The first half of So Much For That was incredibly difficult to get through. It felt like there were too many lectures, and too little characterization. The second half moved at a much better clip, but unfortunately this book felt too much like "American Health Insurance for Dummies." Jackson, for the first half of the book, seemed to exist solely as a mouthpiece for the author. Shep and Glynis, who were the heart of the story, seemed murky and distant, much like a picture from a pinhole camera. The prose is wonderful in much of the book, but it is too flawed to recommend. ( )

Did you ever wonder what you'd do if you found out you had cancer? For myself, I find I wouldn't want the treatment that seems more horrible than the disease itself.

This is a fiction that is unbearably heartbreaking but, thank goodness, has a lovely ending.
Shep Knacker had a handyman business that he worked so hard at that it was a flourishing success. After 20 years he cashed in and sold it to an employee. After being paid 1 million for his business, Shep put his money into a Merrill Lynch account minus capital gains of $300,000. In the book, each chapter starts out with the diminishing value of his account.

His wife has contracted mesothelioma, because of some asbestos she worked with years ago, in her metalworking business. The lousy health insurance that Shep's former employee (for whom Shep now works) has changed to, to save money, doesn't pay much. Out-of-pocket for each chemotherapy treatment is $40,000. Moreover, the best mesothelioma doctor is out-of-network, so Shep must pay 40% for any of his, and his hospital's services.
Shepherd Knacker starts out with $731,778.56 in his Merrill Lynch account.
P.49:
"shep had the sudden impression that this visit, if not the whole song and dance from the x-rays and the cat-scan to all the scalpels and 'abdominal ports' and vile medications to come, was a farce, a macabre charade. As helpful and soothing as this doctor was trying to be, shep felt distinctly humored. In turn, he also felt co-opted into a collusion with the doctor, whereby together they were humoring his wife. the joke was on Glynis. It was a wicked joke, a despicable joke, for which she would pay with every fiber of her being. He did not want to be a part of it. He would be a part of it."

There are two sub Medical crises going on in the story: both involve Shep's best friend and fellow employee. Jackson is forever harping on his favorite subject: how the government has let us all down.
P.78:
"for government was now, in Jackson's view, a for-profit corporation, although a sort of which the average industrial magnate could only dream: a natural monopoly that could charge whatever it wanted, yet with no obligation to hand over a product of any description in return. A business whose millions of customers had no choice but to buy this mythical product, lest they be locked in a small room with bad food. Since all politicians are by definition 'on the tit,' none of them had any motivation to constrain the size of this marvelous corporation that didn't actually have to make anything. Occasional conservative lip service notwithstanding, sure enough, over the decades USA Inc had done Nothing but expand."

Because Shep has worked hard, certain members of his family see him as an ATM. His sister Beryl, who constantly asks him for"loans" that she never pays back, and indeed, Shep's own wife Glynis the metalworking artist quits working after she marries him. His daughter Amelia has never settled down to a steady job after Shep paid for her expensive education.
P.117:
"he was glad, he supposed, that she had earned a degree. Yet he wondered whether the abundance of the information provided by a $200,000 Dartmouth BA in 'media studies' might have been available through a free trial subscription to The Atlantic Monthly and a basic cable package including Turner Classics for $50 a month. His daughter's dubious degree had alone decimated the savings he'd accrued previous to the sale of Knack. Shep may not have expected his own father to send him through school, but it was customary now: a child had a right to a university education. So he should not resent the expense, and therefore he did not resent it. Yet after decades of single-ply, turkey-burgers stinting, actually to be punished for the frugality had been, well - disconcerting. His cash assets had flat out disqualified Amelia from financial aid."

Jackson's daughter Flicka has a rare genetic disorder that is extremely dangerous and high maintenance. In response, his other daughter Heather is jealous of the attention her sister commands, and invents imaginary illnesses.
P.166:
"Christ, she'd been fishing for the designation of learning disability for months. The Cold Truth was that Heather wasn't as bright as her older sister, and maybe having a plain mid-level IQ was a learning disability of a kind. Strange how if you are straight-out dumb it was meant to be obscurely your fault, but with 'ADD' your intellectual shortcomings became blamelessly medical. It didn't really make much sense for the 'learning disabled' to be given an unlimited amount of time to complete standardized tests, while the hopelessly stupid kids still had to finish by the Bell, when both camps were victims of genetics. Hell, it was flat-out dumb kids who should get the extra time, since they'd yet to invent a drug to make you clever."

