This often clinically detailed novel from Ignatieff (Asya, 1991; Blood and Belonging, p. 115) mourns a beloved parent and addresses various kinds of loss: of memory, of faith in conventional medicine, and of pieties. Narrated by the younger son, a philosophy professor, the novel, short-listed for the 1993 Booker Prize, is a personal search for answers to the big questions as well as those smaller mysteries that dog even the happiest families. The mother, now afflicted with Alzheimer's disease, was, in her prime, a woman of spirit, an artist who painted portraits, liked to go barefoot, and sang old Broadway songs as she worked. The father, an immigrant from Odessa, is a scientist with his own legacy, less lethal than his wife's genetic inheritance, but no less vitiating--a childhood that was never safe. And those fears have shaped his relationship with his two sons, who resented his apparent lack of imagination and his emphasis on having ``a profession and a pension.'' As his mother nears 60, the narrator observes puzzling changes in her: She no longer paints, and she has difficulty expressing herself--the long, wrenching decline into silence and nothingness has begun. His own marriage breaks down as he becomes obsessively involved in his mother's care. The elder brother, a neurophysician, appears to be more detached, but it's only a protective mechanism, and while their father's death brings the two brothers closer together, it doesn't really help the narrator. As he struggles to find some meaning in his mother's life, his own, and even in the disease (which he suspects he has inherited), he comes to believe that there is a ``pure and heartless reality beyond anything a living soul can comprehend.'' Disease not as a metaphor but as a prescription for living in a book that confronts our worst fears with bracing insight and finely tuned emotion. A tough read but worth it.