Artfully, Verghese shapes and links successive lives through wars, monsoons, famine. Pivotal scenes are intensely physical; intimacy swept up into widescreen pageantry in the manner of Dr. Zhivago: floods, fires, pestilence, train journeys, teeming streets, far-flung characters coming face-to-face. Some of these coincidences test credulity — yet their urgency defeats doubt. Likewise, when loss and horror strike, they feel inevitable and real. What binds and drives this vast, intricate history as it patiently unspools are vibrant characters, sensuous detail and an intimate tour of cultures, landscapes and mores across eras ... Verghese’s technical strengths are consistent and versatile: crisp, taut pacing, sensuous descriptions that can fan out into rhapsody ... Verghese’s compassion for his ensemble, which subtly multiplies, infuses every page. So does his ability to inhabit a carousel of sensibilities — including those of myriad women — with penetrating insight and empathy. Writerly strokes may occasionally feel broad, but like animate oil paintings, their effect is rich and reverberant. The further into the novel readers sink, the more power it accrues ... a magnificent feat.
Much will be written about Abraham Verghese's multigenerational South Indian novel in the coming months and years. As we've seen with Verghese's earlier fiction, there will be frequent references to that other celebrated doctor-writer, Anton Chekhov. There will also be continued invocations of the likes of Charles Dickens and George Eliot to describe Verghese's ambitious literary scope and realism. Indeed, the literary feats in The Covenant of Water deserve to be lauded as much as those of such canonical authors ... Verghese tends to the lyrical. But he writes with such singular detail and restrained precision that it is a pleasure to be swept along and immersed deeper. Even the characters who only appear for a few paragraphs leave lasting impressions because each is diagrammed as essential to the novel's anatomy.
Its multigenerational story progresses in the gradual, alternating fashion of a Victorian triple-decker ... The miraculous melds naturally with medicine in The Covenant of Water, whether in the form of artistic inspiration or religious awakening. One of the most moving sections concerns an expat Swedish doctor named Rune Orqvist, who is transformed by a nighttime vision and quits his practice in order to live out his days in service to a leper colony ... Such tender attention to the body—the sense that anatomy is destiny—elevates The Covenant of Water, but this is a long, elaborately plotted book and when Mr. Verghese takes off his surgical scrubs his storytelling markedly weakens ... Mr. Verghese’s portrayal of the medical practice is so stirringly noble that it seems even more critical to consider books by equally exacting standards. This strong, uneven novel fell short of mine, but only because it had moved me to set them so high.