My sister, Fauzia, died too young and all we had left of her was her art – small, beautiful, incomplete pieces of her

My sister, Fauzia, had her first big bout of depression in 1990, though none of us recognised it at the time. She had just dropped out of her fine art foundation course at Central Saint Martins even though it had meant everything to her. In the next months, she withdrew from the world, already beginning to speak of the mess of her life at the age of 19.

Then, at Easter, a friend invited her on a trip to Rome. It must have struck a chord because she got excited and my mother scrabbled to find the money for the air ticket in the hope that it would take her out of her fug.

She came back to London with her spirits lifted, at least for a while, and spoke as if the irrepressible, joyous beauty of Rome had burrowed beneath her skin and entered her bloodstream. I was 17 and in awe of her imagination and maturity. The art she had seen had healed her, it seemed. She described the magnificence of the city and the indelible marks emblazoned on it by its Renaissance masters.

That trip was long forgotten by me until she died last summer and we gathered her artwork. She was 45 and had returned to art after decades of depression and an eating disorder.

She was midway through a fine art degree when she began to feel that something was seriously wrong. She went to her GP complaining of weakness, chest pains and heavy night-sweats but the x-rays came back clear.

Then in April last year, she called an ambulance when her face swelled up. It looked like meningitis but again the tests came back clear. She was taken to the Royal Free hospital’s intensive care unit a few days later when she was unable to breathe properly and the chest x-rays shows inflamed lungs, but the doctors were at a loss for a diagnosis.

They put her on steroids and she appeared to get better, but was back in intensive care by May, weaker than ever with slurred speech and strange behaviour. For the next two weeks, the doctors carried out more investigations, but still no diagnosis. Then, on 10 June, she had a catastrophic brain haemorrhage. Days before she died, they retested her spinal fluid for tuberculosis and it came back positive. But it was too late, the haemorrhage had happened. No one knew how she had contracted TB and it might have sat in the body for decades, the doctors explained.

Fauzia had had a difficult life, dealing with her depression and often feeling like the system was letting her down, or failing to understanding her. Now it turned out, weirdly, that she was as unlucky in death as she had been in life. The hospital’s review of her case cited missed opportunities – that “TB might have been more actively pursued as a possible diagnosis”, especially given her ethnicity (those of south Asian origin are at higher risk). We were told they had been looking at the bottom part of her lungs, not the top where the TB marks were patterned.

We were staggered by the sequence of events. We had seen how hard the doctors had worked to diagnose her and how large the team of specialists had become, though that might, according to the medical review, have been part of the problem.

Even though only two years divided us, Fauzia’s early life had been far more unsettled than mine. She was born in Pakistan when our father was in London and they didn’t meet until she was one. We shuttled back and forth from Lahore to London for almost seven years and as the eldest, she must have felt the trauma in being cut adrift from a large family in Pakistan and living in poverty for the first few years after emigrating to England.

Fauzia Akbar self-portrait.

The effects began to show by her late teens. Until then, she and I had been close. She was the worldly older sister, passing down her books and magazines, telling me how to dress in the hope to make me less nerdy.

Her depression created an unbridgeable distance between us so when we gathered her art, I began to look for clues to her inner world, and an odd thing happened – Rome peeped back out at me. So many of the sketches, paintings and embroideries were filled with imagery of the Madonna and child and of the crucifixion. I was puzzled. This was a distinctly western artistic tradition to which I knew she was not in thrall and I wondered why such “stained glass” art would matter to a person who hated conventional orthodoxies.

Then I saw a sketchbook with the religious images on one side of the page, and her own family on the other. The placing was repeated throughout the book – images of my mother, my niece, my sister-in-law and me – and it seemed as if the sketches were working out parallels between the archetypal family and her own, with all the suffering and darkness in both.

She was surrounded by privileged, confident 18-year-olds. She was neither of those and her self-belief leaked away

As I looked, I also saw a joyousness in the work that seemed at odds with her pain. There was an embroidery of delicately stitched angels, cherubs and animals, which were combined with graffiti, and one sentence in dainty pink-and-cream thread jumped out: “I didn’t know how to be assertive so I just raised my voice and said the same thing.” Another, in tiny cursive, said “little sewing girl”. It pained me to realise that her timidity lay behind behaviour that could come across as aggressive to the world.

Fauzia had always found so much of the world in art in a way I never understood as a child. My mother saw how much she enjoyed drawing and encouraged her when we were little. She won competitions and carried on drawing, even when the depression began to take hold. By the summer of 1989, she had finished her A-levels and was buoyed up enough to go for a late interview at Central Saint Martins. She came back home jubilant because they had offered her a place. But it didn’t last; she was surrounded by privileged, confident 18-year-olds. She was neither of those things and over that year all her self-belief leaked away.

The blanket of depression that came after she dropped out lasted decades. It sabotaged so much of her life and robbed her of a creative life too. The art never stopped mattering though and she talked of a return to it but was scared, I think, to embark on that journey in case she failed. And then, one day, she asked my mother if she could go to one of her sewing classes at the local Asian Women’s Centre. She went and excelled quickly until she was making embroidered compositions on cloth that tied eastern and western traditions together with biblical imagery set against Bharatanatyam scenes.

I don’t think Fauzia considered the embroidery to be art at this stage. She was sitting among older Asian women who chatted about life as they sewed. It was more a vent for all her pent up artistic expression.She did it almost constantly, a habit in the hand on the bus, at home, when she was anxious or upset. The urge to pursue art rose up again by stealth in these embroidery classes and she finally submitted an application to Camberwell.

The last time I saw her outside of hospital, last May, she showed me her work-in-progress. She was berating herself for not doing enough, not doing better, but it was clear she was exhilarated by the challenge too. She got out her anatomy sketchbooks and then her bigger projects. There was a portrait of lovers in yellows and oranges that combined embroidery with pastels and I was taken aback by how much she had improved.

When she was lying in hospital, breathless and barely able to sit up, she talked with urgency of getting back to Camberwell.

So much was at stake for her and she was determined to finish the degree. She never did, but the work she left behind contains small, beautiful, incomplete pieces of her. It shows the pain and struggle of her life but it is also bound up in colour and sequins and gleaming gold and silver threads. There is a celebration of beauty there. A piece of Rome.