Miller's debut, an unusual but uneven cautionary tale cloaked in a historical novel, features a cold-blooded English surgeon, literally a freak of nature, who works wonders in the mid-18th century until being spectacularly undone by his pride. Born of his mother's adultery in the midst of a moonlit midwinter skating party, James Dyer is marked by that icy violation: He utters not a sound and is completely numb to pain, whether his or anyone else's. The first condition lasts only a few years, so that he can speak by the time his family is obliterated by smallpox. He learns to feign pain from a huckster who uses the boy's lack of sensation to sell snake oil medicine to crowds thrilled by seeing James pierced with needles. Rescued from this life by a mysterious, wealthy landowner, James soon discovers that he has become part of his patron's personal collection of freaks, but endures it until he observes an amateurish, lethal operation, sickening to everyone but himself, to separate Siamese twins who were also in the menagerie. He escapes to the Royal Navy, where his aptitude for surgical technique soon has him operating coolly in the heat of battle, then leaves the sea to set up a private practice in Bath. His reputation as a surgeon becomes as huge as his notoriety for coldness and greed. He is shunned in spite of his skills when he drives his wine-addled partner to suicide. Unruffled, James joins a wild race between English physicians to minister to the Empress of Russia, but en route he meets a witch in the woods, whereupon he loses the race but gains the ability to feel--a transformation inducing madness and necessitating a long, excruciatingly painful recovery. Vivid and precise in its isolated scenes, but suffering from a loose, ineffectual narrative. The result is a mere accumulation of arresting incidents rather than the taut, haunting story it could well have been.