By Bruce Jacobs

“So Much for That”
By Lionel Shriver
Harper ($25.99, 433 pp.)

Who doesn’t dream of retiring with a million dollar IRA and then moving to some island where the living is cheap, the air smells of spices, and the sun always shines? Shepherd Knacker has it all planned out in the opening of Lionel Shriver’s new novel “So Much for That”. His airline tickets are in hand and bags packed. All he has to do is convince his wife and son to go along; and if they won’t…well, he is prepared to go it alone.

For thirty years he has lived frugally while his Brooklyn handyman company, “Knack of all Trades,” put the gentrifying houses of Prospect Park back together. When he sells the company at age fifty, he has his million dollar nut locked in a conservative Merrill Lynch account. He is well-prepared to leave his rental house in Westchester filled with the stuff of a modest American life and the short term job he took with his company’s buyer in order to keep his health insurance.

Knacker’s wife Glynis is distracted when he confronts her with his pitch for a hasty departure to the island of Pemba off the Tanzania coast. “I can’t keep sitting in traffic listening to NPR on the West Side Highway,” he says. “I must have forty different ‘passwords’ for banking and telephone and credit card and internet accounts, and forty different account numbers, and you add them all up and that’s our lives.” But his wife has a surprise of her own: her doctors have just confirmed that she is in the advanced stages of mesothelioma, a rare and lethal cancer, and will begin a long and painful course of chemotherapy the following week.

For the next 400 pages, Shriver drags us through the painful details of what happens to an ordinary guy when one piece of serious bad luck after another strike. The tickets to Pemba go in the trash. Instead Shep begins the tiresome duties of hospital appointments, doctor consultations, growing isolation from friends and family, and, of course, the endless check-writing, hassles with insurance companies, and applications for special experimental treatments.

Within months, Shep’s life falls off a cliff. He knows that “in relation to Glynis, there was nothing to look forward to. Nothing. While friends would never have described Shep Knacker as irksomely sunny, his view of life did fall on the optimistic side, or so he thought until forced to contemplate a future where not a single cheerful event lay on the horizon.” And that is only the situation with his wife.

His father falls downstairs at home and must be moved to a private nursing home where he contracts a nasty infection common to nursing homes. It shows no sign of healing as he slides downhill. Not poor enough for public nursing homes, his father’s bills now run to $8000 a month – which, of course, Shep pays.

His deadbeat and self-centered sister loses her illegal rent-controlled sublet in Manhattan; so, of course, he lets her move into their father’s house which otherwise might have been sold to help pay his monthly bills.

His best friend and handyman colleague goes into deep debt on a whimsical penis enlargement surgery which he hoped would save his marriage. The surgery is botched, his genitals are deformed and unworkable, and only more uninsured surgery might restore them…he takes a kitchen cleaver to his penis and then blows his brains out. Shep, of course, takes in his friend’s wife and daughters (one with a rare lifelong congenital disease that will kill her before age fifteen and the other suffering depression likely due to her obesity).

It’s hard not to be reminded of Elvis’s version of Red Foley’s “Old Shep,” for surely if there is a heaven, “there’s one thing I know, Old Shep has a wonderful home.” With the load Shriver puts on his back, Shep Knacker makes those of us who whine about the flu and the lousy stock market look like pikers. The guy should have gone to Pemba while he could.

Early reviews of “So Much for That” have praised Shriver’s novel for its unflinching look at our health care crisis. (Shep’s fall is carefully measured out with chapter headers that list the falling balance of his Merrill Lynch account.) Shriver dramatically illustrates insurance companies from hell, co-pays on everything (“You’re out five grand before you’re reimbursed a dime”), co-insurance on top of co-pays that amount to twenty percent of the total bill, “(“and that’s in network”) that peg doctor re-imbursements to the cost of a housecall in 1959 “and stick you with the shortfall.”

“According to my calculations, Glynis’s medical bills for all these treatments already come to over two million dollars. So what exactly did we buy? How much time?” he asks. Her doctor answers: “Oh, I bet we’ve probably extended her life a good three months.” He stares him right back: “No, I’m sorry, Dr. Goldman, they were not a good three months.”

As sharp as the health care criticisms are, they are only a part of Shriver’s bigger picture of life’s often unpredictable batterings. Even if every dime of every medical calamity in the novel were 100% paid by insurance or the State, the devastation to Shep’s life and well-being would have been nearly the same. There is nothing pretty about what can happen to any of us when our daily lives, simple plans, and modest dreams are turned upside down by compounding bad luck. Shep’s persistence in doing what’s required rises to the level of heroic as he continues to wipe his wife’s butt, fix dinners she doesn’t eat, deal with his children’s indifference, visit his weakening father, and on and on . . . all while his dream of a happy island retirement goes down the toilet.

Shriver has such sympathy for her beleaguered hero that she can’t let her novel end on a hopeless note. Shep and his fractured family finally do get to Pemba, although their arrival is less a triumph than a slight uptick of good fortune. Shep Knacker had realized his dream. “For years people had warned him that there was no escape…He would get bored. He would get lonely. He would crave company of his own kind…They were full of shit. It was great.”

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