This was my first novel by Garth Greenwell, though it is the third one that he has published, and is a continuation of those previous novels, though there is no need to have read them to enjoy the pleasures of this work.

Greenwell's narrator, obviously loosely based upon its author, is unwell, in hospital, and is forced to face some big life decisions. Greenwell writes in details of close-up imagery, it is meticulous prose, one which find deep connections in sometimes mundane moments. Your mileage as reader will depend upon how much emotional engagement you have with its narrator.

I can easily see Small Rain appearing on end of year best of novel lists, it is a very minor epic. It is a novel to challenge your perspectives. I enjoyed it very much.

Thanks to Netgalley and the publishers for the ARC.

Garth Greenwell’s third novel (after “What Belongs to You” and “Cleanness”) and I understand – not having read the first two - feature the same narrator and while very much functioning as standalone novels can also be read as part of what the author calls an “unfolding project”.

The novel’s setting is Iowa, at the early height of the Covid-19 pandemic. The unnamed male narrator – a poet who teaches at the University together with his more senior Spanish-speaking partner L (also a poet) goes to hospital after suffering acute pain to be told that he has suffered a potentially life-threatening infrarenal aortic dissection – and that the hospital wants to find out the cause of the dissection so as to work out how to proceed.

It is strongly autobiographical in nature: Greenwell has said in a pre-publication interview that he “underwent a medical crisis similar to that of the narrator” – and that he wanted to “try to find a way in fiction to try and process that experience and to capture the minute-to-minute experience of being a patient”; and his partner is the poet Luis Muñoz, who runs the Spanish-language M.F.A. program at the University of Iowa.

And much of the novel is very much that minute to minute experience – one entirely unfamiliar to the narrator (and presumably Greenwell before his own hospitalisation) but one that will, at least in many respects, be depressingly familiar to even anyone who has sat with a loved one in hospital – with many of the procedures described in detail (ultrasound, X-Rays, ECG, EKG, IV lines) I think being fairly routine for anyone who has visited close relatives in hospital or themselves done similar tests either as part of an investigation or simply a medical.

But there is no question that Greenwell captures these procedures – their oddities, their indignities, the worry they can engender – brilliantly, as well as the more general sense of loss of agency and literally existential fear that accompanies an emergency admission to hospital particularly with an unclear but potentially hugely serious diagnosis. And all of this exacerbated by the lockdown restrictions so that the narrator is largely isolated from loved ones and having to face much of his ordeal alone – Ls rare visits an emotional highpoint of the book.

In many ways this is a book of minutiae: house repairs - on the house that the narrator and L buy and which turns out to be much more of a project than they had ever expected or could easily afford); weather – and in particular the experience of being in the direct path of a Derecho a few months earlier; tree surgery – in the aftermath of a huge oak part falling on their house in the storm; medicine regimes – once the narrator is preparing to go home; and even dog parks – in the novel’s closing scene: all of this are described in painstaking detail to the extent that I did sometimes find myself slightly glossing over the detail or panning the text for its literary nuggets.

The effect I felt was rather like an Ian McEwan novel although with the excessive detail being based on exploring lived experience rather than reproducing research.

Where the book really excelled for me was when the narrator was in a more contemplative mood – either re-examining his life in the light of what has happened,

"Try to remember this, I admonished myself, since I knew it would fade. All happiness fades, or does for me; misery digs deep gouges in memory, sets the course of the self, I sometimes think, it lays down the tracks one is condemned to move along, whereas happiness leaves no trace. Remember this, I said to myself. Why should only suffering be a vale of soul-making, why shouldn’t the soul be made of this moment, too, this unremarkable moment, remember this."

Or even more interestingly reverting to the poetry he has loved, analyses and taught as a way to come to terms with his predicament. At times perhaps it can feel rather pedological (and I have seen implications that Greenwell has shoe-horned in some of his previous blog writing on his favourite poems) but his careful and patient examination of George Oppen’s “Stranger’s Child” really enhanced my appreciation.

His assertion that “Whole strata of reality are lost to us at the speed at which we live, our ability to perceive them is lost, and maybe that’s the value of poetry, there are aspects of the world that are only visible at the frequency of certain poems.” permeates the book.

Overall, this was an impressive book.

Reading this book I was surprised at the US health care system as it seemed to mirror the NHS in UK which was not what I expected. being medical I was unsurprised at his thoughts of his treatment and thought he articulated them very well. Having also been a patient I could easily relate to them. As the book progresses and he talks about poetry and music I could really relate to that too. How often do we find solace in art and culture. How it makes things more acutely relevent to us and how we relate to the world. I enjoyed reading about how L came to terms with his partners health and how he adapted. How everything was affected by this
It became almost inspirational.
A thought provoking book
I would have preferred people to have names rather than initials
There were also a number of formating issues which at times made the book hard to read and some spelling errors (leaks instead of leeks for example, there were others)