HALF THE KINGDOM

Is dementia catching? The possibility sends one emergency room into a tizzy in Segal’s latest, a surreal black comedy.

It’s Miriam Haddad, an ER doctor, who lets the cat out of the bag. She confides to Joe Bernstine, a regular patient, that they’re tracking “all the sixty-two-pluses who go around the bend.” Smiling Joe is unfazed. Nothing fazes Joe, not even the fact that he’s terminal. He’s the retired director of a think tank that figured prominently in Segal’s previous novel, Shakespeare’s Kitchen (2007), and is busy cataloging, in his small Manhattan office, end-of-the-world scenarios. His staff consists of family and friends, most notably Lucy, a 75-year-old poet with emphysema. It’s she who notices the body hurtling past the window. One of the black dressmakers whose space they acquired has committed suicide after taking her sister to the same New York hospital ER where Joe is a frequent visitor. Soon, Joe’s outfit is working with Dr. Haddad to investigate the staggering surge in Alzheimer’s cases. Joe has hinted that undefined “entities” may be using the ER to create an epidemic. Stated that baldly, it sounds pretty silly, but then, this is not a conventional medical-disaster novel, but a wild flight, complete with loops, tangents and quizzical asides. What follows is a parade of new intakes, all about to lose their minds. Observing them unofficially is Lucy, who is being driven crazy herself by the refusal of a magazine to pass judgment on a months-old submission. Back to Dr. Haddad, who, as the hospital’s spokesperson, declares “[t]here is no emergency room...that is not liable to raise the stress level to one that can cause temporary dementia.” That exposes Segal’s debunking of the Byzantine bureaucracy of the American hospital, but it does not prepare readers for the dark ending: a tableau of the demented, all stark naked, and Joe on his deathbed.

A sassy circumnavigation of hospital culture and mortality.