Health and Happiness

Taking as its epigraph a passage from Oscar Wilde’s play, THE IMPORTANCE OF BEING EARNEST, about the incompatibility of a “high moral tone” with “health and happiness,” Diane Johnson’s seventh novel provides a wryly humorous but also timely and at times troubling look at life at an American hospital as a microcosm of American society. Set in a prosperous San Francisco Bay area community and focusing on Dr. Philip Watts’s month-long rotation as chief of medicine, HEALTH AND HAPPINESS concerns doctors and patients, but also spouses, lovers, medical procedures, and the high cost—emotional and ethical as well as monetary—of the American pursuit of health and happiness, immortality and success. Written by the wife of a doctor, Johnson’s novel is informative, touching everything from medical ethics to medical expenses, parking to triage, but also highly ironic. The hospital’s noble mission—to serve private patients, the indigent, and the university medical school to which it is attached—seems curiously at odds with its fortress-like appearance, Wall Street ambience, and sexist power structure.

Over the course of its fifty-seven sections—260 pages—the focus shifts, soap-opera-style, from character to character, dealing largely but not exclusively with Dr. Watts, patient Ivy Tarro, and Mimi Franklin, head of volunteer services. Idealistic and demanding, “judicious and conservative,” Watts outwardly dominates the narrative as well as the staff but inwardly is beset by doubts about his work, his colleagues, and his marriage. Young and beautiful, Ivy Tarro, a single mother, will enter the hospital for tests, be apparently misdiagnosed and mis-treated, suffer a stroke, recover, briefly become Watts’s lover, and gain her release, only to find that medical expenses have ruined her and her daughter’s futures. Ivy’s subsequent plan to become a surgeon and thus attain health and happiness seems more ironic than viable. Mimi’s future seems more assured: marriage to Bradford Evans, the internist who failed to consider that Ivy’s condition may have been nothing more than the result of her breast-feeding. In Johnson’s world, the higher good, alta buena, remains elusive, perhaps even delusive. Instead of health and happiness, Johnson conjures up a world of few miracles, occasional mistakes, and much muddling, in which inexact science and exacting life intersect.