America’s Health Care Crisis Visits Families, and Stays
By Michiko Kakutani
Published New York Times: March 1, 2010

SO MUCH FOR THAT
By Lionel Shriver
436 pages. Harper. US $25.99.

A novel about the health care crisis in America? Well, Lionel Shriver’s new book, “So Much for That,” doesn’t tackle health care head-on, but in recounting the intertwined stories of several characters suffering from medical conditions — ranging from the most grievous and deadly to the more cosmetic and absurd — it creates a harrowing picture of the fallout that the current health care and insurance system can have upon regular, middle-class families struggling to care for their loved ones.

Photo right of Lionel Shriver by Eva Vermandel

This description might suggest that Ms. Shriver has constructed a didactic or lugubrious novel, willfully topical and laboriously relevant. She hasn’t. In fact, she’s managed to take an idea for a kind of thesis novel and instead create a deeply affecting portrait of two marriages, two families, as cancer in one case and a rare, debilitating childhood condition in the other threaten to push their daily lives past their tipping points.

Though there is one farcical plot development that is poorly woven into the emotional fabric of the story, and though some of the asides about health care feel shoehorned into the narrative, the author’s understanding of her people is so intimate, so unsentimental that it lofts the novel over such bumpy passages, insinuating these characters permanently into the reader’s imagination.

When we first meet him, Shep Knacker is contemplating the Big Escape. For years, he’s fantasized about what he calls “The Afterlife,” about using the money he made selling his handyman-home repair business — some $700,000 — and taking his family off to a faraway, third world country, where his savings will last them forever, and they can lead the good life.

His wife, Glynis, has made him postpone these plans for years, and now he’s decided that if she tries to delay their departure again, he will proceed without her. He hates working for the man he sold his business to; he hates the daily commute from the suburbs; and he likes the image of himself as a guy willing to press the Eject button — someone with the guts to get off the New York City treadmill and chase after his long-held dream.

Shep’s pipe dream is blown to smithereens when it turns out that Glynis has an announcement of her own: she’s been diagnosed with mesothelioma, a type of cancer associated with exposure to asbestos, and in her case, a deadly form with terrible survival odds. Glynis’s cancer turns everything in their life into a Before and After, and it indelibly alters their relationship.
The full review at NYT.