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"If you don't belong to a book club, Darin Strauss's bitter and brilliant new novel is reason enough to start one. You can always disband afterward, and in any case your discussion of More Than It Hurts You may be so heated that you'll never talk to those people again. Strauss has packed this gripping story with the whole radio dial of divisive, hot-button issues..." Ron Charles, Washington Post Book World (read the entire Washington Post Book World review)
Synopses & Reviews
Publisher Comments:
The acclaimed author of Chang and Eng returns with a literary showstopper — a beautifully realized novel that at its heart is the story of a woman who will risk everything to feel something; a doctor whose diagnosis brings her entire life into question; and a man who suddenly realizes that being a good husband and a good father can no longer comfortably coexist.
Josh Goldin was savoring a Friday afternoon break in the coffee room, harmlessly flirting with coworkers while anticipating the weekend at home where his wife, Dori, waited with their eight-month-old son, Zack. And then Josh's secretary rushed in, using words like intensive care, lost consciousness, blood...
That morning, Dori had walked into the emergency room with her son in severe distress. Enter Dr. Darlene Stokes: an African-American physician and single mother whose life is dedicated both to her own son and navigating the tricky maze of modern-day medicine. But something about Dori stirred the doctor's suspicions. Darlene had heard of the sensational diagnosis of Munchausen by Proxy, where a mother intentionally harms her baby, but had never come upon a case of it before. It was rarely diagnosed and extraordinarily controversial. Could it possibly have happened here?
As their four lives intersect with dramatic consequences, Darlene, Dori, and Josh are pushed to their breaking points as they confront the nightmare that has become their new reality. Darin Strauss's extraordinary novel is set in a world turned upside down, where doctors try to save babies from their parents, police use the law to tear families apart, and the people you know the best end up surprising you the most.
Review:
"The third novel from the author of Chang and Eng and The Real McCoy is an often satiric page-turner that tracks a Long Island family crisis. Josh Goldin is a happily married TV airtime salesman with an eight-month-old son. When baby Zack is treated twice for mysterious and life-threatening symptoms, the head of a pediatric ICU, Dr. Darlene Stokes, tells Child Protective Services that she thinks Josh's wife, Dori, suffers from Munchausen syndrome, whereby the afflicted injure their children deliberately to draw attention to themselves. The Goldins' ensuing battle to keep Zack provides grist for public debate about issues ranging from parents' rights to race (Dr. Stokes is black, the Goldins Jewish). Strauss takes delight in skewering a world in which everything (news coverage, legal representation, hospital beds) is for sale, sometimes digressively, always amusingly. The stereotypes are intentionally heavy-handed: Josh's perceptions almost always register through race and class-related fear and disgust. But the heart of the story — the unraveling of Josh's life and the steady erosion of his faith that ignorance can be a virtue and happiness a choice — is riveting. (June)" Publishers Weekly (Copyright Reed Business Information, Inc.)
