Segal has written a grimly humorous novel abut old people, mostly demented ones. Whether the humor or grimness takes precedence is open to interpretation. Dementia is grim, yes, bu how is it humorous?
The action takes place in a large New York city hospital emergency room where people with dementia who are a risk to themselves or others show up. An unusual number of cases have been showing up, prompting a research firm, suspecting a possible malevolent plot to undermine America’s mental health, to plant an older person there as a “spy “ to observe and take notes.
What follows is both a comic and tragic, and it is in this mixture that the book has its strength. The 75 year old spy is alert, but she is beginning to slip a bit, shown by her obsession with a story she has written and submitted for publication but has never gotten either acceptance or rejection. The reader begins to wonder if this is even a real situation. She begins to think of another story she might write based on what she is observing and working it into a story which ends with a doctor shouting “Rumpelstiltskin” as his patient who is in pain begins to throw up. To add to the comedy, she is mistaken for a real patient, despite her protests.
There is an assortment of old patients who appear in the ER, most in dire shape but unable to articulate their problems, or even know who they are and what they’re suffering from. They get caught up in bureaucratic delay caused by too many patients before they can be transferred to a special unit for dementia patients, euphemistically called the Senior Center. One old lady continually takes off her clothes while she’s awaiting her transfer. Another thinks he has already died and talks confusedly about where he has ended up. A essentially harmless old man is tormented by music in his head that never stops.
The book opens and closes with a quote from the Brothers Grimm, “And if they have not died, they are living to this hour.” The title, as well, makes an reference to a folk tale about a girl meeting and marrying a prince, and ending with them inheriting “half the kingdom.” The aged and mentally infirm people in this story are half here – the physical half, not in good shape, the mental half missing.
The reader may have been taking his own mental notes, and will find no malevolent plot to undermine our mental health, except a natural and home-grown one of becoming too old. There is no inheritance of a healthy kingdom, just the loss of one.