The themes explored in this novel include the generation gap, romantic and family love, extramarital relationships medical ethics and hierarchical work relationships.
The story is based around the protagonist's life from his time as a child in the 60s and 70s, through to the present day. Three distinct periods are looked at: his last few years at school, his time as a trainee intensive care doctor in the mid 80s and thirdly the present day.
The back-story time spent in the 60s and 70s is where we see the generation gap of that time in full force. The clash is between the father and the daughter in particular. The protagonist is more an observer here. The effects on the daughter and elder son are apparent and manifest later through the story in different ways. The father's obsession with medicine and the way he feels it positions him in society, effects both his son's careers as his over arching expectations come to bear. The middle part of the book details life working in a surgical intensive care unit and how the son deals with a medical ethics dilemma and a love affair.
In the present day, the protagonist has returned home for a visit, after becoming a success in the music industry in North America. This rejection of medicine and success in the much derided 'pop music industry, is a source of astonishment and amusement to the father.
But the son has information that gives him the upper hand - he has accumulated knowledge that his parents pre-children years were deeply effected by an extra-marital affair. Thus when his mother suggests the father and son take a few days away hiking in the mountains, the son senses an opportunity to challenge the father. What plays out in the. Mountains results in a coming of age for both parties.
