Shep Knacker’s surname is British slang for testicle, but will he have the balls to resist financially ruinous U.S. medical practices?
So Much for That. By Lionel Shriver. HarperCollins, 436 pp., $25.99.
By Janice Harayda
Knacker, the surname of the hero of So Much for That, is British slang for testicle. Lionel Shriver is an American who lives in London, so it’s safe to assume she knows this. It’s also safe to assume that a man named Shepherd Knacker has symbolic weight, or stands for more than what he is: a 48-year-old married father of two and a home repairman who has spent his adult life saving for an escapist retirement.
Whom does Shep represent? Try this: The good Shepherd does carpentry and anticipates redemption in what he calls an “Afterlife.” Still stumped? Shep has a wife named Glynis, which means “holy,” and a best friend named Jackson, a variation on John. He’s the son of a Gabriel Knacker, a Presbyterian minister, and has a psychological resurrection after persecution by his boss. His story involves significant fish, water and palm imagery.
Okay, we can see a few religious parallels here. But Shep isn’t a Jesus figure in the usual sense, a charismatic leader whom others worship. He’s far too low-keyed and accommodating. Nor is this book about Christianity. Quite the opposite: It’s a novel about an America in which people entrust their lives not to Jesus but to a broken health care system that betrays even those who can afford to use it.
For years Shep has been a good and faithful servant of mammon, a man who built a home-repair business that he sold for a million dollars. He planned to use to the cash to underwrite his retirement on a palmy island off the coast of Africa. But his wife learns that she has mesothelioma on the day he announces that, with or without her, he’s leaving his job and country to begin his Afterlife on Pemba. Suddenly Shep can’t leave his company or country because Glynis needs his medical insurance, and if he doubts it, he needs only to look at his friend Jackson’s daughter, who has a ravaging degenerative disease.
This jury-rigged opening is the first of several plot contrivances that are less believable than the withering assault on U.S. health care delivered by So Much for That. After years of writing for the Economist and the Guardian, Shriver may be America’s best reporter-novelist now that Tom Wolfe has entered his lifetime-achievement-award years. She’s unafraid of research. This has allowed her to gather the details needed to skewer plausibly a raft of medical indignities: the dubious procedures such as penis-enlargement surgery, the so-called “Medicare spend-down” that requires the elderly to use up their assets before the government will pay for a nursing home, the gung-ho doctors who bombard the dying with unproven treatments that won’t save them and at best will prolong their lives briefly and torturously.
Shep has a natural wariness of the physicians’ impulses toward overkill and feels like “a religious skeptic” when Glynis’s internist refers her to Philip Goldman, a world-class, out-of-network expert on her rare peritoneal mesothelioma. But Shep tries to buy into the medical tent-revivalism when he sees how much it means to his wife: “Since the internist produced more tangible redemption than either Gabe Knacker’s traditional Presbyterianism or [his sister-in-law] Deb’s barmy born-again sect in Tucson, it was time to convert. To become a loyal, tithing parishoner of Philip Goldman’s church.”
For all his doubts, Shep looks like a saint next to the friends and relatives who, in their ignorance or egocentrism, add to his wife’s pain. Glynis is in the hospital after debulking surgery when her born-again sister Deb tries to convert her with a condescending variation on Pascal’s wager: “Like, if a lottery is free, why not grab a ticket? All your teachers said you were so smart.” Glynis resists, and Deb blunders on by telling her sister that at least her asbestos-related cancer made her thin. “Yeah, right,” Glynis says. “The Mesothelioma Diet. The book’s not out yet, but you could still get a head start by chewing on some old insulation.”
Much of this is heavy-handed, an inelegant cross between a protest novel and domestic fiction about a family tested by illness. So Much for That is issue-driven, and some of its characters emerge as vehicles for ideas, or embodiments of arguments made by Susan Sontag and Barbara Ehrenreich about the language of cancer, more than as credible people. Shriver tends to spell her messages in neon: Her book has three medical subplots when two might have made her point.
But Shriver has a moral fearlessness rare among novelists. Health care is one of the three great issues in America today, along with war and the economy, and she wrestles with it perhaps more ambitiously than any fiction writer of her generation. And if she is a polemicist, she can deliver subtle blows. Consider the surname of one of Glynis’s doctors: Knox. In context the name appears to nod to the fiery – and, some say, pernicious – founder of the Scottish Presbyterianism. It also suggests Fort Knox, the U.S. gold Bullion Depository. With one word, Shriver suggests the essence of her novel: a tale of the intersection of money and a misguided belief in the godlike abilities of doctors.
So Much for That isn’t a plea for people to trust in Jesus instead of health-care providers. Shriver has said that she deplores all religions, and nothing in her book suggests otherwise. In this novel she tells us that you are saved neither by God nor by doctors who play Him. You are saved by reason, or pursuing your own vision of a good life. In America, money helps. But you can choose to live elsewhere. Will Shep have the balls to make that choice? Suffice to say that if he often disagrees with his wife, he has something of the spirit she shows when she complains that nobody ever put on a gravestone: “Here Lies, etc., She Swiffered the Kitchen Floor.”
Best line: Glynis rages against the saccharine, kid-glove treatment she gets from family and friends after she develops cancer: “I feel as if I’m trapped in a Top Forty by the Carpenters.”
Worst line: “‘Ipso facto!’ Shep chuckled.”
Editor: Gail Winston
Published: March 2010
Reading group guide: A Totally Unauthorized Reading Group Guide to So Much for That appeared on this site on Nov. 26, 2010, in the post just before this one.
Furthermore: So Much for That was shortlisted for the 2010 National Book Award for fiction. You may also want to read the comments Mark Athitakis made about the novel on his American Fiction Notes blog on Jan. 11, 2010, and on March 14, 2010.
Janice Harayda was the book columnist for Glamour and the book editor of the Plain Dealer in Cleveland. You can also follow Jan (@janiceharayda) on Twitter at www.twitter.com/janiceharayda.
© 2010 Janice Harayda. All rights reserved.