More Than It Hurts You
by Darin Strauss
Reviewed 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, chief among them a form of child abuse 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 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 mother in 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's 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, thinks, " Clearly a Jew," before she quickly pushes "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's 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 re-inscribing 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 Book World. He can be reached at firstname.lastname@example.org