Andrew's Brain By E L Doctorow - book review: Doctor, doctor, I feel like an unreliable narrator

E L Doctorow's previous novels have between them scooped many prizes, including the National Book award and the PEN/Faulkner award. Andrew's Brain is more physically slight than many of his previous works, weighing in at less than 200 pages, but still explores some hefty themes.

A man talks. It is apparent early on that he is talking to a psychiatrist. He starts off speaking about his friend, the cognitive scientist Andrew, but this is a distancing mechanism because, as the reader soon learns, the man himself is Andrew. This need to step back from himself is also seen in the way he switches between the first and third person.

What else does Andrew talk about? What's on his mind? Or on his brain? And is that the same thing? Andrew would like to know. A question that has long plagued him is whether the brain – that mass of millions of neurones and synapses – can be said to be the source of the mind, or soul. If human consciousness and everything that goes with it, from existential angst to the ability to register emotions such as love, guilt and remorse, is conjured up merely by 1.4kg of electrical impulses and neurotransmitters, then surely one day it may be possible to replicate it in vitro.

Not that guilt or remorse are emotions that Andrew admits to feeling. He maintains that he is numb. Yet his experience of grief at various times of his life is unmistakeable. As further details emerge non-chronologically, a jigsaw picture is revealed of a man whose life has been beset by tragedies, often seemingly caused, inadvertently, by himself.

Andrew also wonders about the nature of memory, and whether memories can be inherited via DNA. His own memories are at times unreliable and shifting.

Doctorow's writing is assured and at times visually striking: "This morning it's like the winter fog has frozen. To walk the fields is to feel yourself breasting the air, leaving behind you the sound of tinkling ice and a tubular indication of your form."

A few cavils: characters with the medical condition dwarfism are described as "not disproportioned dwarves with large heads or torsos and short legs, they were perfectly proportioned." But achondroplasia is always characterised by relatively normal sized torsos and disproportionately short legs due to short proximal bones.

A greater criticism is that Andrew's eventual fate seems bewilderingly implausible, given the minor nature of his actions. Still, the book is worth reading for the power of its most joyous and grief-stricken scenes alone.