So Much For That by Lionel Shriver, 2010, * * * *

In So Much for That, Lionel Shriver tackles large subjects — marriage, illness, and the failure of the American healthcare system — and dissects them with her astute and critical insights.  Since selling his handyman home repair business and netting over $700,000, Shep Knacker has fantasized about what he calls “The Afterlife”  - taking his family off to a faraway, third world country, where his savings will last them forever and they can lead the good life. This dream is shattered when his wife is diagnosed with cancer.   Lionel Shriver recounts the intertwined stories of several characters suffering from serious medical conditions  and, in the process, creates a harrowing picture of the fallout that the current health care and insurance system can have on middle-class people struggling to care for their families. There is one farcical plot development that is poorly woven into the emotional fabric of the story, but Ms. Shriver's understanding of her characters is so intimate and unsentimental that it lofts the novel over such bumpy passages.   She turns her schematic outline into a visceral and deeply affecting story, a story about how illness affects people’s relationships, and how their efforts to grapple with mortality reshapes the arcs of their lives.