Small rain A novel

After he finally checks himself into an emergency room at his partner's insistence, a poet learns that what has caused him staggering pain for days is a rare and life-threatening tear in the wall of his aorta. "It had become engrossing, the pain, it had become a kind of environment, a medium of existence." But more than inertia kept the poet, a man in his forties, at home: the country is in the midst of a pandemic, and hospitals, including the ones in his university town in the middle of the country, are to be avoided or navigated alone. The mysterious tear makes the poet a kind of celebrity in the ICU. His days spent at the mercy of harried nurses and beeping machines bore, terrify, and fascinate him, testing his life force in every way. Dense with attention, observation, and imagination, Greenwell's (Cleanness, 2020) engrossing third novel expands its own tight parameters to touch on human solitude and interdependence, art and its purpose, and life itself, in all its ordinary and extraordinary precarity.

A gay poet struggles with a mysterious and agonizing pain in Greenwell's intense latest (after Cleanness). Wracked with debilitating agony that stretches through the first months of the Covid-19 pandemic, the unnamed narrator is urged by his partner, L, to see a doctor. After waiting for hours in the emergency room, he endures a battery of examinations and tests. Eventually, he receives a shocking diagnosis of life-threatening aortic tearing. Weeks of hospitalization and grueling procedures follow, and over the course of his slow recovery, the narrator juxtaposes raw depictions of his vulnerability and helplessness with excoriating critiques of the healthcare industry's inequities and inefficiencies and the alienation he feels among the "relentlessly heterosexual" staff. The narrator also reflects on his dysfunctional family history; meeting L as a creative writing student in Iowa City, where he's remained after graduating seven years earlier; and the negotiations he and L have gone through to find happiness and fulfillment in their shared living space. The virtuosic first-person narration, devoid of dialogue, places the reader front and center in the narrator's bracing account of his grueling ordeal ("The pain defied description, on a scale of one to ten it demanded a different scale"), serving as a palpable reminder to never take one's health for granted, and it builds to a cathartic and unforgettable conclusion. It's a luminous departure from Greenwell's spare and erotic earlier work. Agent: Anna Stein, CAA. (Sept.)

Greenwell, who has written so evocatively about desire and sex inWhat Belongs to You (2016) andCleanness (2020), now probes something quite different: life-threatening illness. With no warning and a violent eruption of pain so intense it felt like someone "plunged a hand into [his] gut and grabbed hold and yanked," the narrator suffers an infrarenal aortic dissection--a tear of the inner layer of his aorta. It's a sometimes fatal malady that usually happens to people older than the narrator, who's in his 40s. Deeply reluctant during the pandemic to go to the hospital in Iowa City, he endures the pain at home until his partner, L, convinces him to get treatment. The medical staff is alarmed, and also titillated, by encountering such a rare malady. The narrator of this autofiction endures lab test after lab test and must learn how to be powerless--how, for example, to refrain from using the bathroom near his ICU bed by himself or how to walk there without tangling the many wires and IV lines threaded from his body. As usual in a Greenwell novel, the tangents are tantalizing, and with so much time spent inert and left to ponder, the narrator finds his imagination flying beyond his hospital bed to the fracturing of his family, his life with and love for L, and the implications of their disastrous home renovations. But this is a novel about bodies and how weird they are, and Greenwell often returns to thinking about them. "What a strange thing a body is," he writes, "…and how strange to have hated it so much, when it had always been so serviceable, when it had done more or less everything I had needed until now, when for more than forty years it had worked so well." There's more suspense here than in Greenwell's previous work, as the reader is eager to discover the outcome of the narrator's illness: How will he get out of the ICU and return to life? Greenwell--such a finely tuned, generous writer--transforms a savage illness into a meditation on a vital life. Copyright (c) Kirkus Reviews, used with permission.