Fiction has the ability to bring a world to life, to offer other viewpoints and ways of looking at the world, and it also has the ability to put us in another body in order to give us the experience of a disease or condition. In Atticus Lish’s excellent new novel The War for Gloria (Knopf, 2021), the disease is amyotrophic lateral sclerosis, ALS or Lou Gehrig’s disease. The story is told from the perspectives of Gloria and her son Corey, who is a young teenager when Gloria is diagnosed with ALS. Lish, whose novel Preparation for the Next Life won the 2015 Pen/Faulkner Award, brings to life the world of working class Boston suburbs.

The book’s exploration of the relationship between our brains and bodies, between emotional and physical strength and weakness, begins at the opening lines, which come from a mostly invisible omniscient narrator: “You never think about nerves and breathing. You take breathing for granted. You take the nerves under your skin or under the skin of another animal for granted.” We take our own good health, the smooth functioning of our bodies for granted, often because we lack the ability or even the need to understand them. The War for Gloria seeks to increase our understanding, while at the same time putting the limitations of science and the ability of the brain to expand to acquire and process new knowledge side by side with the limitations of the body.

Gloria is attending college when she meets a man named Leonard, who talks to her in an endless stream of science metaphors. To keep his interest, she reads “popularized science books” in which she learns of a replicating pattern that will soon be evidenced in her own body in the form of ALS: “Trees, lightning, river deltas all shared the same geometry, a self-replicating fractal pattern where the large-scale structure was repeated on the small scale, on the smallest scale, no matter how far down you went.” Gloria also learns this: “To experience chaos, she saw you didn’t need a storm. All you needed was the right man. Leonard always left her.”

Soon she gives birth to Corey, whom she raises mostly alone in the Boston suburbs. Leonard is in and out of their lives, never a constant. Because we see him through Gloria and Corey’s eyes, it’s hard to get a true picture of him, and he leads both of them to believe he is someone he is not. Corey for a long time believes he’s a policeman and Gloria believes he’s an intellectual, while in fact he’s a security guard at MIT who reads physics in his spare time.

Leonard has always visited Gloria and Corey sporadically, with “such long gaps between his visits that Corey kept thinking he was gone for good.” As Gloria’s condition worsens and it becomes difficult for her to manage on her own, Leonard returns. Both Leonard and Corey try to help her with finances, with the tasks of daily living, and with obtaining government and social service assistance, which often fall short. The two men are often at war with each other, giving the book its title, and also rendering their help ineffectual.

Their contentious confrontations fuel much of the novel’s complex plot. But what interested me as much as the many plot turns, and the reason I think the book will interest Intima readers, is the way Lish, with unflinching, unstinting prose, describes Gloria’s diagnosis and physical decline, as well as the emotions that accompany it. Her struggles are captured in this brief poignant scene: One night Corey hears a crash. Gloria has fallen and Corey helps her up. Lish writes: “‘I tried to jump!’ she screamed in anguish. ‘I tried to jump one last time.’” We feel her distress when she can’t perform the simple act of jumping into the air, both feet leaving the ground, something we take for granted that we can do.

As her condition continues to deteriorate, the chaos inside her body is replicated in Corey’s world, and the novel shifts from exploring how the disease disrupts her body to how it changes her son’s life. When he accompanies his mother to a Longwood neurology clinic in Boston where they fit her for a wheelchair, he observes in the basement workroom “a workbench, plastic templates, a T-square, compass, cutting tools—shears, matte knives…” Lists of all sorts appear throughout the novel, such as this one, when Corey has dropped out of high school and taken on all of Gloria’s care:

During the day, now that he wasn’t working, he had to drive to Star; buy food, prepare it. Strip the sheets, drive to the laundromat, do the laundry. Feed his mom. Give her fluids. Wash the dishware. Take her to the bathroom. Change her clothes. Bathe her. Comb her hair, brush her teeth. Pay electric bill. Gas bill. Phone bill. Get a letter from insurance and not know if it was a bill…

Despite the many responsibilities he assumes as a caregiver, Corey takes on a series of manual labor jobs and studies mixed martial arts. He grows stronger as Gloria weakens. Her brain no longer controls her body; her muscles, unused, atrophy. As she goes from independence to dependence on the two men and a friend named Joan, from supporting herself with a job to relying on insurance and disability payments, the progression of her disease is defined by an ever-growing reliance on assistive devices, first a walker and special braces, then modified eating utensils and a wheelchair, finally a hospital bed. All of these are obtained with difficulty, and none of them are enough.

The drama between the two men—and the turmoil in Corey’s life—continues. Corey fights with his father, makes bad decisions, is led astray, has legal problems. We fear and root for him in equal measure, aware that his actions are in direct response to his mother’s disease even as he doesn’t see this. It’s almost as if, with his cage fighting and his own downward spiral, he’s trying to replicate Gloria’s pain and decline in his own life. Lish writes about his fatalistic mindset in the days preceding a fight: “Once a day he thought whatever was going to happen in the cage would eventually happen no matter what he did and then it would be over.”

Is he fighting for Gloria? Is he fighting to become strong enough to defend himself and Gloria from his father? Or is he fighting for his own life? The cage becomes a strong metaphor in the novel—and Lish’s skill in drawing us into the struggles of Gloria and Corey underscores one of its themes. We’re all in a cage, the book is saying, constricted by the limits of our own bodies and minds.—Priscilla Mainardi

Priscilla Mainardi, a registered nurse, attended the University of Pennsylvania and earned her MFA degree in creative writing from Rutgers University. Her work appears in numerous journals, including Pulse - Voices from the Heart of Medicine, the Examined Life Journal and BioStories. Mainardi, who teaches English Composition at Rutgers in Newark, New Jersey, is Intima’s Fiction editor and has served on the editorial board since 2015.