In this novel, the narrator, a poet and teacher living in Iowa, experiences a sudden and severe pain in his stomach and back, leading to his eventual collapse. His partner, L, who does not drive, causes a delay in seeking medical attention. Eventually, the narrator takes himself to the emergency room, where he faces a long wait due to the COVID pandemic protocols.
The narrator’s condition remains shrouded in mystery, causing him intense pain and confusion. He is admitted to the hospital, and an intern deems his case “very interesting.” It is explained to him that he has suffered an “intrarenal aortic dissection,” a rare condition typically seen in older individuals with chronic health problems. The cause remains unknown, and various tests are conducted while he is prepared for potential surgery.
The COVID restrictions limit visitor hours, and anyone entering the hospital must wear masks and undergo testing. L visits the narrator, and they share a poignant moment, aware that COVID could be fatal for him. Despite being medicated, the narrator’s mind is clear, and he reflects on his past, family history, sexual history, and his loving relationship with L. He avoids notifying his mother, knowing her insistence on visiting could jeopardize his health.
While still grappling with a lack of complete understanding of his condition, the narrator is interviewed by numerous doctors and specialists, contributing to research. A vascular surgeon informs him that he barely survived, as 75% of people in his condition do not make it. This revelation both terrifies and reassures him. He reflects on past risky behaviors, such as unprotected sex during his youth, and his safer practices as an adult. He also admits to using amyl nitrate, or “poppers,” but denies using addictive drugs like fentanyl.
Dr. Ferrier, the narrator’s primary physician, offers hope by explaining that most patients with his condition are older and have chronic health issues, which often leads to poor outcomes. He provides guidance on maintaining his health and avoiding potential triggers. The narrator relies on nurse Aliana, who is compassionate and attentive, to navigate the hospital experience. She shares stories of her experiences during the peak of the COVID epidemic.
A male nurse who sings in a band plays moving music for the narrator, evoking deep emotions and leading to reflections on his love for music and his life choices. The narrator undergoes numerous tests, scans, and observations, but the cause of his condition remains elusive. Eventually, surgery is ruled out, and he is told he can go home with medication.
The narrator contacts his sister, G, a lawyer from Kentucky, who visits and brings her dogs to support him. After being released with medication and home care information, the narrator has a meal with his sister and L, followed by a satisfying intimate encounter with L. The next day, they visit a dog run with G’s dogs, and the narrator begins to see a brighter future for himself.
Throughout the novel, the writing is lyrical and precise, allowing readers to empathize with the narrator’s emotional journey. The narrative transcends its seemingly ordinary premise, drawing readers into a deeply human experience. The narrator’s struggles with his health, relationships, and the healthcare system are portrayed with detail and authenticity. The story is a moving exploration of self-discovery and the appreciation of life.
Greenwell’s writing, while different in subject matter from his previous works, maintains its power and beauty. The novel takes readers on an emotional journey, making them feel the narrator’s pain, joys, and sorrows. The themes of love, poetry, and music are interwoven with the challenges of the American healthcare system, providing a universal resonance that extends beyond nationality, gender, and sexuality.
The novel’s message is not simply a transformation from illness to cherishing life, but it emphasizes the importance of self-care and valuing the ordinary aspects of life. While the narrator’s relationship with his family remains unchanged, it is evident that L will encourage him to prioritize his well-being.