Lionel Shriver has written a very grown-up story that deals with serious subjects in a serious way. Shepherd Knacker has been saving all his life for what he calls the “Afterlife,” retirement to some sort of desert isle, away from the world in which he must work in order to finance his dream. But his plans hit a snag when his wife, Glynis, is diagnosed with a particularly virulent strain of cancer. His best friend, Jackson, has a teenage child with a rare genetic disease and the clear prospect of an early death. Faced with the titanic cost of medical care, both men face potential financial ruin, even with insurance. What is the cost of clinging to fading hope? What are the limits of what should be done to preserve human life? When is it ok to say “enough already?” Lest one think this is a one-sided perspective, there are strong arguments made for varying points of view in the medical insurance debacle that persists in today’s USA.
Shriver looks at these questions through the lens of the characters’ relationships. How do the stresses both families' experience affect them? Does such terror strengthen a couple’s love or crush it? Is it the right thing to do to surrender a lifelong dream just to gain what may turn out to be only little extra time for someone who is likely to die anyway?
There is plenty here about family dynamics, who gives and who takes, who really cares about others and who is only looking out for number one. It says a lot about relationships outside the family as well. How can Shep and Jackson be best friends when there is so much left unsaid between them? How do friends really act when you are in crisis? Who can you count on? There are some workplace scenes that offered a bit of dark comic relief, reflecting some of the madness one must endure in order to survive.
One of the most interesting elements of the book for me was Shriver’s depiction of both Glynis’ and the adolescent, Flicka’s, ways of coping with their burdens.
I confess that as a long-time resident of both Park Slope and Windsor Terrace, where much of the story is set, I enjoyed the local geographic elements. And I recognized in some of the characters, aspects of common Park Slope views that were far too familiar. I can also relate personally to some elements of Shep’s struggle. It enhanced my appreciation.
This is a terrific book, engaging, content-rich, timely. While I do not think it rises to the level of great literature, it is a must-read for anyone interested in the health care debate, or anyone who likes very good contemporary fiction.