Sláinte
by James Morrow

Reviewed by DeanOP
MSWorld Book Reviewer

This work of fiction was written by a neurologist in Northern Ireland. The character with MS is Julie, the wife of a journalist. The focus of the story is the journalist's difficulty with some terrorists in Belfast and a scheme he and his wife's physician cook up to raise money for her injectable therapy. Julie's secondary/progressive MS is accurately described, and how she came to have MS so far advanced is interestingly presented, but she is not a major character in the book and we really don't learn much about her coping skills or her thoughts and feelings.
What is riveting is Morrow's description of the situation with regard to injectable therapies in the United Kingdom.

Apparently the National Health Service gives grants of money to various localities to use for their populations as they see fit. Therefore it's a complete crap shoot as to whether your locality will be willing to provide you with a particular drug or not, regardless of whether your doctor recommends it. Morrow is obviously on the side of the patient here. In addition it has taken the UK a long time to even consider the ABC-R medications efficacious because at best they reduce relapses by a third which doesn't seem cost effective to those who decide these matters over there. One can, however, receive the meds by paying privately, and to this end the characters in the book organize a golf fund-raiser hoping to set a Guinness Book record (I won't reveal how).

The other fascinating aspect of this novel is Morrow's rendering of the situation in Northern Ireland now that a cease fire has been somewhat agreed upon. This has nothing to do with MS or with medication but it's an accurate, insider's perspective, as far as this USA reviewer knows. We in the continental US are new to terrorism as a homeland event and I found it a sobering reminder to read of a place where such violence has been ubiquitous and where people like me (i.e., middle class and with MS) must make their daily lives in spite of it.

It's a shame that we don't learn more about daily life with MS in the UK. I'd imagine that Dr. Morrow is well placed to write of it and I'm sorry he used MS as a pretext for writing primarily about golf and terrorism. Insofar as the character, Julie, is heard from, we are mainly given her fear, sadness and panic over the diagnosis (and her husband's as well). The character really doesn't come to terms with having the disease nor do we get a sense of her resolving some of her feelings and moving on with her life. I know that having an incurable disease is supposed to ruin your life (the more so the younger you are) but most of us with MS do manage to find contentment on some level. The disease needn't be the center of your existence. So, as far as MS goes, Julie is a brave and tragic figure trying to smile through her tears— a little too conventional (from an outsider's point of view) and dimensionless for my taste. But, again, this story really isn't about MS.

The book is not available from Amazon in the USA. If you're interested, it is possible to order it through Amazon, UK. It can be also ordered from the publisher, The Book Guild Ltd. (www.bookguild.co.uk) and it is available in stores for those of you who live in the UK.