So Much for That by Lionel Schriver

This is a very powerful and disturbing book but in the end, uplifting. It deals with a family's confrontation with a serious form of cancer and the accompanying issues at hand when facing such a tragedy: the illness itself, facing death, chemotherapy, changes in your life and then - the health care issues. At the start of the novel, the husband, Shep, is preparing to tell his wife of many years that he is ready for "the Afterlife." For him, the afterlife does not mean death, but instead means that he plans to pick up and leave the United States, his job and his family (if they won't accompany him) and move to Pemba in Africa. It's been his dream for many years to leave the rat race that is life in America and live a simple, self sustaining life in a third world country where the cost of living is very low. Before he can tell Glynnis, she tells him her news: she is sick and has been for a while and has been diagnosed with mesothelioma. She is an artist who works with metal and over the years has had much exposure to asbestos. And the bottom line is - he can't go to Pemba because she needs his health insurance.
There are other interesting characters in the book, mainly his best friend Jackson and Jackson's family. The daughter has a rare congenital disease, familial dysautonomia (FD), which requires frequent and unpleasant medical interventions, and of course, vast amounts of money to contain and control. So the theme of health care, its costs, its inequities are all a very large part of this interesting novel.
One theme that was particularly difficult for me to deal with was the cancer victim's relationship with her family and "friends."  The book hit very close to home for me in this regard, as I have lost several friends to various forms of cancer and grappled all the time with my inability to deal with people who are sick and provide the "right" kind of support. I was always beating myself up for not doing enough. Glynnis expresses her feelings quite frankly about the friends who don't know what to say or how to act and it was difficult for me to read these passages, as they strengthened my feeling of inadequacy in this regard. Glynnis' end was painful to read as well, as I was reminded of being with my mom when she took her last breath.
I don't want to sound as if this book is a terrible downer, because it is not. I really liked the ending, but won't give it away. The book had humor and pathos and I did enjoy reading it.