we-need-to-talk-about-kevinWe Need to Talk About Kevin. Yes we do, I’m afraid. You may have been (like me, for many years) avoiding reading this novel by Lionel Shriver, ducking away from discussions and avoiding reviews, having got wind of the gist of the story through the mass media.

To summarise the book, We Need to Talk About Kevin by Lionel Shriver is written in the form of letters penned by Eva Khatchadourian to her estranged husband Franklin. These missives form a chronological examination of her life before and after the entrance of their son Kevin into their lives (or perhaps, more accurately, the invasion), and they follow the painful path through his childhood, dissecting the family relationships that shape his development along the way. There is no secret about the main event. Kevin, at the tender and cleverly calculated age of 15 years and 362 days, commits mass murder in his school gym.

I need to declare at the outset that I loved this book. It is masterfully written, in my opinion. Any book that can grab you by the throat, shake you until the tears fall and the nausea wells, and every so often cause you to drop the book in shock and surprise, despite knowing the inevitable premise, is a work of consummate skill.

So why are we discussing it in the ALiEM book club? What does this book have to do with critical care and emergency physicians? I would hazard a guess at saying ‘everything.’

When we want to learn about the nuts and bolts of administering the science of critical care, we turn to texts and websites and our colleagues and teachers. But when we want to truly get inside the head of another, and learn about humanity from the inside out, we turn to novels. Books give us windows into the minds of people/characters/good and bad, and allow us to understand and foster empathy. So it is with Kevin. Lionel Shriver tackles an exhaustive list of themes of modern family life in middle America, all of them written with a shrewd intelligence and observation. They are all explored with an almost dispassionate curiosity by Shriver, and never feel like they are falling into polemic.

To list just a smattering of the themes examined:

  • The nature vs nurture debate. Is evil born or made? This is the overarching theme of the book. How much did Eva’s relationship with her son forge the path that he took? If I had one criticism of this book, it would be that the character of Kevin was perhaps unrelentingly evil and malevolent from the start. At times it almost felt like caricature, and detracted from the immersion and faith I had in the importance of the story. Some of the scenes from Kevin’s infant and childhood years seemed impossible to believe. We all have come into contact with antisocial personalities, and seen the spoils of their behaviour. It is difficult to envisage this in somebody so young.
  • Parenting in the modern age. Why do we choose to bear children? The reasons for doing so are often complex, and not always altruistic or venerable. Eva is an ambivalent mother from the start, and this informs much of her interpretation of her relationship with Kevin.
  • The banal and hackneyed wealth of the middle class. Interwoven throughout the book are comments on the choices made from within the luxury of a first world life. These choices bother Eva, and she is quick to speak out about them, peppering the book with her harsh commentary, but they are not enough for her to take any active stand.
  • The phenomena of mass school shootings. This book occurs around the time of Columbine, an event referenced several times, along with others of a similar ilk. There are no answers in here. Like any good novel, it just opens up a space in which you can ask questions of yourself and the world around you. But, particularly as a hopelessly befuddled Australian, where these events seem like they belong to another, crueler, doomed planet, I was left understanding the motivation for these unspeakable horrors no more than when I first picked up the book.

Even the pervasive desire for fifteen minutes of fame in today’s celebrity bedeviled world gets the treatment, with the incarcerated Kevin bemoaning other mass murderer’s substandard methods whilst they hog the limelight.

There are so very many other subplots and themes in this book, that I don’t feel I can do them justice, such as the influence of the American presidential race, the personality of the All-American ‘Gee-Whiz’ husband and his contribution to the unfolding of the story, the civil courts, the responsibilities of the school system, and many more. My recommendation? Go read the book. And be prepared for a surprise.

Discussion Questions

It is customary to conclude a review like this with some questions.  Some of these I have already alluded to. The answers, however, are unlikely to be found in the book. What this extraordinary novel does, is open up the door into further fundamental questions, that we should all be asking of ourselves, and of our society to which we contribute.

  1. What is evil? Is it born, or made?
  2. Why are school shootings, although nominally present in other countries, vastly more frequent in the U.S.? Are there behaviour patterns, individual characteristics, or societal issues, that specifically predispose to these events, and if so, how can they be identified and prevented?
  3. Is the love of a parent for a child unconditional?

We Need to Talk About Kevin was also released in movie format in 2012 staring Tilda Swinton and Ezra Miller. (Rotten Tomatoes Review)

Google Hangout Discussion

* Disclaimer: We have no affiliations financial or otherwise with the authors, the books, Amazon, or Rotten Tomatoes

Michelle Johnston, MBBS FACEM

Michelle Johnston, MBBS FACEM

Specialist Emergency Physician
Royal Perth Hospital
Perth, Australia
Michelle Johnston, MBBS FACEM

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