The protagonist reflects on killing her mother in the first sentence and that remarkably honest viewpoint continues throughout the book. Given that her mother was elderly, had begun to fail to recognize familiar people, was no longer able to live on her own but was terrified of leaving the house one could call this a mercy killing. But make no mistake, this woman was murdered.
The time-line switches frequently and without a lot of warning. But the style wasn't as disorineting as it could have been. Sebold is a very adept writer, and the reader should be able to orient herself in a sentence or two.
As I said, the book focuses on mental illness. The narrator seems to think that her mother was the main victim of this illness, but it attacks every member of the family either directly or indirectly. By the time I was finished I was filled with empathy for the 3 generations we meet, as well as the people who came before and will come after. Mental illness is the awful gift that keeps on giving.
I wish I could say the novel wasn't all grim, but it was. Sebold doesn't try to soften her message with humor. This novel doesn't flinch in being brutally honest and graphic. The kinds of things that make most people turn away don't phase Sebold. She plods right through them, making the reader descend into the hell the narrator is plunging into.
Sebold's first novel, The Lovely Bones, was a huge success, while this book hasn't been nearly as well received. I can see why, but I think people are missing out on a brave work if they miss this one. Sebold is an incredibly strong writer, and just because she isn't afraid to show the horrors of life is no reason to diminish her accomplishment.
Many reviewers have said the situation was unrealistic. I can only assume those people have never been a caregiver for a desperately ill, difficult person--or a colicky baby. Caregiving can make the most well-adjusted person consider murder, and Helen, the narrator, is a long way from well-adjusted.
I'd recommend it highly to people who are interested in a fast-paced tale of family dynamics-no matter how dark they may be.