Review:
If you don't belong to a book club, Darin Strauss' bitter and brilliant new novel is reason enough to start one. You can always disband afterward, and in any case your discussion of "More Than It Hurts You" may be so heated that you'll never talk to those people again. Strauss has packed this gripping story with the whole radio dial of divisive, hot-button issues, chief among them a form of child abuse... Washington Post Book Review (read the entire Washington Post review) labeled Munchausen Syndrome by Proxy (MSBP). Identified 30 years ago by a controversial British pediatrician named Roy Meadow, MSBP describes a monstrous set of mothers who rush their children to the hospital after injecting feces into their bloodstream, sickening them with tiny doses of poison or smothering them until they pass out. They perpetrate these and other covert acts of abuse on their own children to experience the vicarious thrill of solicitous medical attention. In the decades since he first raised the alarm about MSBP, Meadow has been censored for professional misconduct and serious questions have been raised about the prevalence and even the existence of this syndrome, but some doctors and social workers continue to consider it a viable explanation for mysterious, hard-to-diagnose illness when certain warning signs are present. Dori Goldin, the heroine of "More Than It Hurts You," presents a textbook case of all those warning signs, and what she and her husband, Josh, endure at the St. Joseph's Medical Center is a nightmare most loving parents don't even know is possible. The novel bursts into action with the words that "snapped Josh's life into before and after." He gets a message at work that his 8-month-old son has been rushed to the emergency room. When he arrives a few minutes later, he hears that Dori had noticed blood in the baby's vomit and taken him to the hospital. The staff had checked him over, assured her that he was fine and sent them home, but in the parking lot the baby lost consciousness and needed to have his heart restarted. The edges of this chronology are fuzzy and the doctors seem a little confused, but Dori remains amazingly calm. As a phlebotomist, a nurse trained in handling blood, "Dori spoke fluent hospital." She challenges the doctors' treatment of her son, objects to what she claims are unnecessary tests and finally stages a confrontation with the staff that requires the police to intervene. All this makes for a tremendously exciting story, eerily similar to the recent case of the Georgetown parents who took one of their 8-month-old twins to Children's Hospital only to endure accusations of child abuse and to temporarily lose custody of both twins. But Strauss has something more ambitious in mind than merely beating Jodi Picoult to the next ripped-from-the-headlines controversy. The case of this baby's mysterious and recurring illness serves as the starting point from which to examine the health of American culture, which to Strauss looks alarmingly ill. The omniscient narrator of "More Than It Hurts You" subjects all these characters to his own acerbic brutality. Josh Goldin, in particular, is whipped on almost every page for being "a genius of optimism," a Jewish Candide with "no talent for despair." Strauss tells us that "very few people met life with a face that free of grievance. ... He felt comfortable everywhere ... (and) lived his comfy life by having faith in people, faith that whoever he met was like him in some central way." Indeed, there's something almost unseemly about Strauss' urge to ridicule this handsome American, this "machine of happiness," who believes "his own expectations were the only forces that acted on his life." It's like watching a man beat his own dog. Strauss made a name for himself with two historical novels based on real celebrities: "Chang and Eng" (2000), about the original Siamese twins, and "The Real McCoy" (2002), about a boxer at the turn of the last century. This time around, with an extraordinary degree of breadth and confidence, he's moved to a hyper-contemporary setting and invented his own characters. But while this is a smart, witty novel, it's also an exceptionally cynical one, in which all the characters' thoughts and actions are overdetermined by their racial, sexual and class identities. When Strauss isn't ripping into Josh's optimism, he's subjecting American attitudes about blacks and Jews to an equally penetrating analysis. Indeed, all the good liberals who populate this novel are constantly agonizing about race. The Goldins' arch nemesis, Dr. Darlene Stokes, is the "first black woman and the youngest person that St. Joseph's Hospital had ever selected to head an ICU section," but that accomplishment can't protect her from the fear of being humiliated. She makes a point of wearing her lab coat to the cafeteria so that white people won't "mistake her for an orderly." Dr. Stokes thinks she's making the decision to take away Dori's baby on purely medical grounds, but Strauss carefully fills in the doctor's complicated personal experience with Jews in a way that tempts us to wonder if something else isn't motivating her to break up this happy family. Even when he wants to kill her, Josh reminds himself, "Stop thinking about this woman as black," while Dr. Stokes, for her part, is thinking, "Clearly a Jew," before she quickly "pushed that vulgarity from her brain." And when the newspapers and cable news shows get wind of this story — from