This short story by Raymond Carver is one of the most shocking ones I have ever read. Belive or not, the story hooks your attention from the first line but once you are onto it, you really feel the pressure of an uncomfortable situation. On and on you expect a negative conclusion and every clue you get, it makes you feel more pessimistic about the end of it. (I know it all sounds extremely confusing, but I don't want to make it more obvious).
There is no room for imagination in the story, except for the doctor's explanations about the actual situation of his patient; there is no space for anything different from realism either. Every situation shows as it is; as though every scene had been recorded with a camera.
In my opinion, the story is no more than raw criticism against materialistic society and the narrow views of consumerism. The baker, for example, may endlessly go on and on, day after day making his muffins and cakes, but he would not care about anything else except for his money.
Whatever it is, please have a look at Mr. Carver's biography. It is as interesting as his own literature. If you have the chance, please read this short story.