I have read all Salley Vickers's novels but this is easily the best. It has a command and authority which takes you at once into the story so that you want to read on. The cast of characters is broad, a black schizophrenic cleaner, a bewildered Pakistani Muslim, a man who believes he has a wolf trapped in his skull (my favourite) but the characters who really engross us are Dr David Macbride and his patient Elizabeth. The latter has attempted suicide, which is why she is under this psychiatrist's care but what is most compelling about her story is the way it shadows her doctor's, so that in the end the two stories become intertwined and the two characters are linked by their tragedies. I loved the desciptions of Rome and Caravaggio. There is a very subtle ending. A very rich book and it is also beatifully written.