Jackson's wife Carol is beautiful, and Jackson has always felt that he not quite measures up to her. We don't find out till later, but Jackson gets penis enlargement surgery from a quack, with disastrous results.
P.180-1:
"The experiment had failed. He may never have quite fathomed why women would find a penis attractive – with a shriveled, too-thin- skin, the blobby, drooping testicles with straggles of hair, the little mushroom cap at the end somehow not a form that human flesh should assume. at rest it looked frightened and depressed; when alert, impertinent yet insecure, waving about and trying to attract attention like a loud mouth acting out. He'd never entirely trusted Carol's enthusiasm for the thing; her natural kindness made her unreliable. Yet there were limits to Carol's altruism, since she was currently making no effort to disguise her revulsion, as there were also limits to his own disaffection with the phallus of conventional proportions. The unimproved version had still been preferable to this.
"The lumpy tuber between his legs now looked like one of those balloon animals that children's entertainers twisted hastily together at birthday parties. Where before the shaft was thicker at the base, now it was narrowest there, for the collagen used For thickening had slurped downward, bulging over the rim to partially bury the head. His dick had love handles. The filler tissue had migrated asymmetrically, too, and the bulge was larger on the right. Overwhelmed by what now hung more like a third testicle, the head appeared smaller and pokier, no better than a gumdrop. And the shaft emerged from too low down. The snipping of the suspensory ligaments were supposed to have released a whole inch of length otherwise wastefully tucked inside his pelvis; now his prick seemed to be growing out of the balls themselves. The descendant derivation Jarred the eye, like a dirty scroll on a men's room wall by a kid who couldn't draw. Inflamed, bloated, and seeping, this was the kind of fatally festering extremity that battlefield medics in the civil war sawed-off on the spot."

Glynis is describing a chemotherapy session to Flicka, and I'm not sure if the author didn't plagiarize one of the Star Trek movies where Dr McCoy goes into a dialysis center in the past, and raves at how diabetes is being treated.
P.331:
" 'anyway, there's one episode, something about a planet that's done away with war by having scores of people on both sides of a ceasefire volunteer on a regular schedule to walk into a chamber and be euthanized. It's all very orderly; you know, that program loved alluding to the Nazis. And then Captain Kirk comes in and messes up their thing, giving one of his breathy, emphatic speeches about how they either have to go back to killing each other the old-fashioned way or make peace. So every time I go to Columbia-Presbyterian I picture Captain Kirk bursting into the oncology wing and getting a load of all these delusional Lemmings on Planet Bonker mainlining strychnine. I see him getting self-righteously horrified, and yanking the needles out in a frenzy. Delivering a strident, self-righteous speech about how barbaric it is, how you don't cure disease with poison. because the whole routine is completely sick. I really do think that years from now people will look back on chemotherapy the way we look back now on bloodletting and leeches.' "

This was so good, that I'll be reading more from this author. ( )

I was a little disappointed by this book. After reading "We Need to Talk About Kevin," I went on a Shriver kick and currently have a pile of nearly every book that she has written (or at least, every book that I was able to get from the library).

I really liked the premise of this novel, and the exploration that she wrote regarding the price of a life, the cost of health insurance and health care, and infrastructure and social constructs that exist around terminal illness and end-of-life care. There is a dialogue where the dying woman's husband asks the doctor how much time they have bought her and how much money they spent; the doctor replies that they bought her a good three months, and the husband replies, no, they were not a good three months. Anyone who has experienced the death of a loved one after extensive medical treatment will understand that.

I tend to enjoy Shriver's descriptive and lengthy prose, but in this particular novel it seemed overwrought. Although the rants of one character raised interesting points and brought issues to the forefront that were important to the plot, it became a little tedious (which may have been the effect she was going for after all). Topically, this was a great story, but the overall effect was less than I expected from a Shriver novel. ( )

This is my third Lionel Shriver novel, and she's definitely becoming a favoured author of mine. In So Much For That, the novel opens with the male protagonist deciding to finally go ahead with his life's dream of escaping the rat race to live on a small island off the coast of Zanzibar, with or without his family. However (and this is no spoiler as the jacket tells you as much), his plans to live the dream are stopped dead in their tracks when his wife announces that she's had a serious cancer diagnosis.

