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Book Review   |    
Ann L. Hackman
Psychiatric Services 2006; doi:
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by Laurie Foos; Minneapolis, Coffee House Press, 2005,204 pages, $14 softcover

Dr. Hackman is assistant professor in the Department of Psychiatry, University of Maryland, Baltimore.

Before the review, it is important that I disclose something about myself. Three years ago I completed chemotherapy for breast cancer. My husband shaved his head in sympathy, and we were both as bald as grapes. Family obligations took us to Las Vegas. There, we renewed our wedding vows. With an Elvis impersonator. And it was perfect.

So, based on the title alone, I expected that I would like Laurie Foos's Before Elvis There Was Nothing. I was not disappointed. If Anne Tyler had married Tom Robbins in my Elvis ceremony, they might have produced a novel something like this. Cass—the lovely heroine, who has an Ionesco-inspired horn growing in the middle of her forehead—works as a hair-replacement specialist, helping women with varying degrees of hair loss. Cass also takes care of her sister Lena, who is unable to leave the house because of agoraphobia.

Eighteen years before the start of the novel, Cass and Lena's parents left them for Elvis. Well, sort of. The parents were obsessed with Elvis. They raised their daughters in the midst of Elvis music, memorabilia, and trivia, and they have not been heard from since they departed on the tenth anniversary of Elvis's death. Still awaiting word from their parents, Cass and Lena remain quite focused on Elvis, as do other people in their lives: Vance, Cass's podiatrist boyfriend; Ernie, the mailman; and "Psyking," Lena's Internet psychiatrist who observes that "Elvis is everywhere." Cass pursues treatment for the horn growing on her head. This takes her to a bizarre rehabilitation facility where the other patients are developing various animal characteristics, such as zebra stripes. Then things really get interesting.

Obviously, the world of the book is quite surreal and very compelling. The characters in this well-written novel are beautifully drawn, and they have wonderfully real relationships and insights. At one point, Cass reflects, "It's difficult to decide what's true about our parents and what we've made up. I've come to think, finally that it doesn't matter. It's what we believe that counts." The plot is wild, funny, poignant, and imaginative. The social commentary is incisive, and the Elvis trivia is amazing. And although Lena's "Internet shrink" is hardly a role model for mental health professionals, Lena's panic disorder with agoraphobia is clearly and accurately described.

The appeal of Before Elvis There Was Nothing is not limited to people who have had hair loss issues or who are fascinated with Mr. Presley. Foos's delightful book is a novel for people who enjoy unusual and creative fiction.

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