More Than It Hurts You

More Than It Hurts You

by Darin Strauss

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Read Darin Strauss's posts on the Penguin Blog

Josh Goldin's happy yet unexamined existence is shattered one morning when his wife, Dori, rushes their eight-month- old son to the emergency room in severe distress. Dr. Darlene Stokes, an African-American physician and single mother, suspects Munchausen by proxy, a rarely diagnosed and controversial phenomenon where a mother intentionally harms her baby. As each of them is forced to confront a reality that has become a nightmare, Darlene, Dori, and Josh are pushed to their breaking points.

Darin Strauss's extraordinary novel is set in a world turned upside down-where doctors try to save babies from their parents, police use the law to tear families apart, and the people you think you know best end up surprising you the most.

Product Details

ISBN-13: 9781440633560
Publisher: Penguin Publishing Group
Publication date: 06/19/2008
Sold by: Penguin Group
Format: NOOK Book
Pages: 416
Sales rank: 645,901
File size: 558 KB
Age Range: 18 Years

About the Author

Darin Strauss is the award-winning author of the national and international bestseller Chang and Eng, as well as its screenplay for Disney Films and director Julie Taymor.  His work has been translated into 14 languages and he teaches at New York University and lives in Brooklyn, New York.

What People are Saying About This

This book is harrowing, hurtling, heartbreaking and -- more than anything -- devastatingly accurate. Darin Strauss (a novelist whose talents sometimes seem limitless to me) has created characters whose complexities and dark motivations -- though they are always hidden from each other, and even sometimes from themselves -- are never hidden from their author. This is a brilliant, sharp, suspenseful novel, impossible to turn your gaze from. --Elizabeth Gilbert, author of Eat, Pray, Love

Darin Strauss has written a novel that is -- suture by suture, idea for idea -- peerlessly brilliant. Here is a supreme, mature novelist at the height of his powers. --Gary Shteyngart, author of Absurdistan and The Russian Debutante's Handbook

A prize-winning, front-cover-of-the- Times-Book-Review type of story that's sure to be one of the few novels of this era to be remembered in thirty years-and not just because it's going to be made into a movie. Destined to be the most important popular novel since The Corrections. --Kevin Baker, author of Paradise Alley

That rare thing: a blockbuster with a can't-miss commercial hook-and it's also a great story, a cross between Bonfire of the Vanities and The Lovely Bones. --David Lipsky, author of Absolutely American

Darin Strauss's latest is an eviscerating portrayal of contemporary American life, surgical and exact. At turns funny and disturbing, unsparing in its insights yet generous with understanding, More Than It Hurts You is a relentlessly rewarding piece of art. --Colson Whitehead, author of Apex Hides the Hurt and John Henry Days

From the Publisher

"[A] brilliant, sharp, suspenseful novel."
-Elizabeth Gilbert

"Wrenching and flawlessly involving."
-New York Daily News

"Chilling, insightful and bold."
-Chicago Tribune

-Publishers Weekly

Reading Group Guide


Josh Goldin was savoring a Friday afternoon break in the coffee room, harmlessly flirting with coworkers while anticipating the weekend at home where his wife, Dori, waited with their eight-month-old son, Zack. And then Josh's secretary rushed in, using words like intensive care, lost consciousness, blood. . . .

That morning, Dori had walked into the emergency room with her son in severe distress. Enter Dr. Darlene Stokes: an African-American physician and single mother whose life is dedicated both to her own son and navigating the tricky maze of modern-day medicine. But something about Dori stirred the doctor's suspicions. Darlene had heard of the sensational diagnosis of Munchausen by Proxy, where a mother intentionally harms her baby, but had never come upon a case of it before. It was rarely diagnosed and extraordinarily controversial. Could it possibly have happened here?

As their four lives intersect with dramatic consequences, Darlene, Dori, and Josh are pushed to their breaking points as they confront the nightmare that has become their new reality. Darin Strauss's extraordinary novel is set in a world turned upside down—where doctors try to save babies from their parents, police use the law to tear families apart, and the people you know the best end up surprising you the most.


