OUR LONG MARVELOUS DYING

Palliative care, the Covid-19 epidemic, and a doctor’s complicated personal life are woven together in a sober amalgam of existence and departure.

In tone and approach, DeForest’s second novel bears close comparison with their debut, A History of Present Illness (2022), which offered a fragmented, detached insider’s look at medical training and hospital culture from an unusual perspective. This time, another unnamed female narrator is in training, learning to specialize in “pain unto death—or quality of life, as we are being trained to call it,” her work overlapping with the pandemic, aka “the plague years.” Also reminiscent of the earlier book are the narrator’s relationship with a seminarian (here her husband, Eli) and a problematic personal history, which in this case touches on unloving parents and a drug-addicted brother who has left his 5-year-old daughter, Sarah, in her care—“a temporary daughter.” There’s no plot, but the gathering glimpses of the narrator’s backstory and private life, including the death of her father, offer some connection. Loss of life is indeed the central topic, not just the look and sound of death, although these are included, but numerous other aspects: the behavior of relatives; the experience of a patient’s last hours; the fine lines between care and harm and end of life; autopsy; organ harvesting. Eli’s job is “to be with the families in those quiet rooms adjacent to the emergency department, in each wail an instance of scalding, incoherent grief.” Dying also pervades the narrator’s frequent philosophical and abstract musings, including the countervailing question arising at a retreat she attends periodically: “What is the purpose of living?” DeForest, themself a palliative care physician, has delivered less an immersive storyline, more a meditation on both life and death leavened by occasional sardonic humor.

Short, dark, stylish, sui generis. An idiosyncratic form of fiction, stimulating yet not entirely satisfying.