(Riverhead Books, 2020)
Author: Sigrid Nunez
“Death is not an artist.”
—Jules Renard, as quoted in What Are You Going Through
What would you do if a longtime friend with a terminal illness asked you to live in the country with her for the last months of her life before ending her own life with medicine obtained for that purpose? Would you help her take the medicine to end her life when she decides to do so if her illness advances to the point that she can’t take it herself? What if you also are dealing with your own parents’ aging and dementia onset? And what if you, like the book’s narrator, are uncomfortable dealing with illness and death?
These are some of the quandaries addressed in the thought-provoking novel What Are You Going Through, by Sigrid Nunez. The book has received deserved accolades, including being named a best book of 2020 by National Public Radio and a top book of 2020 by The New York Times. It is Nunez’s follow-up to her previous book, The Friend, which won the National Book Award, about the suicide of a woman’s close friend and mentor. What Are You Going Through was written before the COVID-19 pandemic, but the death, and assessments of our lives, caused by the pandemic make the book especially timely.
When the novel’s narrator travels out of state to visit her hospitalized friend, she knows that her friend has terminal cancer but has no idea what the friend will be asking of her. The book’s author does not assign names to the narrator or her sick friend.
When the narrator checks into a bed-and-breakfast for the visit, she learns that her host’s cat recently died. The book’s cover art depicts a cat lounging on a sofa. The cat’s death, and the narrator’s conversation with the host about the animal’s death, set the tone for what follows.
From the first hospital visit, the narrator can tell that her friend is suffering. The narrator finds herself exhausted at the end of the visits.
After a few rounds of failed treatments, the friend tells the narrator that she wants to find a quiet place to spend the last months of her life before she takes medicine to end her life when the time is right. The friend seeks somewhere peaceful to settle her affairs and to “think my last thoughts. Whatever they might be.” She aspires for a “beautiful death in a nice house in a scenic town on a fine summer night.”
The friend asks the narrator to join her, promising to make the trip “as fun as possible.” The narrator initially resists, finding the request baffling. She asks her friend about her daughter and others who might be closer to her. But the friend has been long estranged from her daughter. As for others, the friend says, “I know your feelings won’t be hurt when I say that you weren’t my first choice.” Two other friends have already declined.
After somewhat anguished consideration, the narrator agrees to accompany her friend. Upon hearing the news, her friend’s relief is so great that she begins sobbing.
When they arrive at the picturesque cottage the friend found in the country, the friend realizes that she forgot to bring the pills she plans to use to end her life. She had kept them hidden in the back of a bedroom drawer and overlooked them when she packed. The friend insists on going back that same day to retrieve the pills. “I have to be sure I didn’t lose them or misplace them … . I have to know they’re there.” When the narrator asks her friend whether leaving the pills behind might suggest that she is conflicted about taking them, the friend becomes furious. They return to retrieve the pills, then drive back to the cottage.
At the cottage, the conversations between the narrator and friend are sometimes sad, sometimes uncomfortable, but both women are able to find humor in absurdities. For example, throughout her life, the friend worked hard at staying in good physical shape. They laugh at the irony that this might actually make her death more protracted and agonizing. At one point the friend quips that their situation sounds like a sitcom, “Lucy and Ethel Do Euthanasia.”
The narrator and friend talk about everything: their time in college together, books and beloved writers, favorite old movies, relationships, fond memories, and regrets. The friend has many regrets, especially about her daughter. But she decides not to reach out to her daughter one last time, explaining to the narrator that she has become “reconciled to our not being reconciled.”
Even planning meals and trips to the grocery store take on significance. The narrator cannot help but feel guilty for being hungry when her friend is barely eating. Of course, she does not really feel guilty for having an appetite but for being healthy. At the grocery store, it’s impossible for her to calculate how much food is needed without “touching on the awful question For how long” (italics in original).
The novel has many thoughtful passages that shed light on terminal illness, decisions about how and when to die, and uncomfortable conversations the terminally ill have with others. The friend tells the narrator about some of her awkward discussions with others (italics in original):
No matter what, they want you to keep fighting. This is how we’ve been taught to see cancer: a fight between patient and disease. Which is to say between good and evil. There’s a right way and a wrong way to act. A strong way and a weak way. The warrior’s way and the quitter’s way. If you survive you’re a hero. If you lose, well, maybe you didn’t fight hard enough. You wouldn’t believe all the stories I get about this or that person who refused to accept the death sentence they got from those nasty stupid doctors and was rewarded with many, many more years of life. People don’t want to hear terminal … . They don’t want to hear incurable, or inoperative. They call that defeatist talk. They say insane things like As long as you stay alive there’s a chance. And Medical miracles happen every day … . I never knew that so many smart, educated people were under the illusion that a cure for cancer is just around the corner. Not that I think they all really believe what they’re saying … but they obviously believe it’s what they should say.
The friend adds that she hates the word terminal. The word makes her think of bus stations, which makes her think of exhaust fumes and creepy men prowling for runaways. She prefers the word fatal.
The novel touches on the potential criminal aspects of the plan. No explanation is offered about how the friend obtained the medicine to end her life. Currently only eight states and the District of Columbia have death with dignity laws, and the practice is legal in a ninth state via a state supreme court ruling. In the remaining 41 states, what the narrator and friend conspire to accomplish — bringing about a peaceful, dignified death for the fatally ill friend — is a crime.
As the day when the friend will decide to take the drugs nears, the narrator leaves the cottage to have brunch with her ex-husband. The ex-husband warns the narrator about what to do and how to behave when her friend takes the pills (parenthetical in original):
You need to remember to take some precautions. She has to leave a note. (In fact, that note, already composed, lay in a drawer of her nightstand, lacking only the date. All part of her meticulous planning). And there shouldn’t be any evidence that could be construed as your having been part of the plan, or of having assisted in any way. No one knows, right, besides the three of us? Make sure it stays that way … . You’ve got to keep it together. Don’t go spilling your guts when the police arrive. They’ll check out the house very carefully. They’ll ask you questions. You stick to the script. And you should call the police first, before you call me.
The narrator responds, “This is insane. I don’t understand why we have to go through all this, as if we were criminals, for God’s sake. Why shouldn’t dying people have the right to end their own lives?”
I will not give away the ending, other than that the narrator concludes, “This saddest time has also been one of the happiest times in my life.”
I enjoyed the novel’s references to literature as a means to expose truth. The book opens with a quote by the French philosopher Simone Weil, which is the basis of the title: “The love of our neighbor in all its fullness simply means being able to say to him, ‘What are you going through?’” As the narrator points out about midway through the novel, Weil was writing in French. In French, the question sounds different: “Quel est ton tourment?”
American author Tim O’Brien wrote that fiction is for “getting at the truth when the truth isn’t sufficient for the truth.” Or as American writer Jessamyn West put it, “Fiction reveals truth that reality obscures.”
That is why literature can help lawyers understand, and empathize with, what our clients are going through when we counsel them during trying times in their lives. This is particularly true for elder law attorneys, who counsel clients about such consequential matters as their legacies, interfamily dynamics, dementia, health care dilemmas, and end-of-life decisions for themselves and for loved ones.
In that sense, What Are You Going Through not only is an excellent read but also has the potential to make us better people and more thoughtful, empathetic attorneys.
1 See Death With Dignity, Death With Dignity Acts, https://www.deathwithdignity.org/learn/death-with-dignity-acts (accessed June 15, 2021).