So Much for That

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 show more 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. show less

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 show more 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. show less

Shep Knacker has a dream. As a one-time business owner who has sold out for a million dollars, he now works a regular job, biding his time. Shep has been stashing away his fortune with the intent of fleeing to a tropical paradise to spend the rest of his days, which he calls The Afterlife. But when he decides to go there immediately, with or without his wife Glynis (her choice), he gets the surprise of a lifetime. Glynis announces that she has mesothelioma, an aggressive form of cancer, and that Shep’s money would be best applied somewhere else. As Shep deals with his incredibly ill wife, he finds out that his health care plan is really very paltry, and he must use his getaway fortune on the very expensive rounds of treatment his wife show more requires. Meanwhile, Jackson Burdina, Shep’s best friend and one-time business partner, is having problems of his own. Jackson has a teenage daughter who is afflicted by familial dysautonomia, a debilitating and progressive disease that’s slowly spiraling out of control. Jackson, a very unhappy man, is fond of regaling friends and even strangers with his ranting and raving about the political, social and economic problems in America, and his radical views begin to infect every conversation he has. Between the Knacker and the Burdina families, many ethical and intriguing issues are raised; not only about the characters and their plights, but about the plight of any one of us who may fall critically ill. In Shriver’s dark yet very recognizable world, the persistent struggle of the working class is wonderfully and mischievously elucidated, forming a story of painful beauty and unending strife.

I have to say that after reading We Need to Talk About Kevin a few months ago, Shriver has been on my list of authors to watch, and I’ve been very interested in reading her back list. When the review offer came from TLC Books, I didn’t hesitate for a moment, because although Shriver’s writing is as dark as it comes, it’s also incredibly penetrating and full of contradictions that leave her readers questioning not only the material, but themselves as well.

There’s no doubt that Shep Knacker is downtrodden. Even before Glynis’ announcement, Shep is the kind of guy who is forever taken advantage of, both emotionally and, more importantly, financially within the scope of the relationships he has. Though he loves his wife, the reader is given to understand that she’s a rather cynical and caustic woman, whom Shep always plays second fiddle to. Though Shep has a great fortune at his disposal, he continues to work for the man who bought his company and is treated like a serf by the passive aggressive man who he must now call his boss. Shep is what his friend Jackson would refer to as a chump, and though he longs to escape from his burdensome life, the announcement that Glynis has cancer puts Shep in a strange place. He immediately lets go of his desire to travel and feels that it’s important to do whatever it takes to make her well. What it entails, in fact, is eating away his nest egg and dredging the bottom of his financial pool of resources. But it’s not like he has any other choice, and once I began to understand just the type of guy Shep was (solid, dependable, morally upstanding) I knew there was no other way he would respond. Shep is the everyman who will do anything for his friends or family, and it was very sad to see his dreams wash away once Glynis’ condition came to light. The fact that he chose to stay and fight was only one of the things that made me admire him.

More interesting to me was the secondary plot that involved Jackson and his family. From my perspective, they were living in a nightmare world of feeding tubes, medication upon medication, and a surly attitude that all revolved around his ailing daughter. While I was reading about all of this, I kept asking myself questions about Jackson’s attitude and radical leanings. Was his daughter’s illness and the lengths they had to go to keep it under control the impetus for his ire, or was it all incidental? Secretly, I believed Jackson loved his daughter’s moroseness because it mirrored his own, but there was no doubt that the girl needed therapy. In addition, Jackson is dealing with a troubled marriage, and although it was troubled in a way that was very different than what the Knackers had going on, it was troubled nonetheless. The final resolution for Jackson left me very upset and shocked, and I couldn't help but expend a lot of thought and sympathy over his plight.

The one thing that bothered me about this book was its relentless push of the issues it discusses. Mostly it centered on the state of health care in America, and in that rushing maelstrom, Terry Shaivo, Medicare, insurance companies and the government all made their wicked appearance. This issue-spouting mostly came from Jackson’s rants, but it was littered throughout the book, and at times felt indiscriminate and overbearing. I get that Shriver has some problems with the American health care system and with the government, really I do, but this non-stop approach of bombarding the reader with it wore very thin after awhile. She takes her opinions on “mugs” and “moochers” very seriously. So seriously, in fact, that I think it weighed down what would have otherwise been a five star book. Thinking back on it, Shriver makes some very good points, but by using Jackson as her mouthpiece, it all felt very aggressive and at times even whiny. This non-stop rant spoiled parts of the book for me, but after awhile, I was able to view it as a character with a predisposition for griping, and finally, I was able to read around it.

