It’s been an unfathomably difficult 18 months for Hanif Kureishi. In 2022, the esteemed British writer went to Rome with his wife for Christmas, where he fainted and fell. When he woke up in a pool of blood he had lost the use of his hands, arms and legs. For more than a year, he was confined to hospital beds, questioned and prodded by doctors and nurses. He couldn’t sit, he couldn’t walk, and he couldn’t pick up a pen to write.

So I’m struck by the optimism and humour of the man speaking to me over Zoom this morning. When I join the call, Kureishi is sitting erectly in his kitchen and joking with theatre director Emma Rice about their new stage adaptation of his novel The Buddha of Suburbia, which opens at the RSC’s Swan theatre this week. It turns out the long months of convalescence – Kureishi has spent time in five hospitals, undergone spinal surgery, and only returned to his home last December – haven’t dampened his creative spirit.

“I’ve had a lot of time to think,” he says. “Particularly when I was in hospital and it was so boring. Hours and hours of the day would go by with literally nothing for me to do. I can’t use my hands. I can’t play with my phone. I can’t play music. I can’t send emails to people. I’m just sitting staring at the wall. But staring at the wall is a very good way of generating creativity.”

Kureishi now uses a motorised wheelchair and has a carer, meaning he has only made it to three rehearsals, yet the project has renewed his sense of purpose. “It’s really cheered me up that Emma is doing this play,” the 69-year-old says in his typically wry and concise manner. “It makes me very happy that my work is still alive after I nearly died. It also seems amazing that this book has survived for so long, that the story, the politics, the social background and culture are still of interest to people.”

Published in 1990, Kureishi’s debut novel was a sensation, praised by readers for its relatability and by critics for its satirical humour and social commentary. The semi-autobiographical story follows Karim Amir, a mixed-race teenager desperate to escape Bromley for a more exciting life in a less suburban part of London. Over the course of five years, Karim navigates his relationships with friends and family – including his father, a comical guru-like figure who teaches his neighbours about Buddhist discipline – while experiencing a range of sexual and social awakenings.

“It’s rather like what The Catcher in the Rye was for young people in the US,” Kureishi muses. “There’s something about Karim’s voice, his naivety, his vulnerability, and the idea of this kid emerging from a suburban house into a world of ambition and politics and sexuality that is very seductive. Everyone can identify with it.”

Karim faces hurdles in the book that mirror Kureishi’s own – like having to juggle two worlds and cultures, the Indian and English. Kureishi’s father came from a wealthy Indian background, moved to Pakistan after partition and then to London, where he met Kureishi’s English mother. Kureishi was the only child of colour in his school in the 1960s and endured racism and xenophobia. He was 14 when Enoch Powell made his “terrifying” rivers of blood speech.

In response, the youngster turned to books, music and fashion as a means of escape, which in turn equipped him with an ability to capture the cultural and social environment around him. For his efforts, Buddha won the Whitbread award for best first novel and was made into a BBC series soundtracked by fellow Bromley boy David Bowie. “There was one copy going round our school like contraband,” Zadie Smith once recalled.

“It’s one of the best modern stories there is,” says Rice, who was artistic director of Shakespeare’s Globe from 2016 to 2018, before she founded the Wise Children theatre company. “It’s like a modern-day Hamlet. I read it when I was 23 and it blew my mind. It was like a bomb dropping culturally. It’s so funny, so political and so tender.”

The pair’s collaboration should be distinctive. Kureishi, whose other notable works include the 1985 film My Beautiful Laundrette (earning him an Oscar nomination for the screenplay) and the 1998 novel Intimacy, which saw him described by the New York Times as a “postcolonial Philip Roth”. Meanwhile Rice, whose directorial credits include The Red Shoes and Wuthering Heights, has been called the “Wes Anderson of the theatre world” for her idiosyncrasies.

During our hour-long conversation, they discuss the difficulty and joy of trying to distill a novel into a theatre experience. “After my first draft, Hanif told me I’d got it entirely wrong,” Rice says. “He’s consistently said the story’s got to be political and funny.”

Rereading the book, I am struck by how relevant it still feels, despite ending on the brink of Thatcher’s victory. There are numerous parallels between today’s society and the Britain of the 1970s, when inflation was high, workers were striking, and people took to the streets in protest against a government that ignored them. Kureishi acknowledges this but is quick to highlight some major differences.

“Everyone’s much more pessimistic now,” he says. “I think people in the 70s really believed in the future and were quite optimistic about it, certainly with regards to music, fashion, the media and photography. Karim and his friend Charlie really believe they can make it, that they can be pop stars. But I don’t think my kids are optimistic like that about Britain and the future at all.”

The world, Kureishi says, “is more likely to make you crazy” now. “People are aware that the issues facing us are so overwhelming, like climate change.” He lists other problems to do with the lack of social mobility, the failure of the NHS and the lack of housebuilding. “One of the things you notice about the young people in Buddha is they never talk about money. They don’t want to be rich, they want to lead fulfilling lives. But that’s changed. My kids and their friends talk about money all the time.”

