This rather humorless but tenacious examination of a marriage, in fact marriage in general, takes place in the minds of David, a surgeon and now resident of a psychiatric bed after his suicide attempt, and of Anne his wife of seventeen years, Anne who has ""emptied [his] life with the precision of an embalmer."" Or so at first he thinks as he picks away at some of the arid areas of their corporate life with some of the irritability you might apply to a hangnail -- the lack of mutuality, of communication, and so forth. Anne by the way gives her side of the story via letters -- sort of written reports on what has long remained unspoken. Much of the book unfortunately comes down to his and her behavior in the bed with a final admission on how active (really a passive word for what she's been up to) she's been elsewhere. The novel fails, as David and Anne did, by never creating any real community of interest and Horwitz-using the same semi-sociological approach he has before -- is talky when not preachy.