Reading Lionel Shriver’s latest novel feels like being caught in the middle of a guerrilla war. Just when you think things have calmed down, you turn the page and – bang, bang, bang – Shriver’s scattergun rage blasts you down again. The target of that anger? The US healthcare system, a timely but unsexy subject, which Shriver admirably approaches head on.
Shep Knacker is a handyman dreaming of escape. He has scraped and saved, working in a job he hates, all to achieve his life’s ambition: retirement on a tropical island. His plans are stalled when he discovers his wife, Glynis, has cancer – and she’s going to need his medical insurance. He soon realises he’ll have to foot large chunks of the bills himself. The unravelling of the Knackers’ world is mirrored by the relationship of their best friends, Jackson and Carol, who are struggling to cope with their daughter’s debilitating genetic disorder.
This is warts-and-all middle-America family life, with all its banality, unpleasantness, shattered dreams and emotional cruelty – and it makes a powerful and provocative read. However, there is an iciness about Shriver’s dissection of her characters. Ultimately, the novel is saved by the author’s trademark acerbic wit, as well as rare moments of tenderness and a surprisingly moving ending.