The Echo Maker by Richard Powers

 

At first they didn't think he would live.  Twenty-seven year old Mark Schluter flips his truck one icy Nebraska winter night.  It was a while before the wreck was found and a while before they got him to the hospital where he lingered in a coma.  His only family, his older sister Karin, comes back to Nebraska to be there if he wakes or to plan a funeral if he doesn't.

Mark does emerge from his coma but not unharmed.  He insists that his sister is an imposter, an instance of a traumatic brain injury named Capgras Syndrome.  He recognizes others but also insists his beloved dog has been substituted.  As time goes on, he develops wilder and wilder delusions, that he is being constantly watched, that some entity has spent time and money to build a substitute life for him.  His doctors don't seem to have any idea how to help with this syndrome so Karin reaches out to a famous neurologist, an author known for his approachable works explaining the brain and its functions.

The neurologist comes to Nebraska but leaves having no real ideas to help.  He is undergoing his own crisis, his research methods becoming obsolete and his time in the limelight fading as new discoveries are made in the lab to explain the brain.  Karin gets support from an old boyfriend, Daniel, who used to be Mark's best friend but who Mark refuses to have around.

This novel was the National Book Award winner in 2006.  It explores the ideas of reality versus delusion, of what it is to be an individual and how we recognize ourselves in the world.  The concept of family and what sacrifices can reasonably be expected are discussed as well as a lot of brain discoveries and how our brain defines our personalities and our reality.  There is a subtheme about climate changes and how species are being pushed out of existence by development and change.  This book is recommended for readers of literary fiction.