For those of us who promised to stand by our partners in sickness and in health, the debilities of age, disease or chance come as a hideous shock. Jane Mackenzie, the heroine of Alison Lurie's tenth novel, "saw her husband fifty feet away and did not recognise him . . . an ageing man with slumped shoulders, a sunken chest, and a protruding belly, leaning on a cane". His transformation from an active, handsome, confident academic is a prelude to the collapse of the Mackenzies' marriage.
Just how much does adversity, and particularly the adversity occasioned by pain, reveal about your true nature? As someone who has spent the past year in and out of hospital, I am still not sure. Lurie's two couples, heading for adultery, could have been devised by Wife Swap, in that each consists of a self-centred invalid and a self-sacrificing spouse. Jane's marriage is old-fashioned. Her life revolves around her administrative job at the University of Corinth (Lurie's imaginary grove of academe, visited in previous novels), the weekly farmers' market, her vegetable patch and her husband's career. They have no sex life and no children. The life of Alan, her husband, is dominated by self-pity, thanks to chronic back pain, which he imagines as a lizard clawing at his back. Neat, prim, self-sacrificing Jane is not interested in his imaginative garden follies or his drawings.
When Delia Delaney, "the American Angela Carter", descends upon Corinth as a lecturer, accompanied by her handsome husband Henry, the Mackenzies are each swept into an elegant minuet of desire and ill health. As in Lurie's Pulitzer- winning Foreign Affairs, the story unfolds through the eyes of a woman and a man, Jane's conventional guilt and healthy philistinism contrasting with Alan's selfish pleasures and artistic sensibilities. Truth and Consequences is more than a satire on sickness and health: it is also a parable about creativity and suffering.
Delia, a glorious creation, paraphrases Edmund Wilson's essay "The Wound and the Bow" in suggesting to Alan that "you have to accept your affliction as a gift . . . Inspiration comes from a dark, distant place, and it can't come without pain." The author of unmistakably dreadful stories about her violent childhood in the Deep South, Delia is as absurd as any character in David Lodge, yet she is also a genuine muse. While Jane and Henry make out in haystacks and library stacks, Alan does indeed discover his talent as an artist as a result of welcoming his pain. Lurie's underlying preoccupation in all her fiction is the mystery of creativity - something that most great writers address. Naturally, this does not prevent Alan's selfishness from being appalling, and appallingly funny: his back matters more to him than the victims of 9/11. We are all like this, deep down, and the truth illness reveals is often no better than that.
Lurie's novels, peopled by middle-class white academics, may seem conventional, but they examine the aspects of love and life we prefer to ignore. The essential lunacy of children, the triggers for infidelity, the inevitability of death, the unknowability of another person and the consequences of being too truthful are all explored by her in fiction that, read as a body of work, provides us with a moral compass for modern America. It is Lurie, not Updike, whom people will one day read to discover what our life and times were really like. Dazzlingly intelligent, witty, perceptive and engaging, she is not to be missed - in sickness or in health.
Amanda Craig's most recent novel is Love in Idleness (Time Warner)