Darin Strauss is the award-winning author of the national and international bestseller Chang and Eng, as well as its screenplay for Disney Films and director Julie Taymor. His work has been translated into 14 languages and he teaches at New York University and lives in Brooklyn, New York.

  • Author Darin Strauss opens his novel with a quotation from Anton Chekhov. What do you think it means? How does this quote set the stage for what transpires in More Than It Hurts You?
  • When you began reading More Than It Hurts You, what did you know about Munchausen syndrome by proxy? Do you believe that its origins are biological, or do you agree with the viewpoint that there is no medical evidence for such a condition and that it's a way for abusive mothers to be absolved of their actions? Is Munchausen syndrome by proxy a metaphor for something else in the book?
  • Talk about Dori. When did you suspect that she might have harmed Zack? As she imagined someday confessing her actions, did you think she believed people would actually understand her motivations for hurting him? Did you have any empathy for her?
  • "The question for Josh had always been, how much blindness does a happy life require?" (page 277). What does this sentiment reveal about Josh's personality? Was the fact that he loved his wife "honestly, faithfully, and blindly" the reason why Josh didn't suspect Dori sooner? Why did he feel such antagonism toward Darlene Stokes?
  • "Maybe the truest way to know a person is to learn what she's ashamed of." (page 63). This statement refers to Darlene—what was her secret shame? How does this statement apply to other characters?
  • Do you think it's fair for a person to be judged on actions they took years before? In what other instances are incorrect assumptions made about characters based on their pasts?
  • What was your opinion of Darlene? If you were in her shoes, would you have done the same things she did, whether in her role as a doctor or as a woman? How do you think her life would have been different had her father stayed with the family, or had she and Leo been able to work things out? Do you think she knew joy?
  • "Because if a woman never feels the full power of a man's affection all at once, there are ways to increase how he rations it out." (page 186). Talk about Dori's manipulations of Josh and of the people around her. Do you think she realized how much they would cost her?
  • When Darlene heard from her father for the first time in forty years, she realized that "her strongest wish . . . was to hang up on him." (page 230). Was her reaction surprising to you? Can you understand why she would feel this way?
  • Discuss the wrenching scene in which Zack is removed from Dori and Josh's custody by Child Protective Services. Was it difficult for you to read? What would you have done if you were Josh or Dori? Do you think CPS did the right thing in placing Zack in foster care?
  • The author reveals certain plot twists after they've taken place. What did you think of this device? Did it enhance your reading experience? How would the novel have been different had all the events unfolded in real time?
  • What is the role of prejudice in the book? Which characters exhibit it, or otherwise allow themselves to accept stereotypes? In Part VI, Josh refers to Darlene as a "reverse racist"; do you think there is such a thing?
  • "When did Dr. Stokes know the public case had tipped against her?" (page 331). Did you expect the court case to end the way it did? Talk about the subsequent encounters between Darlene and Josh. Would you have acted in the ways they did?
  • After the court case was dropped, Martin Seidel thinks to himself, "The good guys have won." Do you agree? Were there any "good guys" in More Than It Hurts You?
  • What was your opinion of the book's ending? What do you think might have happened after Dori uttered the book's last line?

