches have been collected, edited, and expanded into a memoir.

In print and on screen, Kureishi is the author of many irreverent, funny stories about sex, drugs and coming of age. In The Buddha of Suburbia (1990), which won the Whitbread award for best first novel, he wrote unabashedly about the sexual ambitions and discoveries of a mixed race kid in London at the tail end of the 70s. Given the diet of shame most children of immigrants were fed back then, Buddha was groundbreaking. Nothing was too shocking for Kureishi, and that was what made his writing so exciting.

Shattered immediately reassures us that his raw, earnest humour is intact. “My head became jammed down the side of the bed,” he writes early on. “It seemed like a good opportunity for some contemplation.” As he tries to reckon with a new reality, he envies the unbroken bodies around him. What parts of himself will he get to keep? “Eventually I could be capable of a little light cunnilingus, and I hope I will be. But right now I am a desperate man attempting to open a bag of cashews using only my teeth and a brick wall for purchase.” Often he gives the impression of trying to make Isabella laugh, to be less of a burden to her. “The worst part of the day is the early evening when Isabella puts on her coat and leaves. When I see her walk out the door, I know I have to survive the night without her, alone.” This subtext to his diligent wit is heartbreaking.

Meanwhile there are the indignities and wonders of life inside a frozen body: being spoon fed dirty cold tea and mushed-up biscuit for breakfast, the toil of getting upright, the luxury of a scratch. Fellow patients, including an actor and director he calls the Maestro, pushing him to the food bar in a “wagon-train” of wheelchairs. Catheters, “an anaesthetic in the penis”. Having to wear a butt plug for hydrotherapy.

He writes of the “guilt and rage” that comes with dependence, and of quietly devastating moments such as when a cleaner knocks over his propped-up iPad before turning off the light behind her, leaving him to watch the rest of his film as merely “silhouettes flickering on the ceiling, like a shadow puppet show”. On another day, Netflix asks are you still there? “I then tried pressing my somewhat bulbous Indian nose against the screen but succeeded only in pushing the iPad further away. The legend remained. Was I still there? Was I anywhere?”

Woolf observed that, in illness, the mind gives way to a thousand fantasies we don’t find time for in health, “setting us to wait, hour after hour, with pricked ears for the creaking of a stair, and wreathing the faces of the absent (plain enough in health, Heaven knows) with a new significance”. Kureishi’s mind overflows with memories and thoughts, the loss of his body giving him new focus, new ways of listening. These pages contain many ideas that beg for a more careful working-out: the nature of care, how much we should ask of our helpers, how expectations of perfect health make the disabled invisible, even cowardice and censorship in modern writing (“It is part of the writer’s job to be offensive, to blaspheme, to outrage … I am relieved not to be a young writer today, working in this atmosphere of self-consciousness and trepidation, this North Korea of the mind”).

But sense-making takes time and psychic distance. Mired in loss and pain, with his perspective still narrowed, Kureishi’s preoccupations are primarily nostalgic and scattered, and he knows it: “this is how I write these days; I fling a net over more or less random thoughts, draw it in and hope some kind of pattern emerges”. While more time might have shaped Shattered into a powerful addition to a growing literature on pain and illness, it is missing a vital layer. In his rush to make meaning (and to reclaim himself), Kureishi tips into mythologising his own life. “I have eaten in fine restaurants. I have dined with scientists, artists and Brian Eno.” It’s a good joke – but the book is a little too full of famous names. Yet they do add magic and humour to his stories. He quotes from Chekhov’s The Seagull: “I’m in mourning for my life”. He wants it all back – to hold a pen, to have sex, to walk with Isabella – and that grief is urgent and visceral.

Shattered is much shaped by the immediacy and limitations of its original medium. It began as a survival diary for worried fans who received the brief dispatches eagerly, waited for them: their form, and the waiting, gave them meaning. They are also a personal record of physical struggle and grievous longing, a real-time lamentation for a suddenly out-of-reach past. Kureishi’s craving to get that past, with all its lovers and luminaries, on to the page is crushing. And it’s impossible to forget that Isabella and Carlo are typing this; their strange presence adds tension to every thought and memory. Recalling a threesome in Amsterdam Kureishi writes: “if this was a film, the camera would be close on Isabella’s face as she writes this down for me”.

The agony of becoming a burden turns slowly to acceptance and thanks, a new softness. “I wish I had been kinder; and if I get another chance, I will be.” In his broken state, he finds himself engaging in unlikely conversations, experiencing joy in small things, finding new empathy for the healthcare workers who tend to him. He meditates on illness, as Woolf and Sontag and Scarry and Biss and others have done. “I am in fact more powerful now as a sick person. The sick can dominate a family, sucking out all the oxygen. To be sick is sometimes to have a stranglehold over others.” He moves from the unreality of a terrifying loss to depression, paranoia, and finally a renewed interest in others. “Out of horror, something new must arise.”

Kureishi’s fans will find Shattered wildly inspiring; his singular voice, his bawdy humour, his efforts to create meaning, all so characteristic and moving. He is back home in London now, his world forever altered. “I sat in the centre of this old city that I loved … surrounded by people I loved,” Kureishi wrote 35 years ago, in The Buddha of Suburbia, “and I felt happy and miserable at the same time. I thought of what a mess everything had been, but that it wouldn’t always be this way.” The young Kureishi wrote his way into a different kind of life. And now, someone new is emerging. I can’t wait to read everything he has to write.

Dina Nayeri is the author of The Ungrateful Refugee and Who Gets Believed? Shattered by Hanif Kureishi is published by Hamish Hamilton (£18.99). To support the Guardian and Observer, order your copy at guardianbookshop.com. Delivery charges may apply.