So Much for That / Lionel Shriver

This novel comes from the 2005 Orange Prize winning author of We Need to Talk About Kevin, a disturbing book in which a parent with ambivalent feelings towards motherhood deals with the aftermath of a Columbine-style school killing perpetrated by her son. Lionel Shriver has said that she prefers to create characters that are hard to love, and So Much for That certainly contains some flinty characters, who although they may be hard to love, are nevertheless very believable.

The topic this time is healthcare in America. Shep is all ready to launch into an exotic early retirement on the island of Pemba off the eastern coast of Africa, but when his wife reveals a diagnosis of mesothelioma, he must hold on to his job to maintain family health coverage to see her through her devastating illness. His work colleague and friend, Jackson, experiences a medical dilemma completely of his own doing, which proves to be his undoing. Jackson's daughter suffers from an unusual genetic disorder, familial dysautonomia. And Shep’s octogenarian father requires long-term care after he falls at home and then becomes infected with an antibiotics-resistant superbug. By the end of the novel Shep’s retirement nest egg has all but disappeared, going to hospitals, labs, out-of-network specialists, and a nursing home.

Full disclosure-- this book can be a huge downer. Anyone who has had even secondhand experience with a prolonged medical crisis will identify with the mostly unpleasant situations in this book, but let’s face it, those same people who have had experience with prolonged medical crises may not want to read a novel detailing the agonies and finanicial stresses associated with terminal cancer or extended care. There was a point where I considered putting this book down, but it has a surprise ending that ties things up rather nicely and gives the reader a smidgen of hope. This is a polemic that targets the American way of healthcare the way Upton Sinclair targeted the meat industry in The Jungle. So Much for That certainly doesn’t make the US look like a medical paradise, pre or post Obamacare. It would probably be impossible for a novel on American healthcare to be anything but depressing. At least it leaves you with a lot to think about, but I think I'll choose a more uplifting book for my next read.