For her debut novel, Steinbach offers a book consciously (though to no apparent purpose) divided into two styles: about half is an expressionist, poetic-prose mosaic; the other half is an often quite involving story about the emotional pressures felt by a young Iowa couple, Zara and Michael--both of them new young doctors. Zara Montgomery's father is a prominent small-town surgeon; her mother, once a Chautauqua singer, is dying gruesomely of bone cancer. And so Zara, a fourth-year med-student, chooses--and is chosen--to be her mother's nurse. Unsurprisingly, however, after the ordeal ends, Zara finds she has no more taste for death: she drops out of medicine, which she leaves to her father and to her new husband Michael O'Dea--an orphan who takes an extremely gingerly path through adult life. Impotent with Zara (but not when he philanders), Michael finally breaks down and is committed. Thus, Zara, suffering her husband's plight with patience yet without hope, finally breaks free into a life all her own--first taking up the manufacture of beautiful puppets (not Steinbach's most subtle touch) and then becoming an orthopedist when she returns to medicine. This realistic story, with its theme of dependency, has grain and heft. So, too, do a few of the elaborate, far less realistic set-piece scenes here, with their leaping flares of Virginia Woolf-ian prose. (One of these--in which Michael dresses up as a Christmas tree for a costume party--is centrifugal and formally brilliant.) But Steinbach fails to build a bridge between the alternating, not-really-complementary sorts of storytelling she does here--and this remains a half-involving, obviously skillful first novel which can't seem to decide what kind of fiction it wants to be.