So Much For That - Lionel Shriver

So Much For That is an extremely timely and topical novel to be reading at the moment with so much discussion and change occurring within the health systems both within the USA and Australia. As both a consumer and an employee of the health system in Australia I am keen to dissect these debates further so whilst So Much For That is set within the American system I find it offered some interesting and relevant points for our own current, and possible future, health care system.

Shriver has produced a very blunt and "in your face" narrative with this book. One of the main male characters, Shep Knacker, has reached middle age and his dreams of leaving his middle class existence in New York and moving to a Developing African Island to live out his days are about to come true. He has talked and dreamt and planned of this "After Life" and it is now about to finally come true. Except for one thing, Shep's wife Glynis has just announced she has been diagnosed with a very aggressive type of cancer. Shep and Glynis aren't going anywhere and the course of the novel follows as Glynis's treatment increases and the family bank balance decreases. Sounds like a fun ride doesn't it?? It is a gloomy book in many respects but I thought Shriver did well to balance the real human emotion of facing a terminal illness with the concrete practicalities of searching out treatments that might work and subsequently fighting medical insurance companies to have these treatments paid for. What I thought didn't work so well was the inclusion of Shep's best friend, Jackson whose family is struggling with their own medical issues in the form of their 16 year old daughter who has a very rare degenerative disease. The stories did compliment each other in many ways but for the most part I just felt overloaded as a reader trying to take in two such serious story lines in one gulp.

I am a huge fan of Shriver's writing and her outspoken personality (I am hoping to be able to hear her speak in person at the upcoming Sydney Writer's Festival) and she hasn't let me down with this book. The ending gave me a couple of problems but overall So Much For That is tough, thought provoking, extremely well researched and provocative - just what I want from a Shriver book!