Another quiet, alluring, intelligent, amusing novel from the author of Ghosts (1967), covering similar ground--remembered teenage life in an upstate New York town, current life among citified doctors and doctors' spouses. The current events are narrated by Dr. Nell Dreher Kurtz Calverson, a tremendously likable, twice-divorced M.D. whose first husband (now married to Nell's childhood friend Carrie) has suddenly turned up near death in the hospital emergency room. While looking after smart-dumb, bovine Carrie, Nell turns her thoughts to her new lover, scruffy writer Jack Shaughnessy (problems with their conflicting careers) and to growing pains in Veddersburg, N.Y.--these memory chapters wisely shifting to a serenely neutral, third-person narration. Nell and Carrie were best friends back then, but the girl who stood out was morbid Mina Van Duyne, who knew more, who dared more, who had the most charismatic family. (Carrie's mother was a steely adulteress; Nell's immigrant father was a vague M.D. who, amid a malpractice suit, declined into a rare illness causing premature senility.) The poignant evocation of adolescent chum-ships soon gives way to more troubled vignettes when Mina and Nell go off to Smith and fall for the same selfish charmer (Nell's first husband)--and especially when Mina loses a leg in a strangely willful Cape Cod accident and much later commits suicide, leaving behind a body of Sylvia-Plathlike, legend-making poetry. How does Perrin tell all this--and smoothly interweave Nell's hospital duties and her relationship with Jack--in such a small book? By wasting no words, by arranging for every nuance to do double duty, and by never overemphasizing or forcing--virtues that may be related to Perrin's having waited more than ten years since Ghosts to let this story (probably partly autobiographical) assume its own natural shape. Let's hope it's not another ten years between novels, but if it is, you can be sure the next Perrin, like Heart Failures, will be a dead--centered, honest pleasure worth waiting for.