So much for that, by Lionel Shriver

Courtesy: HarperCollins Australia

Nine Minervans, including new member Sue (welcome, Sue), met a few Tuesdays ago to discuss Lionel Shriver's latest novel, So much for that. The book was not universally loved by all members which resulted in a lively - though always respectful of course - discussion.

But first, the plot. The book starts with 48-year-old nice-guy Shep Knacker planning to escape the American rat-race to his dreamed of, and as it turns out ironically named, AfterLife in Pemba off Zanzibar. However, his plans are overturned by his wife’s announcement that she has a rare aggressive cancer called peritoneal mesothelioma and will need him to continue working, for his health insurance. Alongside Shep and Glynis’ experience of health service and insurance – and told in roughly alternating chapters – is that of their good friends Jackson and Carol whose 16-year-old daughter, Flicka, was born with the degenerative disease, familial dysautonomia. Two more health issues are added later in the book: Shep's father has a fall and needs to enter a nursing home, and Jackson undergoes some, let's call it, male "cosmetic" surgery which doesn't quite go according to plan. The novel plays these situations, economically, socially and psychologically to their relatively inevitable conclusions.

All this does make it sound a little contrived, which was one of the criticisms of the novel. Another criticism, somewhat related to this, was that it's a little too polemical. Some felt Shep was too good to believe. And some thought the ending was a cop-out which undermined the polemics. Then, of course, there were those who disagreed with these criticisms and who thought that the polemical aspect was balanced by her addressing other concerns such as the psychology of terminal illness, the language of health, and the implications of the American dream (or rat-race) from which Shep, for one, wished to escape.

Oh, and there were some things we all liked - such as the scene in which Shep and his free-loading sister discuss their father's post-operative care, and the clever title.

Not surprisingly with a book like this, discussion roamed beyond the book into Australia's health system and fears that it is slowly declining into something more American-like, particularly regarding things like funding and equity of access. We also talked about such issues as over-servicing or unnecessary servicing. Who makes the decision when, for example, tests are really needed and should be done, when treatment is no longer worthwhile and how do we define worthwhile?

This is a pretty superficial report of our discussion, but my excuse is that it was a while ago now. Comments elaborating on these - or anything I've missed are most welcome from those who were there and those who weren't.

Quote of the night: Celeste told us that after having an MRI some years ago she thought "I was relieved to find I had a brain". What a shame she had to go through an MRI to discover that. We've known for a long time that she has one! She only had to ask.