This is an epic story starting in the 1900 and ending in 1970 that shows the progress in India through following one family with all their trials and tribulations which are many. It starts with a 12 year old bride sailing across the water to meet her 40 year old, widowed husband, leaving behind her mother and family. She is Big Ammachi, a tiny woman, with a big heart who welcomes everyone who stays regardless of who they are.

Divided into 10 sections, each section takes us through the family life gradually revealing the secret ‘Condition’ that runs through the generations and is recorded on a family tree kept hidden. In every generation someone drowns and others hate water and Big Ammachi tries to get the children she looks after to become doctors who can find answers to their problem.

We don’t have children to fulfill our dreams. Children allow us to let go of the dreams we were never meant to fulfill.

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Each section revolves around an accident, a death or an illness – it’s all in there. Floods, fire, train crashes, addiction, childbirth and leprosy with all of the characters questioning why God would allow these things to happen.

The community is Christian: St Thomas Christians with many following the faith and some ‘doubting Thomases’. This faith community married within although you wait a long time for this to be revealed as you do so many things in the book. And, it also has a role to play in the ‘Condition’.

Verghese is a doctor and the medical elements of the story are told in detail from surgery on lepers hands to childbirth, documenting how these changed over the years. The thing about an epic is that you can see changes in society politically and socially so we move from the lowest caste not being able to enter the house of the man that he has worked alongside for over 30 years to his son eating at the same table as the family he works for.

The characters are all believable and are all good people to whom terrible things happen. Perhaps a little too good if I had anything negative to say about the book. And the water? It is there in the background as a constant – the sea, rivers and streams running through time and place constantly like the family.

The book is quite a page-turner I discovered, forcing me to read just one more page until I had read it over the course of two days. It has quite an unexpected ending – I hadn’t guessed it – and it does provide the family with an answer to their ‘Condition’.