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This is a truly challenging book to rate. There are several minor characters who really should have made more appearances. Their absence left a bit of a void in the overall narrative. However, aside from that and a somewhat sluggish start, this book has a great deal of substance. The dilemma that the book presents comes alive in a vivid and engaging way. The real emotions and the intense suffering of the central cast are captured with remarkable brilliance. It's as if you can feel their pain and turmoil right along with them. And the humor in the book is just perfect. It comes in those deliciously black doses that add a unique flavor to the story. I found myself thoroughly enjoying this book as I read it on planes, in a hotel room, and even while sitting in a parking lot in my car at night. I simply couldn't put it down. It held my attention from start to finish. Based on all of these factors, I am more than happy to give this book 4 1/2 dark stars. It's a remarkable piece of work that definitely deserves recognition.