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Rilke's poem, which seeks to close the Judaeo-Christian wound between spirit and flesh, ends with the line "You must change your life." It is hardly needed as a reminder that The Breast represents a change in Philip Roth's perspective. Coming to grips with small r reality has been the strife of his writing career. Nearly a dozen years ago, he joined the chorus of writers and critics who complained that the bizarre reality of American life exceeded anything a writer could invent. It was really a way of saying that for the moment, he was stumped. That moment passed with Portnoy's Complaint, in which reality was handled as painfully funny fantasies on a psychiatrist's couch. The Breast is the next risky step: an attempt to outflank reality by being more grotesque than it can be. Remarkably, Roth does it without descending to the level of a vulgar joke. The Breast is more touchingly human than funny, whether read as a fable or credo. Roth can even be charged with committing uplift—especially in his awe of Rilke, who kept his shape as a great artist by refusing to submit to the probings of clinical psychology. Rilke's inspired reason was that if his demons were exorcised, his angels would leave him too.
· R.Z. Sheppard