While this book was very heavy on the issues, the story it told was rather poignant and also very interesting to read. Shriver’s ability to capture her audience early on and hold them by the throat all the way through is not only impressive, but also unusually stimulating. She knows how to tell a hell of a story, and though it’s dark and very portentous, it kept me hooked into the narrative despite some slight misgivings. I was also surprised by the ending. I would recommend this to fans of Shriver and also to new readers because the book really gets to the heart of its characters and their motivations with unusual flair. Though parts of the book were morose, the execution of the story was really quite amazing. A fabulous read with a little gristle that may offend but will surely entertain. show less

I laughed out loud at times, but I wouldn't tag this book as humour. It's mostly dark and sad. In fact, I'd say it's a realistic perspective on what it's like to find out that your wife has mesothelioma: It's terrible. Despite all the money and energy you put into 'fighting' the disease it still kills you - and it's not at all a peaceful death. Actually, although many will see this as primarily a book about the American health care system and its financial burden, I saw it as very much a story about the idea of 'fighting' against illness and disease. Is this some noble process in which your effort and virtue are rewarded by restoration to good health? or is it as useless as fighting the weather? Two characters in this novel deal with show more their terminal diseases in quite different ways and the reader is challenged to think about what really is the most appropriate response. Further, we see different perspectives on American society as a whole - of which the health care system and its treatment of participants is perhaps an archetype. I reckon Shriver is a very perceptive observer of the human condition and I've enjoyed all her work I've read so far. show less

I find it difficult to discuss this book properly without revealing much of the plot, so take this as a serious SPOILER ALERT.

From the viewpoint of a former employee and occasional user of the UK National Health Service this book displays in awful detail just how dangerous is US healthcare - not because it is bad but because it is capricious. Sick people, either rich enough to afford their own insurance premiums or having a secure job with a responsible employer, get high quality, technically advanced medical treatment. Those lacking these advantages risk financial ruin or inadeqate treatment if they are unlucky enough to get a chronic or terminal illness. The situation is worsening, as Shriver demonstrates, because of extraordinarily show more expensive new therapies coupled with the idea that absolutely anything that can be done to delay death should be done. Shep goes along with the idea that you can't put a monetary value on life for most of the book but finally manages to confront his wife's oncologist with the reality that he hasn't got the hundred thousand dollars needed for the new and untested drug that, the doctor eventually admits, has a "distant" chance of helping her. Shep takes the doctor to task for using the militaristic vocabulary to which we have all become accustomed - the battle against cancer, the arsenal of therapies, the struggle with the disease - and points out the unfortunate consequence that "losing the fight" may then be seen as some sort of failure on the patient's part.

As if Shep's wife's illness wasn't enough, he is also faced with the financial burden of his aged father's leg fracture. Unable to be cared for at home and with Shep's impecunious sister living in his house, the old man has to live in an expensive care home with endemic C. difficile. I don't understand Medicare and Medicaid but they are clearly not much use to Rev. Knacker and Shep is presented with the bills.

I am, perhaps, starting to sound like the book's other main protagonist, Jackson Burdina, whose rantings have rather put off other reviewers. I have known people like Jackson: he is not a whiner but he enjoys going on and on about life's problems. He risks becoming boring, but his analysis does not have too much wrong with it. He is also a victim of disease and medical interventions. His daughter suffers from a rare and incapacitating familial disease and he has had penile enhancement surgery which has gone wrong. His wife is tied to a disagreeable job by the need to have adequate health insurance for their daughter and he is maxing out his credit cards to meet his own bills. Despite all his inconsequential grumbling, he proves to be a true pragmatist at the end: Shriver gives the reader one of the most wince-inducing scenes I have ever come across.

Other reviewers have suggested that Shep seems wimpy and lacking in backbone: I did not see him in that way. He is a man with a vision of what life should be about and sees himself as a self-sufficient individual with unduckable family responsibilities. His wife, Glynis, is a strong character, flawed by her inability to come to terms with the limitations of her not inconsiderable talents, but standing up in an admirably self-centred way to the awfulness of her disease. The other important and well defined character is Jackson's daughter, Flicka. She is another strong female, mature beyond her years, realistic and unforgiving both in relation to her affliction and her parents' emotions. Self-sufficiency is obviously an important characteristic for Shriver.

Most of the other characters are not particularly well-developed, mainly being there to support another important theme in the book, what Norbert Elias described as the Loneliness of the Dying. In various ways friends and relatives of Glynis separate themselves from her after their initial sympathy, for the most part apparently unable to find something more to say. Shep is sustained and kept engaged by his love for her. Jackson sensibly stays in character and goes on with his rants, and Flicka relates to her in a very equal way, facilitated by her own poor prognosis. Shep's ex-pastor father, who obviously spent much of his working life comforting the dying, is unable to help much because his own ageing has been accompanied by a loss of faith. Shep's sister is worth a mention - a creature of mind-boggling self-centredness and insensitvity.

