At the beginning of the vaccine distribution, I was inordinately miffed at somehow being classified as too young to be vaccinated. Having overcome my umbrage, I found Lionel Shriver’s Should We Stay or Should We Go had me considering old age again. Although the author is 64, she uses 80 as the marker for the beginning of being “really old.”

When her father dies after a long and debilitating illness, Kay Wilkinson can’t cry; she is relieved. Determined to die with dignity, her husband Cyril makes a proposal. To spare themselves and their loved ones such a humiliating decline, they should agree to commit suicide together once they’ve both turned eighty – end it all before it gets any worse. A medical Doctor, Cyril has access to Seconal and neatly places the pills in a black box in the refrigerator, to be washed down with a good wine when the time comes.

Although the subject matter is morbid, Shriver uses Gallow’s humor to good advantage. I knew by page fifty there was not a simple solution to the dilemma of Kay and Cyril when the chapter title “The First Last Supper” promised more adventures to come. Shriver creates a parallel universe in alternate chapters, showing how their decision on that fateful birthday could resolve. If they cut their lives artificially short, what might they miss out on, or what horrors might they escape?

Shriver cleverly creates thirteen chapters of scenarios, including surviving cryogenics, being hit by a bus, using long-term health care to live at the London version of the Ritz old folks home, contrasted nicely with no health care and living on the government dole at a place right out of “Over the Cuckoo’s Nest.” And she addresses the “five-minutes-to-12 syndrome” – the temptation to hang on until it’s too late, and lose the opportunity to decide anything. Sometimes it’s good to stay, sometimes it’s better to leave.

Some chapters have them leave; others have them stay, and Shriver, an American writer living in London conveniently connects the Leave or Stay to the Brexit vote. Later, the Covid pandemic shows them in two versions of lockdown, one in dire straits of near hunger and isolation, the other living so well they are reluctant to rejoin the fray after quarantine is lifted. Shriver also tackles the future of immigration and its unexpected effects on the old couple.

The topic is becoming popular: Roz Chast humorously addressed it in her New Yorker style cartoon book – Can’t We Talk About Something More Pleasant, and Derek Humphry’s 1991 self-published Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, was on the New York Times bestseller list for over four months. Katie Engelhart’s 2021 book, The Inevitable, is about people determined to exercise control over their own deaths.

And yet, most of us will put up with anything rather than die. Shriver notes that most think “If they ever do die – not that most people believe in their heart of hearts that they ever will – they’ll be wise, warm, funny, and sound of mind until the very end, with doting friends and family gathered round.” But it doesn’t always work out that way.

My mother, who died at 94, after a life of never going to the hospital except to give birth, and 5 last days of slow decline, told me – “Noone wants to leave the party.” Shriver would caution – make sure there’s still a party.

At times disturbing and even gruesome, Shriver’s sardonic wit provided enough comic relief to keep me reading, and her ingenious possibilities kept me wondering what would come next.