Our long marvelous dying

DeForest, a physician trained in neurology and palliative care medicine, continues the story of the medical student they portrayed in A History of Present Illness (2022) in their gripping but grim second novel. Here the distressed narrator completes a yearlong training program in end-of-life care in which her major responsibility is controlling patients' pain. Unsurprisingly, such constant proximity to dying produces an osmotic effect. Something inside the narrator (maybe the soul, perhaps love) is slowly dying too. Her personal life is mostly a mess. As a child, the narrator's mother deserted her and her father neglected her. She now raises a five-year-old niece, and her marriage to a chaplain is on the rocks. For the narrator, everyone is either an enigma, dilemma, or failure. Constructed more like memoir than novel, the plot is thin. There is a whiff of Edgar Allan Poe: a preoccupation with death, an unmoored narrator, a deadly pandemic spread invisibly by a breath or a cough. The patients she treats are miserable or pitiful, including a woman with alcoholic cirrhosis whose body is yellow and bloated, someone hemorrhaging from tuberculosis, a person with ALS. DeForest has created a bleak yet powerful account of the toll of dying on family members and health professionals who care for the almost-dead.

DeForest (A History of Present Illness) provides a ruminative if underdeveloped autofictional account of a palliative care doctor during the Covid-19 pandemic. The unnamed narrator works in a Manhattan hospital, where their job is to help terminal patients transition to death. The narrator's home life offers little respite from the emotional strain of daily interactions with the dying. Their grief counselor husband is absent for much of the time, leaving them alone to care for their five-year-old niece while their brother is in rehab. As the narrator's thoughts consistently turn to their recently deceased father, they try to make sense of their estranged relationship. Meanwhile, the virus seeps into every aspect of the narrator's life. The narrative that emerges feels simultaneously like a documentary and a fever dream. Without a plot or much character development, readers may have a tough time becoming emotionally invested. Still, DeForest draws from their own experience as a palliative care doctor to write with acute perception about the thin membrane that separates life from death. Readers of When Breath Becomes Air will want to add this to their shelf. Agent: Sarah Burnes, Gernert Co. (July)This review has been updated with further information.

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. Copyright (c) Kirkus Reviews, used with permission.

*Starred Review* DeForest, a physician trained in neurology and palliative care medicine, continues the story of the medical student they portrayed in A History of Present Illness (2022) in their gripping but grim second novel. Here the distressed narrator completes a yearlong training program in end-of-life care in which her major responsibility is controlling patients' pain. Unsurprisingly, such constant proximity to dying produces an osmotic effect. Something inside the narrator (maybe the soul, perhaps love) is slowly dying too. Her personal life is mostly a mess. As a child, the narrator's mother deserted her and her father neglected her. She now raises a five-year-old niece, and her marriage to a chaplain is on the rocks. For the narrator, everyone is either an enigma, dilemma, or failure. Constructed more like memoir than novel, the plot is thin. There is a whiff of Edgar Allan Poe: a preoccupation with death, an unmoored narrator, a deadly pandemic spread invisibly by a breath or a cough. The patients she treats are miserable or pitiful, including a woman with alcoholic cirrhosis whose body is yellow and bloated, someone hemorrhaging from tuberculosis, a person with ALS. DeForest has created a bleak yet powerful account of the toll of dying on family members and health professionals who care for the almost-dead. Copyright 2024 Booklist Reviews.

DeForest (A History of Present Illness) provides a ruminative if underdeveloped autofictional account of a palliative care doctor during the Covid-19 pandemic. The unnamed narrator works in a Manhattan hospital, where their job is to help terminal patients transition to death. The narrator's home life offers little respite from the emotional strain of daily interactions with the dying. Their grief counselor husband is absent for much of the time, leaving them alone to care for their five-year-old niece while their brother is in rehab. As the narrator's thoughts consistently turn to their recently deceased father, they try to make sense of their estranged relationship. Meanwhile, the virus seeps into every aspect of the narrator's life. The narrative that emerges feels simultaneously like a documentary and a fever dream. Without a plot or much character development, readers may have a tough time becoming emotionally invested. Still, DeForest draws from their own experience as a palliative care doctor to write with acute perception about the thin membrane that separates life from death. Readers of When Breath Becomes Air will want to add this to their shelf. Agent: Sarah Burnes, Gernert Co. (July)This review has been updated with further information.