Book Review: Death as a Side Effect by Ana María Shua

Dystopian literature stems from no particular geographic boundaries. Aldous Huxley and George Orwell were British, Margaret Atwood is Canadian, Philip K. Dick and Kurt Vonnegut were American. Thus, while Ana María Shua sets Death as a Side Effect in her native Argentina, the conditions that beset that future society are perhaps universally possible.

Survival is one of the underlying themes here, both personal and economic. The rich live in gated neighborhoods with 24-hour surveillance and security guards. The average person lives in “no-man’s-land,” avoiding the “occupied zones” controlled by criminals and dangerous thugs. Marauding gangs make the streets of Buenos Aires so unsafe the average person takes armored taxis to get around town and to go to protected areas for walks. Thus, when “vandals” break into the apartment below him, Ernesto Kollady’s reaction is ingrained:

When I heard the banging and explosions, I did what we all do: I made sure the security features in my apartment were working. I played music full blast so I wouldn’t hear the screams. I locked myself in the bathroom and turned on the shower.

Ernesto, like others, must deal with life in a society where life seems cheapened. Paparazzi with video cameras crowd around hospitals hoping to get footage of someone dying. The Suicide Channel is one of television’s more popular offerings. Only the poor go to hospitals, where, to ensure a profit, the “franchise owners” require patients’ families to provide the food. Both physicians and families, meanwhile, are required to report the declining health of older people so they can report to “convalescent homes,” paid for by selling what property the individual has. As a result, older and ill people pay doctors under the table to be their “secret” physician because an “official” physician would be required to report them.

Yet while Death as a Side Effect has abundant social commentary, Shua does far more with the narrative. At bottom, the dystopia she envisions is essentially a stage upon which a larger and more common literary theme plays out — human relationships. Told in the form of Ernesto writing to the mistress who abandoned him, this slim narrative examines family relations, particularly that between Ernesto and his father. Although impacted by this society’s mandates, particularly the convalescent homes, the family issues here are not necessarily unique. Ernesto is a seemingly ineffectual everyman. His father on the other hand is a powerful, controlling figure who seems to have always found joy in humiliating Ernesto. Yet Ernesto has a somewhat kinder view of his father than his sister, who never really had a life outside the family home and in whom a searing hatred has grown. Their mother, meanwhile, has descended into Alzheimer’s-type dementia.

When a large intestinal tumor forces Ernesto’s father first into a hospital and then a convalescent home, his mother’s dementia and his sister’s enmity leave Ernesto responsible for his father’s fate. Thus, although Ernesto’s own children are no more than passing references in his writing, he is required to come to grips with the archetypal father-son conflict. Despite his father’s long history of demeaning him, Ernesto also confronts the preservation of personal dignity in a society seemingly devoid of the concept.

Originally published in 1997 and translated into English for the first time by Andrea G. Labinger, Death as a Side Effect uses dark satire to effectively meld societal and personal tribulations. Although the Spanish edition of the book was selected by the Congreso de la Lengua Española as one of the 100 best Latin American novels published in the last 25 years, its themes and issues are universal.

Ana María Shua, Death as a Side Effect