This is such a wonderful book. Ishiguro is a master of atmosphere and subtlety... he doesn't shout and wave his arms when making his points, but only murmurs... you do have to pay attention. This is wonderfully, eerily effective in A Pale View of Hills. I bought this book yesterday and have read it twice already... the first time, as another reviewer mentioned, my hair nearly stood on end when I reached the last dozen pages; the second time I combed through looking for all the clues I hadn't realized were clues the first time (her husband's missing tie, the rope tangled around her sandle, Mariko's frequent fearful retreats, so many things!). Memory is unreliable indeed, and time folds over on itself.
After loving Never Let Me Go so much I was afraid that a debut novel could only be a disappointment, but this is not at all the case here. If you've read any of Ishiguro's other wonderful works, give this one a try as well. Pay attention, it's very much worth it.