Though he calls the increased likelihood of a change in government “a shard of light”, he doubts “anybody is wildly optimistic about a Labour government”. The left, he says, “was much more active and coherent then. We don’t really have an organised left anymore.”

Rice also reflects on modern society’s sense of hopelessness. “I feel that we’ve been let down by everybody – by the church, by our politicians, by our TV presenters,” she says. “It’s hard to feel like anything we do at the moment can create change.”

What lights both Rice and Kureishi up, however, is the progress that’s been made in terms of identity and sexuality. When Buddha came out, it was still scandalous for Karim to want to “sleep with boys as well as girls”. “Now, it’s very liberating to see that there are so many new forms of sexuality; that the binary story just doesn’t provide enough opportunity,” Kureishi says. “It’s very creative and innovative. People are thinking and talking about gender, they’re exploring their own bodies and cultures.”

“Also, I don’t think people are pressured into having sex to the same extent that we were then, when it was considered to be almost revolutionary. When you think about what you do all day, you spend so little time actually having sex.” He smiles. “It only takes about five minutes.”

“I feel very optimistic watching my stepkids grow up,” adds Rice, “not labelling themselves in the way we did.”

And what of racism today? As Kureishi has noted, there aren’t gangs of skinheads pushing excrement through people’s doors any more. But some discourse remains familiar – the government is still tying itself in knots over asylum-seekers and immigration figures. It’s something the writer has been reflecting on in hospital.

“I could see that the NHS is entirely run by immigrants,” he says. “Most of the nurses doing the all-night and weekend shifts – and all the care workers – are recently arrived immigrants. If you cut that off, then you’re going to have an ageing population that isn’t going to be taken care of.” He calls this “a real dilemma” at the heart of Britain. “You can’t fill those institutions with indigenous people. It doesn’t work, everybody knows that. And sending a few people to Rwanda isn’t going to address the problem.”

How will they be invoking all of this in a stage play? “The sound design is really key. We’re using archive political footage,” Rice says. “I’ve also used a construct to make a bridge between the 70s and now: Karim speaks into a mic a bit like the early standup comedians, really telling the audience where the conflict was.”

But for Kureishi, sound – and music in particular – has been a source of pain recently. When he guest-edited BBC Radio 4’s Today programme last year, he said he couldn’t bear to listen to music any more because “it would be too moving”. But with music being so interwoven into Karim’s story, did he find a way to cope? “I’ve gone back to music now,” he says gladly. “I just couldn’t listen to all the stuff I loved in that horrible, depressing atmosphere with nurses and doctors. But I’m back at home now, and I’ve got my kids, my friends and my world around me. I’m trying to resume my working life again.”

Kureishi has been working hard on physio and has gained some strength in his arms and legs, although he has been told by doctors that movement in the hands is the last thing to return. Still, he remains optimistic about his current situation. “Although I’m tetraplegic, I’ve started to feel like a normal person. Writing gives me a sense of self-esteem and dignity. That I’m not just a broken body. I still have health issues; every day is a lucky day for me. Working really keeps me believing in something worthwhile in my life.”

One of the things he’s working on is his forthcoming memoir Shattered, which is based on his writings on X and on his Substack, The Kureishi Chronicles. The posts began several days after the accident, when Kureishi was still in ICU and trying to make sense of what he calls his “Kafkaesque metamorphosis”. He began dictating his thoughts to his son Carlo, who duly transcribed them. Since then, the dispatches have attracted thousands of global subscribers – many of whom write to Kureishi about their own tragic experiences. His X following has quadrupled.

Just as he did when he was younger, Kureishi says he finds himself writing “to communicate with a wider world, with other people who will be sympathetic”.

“I really needed to do the blog,” he continues. “It’s a new way of writing for me because I have to dictate it to a member of my family – one of my sons or my partner Isabella. My kids call me The Great Dictator because I shout at them and they write it down. It’s like a spontaneous bop chain of words. You kick off and off you go – you don’t know what you’re going to say, and you make sense of it by the end. I’ve started to really enjoy writing in this way. I write much quicker. The other day I wrote for two hours, dictating, and I did 3,000 words, which is a shitload for me.”

The Buddha of Suburbia follows on the tail of a stage adaptation of My Beautiful Laundrette, which was revived at Leicester’s Curve theatre. I wonder what makes theatre the right medium to tell these stories? “Buddha is a love letter to theatre,” Rice says. “That’s what drew me to it. And there’s an immediacy and a humanity to theatre. You’re going to feel close to an orgy, close to a racist beating. You’ll feel the heat coming off the actors when they dance. Unlike TV, theatre also brings imagination and suggestion – the audience can go anywhere.”

“Writing, theatre, acting and music are really what we’re good at in this country,” concludes Kureishi. “That’s our reason to be optimistic.”

• The Buddha of Suburbia is at the Swan theatre, Stratford-upon-Avon, from 18 April to 1 June