the Goldins' crafty Jewish lawyer — its racial elements flame it into a cause celebre, all superbly captured with Strauss' pitch-perfect ear for media bluster and grandstanding. As a Jew, Strauss can defend himself a la Philip Roth from the novel's juggling of anti-Semitic stereotypes, and for all his exploration of African-American pathologies, he's careful to make the most successful and reformed characters black, but how will women respond to his aggressively negative and dated portrayal of motherhood? How can a novel that so smartly analyzes the racial constructs of modern life dredge up the specter of Medea so uncritically? Even way back in 1960, the feminists' boogeyman John Updike didn't let Janice drown Rabbit's baby on purpose. Despite all his modern insight and wit, Strauss ends up reinscribing that old chauvinist canard: Men don't want to take care of their children, but they can't trust women to take care of them either. Ron Charles is a senior editor of The Washington Post Book World. He can be reached at charlesr(at symbol)washpost.com. Reviewed by Ron Charles, Washington Post Book World (Copyright 2006 Washington Post Book World Service/Washington Post Writers Group)
(hide most of this review)
Review:
"This book is harrowing, hurtling, heartbreaking andmore than anythingdevastatingly accurate. Darin Strauss (a novelist whose talents sometimes seem limitless to me) has created characters whose complexities and dark motivations though they are always hidden from each other, and even sometimes from themselvesare never hidden from their author. This is a brilliant, sharp, suspenseful novel, impossible to turn your gaze from." Elizabeth Gilbert
Review:
"The novel feels like an episode of Law & Order: SVU (without the predictability or the ads), allowing one-time wunderkind Strauss (2001's Chang and Eng) to shake off that sophomore slump and hit a homer." Marie Claire
Review:
"Nothing in Darin Strauss's previous big novel, Chang and Eng, prepares you for the emotional wallop of More Than It Hurts You. At its core, this one is a thriller... Strauss uses his suburban malcontents to touch on election-year issues — HMOs, race-baiting, gender politics — so look for this one to dominate the conversation like nothing has since The Corrections.... Strauss hits you where you live." GQ
Review:
"Josh Goldin agrees with his wife, Dori, that their infant sun ended up in the emergency room due to a freak illness. After all, he seems fine now. Which is why Josh doesn't understand when an investigation opens up to scrutinize their parenting. As the family is ripped apart, Josh and Dori are forced to confront the lies they've been telling each other — and themselves." Redbook Magazine
Review:
"Strauss' novel is most effective not in its sweeping, occasionally grandiloquent observations about society as a whole, but in its mastery of personal, domestic issues." Chicago Tribune
Review:
"The narrative switches from medical to psychological to courtroom drama as each character is gradually forced to face his or her own reality. Highly recommended." Library Journal
Review:
"Darin Strauss's latest is an eviscerating portrayal of contemporary American life, surgical and exact. At turns funny and disturbing, unsparing in its insights yet generous with understanding, More Than It Hurts You is a relentlessly rewarding piece of art." Colson Whitehead, author of Apex Hides the Hurt and John Henry Days
Synopsis:
The acclaimed author of Chang and Eng returns with a beautifully realized novel that at its heart is the story of a woman who will risk everything to feel something and a man who suddenly realizes that being a good husband and father can no longer comfortably coexist.
Darin Strauss is the author of the international bestseller Chang and Eng and the New York Times Notable Book The Real McCoy. Also a screenwriter, he is currently adapting Chang and Eng with Gary Oldman. The recipient of a 2006 Guggenheim Fellowship in fiction writing, he teaches writing at New York University.
joliehale, April 20, 2009 (view all comments by joliehale)
This novel is that rare (in my experience so far) type of literary fiction that, although it doesn't use a classically constructed plot, can still keep a reader's attention because it holds momentous central questions over your head for the duration of the novel. You'll spend much of the novel wanting to know whether Dori really did something to the baby, and the rest of it (up to the very last line) wondering which side of the debate Josh will end up on.
I first heard of this book when I read a pair of blog posts by Darin Strauss on the Powell's book blog, about some of the problems in contemporary literary fiction (read it here: http://tinyurl.com/c6knyv). He said:
"It's not a question of a writer's skill; it's a question of intent, of pinched ambition. Too much contemporary fiction seems purposefully to address small things in small ways. And yet why not try for the all-inclusive, the gripping, for the audacious? For the masterly, high-wrought, and the beautiful?"
In the article, Strauss is calling on writers of literary fiction to raise their genre out of the "boring" stereotype that it often deserves. Although MORE THAN IT HURTS YOU does slow down at certain points in the narrative, I would say Strauss has largely succeeded in taking his own advice. This novel is ambitious in style and bold in content, and the final pages pack an emotional punch that knocked the wind out of me.
