Though there is one farcical plot development that is poorly woven into the emotional fabric of the story, and though some of the asides about health care feel shoehorned into the narrative, the author’s understanding of her people is so intimate, so unsentimental that it lofts the novel over such bumpy passages, insinuating these characters permanently into the reader’s imagination.

Shriver's fearlessly candid approach to illness may be laudable, but eventually it begins to feel less like nerviness and more like sadism. She doesn't try to move readers to tears (which is good, since none were shed), but rather to provoke anger. She does this. But by the end of So Much for That, we're not motivated to write our lawmakers to demand better health care; we just want an aspirin.