Customer Reviews

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More Than It Hurts You 3.4 out of 5 based on 0 ratings. 35 reviews.
bkrdr63 More than 1 year ago
Darin Strauss is a gifted writer who can describe events and feelings in ways that I have never thought of before. He worked very hard in order to make sure that the reader fully understood each character and his/her motivations. That said, sometimes the details bordered on the tedious(especially in reference to Josh's job and the world of big-time advertising) and I just wanted to get back to the story at hand. There are many shades of gray with each character and no good vs evil story here. Unfortunately, I didn't particularly like any of the characters. Although, I would say the book is well worth reading it is probably not for the more casual reader who likes their books more "plot-driven" than "character-driven".
Guest More than 1 year ago
I read this entire book but had to force myself through it after the first few chapters. I agree that the author spent too much time describing people and places time that should have been used to develop the underlying story more fully. At one point I thought some other book was mistakenly included in my printed copy! The premise was promising but the book disappointing.
coolmama on LibraryThing More than 1 year ago
I was compulsivly reading this book until about 3/4 the way through. Then is short of fell short and became predicable, then it had a twist.Incredible story of reverse racism (perhaps) and MSBP with a white couple and a black nurse.Well written and had threads of all.Recommended.
txwildflower on LibraryThing More than 1 year ago
A very good book that would make an excellent book club selection. Who makes a good parent or a bad one?
Jennifyr on LibraryThing More than 1 year ago
Overall, Darin Strauss wrote an enjoyable read. I feel he has a potential to be a good writer, and, at times, sounded a little like Jonathan Franzen. However, he needs a bit more polishing, and a better editor, as there were a lot of typos, extra words, and a few instances of omission of events. (For example, about halfway through, the author makes a note of Dori buckling the baby, Zack, into a highchair, but after a few sentences of dialogue, they discuss how he is down the hall in a playpen, yet no narrative of him being moved at all., nor any lapse of time is indicated.) Strauss also covers a lot of different topics, but fails to do any actual research into them, leaving a lot of facts to feel a bit... off. He could have done a lot with MSBP, but instead glazed over facts and used what space he could been educating his audience with lame facts and silly bits of "media". I feel he also brought up a lot of issues just to state his personal opinion on them (music, culture, race, sexuality), even though they had no relevance to the story line. While certain opinions like this may build up a character, in this case, it doesn't. In fact, over all, I feel he focused FAR too much on the race based parts of the book (not to mention used the term reverse racism, which is a huge pet peeve of mine. Racism is racism no matter if it's coming from someone black, white, whatever.) and turned it into another plot device, when it should have been left alone, or at least, made interesting and insightful. Why mention every chapter that Dr. Stokes is a black woman doctor? We get it. The words black and Jewish were used so often that it sounded like an echo. And both of these issues weren't built up in any new way, but instead relied heavily on cliches and stereotypes, along with the one instance of homosexuality that was brought up. It got tiresome very quickly, and at times, a bit maddening.Another little nit picky instance - the author writes about how Darlene is boring her date with her rambling on and on about music and culture, etc, yet he takes up 5 pages on her rambling - which has nothing to do with the story line at all - and bores the reader. If, as an author, he knows the topic is rambling, and boring, why take up so much room and in turn bore his own audience? There are many ways to indicate rambling without actually rambling.Over all, I feel that this book does have potential, and is an enjoyable read if you take away the small failures. It's a bit of a let down though, because the plot/storyline was really interesting, and so much could have been done with this story, but it fell short. Ultimately, this book is just alright- not bad, not good, but lacks any real character connection, any sympathy towards your characters (especially Dori, who is a horrible person, not only self absorbed and using a method of hurting her infant for attention in her marriage, but dragging a doctors name through the mud, wasting the states and the hospitals time, and all the while, feeling as though she is the victim, while trash talking the real victim - Dr. Stokes.) and uses far too many pop culture references, which seemed to trivialize the book and the issue, MSBP, at hand. Worth reading if you have it at hand, but nothing extraordinary, and not worth going out of your way to pick up. Thankfully, I only spent $6 on it, so in my opinion, it at least passed the time in a somewhat entertaining way.SPOILER PAST THIS POINT.I hardly ever write about the ends of books, but the ending was extremely anticlimactic. You wait the entire novel for Dori to get any sort of consequence, and right at the end, just when the truth finally comes out, the story stops. There is never any happy resolve. The doctor is ruined and an emotional mess, and Dori is still smug with the exception of the last page, but we never see her get what's coming to her, which is a big let down. The entire novel I wanted Josh to just leave that smug self absorbed woman, take his baby and r
