Childhood innocence--imperiled through the ages and nowhere more at risk than in the heart of modern Los Angeles--stands as the imposing theme of Powers's latest complex, wrenching saga. As overwhelming and erudite as its acclaimed predecessor, The Gold Bug Variations (1991), here evidence of children at odds with the adult world in which they live abounds, from the legend of the Pied Piper to tragic details of the Children's Crusade to more recent obliterations of youthful dreams in Southeast Asia and Watts. Holding this savage, sorrowful indictment of post-adolescent behavior together is the tale of a pediatrics ward in an inner-city hospital, into which the world's indigent wounded are thrown with abandon. Cared for by a fiercely protective therapist and a sensitive surgical resident--themselves careworn and devastated by traumas of youth, but seeking redemption--the ward acquires a life and plan of its own when Joy, a Laotian boat girl whose ravenous appetite for knowledge cannot stave off the rot consuming her from the ankles up, and Nicolino, a street-wise, shrewd trader in comics and other commodities wizened well before his time by Methuselah Syndrome, take the situation in hand. Using a ward-wide production of the Pied Piper story presented to the outside world as their means, they plot a mass escape in order to become masters of their own fates--but their designs for liberation falter before the realities of disease and adult agendas. Mingling wisps of whimsy and a hard-edged, surgical view, this cuts deeply into the human condition--to a dark, profoundly troubled place where hope and despair exist side by side.