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Darin Strauss in this, his third novel ('Chang and Eng', 'The Real McCoy'), permanently secures his position as one of America's finest novelists. The sheer variety of his choices of stories, his elegant ability as a wordsmith, and the fervor with which he approaches difficult issues within the context of creating a fascinating story are only a few of the reasons for his success. Strauss has the gift to create unique characters, develop them thoroughly and gradually throughout the weaving of his tale, and leave the reader with a high degree of concern about the future of these people long after the lat page of his novels are complete.
Always electing to introduce rarely known information as a key to his works, MORE THAN IT HURTS YOU explores the definition and significance of the mysterious phenomenon Munchausen's Syndrome by Proxy (or MSP - the 'DSM-4 factitious disorder by proxy'). It is important to the author that the reader understand this complex entity: according to the dictionary it is defined as follows: 'Munchausen syndrome by proxy (MSP), a type of factitious disorder, is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. People with MSP assume the role of a sick person indirectly by producing or lying about illness in another person under their care, usually a child under 6 years of age. (The term "by proxy" means "through a substitute.") People with MSP have an inner need for the other person (often his or her child) to be seen as ill or injured. It is not done to achieve a concrete benefit, such as financial gain. People with MSP are even willing to have the child or other patient undergo painful or risky tests and operations in order to get the sympathy and special attention given to people who are truly ill and their families. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties'.
Strauss very subtly investigates this syndrome through his creation of a happy family - Josh and Dori Golding and their infant son Zack. Josh is a well-liked, creative salesman for the television network Sparkplug, while Dori is a trained nurse/phlebotomist whose devotion to her family is exemplary. As Josh's attention to new work developments strays from his family focus, Dori rushes Zack to the hospital for gastric pain and subsequently for hematemesis and there is 'treated' the Pediatric ER doctor Darlene Stokes and her intern. Dr. Stokes fails to do certain blood screening tests and Dori accuses her of mismanagement. Zack of course recovers (we later learn that Dori has placed blood in Zack's emesis to begin the Munchhausen Syndrome by Proxy process) and the race between patient/parents and physician/hospital is on.
Each of the characters reflects backgrounds that make them 'persons of interest': Darlene was the illegitimate child of a young African American woman, impregnated by one Charles Stokes, a drug dealer who is imprisoned where he changes his religion to Muslim and his name to Intelligent Muhammad. From this rather lowly background Darlene rises above her white classmates, elects to affiliate with her black brethren in housing and activities, becomes a physician, has a brief affair with the first man who pays attention to her (a Caucasian Jew), becomes pregnant, marries, has a child she names James, and when her husband dies, centers her life on her career, her son, and her single mother Alice. Josh Goldin is Jewish as is Dori, a girl of Turkish descent. As the accusation of Munchausen's Syndrome is made against Dori, the Goldin's seek advice from a haughty Jewish lawyer who manufactures concepts that Darlene has vindictive feelings against the Jewish Goldins (racism) and causes the Goldin's to believe his case against 'the poor black woman' Darlene (racism). When Darlene engages Child Protective Services to investigate the Goldins, the investigator is perceived as a gay male (homophobia) who couldn't possibly understand a straight family. And as if these summed prejudices weren't enough, Darlene's father is released from prison and seeks out the daughter he never knew: Darlene softens and allows him to move in - a convicted felon to care for her young son and to work as a janitor in her hospital (prejudice against outsiders/felons becomes an issue with the hospital and lawyers as the case moves towards hearings).
Strauss weaves this complex cast of characters into a drama that is not only fascinating as it unfolds, but is also cause for serious contemplation of the state of our society's views of human rights, social injustices, racism, homophobia, paparazzi, yellow journalism, medical malpractice, and parenting. But one of the reasons this story works so well is the fact that Strauss knows how to manipulate all of this information while keeping his dramatic story moving along at breakneck speed. No one in this novel is free of flaws and no one is completely 'beyond redemption'. The reader is brought most closely into Josh's response: he is the affected one by all of the circumstances and it is his resolution that brings this story to an end. 'A greater sin than emotional blindness is to play at love without purpose, to be caught just visiting the high points of your own existence. Josh loved Dori honestly, faithfully, and blindly. And that was the reason he failed to avoid this strange shipwreck of his family life.'
