How a medical crisis inspired novel ‘Small Rain’

“They asked me to describe the pain but the pain defied description, on a scale from one to ten it demanded a different scale.”

So begins “Small Rain,” the new novel by literary sensation Garth Greenwell. It begins with a nameless narrator having a medical emergency and ends up exploring no less than the nature of love itself and the very meaning of our shared humanity.

Reviewers are describing “Small Rain” — published this month by publisher Farrar, Straus and Giroux — as “profound,” “a triumph of genuine vulnerability,” and “an exquisite addition to the literature of illness.”

Greenwell’s first novel “What Belongs to You” in 2016 established the 46-year-old Iowa resident as a force in contemporary American literature: That book won the British Book Award for Debut of the Year, was longlisted for the National Book Award and a finalist for other major laurels including the PEN/Faulkner Award. Plus, it was named a Best Book of the Year by more than 50 publications across nine countries. His second work, “Cleanness,” also garnered critical praise — it was a finalist for the Lambda Literary Award, and was cited as a top book of the year by numerous outlets including the New York Times, the New Yorker, TIME, NPR and the BBC.

Love, carnal desires, emotional intimacy and distance — that’s the terrain Greenwell mines in both “What Belongs to You” and “Cleanness.” But the scale of “Small Rain” feels even more intimate and personal. Greenwell renders to devastating effect the way illness makes you defenseless, how dehumanizing the medical process is even as it saves your life, and why at the end of the day all that truly matters is being with the one you love.

“What makes me want to write a book is feeling utterly bewildered by something that I have witnessed, or something that has happened to me,” Greenwell said in a Zoom interview for the Southern California News Group’s virtual program Bookish.

“I did have a medical crisis like the narrator’s in the summer of 2020,” Greenwell said. “I wasn’t in the hospital as long as he was, but after spending, I think, about eight days in the ICU, I just felt like something had happened to me that I couldn’t understand. And it’s that feeling that makes me feel like I need to write a book.”