First, an apology/admission: I finished this book a couple of weeks ago, and really should have written about it straight away while it was fresh in my mind. It was so good that I raced through it, and really I should have re-read it before writing about it, but it's over 700 pages long, so that isn't going to happen!
It is set in the southern tip of India, in what was then called Travancore, but is now, I think, Kerala. It begins in 1900, with a 12 year-old girl called Maryamma (but always to be known as Big Ammachi), who is on her way to become the second wife of a much older man, and the mother of his child, Jo-jo. Parambil, where he lives, is a remote, tiny hamlet. You might expect this to end badly, but in fact it doesn't: eventually the unlikely couple fall in love, and Big Ammachi becomes the matriarch of a successful community.
After a few chapters, there is a sudden switch to the other side of the world - to a boy named Digby, growing up in Glasgow with a mother who is incapable of looking after him. Despite this difficult start, he becomes a surgeon, eventually joining the Indian service. A terrible accident ends his career in the service, and by happenstance, he ends up not far away from Parambil.
It takes a long time, however, before we find out how these two stories intertwine. The novel is meticulously and very cleverly structured, with one thing leading to another seemingly inevitably. Everything, it turns out, is connected: something that happens in one generation is bound to affect the lives of later generations, sometimes for good, sometimes not - there is a lot of terrible tragedy in this novel, though also a lot of tenderness, a lot of love, and quite a bit of humour. It's a family saga - it takes us all the way up to the 1970s, telling us a lot about the history of India in the 20th century along the way. The large cast of characters are beautifully realised: it's like Dickens in that way: no character is too insignificant for the author to be fascinated by him or her, to want to get under his/her skin.
I found it quite rivetting - a marvellous book. One thing - Verghese, who also wrote Cutting For Stone, is a surgeon himself. He describes medical procedures and the pathology of various diseases in considerable - often excruciating - detail: I found myself skipping paragraphs at times. And therein lies another puzzle: how on earth does he find the time to write a book - especially one of this length - alongside maintaining such a demanding career? I have no idea. But I'm glad he does.