The rest of the novel plays out predominantly around the impact that the terminal diagnosis has on his marriage, his family, their friendships and his own life plans. Such a topic could make for a very depressing read, but So Much For That is not so much focused on the sadness of the diagnosis but more on the emotional, practical and financial difficulties of caring for a partner whilst other life problems carry on regardless.

It throws out the window the stereotypes of terminal cancer patients somehow being super human and without flaws. Glynis (the wife who has cancer) was a difficult woman to deal with before the diagnosis, and as a patient is more difficult still. She's angry with the cancer, angry with family members who start to make appearances after long absences before the diagnosis, and rude with visitors whose visits she feels are to make themselves feel at peace once she's gone rather than being for her benefit. Doing the right thing is a very difficult line for Shep (the husband) to tread, and the strain of trying to keep the daily plates of life spinning whilst he cares for his wife is huge.

This is also a novel that heavily rails against the American health system (although granted this dates back to 2005 so I don't know how much things have progressed). Shep starts the novel with a tidy nest egg after selling his business, but the poor insurance plan provided by his new employer means that he has to cover vast excesses relating to the cancer treatment. Shriver (through this and another back story) is constantly poking at the sore of why those who have worked hard all their lives and paid their taxes should be penalised so heavily when it comes to needing health support, and the difficulties of trying to hold down a paying job when supporting a family member who's seriously unwell.

It raises some similar questions to those raised by Atul Gawande in his later non-fictional book Being Mortal: Illness, Medicine and What Matters in the End which was interesting, and is searingly honest in it's questioning of whether it's right to spend extortionate sums of money to extend a life under excruciating treatment for short-term gain.

In all, this is not a novel falling under misery lit. There's plenty of humour woven into the story, and I didn't find it a sad read despite the subject matter. Nothing escapes Shriver's eagle eye, such as familiar family stories where one sibling is left to bear the brunt of looking after an elderly parent.

It's not perfect - at 530 pages it probably took half of that before it become a page turner for me, but it's one of those novels where the second half is good enough to make allowances for that, and the ending is great.

4 stars - honest, brave and funny. ( )

This is my third Lionel Shriver, and I didn't love it as much as the first two, because the secondary plot was a bit annoying and tiresome. Without it, the book may have garnered five stars and been a more satisfactory length as well.

Our hero has a dream, and has had it since he was 15: to work and save enough to finally move somewhere cheap enough to live out the rest of his life without having to work anymore. He marries someone allegedly simpatico, but who manages to find a reason to nix every destination that they explore as a possible retirement grounds. Having had enough delay, he decides at around age 50 to buy the tickets unilaterally and lay down the ultimatum that he is finally going, to Pemba, an island off the coast of Tanzania, very much hopefully with her, but with or without her. And she in turn lays down the bombshell that he can't go, because she's been diagnosed with mesothelioma, and she's going to need his health insurance.

Shep loves his wife, and thus do his plans immediately invert. For the next year plus, it's all about trying to keep Glynnis alive and get her well. And each chapter begins with a statement of the balance of his life savings, which falls surely, immediately, and then precipitously, eventually to near nothing.

There's a side plot about his friend. I won't summarize that plot or any more of this one... What is wonderful about Lionel Shriver is that she writes about people like me and situations I know. Her characters are in my demographic. These live in Westchester. They have sometimes unspeakable feelings that I have too. Nobody really talks about the expense of end-of-life, and how that expense feels to those who have to undertake it, and how it feels to know you aren't supposed to feel ANYTHING about money when someone's life is at stake, even if the prognosis is hopeless.

Shep really does love his wife, but he's not unfeeling about the fact that the means to fulfill his life's dream is dribbling and then pouring away into her probably futile treatments; and the tragic fact is that he is destined to outlive her, and might still want to pursue his dream.

Oh, and then there's his aging father and guilt-trip-laying sister. Yes, these books are really about people like me and situations I know.

It's all very real and not something you usually read a novel about. And the ending is FANTASTIC. ( )