Dutch-born Tobias Nord, 48 and divorced and the chairman of neurology at a Manhattan teaching hospital, can't sleep. Things gnaw at him, ranging from the inefficiency of the hospital elevator system to hospital politics, from telling the young they're dying to his genetic disposition for melancholy. He finds momentary solace in talking now and then with a patient who was an Allied WW II soldier, a liberator from the Nazis that Tobias has so hated all his life. But what he really needs is a vacation--and he takes one, to the Riviera, where he meets Carlotta, a young Italian philosophy professor who makes him happy. But it's not long-term. Stopping off in Holland on his way back home, he's struck by ""how many words ended with -je, meaning 'little': cup was kopje--a little cup--tafelie for table, bierje for beer. . . . I started to suffer a Lilliputian delusion: I was visiting a country for children."" Home in New York, he has a little fun with a nurse; what revives him, though, is a good old fashioned power-struggle (which he wins). Strobos, a neurologist himself, portrays Nord's decent but deep accidie smartly, dryly, and economically. But the novel picks up the malaise a bit itself: it steps out and away, and rarely is there any advance. So: aimless--but firmly, gracefully so.