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A Novel Tallies The Real Cost Of Health Care

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A Novel Tallies The Real Cost Of Health Care

Book Reviews

A Novel Tallies The Real Cost Of Health Care

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DAVE DAVIES, host:

Novelist Lionel Shriver says she got the idea for her latest novel, called "So Much For That," by watching a friend go through harrowing and expensive cancer treatments that ultimately didnt work.

Critic Maureen Corrigan says that Shriver's novel, by turns horrifying and hilarious, is just what the book doctor ordered.

MAUREEN CORRIGAN: My knee-jerk reaction to hearing a novel touted as topical is to think opportunistic. And most times my skepticism is justified. Novels on so-called topical subjects like terrorism and illegal immigrants often feel derivative, mere fictional shadows of the serious issues they aim to tackle. But then along comes a gifted novelist like Lionel Shriver, whose new book, "So Much For That," makes me shut my mouth, swallow my cynicism and respectfully acknowledge the dramatic depth that fiction can bring to current events.

Shriver's 2005 award-winning thriller, "We Need to Talk About Kevin," was inspired by the Columbine massacre. She reaches to the headlines again for this satirical novel, which is about the price - emotional and financial - of health care in America. Far from being rendered moot by the passage of the health care bill, Shriver's glinting novel of ideas about the lengths people will go to to avail themselves of advanced medical care is all the more topical now that more Americans have the chance to do so.

Shriver's hero here is a middle-aged everyman named Shep Knacker. For years, Shep ran his own successful handyman business in Brooklyn. He eventually sold it for a million dollars in order to fulfill his dream of what he playfully calls The Afterlife - early retirement in a Third World country. But Shep's wife, Glynis, a mostly self-employed artist, has been dragging her heels about this life change for the eight years, since the sale of the company. In order not to deplete their savings, Shep has been working as an employee for the oaf who bought his company.

When the novel opens, Shep has had it. He's just bought one-way tickets to the clove-scented island of Pemba, off the coast of Tanzania, and Glynis can make up her mind to join him or not. When Shep throws down the airline tickets on the kitchen table that night, however, Glynis has her own punch-in-the-gut announcement to make. She's been diagnosed with mesothelioma, a particularly virulent type of cancer associated with asbestos exposure. Shep can't quit his job, they'll be needing his employee health insurance.

What follows is a complex social satire that rips apart the machinery and the psychology of the American health care industry with much of the vigor, wit, and empathy that Dickens ladled on the law in "Bleak House." Inventive medical subplots abound. Shep's work partner has a young daughter who suffers from a genetic degenerative disease.

And Shep's own 80-year-old father, a mystery addict, was absorbed in a Walter Mosley novel when he fell down the stairs and broke his femur bone. Into the nursing home Dad goes. Shep's sister, an unemployed documentary filmmaker, had been living with the father and could conceivably care for him but, as Shep sourly reflects, his sister's immediate ministrations had quickly drained her wading pool of Clara Barton altruism and the cardboard bookcase of her character had already collapsed under the strain.

What's really striking here is the way Shriver's juiced-up language and droll social commentary never flag once throughout this long and deliciously involved novel. Every chapter contains brilliant riffs on, among other things, sex and sickness, the nitty-gritty of mopping up the bodily excretions of the sick, and the cocktail of drugs needed to counteract the side effects of chemotherapy, which then generate their own side effects, requiring another cocktail of different drugs, ad infinitum.

As the normally temperate Sheps investment portfolio sinks into bankruptcy in the effort to arrest Glynis's cancer, he delivers a rant to her oncologist about the medical fondness for relying on military metaphors when talking about cancer treatment:

Arsenal, struggle, Shep says, surmounting the odds. You make Glynis think that there's something she has to do to be a good soldier, a trooper. So if she deteriorates anyway, then there's something she didn't do, she didn't show courage under fire. After all this military talk she now equates dying with dishonor.

"So Much For That" elegantly tackles the twin questions that nobody is comfortable in asking about cutting-edge medical treatments of life-threatening illnesses: At what cost and to what end? None of us really wants to think about those questions, but it's illuminating, entertaining and horrifying to watch Shep go through the process.

DAVIES: Maureen Corrigan teaches literature at Georgetown University. She reviewed "So Much For That" by Lionel Shriver.

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For Terry Gross, I'm Dave Davies.

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