caroline123 on LibraryThing More than 1 year ago
A Jewish couple, Josh and Dori Goldin, are accused of child abuse by a black woman physician when the wife (Dori) brings the young baby to the ER with a mysterious illness, for which nothing can be diagnosed and the mother who has a medical background, insists that she take the baby home despite the fact that he has "coded" and then recovered. A dark subject, but handled very well by author Darin Strauss. There is satire, stereotypes, news media involvement, and finally legal action. The characters are well drawn but are not especially likeable. The physician who makes the accusation, Dr. Darlene Stokes, has never seen a case of Munchausen by Proxy before but is convinced that Dori is harming her baby, Zack.In spite of a lack of empathy for most of the characters (except the baby), I enjoyed this novel for it's literary style as well as the fascinating glimpse of MBP which is quite a rare diagnosis. Recommended reading.
bhowell on LibraryThing More than 1 year ago
I picked up two medical thrillers for a lazy long weekend, this book and "The Second Opinion" by Michael Palmer. This is a mildly entertaining book but some characters, particularly the lawyer, were unreal caricatures which detracted from the real drama of the story. Still, both books were easily read on the weekend and will be given away to a used bookstore the following week.
LilRedRidingHood More than 1 year ago
This book moved very slow at a number of times and then ending left a lot to be desired.
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I liked this book alot. I always couldn't wait to get back to it. It was true to form. I have to admit I was a little disappointed in the ending. I guess that it does happen that way too.
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Guest More than 1 year ago
I loved this book. It's an incredibly powerful story, exceptionally told. My whole book club loved this one. I highly recommend it.
Guest More than 1 year ago
Darin Strauss in this, his third novel ('Chang and Eng', 'The Real McCoy'), permanently secures his position as one of America's finest novelists. The sheer variety of his choices of stories, his elegant ability as a wordsmith, and the fervor with which he approaches difficult issues within the context of creating a fascinating story are only a few of the reasons for his success. Strauss has the gift to create unique characters, develop them thoroughly and gradually throughout the weaving of his tale, and leave the reader with a high degree of concern about the future of these people long after the lat page of his novels are complete. Always electing to introduce rarely known information as a key to his works, MORE THAN IT HURTS YOU explores the definition and significance of the mysterious phenomenon Munchausen's Syndrome by Proxy (or MSP - the 'DSM-4 factitious disorder by proxy'). It is important to the author that the reader understand this complex entity: according to the dictionary it is defined as follows: 'Munchausen syndrome by proxy (MSP), a type of factitious disorder, is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. People with MSP assume the role of a sick person indirectly by producing or lying about illness in another person under their care, usually a child under 6 years of age. (The term 'by proxy' means 'through a substitute.') People with MSP have an inner need for the other person (often his or her child) to be seen as ill or injured. It is not done to achieve a concrete benefit, such as financial gain. People with MSP are even willing to have the child or other patient undergo painful or risky tests and operations in order to get the sympathy and special attention given to people who are truly ill and their families. Factitious disorders are considered mental illnesses because they are associated with severe emotional difficulties'. Strauss very subtly investigates this syndrome through his creation of a happy family - Josh and Dori Golding and their infant son Zack. Josh is a well-liked, creative salesman for the television network Sparkplug, while Dori is a trained nurse/phlebotomist whose devotion to her family is exemplary. As Josh's attention to new work developments strays from his family focus, Dori rushes Zack to the hospital for gastric pain and subsequently for hematemesis and there is 'treated' the Pediatric ER doctor Darlene Stokes and her intern. Dr. Stokes fails to do certain blood screening tests and Dori accuses her of mismanagement. Zack of course recovers (we later learn that Dori has placed blood in Zack's emesis to begin the Munchhausen Syndrome by Proxy process) and the race between patient/parents and physician/hospital is on. Each of the characters reflects backgrounds that make them 'persons of interest': Darlene was the illegitimate child of a young African American woman, impregnated by one Charles Stokes, a drug dealer who is imprisoned where he changes his religion to Muslim and his name to Intelligent Muhammad. From this rather lowly background Darlene rises above her white classmates, elects to affiliate with her black brethren in housing and activities, becomes a physician, has a brief affair with the first man who pays attention to her (a Caucasian Jew), becomes pregnant, marries, has a child she names James, and when her husband dies, centers her life on her career, her son, and her single mother Alice. Josh Goldin is Jewish as is Dori, a girl of Turkish descent. As the accusation of Munchausen's Syndrome is made against Dori, the Goldin's seek advice from a haughty Jewish lawyer who manufactures concepts that Darlene has vindictive feelings against the Jewish Goldins (racism) and causes the Goldin's to believe his case against '