In a heady new novel, a sensitive psychiatrist observes the art of the mind.

"David also knew those moments of choice when Yes and No collide . . . the comprehension that all our acts have consequences, which we must bear, and with which we must live consciously, if life is not to become a desperate flight from ourselves."

This is, I need hardly say, a heartbreaking novel and, yes, a love story. Some readers may feel that Vickers's diction is outmodedly formal and her observations verging on the sententious. I don't. After all, she is writing about grief and regret and self-knowledge, of how to live with the recognition that one has made the wrong choices and that they are unchangeable. As Dr. McBride says, "It's naive to pretend that life for many people isn't pretty wretched much of the time."

The title for Vickers's novel comes, quite appropriately, from T.S. Eliot ("Who is the third who walks always beside you? . . . Who is that on the other side of you?"). Eliot is, after all, one of the laureates of disappointment, of "the passage which we did not take/ Towards the door we never opened." Vickers's prose possesses something of that same still, sad music. "Poor all of us," she writes, "if we but knew it, blindly crawling along our parallel lines, unmindful that all around us are others as much in need of comfort and consolation."

If you enjoy the work of Marilynne Robinson, Penelope Fitzgerald, James Salter or Anita Brookner, you should be reading Vickers. All these authors reflect, with grace and gravity, on life's moments of sorrowful epiphany, so achingly summarized by the Elizabethan playwright Thomas Heywood:

O God! O God! That it were possible

To undo things done; to call back yesterday. . . .

Michael Dirda's e-mail address is mdirda@gmail.com.