So Much for That [Englisch] [Taschenbuch]

I resisted this book. I read sporadically at first, wondering if my reluctance stemmed from the topic (SO MUCH FOR THAT concerns the bell that tolls for us all) or some flaw in the novel itself. In the end, the voices pulled me in. Even in (especially in) the throes of the most extreme stress, the characters are smart cookies: frank, fast-thinking, often sarcastic, always interesting. They are so articulate, they could pass for embittered stand-up comics.

Their territory, however, is not realism à la Jodi Picoult. Lionel Shriver is the anti-Jodi Picoult (each wrote a novel about a high school killer, but how different they are!). I do not mean to malign either writer. I love Picoult's down-to-earthness, how she mixes dinner dishes, soccer games and homework with life's gravest moral and spiritual dilemmas. Shriver, however, is to Picoult what an indie film is to a Lifetime movie. In SO MUCH FOR THAT, Shriver not only nails the expected pain and grief of terminal illness, childhood disease, sexual angst and financial roulette, but also brings out their absurdity.

When Shepherd Knacker sells his handyman company (Knack of All Trades) for a cool million, he thinks he is about to realize his dream (he calls it The Afterlife): to retire to some third-world country where a well-stocked investment account can last pretty much forever. He and his wife, Glynis, have gone on "research" trips throughout their 26-year marriage, but she always finds some drawback. At 48, he can't wait any longer (he has been marking time, working as an underling at his former company and paying too much rent for a suburban house). One day he buys plane tickets to Africa. He is determined to go, with or without his family. But that night, everything changes: Glynis tells him she has cancer, and the word afterlife now takes on a grimmer meaning.

Destiny has also played a cruel trick on Shep's best friend and co-worker, Jackson Burdina, and his wife, Carol. Their daughter, Flicka, was born with a rare genetic nervous-system disorder called Familial Dysautonomia (FD) and requires constant care ("It was like being a doctor yourself but without the golf. You were always on call"). Flicka isn't the blandly adorable dying kid you see in TV's medical melodramas; she is tough, furious, wildly intelligent --- and seriously suicidal.

Flicka and Jackson are two of a kind. His characteristic mode of expression is the rant, and his world view typically divides people into Mooches and Mugs --- those, particularly in the government, who cheat and squeeze and come out on top; and those who meekly accept their lot. His monologues are Shriver's principal mouthpiece for attacking the American health-care system and sundry other ills of modern life. Black comedy is Jackson's strategy for coping with fate. Uncomplaining servitude is Shep's.

Shriver's cutting wit and lack of sentimentality make her book particularly disturbing. Apparently affable doctors deliver death sentences in code (Shep thinks, "[A] doctor was like a handyman who, some appreciable percentage of the time, had to knock on your door and say, I'm sorry, but I cannot clear your drain. ... And then he walks away and maybe he waves, leaving you with scummy standing water in your bath"). Denial is described as "scroll down" versus "skip down." Chemo is "sick" and "surreal" and tantamount to bloodletting and leeches.

There is tenderness, too, but doled out judiciously. Shep's relationship with his aging father is as poignant as his relationship with his narcissistic sister, Beryl, is poisonous. And you cannot help but be moved by his observation, as he and Glynis wait for her surgery, that "only a warm hand on her neck seemed to make a difference. This was a time of the body. To communicate was to communicate with the body." Talk, in other words, has its limits.

Perhaps the core of SO MUCH FOR THAT is Shep's yearning for some protocol that suits his circumstances: "He couldn't see the utility of a civilization that had an etiquette for...placing the fork to the left of a plate, but as for what to do while your wife was sliced open you were on your own." Most of our reference points about illness are drawn from TV ("Cancer in the world of entertainment was a neat one-word expedient for the disposal of characters who had served their purpose...."), so no wonder Glynis's friends and family fall away as her illness progresses --- they have no idea what to do or say.

The downside of Shriver's acerbic, epigrammatic style is that the novel becomes a bit like a series of riffs on taboo subjects --- entertaining and provocative but emotionally unsatisfying. Although the characters are tested by adversity, they do not really evolve, and the parallels between Shep and Jackson, and Glynis and Flicka, are too heavily signposted. I also felt slightly cheated by shifts in tone toward the latter part of the book. First there is the intrusion of a grand guignol shocker (I won't be a spoiler, but believe me, this event is bizarre and off-key --- the plot is not so much twisted as totally distorted), then a sort-of-happy trick ending. Ironic fables are not my thing.

Still, in a world where books seem ever more formulaic, I love Shriver's willingness to take chances. She is to be congratulated for addressing the hard subjects that most people gloss over, and for doing so with complexity, honesty and humor. SO MUCH FOR THAT, with its explicit critique of the current state of medicine and this culture's benighted attitudes toward death, is horrifyingly timely.

