Shep Knacker is a very good man -- the kind of dutiful and responsible guy you'd like to have as best friend, employee, son, brother, father or husband. He works hard, pinches pennies and saves every dime while planning his ultimate escape to Pemba and the Afterlife -- retirement and freedom from all his middle class cares and worries. When his somewhat caustic and pampered artist wife Glynis is diagnosed with cancer, his kindness and obligation are brought to a supreme test.
Glynis enters treatment for mesothelioma (a cancer that has been associated with asbestos exposure) while Shep still has his healthy Merrill Lynch portfolio worth nearly a million dollars -- all earmarked for his planned one-way trip out of the USA. He quickly learns that he won't be able to leave after all because he needs to work in order to keep his health insurance for Glynis's fight against the cancer. He nobly accepts his care-taking role and soon finds himself at odds with work and his family and friends because of the tremendous pressure and stress on him to continue to provide. Inexorably, we see that Shep is slowly being metaphorically exsanguinated (bled dry) by all the demands placed on him at work, at home with Glynis, with his sister and father, by his children, and with his best friend Jackson. In addition, there goes the bank account -- draining dollar by dollar for drugs and treatments that don't seem to be doing much.
At the heart of this novel is the question -- how much is one willing to pay for a few extra hours, days, weeks or months of life? How much is one person's life worth and when is enough good enough? As Shep continues to take care of the bills and the people in his life, he becomes more resigned and trapped by the realization that even after Glynis dies, he still won't be able to escape to Pemba because he will be completely broke. And to what end? Glynis is still going to die.
I really cared about the people in this novel. There are other side plots dealing with Shep's friend Jackson and Jackson's family, Shep's sister and father that also provided insight into the character of a man who indeed "shepherds" those he cares for. It was neither an easy read nor a particularly uplifting one. It was, however, a poignant testimony to the power of love and the virtue of duty. I recommend it.