Altruism, self-sacrifice, and the self-serving nature of magnanimity lie at the core of Toronto author Cynthia Holz’s fourth novel. The book examines the lives of 53-year-old Ben Wasserman, a psychiatrist who analyzes the mental states of potential organ donors to determine their suitability, and Renata Moon, his psychologist wife.

Ben and Renata are not happy in their marriage. Their inability to conceive a child is a constant burden, freighting every silence with unexpressed blame and disappointment. Very traditional in his professional approach, Ben often scolds Renata (who is 13 years his junior) for her unorthodox treatment choices. Both are challenged by patients who unsettle them.

For Ben, the patient is Arthur, a man of a similar age who, with no apparent ulterior motive, is determined to donate a kidney to a neighbour he knows only glancingly. Arthur’s generosity, calm demeanor, and ease in his own skin speak to Ben, who is also an unpublished and unfulfilled poet.

Renata’s therapeutic relationship with Stella, who suffers from panic attacks, is off-kilter from the start, but gets worse when Stella discovers she is carrying her recently deceased husband’s baby. The patient/doctor relationship is fractured when Renata breaks down in front of Stella. 

Despite their professions of love, Ben and Renata treat each other with little respect or understanding, let alone affection. Ben acts like a sulking teenager, locking himself in his room to pen watery poetry, while Renata pouts and throws tantrums. It defies credulity that two people trained to have insight into the human psyche could be so clueless about each other and themselves.

Holz is a talented and experienced writer with a proven track record for producing interesting, complex examinations of the intricacies of relationships, but her latest effort falls flat due to a pair of protagonists whose selfishness, contrasted so sharply with the altruism of other characters, renders them whiny and dull.