Though this novel flows rapidly, Darin Strauss allows breathing spaces for contemplative painting with words: it is rare to turn a page without finding at least some brief eloquent and poetic thoughts and sentences that stay with the reader throughout the book. He is a gifted, dependable, and eloquent artist and while watching his first book become a film, we can eagerly anticipate his next intelligent and fascinating novel. Highly Recommended.
Grady Harp
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"Publishers Weekly Review"
by Publishers Weekly,
"The third novel from the author of Chang and Eng and The Real McCoy is an often satiric page-turner that tracks a Long Island family crisis. Josh Goldin is a happily married TV airtime salesman with an eight-month-old son. When baby Zack is treated twice for mysterious and life-threatening symptoms, the head of a pediatric ICU, Dr. Darlene Stokes, tells Child Protective Services that she thinks Josh's wife, Dori, suffers from Munchausen syndrome, whereby the afflicted injure their children deliberately to draw attention to themselves. The Goldins' ensuing battle to keep Zack provides grist for public debate about issues ranging from parents' rights to race (Dr. Stokes is black, the Goldins Jewish). Strauss takes delight in skewering a world in which everything (news coverage, legal representation, hospital beds) is for sale, sometimes digressively, always amusingly. The stereotypes are intentionally heavy-handed: Josh's perceptions almost always register through race and class-related fear and disgust. But the heart of the story — the unraveling of Josh's life and the steady erosion of his faith that ignorance can be a virtue and happiness a choice — is riveting. (June)" Publishers Weekly (Copyright Reed Business Information, Inc.)
"Review A Day"
by Ron Charles, Washington Post Book World,
"If you don't belong to a book club, Darin Strauss's bitter and brilliant new novel is reason enough to start one. You can always disband afterward, and in any case your discussion of More Than It Hurts You may be so heated that you'll never talk to those people again. Strauss has packed this gripping story with the whole radio dial of divisive, hot-button issues..." (read the entire Washington Post Book World review)
"Review"
by Elizabeth Gilbert,
"This book is harrowing, hurtling, heartbreaking andmore than anythingdevastatingly accurate. Darin Strauss (a novelist whose talents sometimes seem limitless to me) has created characters whose complexities and dark motivations though they are always hidden from each other, and even sometimes from themselvesare never hidden from their author. This is a brilliant, sharp, suspenseful novel, impossible to turn your gaze from."
"Review"
by Marie Claire,
"The novel feels like an episode of Law & Order: SVU (without the predictability or the ads), allowing one-time wunderkind Strauss (2001's Chang and Eng) to shake off that sophomore slump and hit a homer."
"Review"
by GQ,
"Nothing in Darin Strauss's previous big novel, Chang and Eng, prepares you for the emotional wallop of More Than It Hurts You. At its core, this one is a thriller... Strauss uses his suburban malcontents to touch on election-year issues — HMOs, race-baiting, gender politics — so look for this one to dominate the conversation like nothing has since The Corrections.... Strauss hits you where you live."
"Review"
by Redbook Magazine,
"Josh Goldin agrees with his wife, Dori, that their infant sun ended up in the emergency room due to a freak illness. After all, he seems fine now. Which is why Josh doesn't understand when an investigation opens up to scrutinize their parenting. As the family is ripped apart, Josh and Dori are forced to confront the lies they've been telling each other — and themselves."
"Review"
by Chicago Tribune,
"Strauss' novel is most effective not in its sweeping, occasionally grandiloquent observations about society as a whole, but in its mastery of personal, domestic issues."
"Review"
by Library Journal,
"The narrative switches from medical to psychological to courtroom drama as each character is gradually forced to face his or her own reality. Highly recommended."
"Review"
by Colson Whitehead, author of Apex Hides the Hurt and John Henry Days,
"Darin Strauss's latest is an eviscerating portrayal of contemporary American life, surgical and exact. At turns funny and disturbing, unsparing in its insights yet generous with understanding, More Than It Hurts You is a relentlessly rewarding piece of art."
"Synopsis"
by Ingram,
The acclaimed author of Chang and Eng returns with a beautifully realized novel that at its heart is the story of a woman who will risk everything to feel something and a man who suddenly realizes that being a good husband and father can no longer comfortably coexist.
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