The 'with-a-single-bound -he-was-free' ending comes as light relief in the final two chapters. Having restored his bank balance (usefully noted at the beginning of each chapter of the book) by getting Glynis to lie about her exposure to asbestos, Shep achieves his dream of a relaxed life in a poor but friendly country in the process providing exemplary palliative care for Glynis, resolving the difficulties that had arisen with their own children, managing Flicka's final months very satisfactorily and giving his father a new lease of life (without C. diff.). It was not what the rest of the book had prepared us for and really didn't fit, but the elevation of mood was very welcome.

A more entertaining book that a brief synopsis might suggest, well crafted by a worthwhile author, it deserves four stars. show less

When I commenced reading this book I wondered whether it was a wise choice as I have an old school friend losing the battle with cancer. For many this would seem a grim, uncomfortable read but the skill of this author is that yes she takes us inside the lives of Shep and Glynis Knacker as they are confronted with the devastating news and change of life plans.
In fact, for Shep, who announces to his wife that he has bought one-way tickets to the island of Pemba, for them to begin an alternative life, the news is twice as shocking. His nest egg that he has accumulated by hard work and thrift, to buy a simple life in a Third World country is about to be eroded by the exorbitant medical costs of trying to cure his wife of a terminal show more illness, despite health insurance.
This is a challenging and serious look at a modern day problem and the ethics of maintaining life no matter what the cost.
The character portrayals of Shep and Glynis and of their close friends Jackson and Carol, whose daughter was born with a rare debilitating illness, are powerfully portrayed. At no point did the rendering of this tale reduce this reader to tears, unusual given the topic, but it did give me an uncomfortable, soul searching, thought provoking but nonetheless page turning read. With deftness, the author even manages an uplifting ending. show less

So Much For That by Lionel Shriver will win awards this year. It has to. If it doesn’t, a black hole of injustice will open and swallow the universe, and we can’t let that happen.

Ever since Shepherd Armstrong Knacker was a young man, he planned to take an early retirement to a third world country where he could live the rest of his life happily on five dollars a day. He calls this dream “the Afterlife.” He has worked hard all his life to make that dream happen. He started his own company and sold it for a million dollars. He kept a management position in the company until he felt the family was in a position to move. He has denied himself simple pleasures, but anytime a family member or friend needed something, in particular show more money, he gave it willingly. He has always played by the rules.

When he feels it is time to go, to take what is left of his savings and make the Afterlife a reality, he tells his wife, who has written his dream off as goofy and somewhat pathetic, he has decided to go with or without her. He gives her the same spiel he has given her many times before:

"I know we’ve seen plenty of poverty—raw sewage running in gutters and mothers scavenging for mango peels. But they know what’s wrong with their lives, and they have a notion that with a few shillings or pesos or rupees in their pockets things could be better. There’s something especially terrible about being told over and over that you have the most wonderful life on earth and it doesn’t get any better and it’s still shit… I must have forty different ‘passwords’ for banking and telephone and credit cards and Internet accounts, and forty different account numbers, and you add them all up and that’s our lives. And it’s ugly, physically ugly. The strip malls in Elmsford, the K-Marts and Wal-Marts and Home Depots… all plastic and chrome with blaring, clashing colors, and everyone in a hurry, to do what?"

And then his wife tells him she has cancer. It turns out to be Mesothelioma. Shepherd does what he has always done. He sacrifices his own desires to take care of those who need him.

Shepherd’s wife, Glynis, was an artistic metalsmith, but she has paralyzed herself into inaction with her own exacting standards. She’s a difficult character to like for most of the book. Several times Shepherd compares her demeanor and soul to the very metal she used to work with. Shepherd notes, “Maybe you never really knew anyone until they were dying.” I imagine Shriver had to write Glynis this way to avoid the sentimentality and gushing sympathy the reader would feel for anyone nicer suffering so much. And she does suffer. Shriver depicts the treatments, the side effects, the exhaustion, all of it, in stark detail. This is not a sentimental book. It will not be a Lifetime movie.

Shepherd’s father needs to be put in a nursing home. His freeloading sister wants Shepherd to finance her lifestyle. Jackson, Shepherd’s loquacious best friend, rants about the government and basically calls Shepherd an idiot for not “sticking it to the man;” yet, Jackson has his own secrets and problems. As things progress, Shepherd’s savings account dissolves.

The book is about how our society and culture treat death and illness. How we talk around it, but never really about it. How we treat those who are terminally ill. It is also a look at a system with stringent rules, but if you play by them, you lose. It is a system where the nice guy really does finish last. It is probably important to note that the events in the book roughly take place between 2004 and 2006, before the Great Recession and ObamaCare. The politics discussed in the book are universal to our consumerist, self-obsessed culture regardless of what political party is in office.

I realize all of this sounds depressing. Fear not, Shriver doesn’t wallow in the gloom. It is really a very funny book, though sometimes it is the darkest of comedy given the situations. The characters and especially their inner dialogues drive the book, and ultimately the reader. You want to find out what happens to these people. Bottom line, you need to read this book. Buy it, borrow it, whatever—just read it. show less