'So Much for That' by Lionel Shriver is a timely novel about the dire straits of our country's healthcare system. It is also a diatribe about our country's policies of taxation, what the average Joe gets in return for his taxes, and the government's rip-off of average tax payers. The novel does not spare the evils of the banking industry, corporate America, or the wealthy as they are vilified for creating an environment that harms poor workers and the middle class.

Shep had spent years building up his handyman business. It flourished, and when he sold it he received a million dollars. Naturally, close to one third of the gross payment went to the feds. Shep's dream was to use his money for what he called 'the Afterlife', his plan to settle on a remote island where he could live the rest of his days cheaply and well, utilizing the proceeds from his business. He hoped that his wife and son would join him but that remained up in the air. Meanwhile, until he could accomplish his dream of the Afterlife, he continued to work at his business, for the man to whom he'd sold it.

Just days before Shep plans to leave for an island near Zanzibar to spend the rest of his days, his wife, Glynis, is diagnosed with a rare and incurable type of cancer - peritoneal mesothelioma. It is caused by exposure to asbestos and Glynis figures that this exposure occurred from her exposure to Shep after he worked with asbestos or when she was an art student. She is angry at the world and not a pleasant woman. Her anger is not caused solely by the cancer; Glynis was always a difficult and angry person.

Shep doesn't realize that his medical benefits have been reduced to a pittance by the new owner of the company. Not only must he stay in network, but the 'Usual and Customary Costs' seem to be based on an arbitrary formula that was developed in 1959. Trying to decipher the hospital bills is nerve-wracking. He can't understand the myriad codes and all the charges. Reimbursement is minimal and appears to be based on what charges 'should be', not what they are in the real world. The costs of medication are phenomenal and Shep watches his money fund account begin to dwindle from its original $700,000+ on a downward spiral. He also becomes more cognizant of all the ads for medications, doctors and insurance and realizes that they are all propping one another up at his expense.

Shep's best friend, Jackson, has a daughter named Flicka with familial dysautonomia (FD), a hereditary disease found in people of Ashkenazi Jewish descent. Flicka's life is difficult and she manages to live it with grace and humility. Flicka lives with horrific symptoms. "She did mind waking up with puffy red eyes halfway to conjunctivitis before breakfast. She did mind not being able to talk right when she had plenty to say. She did mind drooling all the time, and sweating all the time." "She might have been grateful, too, that they'd given up on the chest drainage sessions that had tyrannized her childhood: the tube worked unpleasantly down her nose, the pump's sickening gurgle and slurp, the grotesque accumulation of mucous in the waste container." Despite all of this, Flicka is resilient for her sixteen years. However, she's reached a point where she's thinking of not going on. The amount of effort, cost, and personal pain that it takes to live is becoming too much for her.

Meanwhile, Glynis is fighting with her life, for her life. She is difficult to live with, nasty and demanding but refuses to let go despite every odd against her. The comparison of Flicka and Glynis is both poignant and profound.

The book, at times, reads like a polemic against the healthcare system and corporate greed, disguised as a novel. It does make some very salient and timely points. I just wish that more of the book was about Flicka, Glynis and their families, and less about the history of the pharmaceutical, health insurance, medical, corporate and banking systems in the United States. Because this book is so pedantic, it tends to lose its connection with the reader.

The parts that are about Glynis and Flicka are well-written and painful to read. Not only is the reader privy to the agony and struggle of the chronically and terminally ill, we also see the pain and agony that beset their loved ones. There is some comic relief when a friend of Shep's has some cosmetic surgery that goes awry. This can be a hard novel to read because of its direct and graphic medical descriptions. It is a book for our times and one that is important because of its subject matter and scope.

There is an excellent quote in this book, which, while the quote is about movies, comes close to summarizing this book very succinctly: "Remember how sometimes, in the middle, a movie seems to drag? I get restless, take a leak, or go for popcorn. But sometimes, the last part, it heats up and then right before the credits one of us starts to cry--well, then you forget about the crummy middle, don't you?" The problem with this book, however, is that the wonderfully-written ending to this story did not make up for the crummy middle.

The book follows Shep and his wife, Glynis, and their friends and family as she battles cancer, and the challenges this brings physically, emotionally, and financially. First, the good parts. In my opinion, the writing about Glynis's experience with cancer is very, very real and completely accurate. And without giving anything away, the ending of the book is a lovely piece of writing. Additionally, there were many points made in the book about the American healthcare system that I happen to agree with.

However, for the bad points of the book--many times the dialogue on the point of healthcare was just completely overdone and redundant. On and on and on the characters went, blasting away at it. Okay, we get it, let's talk about something else now! I was skipping entire pages because of the repetition. The middle of the book just crawled along with characters bursting out in soliloquy with no movement of the the plot at all. I really do believe that about 200 pages of this book could've easily been cut out.

In short: I'm afraid the book was extremely dull. It was akin to sitting next to someone at a dinner party who bombards you with their immovable opinions on one thing or another, regardless of the fact that your eyes have long since glazed over. I wouldn't recommend the book unless with a suggestion to read the first three and final chapters only.