on June 4, 2010
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.
I loved this novel for its willingness to blow up every cliché and pre-conceived notion and TV pundit talking point associated with illness, death, and the American health care industry. I also can't believe that "So much For That" will be very popular with readers because it so boldly dismantles a notion so many hold dear: the idea of The Good Death.
The ordeal of Glynis Knacker, a fifty-year old with a diagnosis of asbestos-related cancer and access to the best care a cut-rate medical plan and her husband's sizable savings account can buy, is rendered with such detail and authority that it is as if Lionel Shriver had drawn aside a curtain to make us look at details we know are true even as we wish they weren't. Here is the World Wellness Group, a health insurance company whose minions are more concerned with denying coverage than providing it and who specialize in putting claimants on HOLD. Here are the hospital's indecipherable bills and codes for sums that bear no relationship to goods one might buy in any other marketplace. Here is the cancer specialist who speaks in military language and who sees a refusal to pursue a last-ditch, likely-to-fail drug regimen as a "defeat." Then there are Glynis's friends and family, most of whom begin to keep their distance as she becomes more ill, even though they always "mean" to visit. Finally, there is Glynis's refusal to embrace her fate and submit to the false spirituality everyone tries to impose upon her. As her disease progresses, she becomes ever more angry and difficult to live with.
As if this weren't enough, the portrait of Flicka, a teenager born with a terminal wasting disease, is stunning. I have never read any account, fiction or non-fiction, of the complex care of a handicapped child that is as true as this one. And Flicka herself definitely does not fit the poster child model; in fact, her commentary is cut out of a film being made about her disease because she is not upbeat enough. As she grows older, her notion of the right to life includes the right to leave it if she chooses.
Hmm, you say, this novel must be a real downer. The amazing thing is that it isn't, even as it mocks every aspect of the American health care "system." While some parts of the plot do seem a bit contrived, the actual talking (and thinking) is anything but. And there is a lot of it: political, socio-economic, religious, ethical, philosophical. It draws you in, the way good conversation with a variety of viewpoints always does. Much of the energy for these discussions comes from two men. Jackson Burdina, Flicka's father, spouts a kind of anti-government rage that he bolsters with Internet downloads and "facts." His type is familiar enough, but his foil is Shepherd Knacker, Glynis's kind and long-suffering husband. Even though his dream is to abandon his quotidian life for an "After-life" on Pemba, a tropical island, he turns out to be one of the few people in the novel who actually cares about someone besides himself. The ending of this novel is indeed a fantasy, but with this core of truth: a social compact in which human beings truly care for others, succoring the ill, the aged, and the dying, is the measure of a man---and of a society.
Don't miss this novel.
on October 28, 2013
So much for expecting to to read an engaging and enlightening novel about the sad state of health care in America. Instead I got an irritating polemic presented as a novel. Page after page of spewed vitriol mouthed through Jackson, one of the most unrealistic characters ever. I found most of the characters one dimensional and just plain unbelievable. The protagonist is presented as saintly and long suffering cast against myriads of flat negative unlikeable characters. A horrible wife who is sarcastic and insulting but terminal so he can't tell her off, kids who are distant and sucking money out of him right and left, a sister who sees him as her meal ticket, a father ditto, a punk boss who is demeaning and insulting, friends who drop out of their lives like flies. The protagonist apologises and apologizes, scrapes and bows, pays up and pays up and hardly ever pushes back. I was really irritated at the author for explaining certain words to the reader straight out. I know what "knacker" means and you don't have to hit me over the head to "get" why the protagonist is named Knacker! As for the ending, well all I can say that the author has trouble knowing when and where to end the story. At the airport before the whole unbelievable trip would have been a good ending. But no, we are then presented with a cast of characters on a journey that strains credibility. Readers are often asked to suspend disbelief, but sometimes to do so is nearly impossible and I felt that way with this book and particularly the ending. That fairy tale ending was the last straw and I felt set up and insulted. So much for that.
on April 15, 2010
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.
on May 10, 2015
Just finished reading this novel. I had not read Lionel Shriver before. The work is perfectly titled ("So Much for That"), about a man whose plans to retire to a remote island are derailed by his wife's diagnosis of cancer. Circumstances intervened so it took a long time to finish and when I did I was kind of sorry it was over.
The main and supporting characters are people we may know and Shriver accomplishes this with clarity of prose and realistic dialogue as well has having a firm grasp of the forces of culture that contribute to our problems. Consider this passage:
"Never knowing when the person you count on to make life seem worth living will suddenly make a rude, unannounced exit and it turns out, gosh, you were right--actually, now life really isn't worth living?"
The book is filled with gems like that. Shep's wife, Glynis, with all the treatments not covered by their insurance causes a vast portfolio Shep acquired from selling his handyman repair company to disappear within months. Glynis is diagnosed as terminal and Shep is fired. The same day, his best friend, Jackson, beset with his own serious problems, commits suicide. A lawsuit was filed alleging that Glynis's illness was caused by exposure to asbestos, which is traced to a particular manufacturer, who wishes to settle.
Through a dishonest and cynical twist, Shep's portfolio is restored and he makes it to his "afterlife", his island paradise, with Glynis (who has only a matter of days), his reclusive son, father who was withering away in nursing home, Jackson's widow and their two sick children, one of whom is not supposed to survive adolescence. The "twist" seems a kind of payback to the oppressive culture Shep wishes to escape.
