Preaching to the choir

In So Much for That, Lionel Shriver has drawn a painfully honest portrayal of an American family sinking under the financial and emotional burdens of illness. Shepherd Knacker, who lived frugally all his life so that one day he could chuck his job and live close to nature, finds out his wife, Glynis, has mesothelioma. That means they can’t survive without the health coverage his job gives him. During a year’s painful and futile medical treatment, Shep realises that no matter how much he has paid in taxes and insurance premiums during a long working life, he will get little in return.

The cost of health care is the big issue in Shriver’s novel, and every character is sucked into it. Shep’s friend Jackson has a daughter with a congenital, fatal disorder that involves heavy daily expenses only partly covered by health insurance. That doesn’t stop him from finding a quack to perform an (uninsured) elective surgery to enlarge his, well, let’s call it “confidence”. He comes down with an infection and sends more money down the tubes, along with his marriage. Meanwhile, Shep’s aged father falls down the stairs and must be treated for months in a nursing home. In the United States, Medicare is supposed to meet the health expenses of the elderly, but there are huge gaps in the coverage, as Shep discovers.

Shriver’s story rests on this tripod of medical histories. She chalks out exactly what happens, body and mind, to a woman with malignant cancer. Glynis does not find deep philosophical lessons in the face of her mortality and inspire those around her. No, she becomes whinier and more self-centred, more hostile to her husband, more contemptuous of her friends and professional rivals.

Shep’s father, an upright and self-reliant minister, should not have to suffer what he does, certainly. But we are hard put to understand how Shep allows his parasitic sister to appropriate their father’s house while she refuses to care for her father in any way. Jackson, who rants full-time about his life, his problems, his government, is impossible to sympathise with. He digs himself into a deeper fiscal hole by gambling on dog races and buying compulsively. It’s a relief to see him go before he destroys his family.

Shriver must show her characters warts and all because they are mostly warts, but she seems strangely fond of Shep, who subsidises his sister, his grown daughter and his in-laws in addition to his own endless responsibilities. If I showed up on his doorstep, no doubt he’d pay my cab fare as well. Yet, while his wife is dying, he always has his eye on the meter, wondering when his dream fund will dry up.

Artistic consistency would demand, in this frank novel, that he go back to fixing leaky faucets for a living. So Shep’s eleventh-hour reprieve rings more hollow than if Shriver had waltzed us through la-la land from the beginning.

Still, a reviewer ought to repay her overall honesty in kind. Here goes. Shriver’s writing is dull and long-winded. This is her ninth novel and she perhaps plans in future novels to cover every major issue of our time. Granted, she wrote her story when Obama’s hard-won health care reforms were in danger of being derailed by a cabal of pharmaceutical and insurance companies and the politicians they employ. The writer has put a face on the various ways in which laws and private enterprise let sick people down.

But that cabal is unlikely to be reading this paperback and Shriver is preaching to the choir. After 500 pages, we the choir are tired of being shouted at.

Plenty of journalists turn reportage into powerful fiction. Shriver is not one of them. And yet she smugly declares in an afterword that her work is not a drag.

After all that truth-telling, a bare-faced lie. Next, let’s have a story about how a numbers-driven publishing industry has created a wave of self-attested masterpieces and bloated egos. But maybe that’s not a story Shriver would write.