On a tropical, volcanic island, in a hospital for the insane, lives and works a young orphan, a mute and sensitive girl, believed to be of limited intelligence. She is given simple tasks in the hospital and seems to be well-liked by most. There are a handful of ‘insane’ patients she considers 'friends' known only as the witch, the virgin, the duke, and the archangel. One day, a new patient. 'the foreigner', is brought in, in what seems a permanent comatose state, and he is housed in the only space available in a remote spot in the hospital. He is more or less ignored until the orphan 'senses' him and he begins to communicate telepathically with her.

Told from the perspective of the young orphan girl, this is a intriguing story that draws the reader in quickly. What starts out concretely in a dark, decaying hospital soon moves into the fantastic as the foreigner communicates with her and all manner of strange phenomena begins to happen.

This is an ambitious and thought-provoking book about everything from consciousness, mental illness and the power of the mind to environmental issues, but I did find it a bit too long even at 327 pages perhaps because there is so much going on in the book. ( )

I loved this book. The plot was bizarre and totally fantastical and if it wasn't so beautifully written I would not have been the least bit interested. The writing just swept me along and I found myself picking it up to read a few lines at every chance I got.

It left me wondering about perceptions people have of themselves and their own sanity. Andrew McGahan made these characters come to life without giving them a name, one of which is comatose and the other a "retarded" orphan who does not communicate.

I am now a Andrew McGahan fan and have two more of his books to read. ( )

I didn't like this book at all, and would actually describe it as 'nasty'. The relationship between the foreigner and the orphan was beyond creepy and sinister, her night time relief didn't seem to have any genuine baring on the story, the violence was predictable and meaningless, and narrative, told through the mind of orphan, become downright irritating - every scene was being spelt out and there was nothing left to my interpretation or imagination.