I intend to read more of her work. The America Shep wishes to flee is the one we live in; many deride him for his "escapist fantasy", those who are blind to the dysfunction and consumerist bloat in which we subsist. Last line: Shep thinks of those people and says "They were all full of s***."
on December 31, 2012
I tried very hard to like this book, because a friend told me it was one of the best he ever had read. But I got too bogged down early by a family of sniveling whiners with whom I could never sympathize. I put it down after 50 pages, picked it up again and got through page 80 and then stopped, looked at the title and said to myself: "So Much For That!"
on June 13, 2015
It was slow, I didn't think I would like all the ranting but it was actually very true to what's going on today in the healthcare industry in america and I work in the ER so I see it all the time, it was interesting the see the patients perspective. Plus everyone knows someone with cancer so that perspective is in there for others to see too. I like it a lot.
on March 21, 2013
I opened this book with trepidation, having finished "We Need to Talk About Kevin" in January (but that is a topic for a different review). This was a witty, satirical skewing of the ludicrousness of the American health care system that, in addition to carrying a message, ended up being funny and fast-paced. The poor hero has decided to ditch it all and move to an island when his wife drops a health-care bomb on him. His new bottomline is that he's got to keep his job to keep his health insurance. I think this is a situation that most of us here in America can relate to with regard to keeping a job one does not want because of its benefits, however meager.
Somehow, Shriver manages to convey the depth of sadness tempered by humor in a way that totally, totally works. We take a journey along with a whacky cast of characters that includes a best friend with a botched male member enlargement, and a full cast of other characters unique in their zaniness. As I find typically with this author, none of the characters if very likeable, but then I don't think that is the author's priority. She makes us think and exercise that brain and at the end of the day, we're better for having gone through the motions. This was a quick, entertaining read that managed to be thought-provoking as well.
Shep Knacker has spent most of his adult life preparing for "The Afterlife"--his shorthand for early retirement in a Third World country where his nest egg will last longer. Numerous research trips with his wife Glynis have narrowed down the options to an island off the coast of Africa. Yet Glynis always finsa one reason or another to delay The Afterlife. Impatient to pull the trigger (after all, he sold his handyman company for $1 million a few years back and has been miserably slaving away for the asshat new owner since then), Shep decides he is ready to start enjoying The Afterlife NOW--even if that means going without Glynis and their teenage son Zack. With one-way tickets in hand, Shep girds himself to do battle with Glynis to convince her that he isn't willing to wait any longer, that The Afterlife must begin now. However, it turns out that Glynis has news of her own--she's been diagnosed with a rare but deadly form of cancer called peritoneal mesothelioma. What can a good husband do? Of course, Shep delays The Afterlife. Yet as the months tick by and the balance of his retirement account dwindles steadily due to mounting medical bills, Shep begins to realize that The Afterlife might never be in his grasp.
You just never know what you are going to get with a Lionel Shriver book. After thrilling to the parallel universes in The Post-Birthday World and feeling depressed and disturbed after her stunning We Need To Talk About Kevin, I signed up for her latest book without hesitation. I so wish I'd listened to the reviews I'd read beforehand that said that the book felt more like a diatribe against the U.S. health-care system than a novel as So Much For That was a bit of a slog.
Shep's best friend, Jackson, takes on the role of pissed-off ranter--launching on these epic rants about Mooches and Mugs (his favorite term for all the corrupt asshats who are sticking it to us idiots). These rants quickly grew tiresome, and I felt that Shriver let Jackson run on way too long. In addition, I thought the ending was unrealistic and uncharacteristic of Shriver. I honestly couldn't believe how she ended the book. If there was ever a book made for an unhappy ending, this was it. Yet Shriver turned everything on its head and gave these very unlikable characters an almost fairytale ending that just didn't jibe with the rest of the book. (Well, except for Jackson.)
That being said, Shriver is still is darn good writer. Her focus on little details and her way with words made this book tolerable. However, her writing skills often created vivid and graphic scenes that were almost too much for me to handle. At one point, when Shriver described some bodily functions plaguing Glynis, I felt my stomach turning with nausea. In addition, a subplot with Jackson's botched surgery contained one too many graphic descriptions that almost turned me off of intimate relations forever. Let's just say this: you'll never look at an "Enlarge Your Penis" spam e-mails the same way again.
In the end, this book felt more like Shriver communicating an agenda rather than writing a novel. Still, the lady (yes ... Lionel Shriver is a woman ... it threw me off the first time I read her books) can write and that saved this from being a complete turn-off ... but just barely.
About the Narration: I thought Dan John Miller did an excellent job narrating what must have been a difficult and long read. His voice was gripping, and I didn't mind spending more than 17 hours listening to him. In fact, his narration may have kept me in the book longer than if I had read it in print. (I definitely would have skipped over almost any Jackson rant in the print version.) In addition, Miller created different voices for each character, including Shep, Glynis, Jackson and Jackson's disabled daughter Flicka. (I'll confess, when I first heard his voice for Flicka, it was a real turn-off and almost seemed like a parody. Yet, as I listened, I grew accustomed to it and thought perhaps the voice brought the character to life in a way she might not have come to life in the print version.) It was amazing to me how Miller could morph into each character's voices and I'd know immediately who was talking ... even between Shep and Jackson.
Recommended for: People who have an axe to grind against Big Government, the health-care system, politicians and the "system" in general ... you'll find an ally in Jackson! I honestly don't know that I'd recommend this book to anyone. It wasn't an easy read/listen, the characters were often unlikeable, and the "plot" felt more like a chance for Shriver to communicate an agenda rather than craft a cohesive and gripping narrative. (I'm not saying I disagree with Shriver's agenda and criticisms. I just felt she bludgeoned the reader with it.) Although Shriver can write, she has written better books than this one.