"The Gambler's Anatomy" by Jonathan Lethem starts off as a James Bondesque novel but takes a dark turn halfway through. (Ron Charles/The Washington Post)

Jonathan Lethem’s new novel combines a little of the intrigue of James Bond with all the sexiness of backgammon. The result is a literary game that’s shaken not stirred. But that’s hardly the weirdest mash-up in “A Gambler’s Anatomy, ” the latest from this MacArthur “genius” who’s been splicing together disparate genres since his first novel appeared in 1994.

(Doubleday)

The story opens with another motherless hero, a professional gambler named Alexander Bruno. Raised on George MacDonald Fraser’s “Flashman” adventures, Bruno was abandoned early by his mother and raised by a gay cafe manager who taught him how to “make his newly strapping body both unthreatening and fascinating.” Now, blessed with a face of “ruined glamour,” he travels the world to strip wealthy men of their cash — and pretensions. “Bruno had for his entire life associated backgammon with candor,” Lethem writes, “the dice not determining fate so much as revealing character.” Polite and reserved, he preys on others’ overconfidence. He’s “a courtesan of sorts. A geisha boy massaging the customer’s vanity.”

But how much longer can Bruno keep that up? Lethem adopts just the right tone for this handsome rake, who can hear Time’s wingèd chariot hurrying near. Almost 50, Bruno already sees that sad day when someone will offer him “a discount on movie tickets.” And more troubling, a dark blot has started to float in the center of his eyesight. He should probably get that checked out, but he’s too busy fantasizing about making one more killing so that he can break away from his smarmy manager.

As the story develops, Bruno does not so much break away as fall away, and “A Gambler’s Anatomy” is largely the story of his mortifying descent. The opening scene — the novel’s best — takes place in Berlin, where Bruno has flown to play a high-stakes game with “a potentially historic whale,” a gambler willing to wager $5,000 a point. The dice are rolling Bruno’s way (he’s up $36,000), but then his luck turns, and the scene grows phantasmagoric: His wealthy host plays scratchy jazz music on the phonograph; a leather-clad dominatrix serves tiny shrimp sandwiches. Moments later, Bruno’s nose begins bleeding, he passes out, and he’s rushed to the emergency room.

The title, it turns out, is less metaphorical than you might expect. In the center of “A Gambler’s Anatomy” sits a long, graphic story about a tumor that sits in the center of Bruno’s skull. If you’re at all squeamish about such things, fold up your backgammon board and go home now because Letham cuts awfully deep on this anatomical subject. (In his acknowledgments, he thanks several doctors, including Atul Gawande, author of the bestselling book “Being Mortal.”) He’s written about odd scientific and medical issues before, of course, but this time he takes us through a 15-hour operation that involves temporarily removing Bruno’s face and scooping out a mass from behind his eyeballs. Maybe you won’t learn enough to try this at home, but you’ll come bloody close.

If you survive that procedure, you’ll continue on with a novel that, unfortunately, grows increasingly derelict. Puffy and scarred, Bruno wonders whether he should “mourn his beauty,” but he knows that what really matters is “one’s inner mask,” as though there were no essential self beneath his layered poses. His condition doesn’t require it, but Bruno insists on donning medical masks that wrap around his entire head. “These resembled Mexican wrestler’s costumes,” Lethem writes, “or items from a masochist’s toy kit, only purged of florid decoration in favor of the uniform sallow color of a Band-Aid.” In that bizarre get-up, he wanders back into the world.

The author Jonathan Lethem (Jerry Schatzberg)

Lethem’s reflections on faces and identities would enlist more interest if we could feel a stronger pulse in Bruno — or if the concept of a man without a self were developed to more harrowing existential effect. Particularly after the surreal section in Berlin and his gruesome ordeal in the hospital, Bruno’s convalescence in Berkeley, Calif., grows tedious. (And in Berkeley, wearing a giant facial Band-Aid attracts no special attention at all.) A much-hated real estate baron whom Bruno used to know in high school picks up the tab for his expensive operation and gives him a place to stay, but the mystery of this patron’s motives is not enough to keep the novel engaging.

Lethem’s wit germinates and blooms within single sentences, which makes him a pleasure to read. And he’s a master at letting the weirdness of situations slowly accrue. But too many of the strange elements in “A Gambler’s Anatomy” merely bleed away. Bruno’s alleged telepathy flits through the novel so underdeveloped that I have no idea what Lethem was thinking. (But I’m psychic enough to know that hipsters will tell you to read this novel.) The lefty political battle that eventually dominates the story in Berkeley is a weak echo of his recent New York novel, “Dissident Gardens.” And the romance that Bruno pursues with a woman he doesn’t know feels completely synthetic.

Late in the story when someone finally asks Bruno, “What are you meant to be,” he dodges the question and in a flippant bit of feigned melodrama calls himself “The Martyr of Anarchy.” In truth, his life has become “a holding game: count the pips, obey the dice, and move his trailing checkers to safety.”

That might be an effective strategy for backgammon, but for a novel it’s a bored game.

Ron Charles is the editor of Book World. You can follow him @RonCharles.

A Gambler’s Anatomy

By Jonathan Lethem

Doubleday. 304 pp. $27.95