As a narrative of Ruth's suffering, loneliness (despite her almost suffocating surround of exclusively female friends, including a fiercely misanthropic and aggressive homosexual--but ultimately sensitive--woman named "L.D."), depression, and trying to figure out what dying is all about, this novel is quite effective in depicting the interactions amongst women in a group; the agony of one of those women dying before her time; and how the group and individual continually behave towards each other, singly and as a corporate entity. Unfortunately, like many books with much pathos, Talk Before Sleep often missteps into the territory of bathos.

Equally unfortunately, the book is mortally flawed in its two-dimensional portrayal of men as unfeeling husbands, doctors, and family. With the anemic exception of Joel, one male friend who can only be described as too little, too late, the men in this book are laughable caricatures who do nothing to lend a sense of balance and fairness to this author's otherwise obvious talent for narrative.