Not often that a blurb is correct in stating: "A dazzling first novel", but in this case accuracy is not sacrificed for hyperbole. Set in 18th-century England and Russia, the book tells the story of James Dyer, a man born unable to feel pain. What more likely, then, than he should become a brilliant if heartless surgeon, plying his trade for the rich and famous and oblivious to the distress he might be causing. But on a trip to St Petersburg in 1767 to inoculate the Empress Catherine against smallpox, he meets an ethereal woman who introduces him to pain, the consequence being that he goes mad and has to be incarcerated in an insane asylum. Released, he goes to live with a village parson and his sister, and in the dying fall of his life discovers love and compassion. This rather stark outline does little justic to a book that is richly opulent in its language and settings, that draws its characters from life, and is unobtrusively intelligent in its depiction of an epoch poised between the shibboleths of the old world and the empirical concepts of the new. Highly recommended.