It is about the horror of cancer; it also describes the bureaucracy of the American health care system.
It’s Ambulance Chaser lit, as my friend A would say. She has a ghoulish interest in disease, has been known literally to follow ambulances and fire trucks, and is a godsend in that she actually enjoys visiting hospitals.
But this novel is more than illness lit: it is a small masterpiece, the tragic story of a young couple devastated by the crisis of leukemia.
From the beginning I was hooked by Bock’s quietly observant style. In the first chapter, the endearing heroine, Alice, who is a fashion designer, the mother of a newborn baby, a Buddhist, and a key lime pie junkie, is determined not to let her “cold” interfere with Thanksgiving plans to visit her mother in Vermont.
Bock’s description of Alice is vivid.
There she was, Alice Culvert, a little taller than most, her figure fuller than she would have liked. This brisk morning, the fourth Wednesday of November, Alice was making her way down West Thirteenth. Her infant was strapped to her chest; her backpack was overloaded and pulling at her shoulders. The Buddhist skull beads around her wrist kept a rattling time. She drank coffee from a paper cup. Sweat bubbled from her neck. Her scarf kept unraveling. She was rocking knee-high boots–sensuous leather, complicated buckles. Her gaze remained arrow straight, focused on some unseen goal. But she was slowing. A businessman only had a moment to avoid running into her. Alice bent over, coughing now, a coughing fit, bringing forth something phlegmy, bloody.
Oliver is not sure they should make the trip, but Alice insists. Her mother takes one look at her and calls the family doctor, who has known her all her life. The diagnosis leukemia: she has no white blood cells and a severely compromised immune system. She is immedieately hospitalized.
What happens to a marriage when one partner is diagnosed with cancer? Do they come closer together, as in a TV movie? No, that’s not the way it works.
The big business of cancer, both the barbarous treatment of the disease and the red tape of the health care bureaucracy, slowly cracks the marriage. After she is stabilized in a hospital in New Hampshire, she and Oliver go home to New York and must start all over with new doctors at a prestigious cancer clinic. They spend hours in what Alice calls “the blood cancer waiting room,”trying to distract an increasingly tired baby, because they couldn’t get a sitter. When they finally see the doctor and are asked for her medical history yet again, Alice is exasperated.
“I don’t mean to be difficult…But we seem to keep going over information your staff asked me ages ago.”
Eisenstatt tipped his forehead, the nineteenth-century gentleman conceding a thorny point. “It’s maddening . You’re going to get a lot of it. Standard medical procedure. We go over things repeatedly. this is our thinking: it’s possible you’ll remember something that deviates from what the nurse heard…. Each time a staff member or doctor hears your story, it gives us a chance to consult with one another, and hear everything fresh in our own ears. It’s an inconvenience for you, I know–“
And then there are the insurance problems. At the end of their first visit to the clinic, they are sent back to the business office because the cap of their insurance money is “only” $350,000. It turns out they’re going to need a lot more than that. Alice needs a bone marrow transplant. They have some time to get the money, because they have to find a match.
Alice is in for a long haul of hospitalizations, painful procedures, chemotherapy, nausea, surgery, and general agony. Oliver, a computer nerd with a small software development company, must put his life on hold and turn his work over to his colleagues while he spends the majority of every day organizing Alice’s care, babysitting, and haggling for an acceptable insurance plan.
This quietly powerful novel is semi-autobiographical: Bock’s wife, Diana Joy Colbert, was diagnosed with leukemia in 2009 and died in 2011 before their daughter’s third birthday.
But it is not straight autobiography. It is set in 1993, and the trajectory of the story differs slightly.
Some of the best parts of the novel are very clinical: Bock brilliantly captures the slowness of hospital routines, waiting, interactions with nurses and aides.
Anyone who has been very ill or cared for a sick family member will relate to this book. Alice and Oliver are two very ordinary people whom we get to know in the midst of a crisis.
A stunning book, never maudlin, never overwritten.