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Patricia Ferguson's fifth novel, Peripheral Vision, led to her second nomination for the United Kingdom's Orange Prize for Fiction. Ms. Ferguson's background in nursing and midwifery is obvious in the clarity and accuracy of the medical scenes and themes. Also, her experience in dealing with individuals in a professional capacity is most likely responsible for her psychological insight into how we deal with disease, disaster, death, disappointment, and rejection—all factors present in the story lines of the diverse characters in this literary tapestry.

For me, reading Peripheral Vision was not something to be done in the presence of background distraction. After the opening chapter, this novel required my undivided attention to keep track of the beautifully written—albeit in the early stages hard to connect—story lines. The relatively long opening chapter, set in 1995, introduces one of three primary female characters. Sylvia is a successful eye surgeon whose life becomes more complicated when she attains the last two things on her list of "everything she had ever wanted"—a husband and a child. As the chapter ends, Sylvia is distraught to the point of despair at a lack of maternal love for her newborn daughter. Having been drawn into the drama of Sylvia's story through the author's insights and artistry, I was eager to learn more.

Instead, the next chapter, although still set in 1995, tells the story of Will, a key male character who is caring for his aged mother in her home. Sylvia's life is out of the picture, although it is in the periphery; Will clearly knows her, but the reader knows hardly anything about the nature of their friendship.

In the third chapter, the novel moves backward in time, to 1953, with new characters and story lines. And so it goes—from one seemingly unrelated character to another and back again, and from the 1950s to 1995 and back again. Then, just when I became anxious with literary confusion, Ms. Ferguson's intent to integrate the stories of three women and their sons, husbands, or lovers came in focus.

Visual themes and problems are present throughout the novel, and the title of Ms. Ferguson's book has metaphoric, not literal, meaning. Metaphorically speaking, whereas we may be aware of those who are in focus in our visual field, we are also connected, in significant ways, to others through our peripheral vision.

The reviewer reports no competing interests.

Dr. Goldstein is professor of psychology, Samford University, Birmingham, Alabama.