The book opens with Shep
Knacker packing his bags for his long-dreamed of “Afterlife”—his word for
retirement—in Pemba, an island off the coast of Tanzania. He plans to take his
wife, Glynis, and his high school aged son, Zach. This plan is not unexpected
because Shep and Glynis have made many “research” trips during their 26-year
marriage to find the right place (though never to Pemba). But, there were
always reasons not to act on their research. An intervention was needed. Glynis
is not home while he is packing because she is at some “appointment.” When she
gets home, Shep informs her of his plans for the three of them to leave for
Pemba, and he further informs Glynis that he’s going whether she comes or not.
In response, she informs him that she has cancer—a bad one (mesothelioma); he
unpacks, so much for that.
What unfurls from there is
more complicated than just the challenges Glynis’s disease produces, though
these are monumental challenges. Other people, too, are in need of Shep’s
attention. His father’s decrepitude is advancing, his sister is on the brink of
homelessness, and his teenage son is detaching from him and life in general.
Shep eventually loses his job as an employee at the handyman company he once
owned (“Knack of All Trades”) then sold to fund his Afterlife. There’s more.
Shep's best friend,
Jackson, who also worked with him at Knack of All Trades has two girls, and one
of them has familial dysautonomia. This progressive genetic disease of the
nervous system produces a constellation of medical problems that are bizarre,
intense, and serious, before it ultimately produces a tragic end. The trauma
and tragedy this disease inflicts in this story (and in life) encompass the
entire family, in spite of the heroic efforts of Jackson’s wife, Carol.
The many plot lines in this
novel at times proceed independently of one another, and at other times
intersect. They concern serious illness experiences and the effects they have
on families and also how the American health care system can place burdens
on those who need it. Nevertheless, the two families,
beaten down by illness, fatigued from encounters with doctors and hospitals,
and exasperated from fights with insurance companies, rally enough to make it
to Pemba. The trip becomes financially affordable as the result of some
narrative gimmickry involving a financial settlement of $800,000 from the company
that put asbestos in equipment Glynis had used years before. They would spend
the rest of their lives there, longer for some than for others.
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