Book Review: So Much for That by Lionel Shriver

photo 2This is another book that has come to me by way of my book club.  You can see by its slighlty battered appearance that it has been well read and come to me via the hands of many others.

This is the first book I have read by Lionel Shriver.  I have studiously avoided ‘We Need To Talk About Kevin’  althoughI have had my eye on her latest novel ‘Big Brother’ for a while now.

This is the story of Shep, his wife Glynis and their slightly peculiar friends and family. Shep has been saving his whole life for the ‘after life’, his escape from the New York rat race. Just before he is about to leave with or without Glynis, she drops a bombshell. She has mesothelioma a rare and as it turns out expensive cancer. Suddenly the small fortune he accumulated for his afterlife is needed for other things, namely Glynis’s medical bills. What follows is a combination of political commentary, and a witty, no nonsense analysis of the effect of deteriorating health on relationships.

This is a meaty tome but 50 pages into the 531 and I was hooked. One of the particularly striking and important things for me is that the story is told from Sheps perspective. Glynis has the cancer but Shep her husband, very soon to become her fulltime carer lives with that cancer too.   Glynis body and mind is consumed with cancer. Shep is consumed with feeding, protecting, nurturing, cajoling and caring for that body and mind. The role of carer is such a valuable one, and one that even in our free healthcare system is largely undervalued. I loved how Shep changed and grew into the man I think he had always felt destined to become as a result of this.

I loved that this novel isn’t cosy, and the characters aren’t cutesy. Cancer is neither cosy or cutesy. From what I know of Shriver’s writing I understand this to be characteristic. Few of the characters have many endearing features, with Glynis being a particular tricky customer. For the most part Glynis is a monster, albeit a spirited one. We learn that she has always been feisty and even spiteful and the diagnosis of mesothelioma seems to have made her more so.

“Glynis didn’t look insidiously satisfied; she looked delighted. Ever since her diagnosis, she’s seemed to relish anyone else’s misfortune”

The novel is realistic and unsentimental and I think all the better for it.

“ ‘you look fantastic’ Jackson cried. She said thanks with girlish shyness but he had lied. It was the first of many lies to come….”

This book is about cancer, living with it, dying with it and paying for it; emotionally, physically and financially.   The majority of my nursing career has been spent working as an oncology and palliative care nurse. The intricacies of cancer and it’s treatment is something I feel I know quite well. It became clear to me early on that it’s something Lionel Shriver knows pretty well too. The descriptions of going through chemotherapy, medical procedures and the often horrific after effects are base and at times gruesome, but also I am sure, realistic.

At one point Glynis hads been told she could possibly take part in a clinical trial, with a drug that hadn’t been used for Mesothelioma but might help her. At this point Shep finally confronts her.

….all this talk in the hospital of ‘fighting,’ and ‘beating’, and winning’……..But it’s not a contest. Cancer is not a ‘battle’. Getting sicker is not a sign of weakness. And dying…..is not defeat”

I almost punched the air when I read this (not something I am accustomed to doing) but it is exactly what I believe. I know it is only my opinion and for some people treating cancer as a battle is helpful. However I know that for many others it’s not that at all. Cancer is what it is and it is something to be got through and lived with. For me that feels a healthier more realistic way of managing cancer. Treating Cancer as a battle to be fought and won has the potential to induce guilt, when that so-called battle is inevitably being lost.

I love that towards the end Shep, Glenys and their extended tribe were able to do what most of us would only talk about doing. They took the creativity that is involved in managing cancer and death to a beautiful extreme.

This book has taught me. It has made me question the daily conversations I have with people facing cancer, treatment and death.  I wonder how glibly I have discussed ‘potential’ side effects of potent chemotherapy drugs and other treatments.  Treatments that rip you apart from the inside, sucking the lifeblood, making you unrecognisable to yourself and others. I am not for one moment saying chemotherapy is a bad thing, it absolutely isn’t. Despite all the above it can also be life-giving, sustaining and improving. I also know for many people it won’t feel like that whilst they are having it.

There is humor in this novel. I didn’t laugh out loud, but I certainly smiled out loud. It would be nigh on impossible to read this book without it provoking a response. I appreciate that because of my job my response may be a little more impassioned than some, but this book says so many good things about cancer, death and dying. All subjects that despite our liberal and open society we are still scared to discuss. This is certainly a book I will recommend to my colleagues who like me are involved daily in the business of cancer.

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