This brilliant, sweeping historical opus by Vergese (author of the simply amazing book Cutting for Stone, along with two others) opens with a young 12-year-old girl getting married off to a widower in his forties, to go live with him and his young son on a remote jungle estate in Kerala, located in Southern India right on the coast. The marriage has been arranged by the widower’s sister, who encourages him to raise the girl as a child in his home and caregiver to his young son until she comes of age to take on wifely duties. She proves endlessly resourceful, buoyed by her strong Indian Christian religious faith and tough resilience.

What enfolds encompasses three generations, with the young girl growing into a powerful, loving, strong and tough matriarch known as Big Ammachi (“Big Mother”), who raises the orphaned JoJo and goes on to have a son and daughter of her own, and eventually a daughter-in-law and grandchild who grows up to become a physician. Hauntingly running through the narrative is a family curse, couple with a fear of water, that leaves one family member drowned in each generation. The novel opens in 1900 and stretches to 1977, with historical events unfolding from the emergence from British colonial control to social upheavals and struggles with the caste system to the end of the Raj. Verghese tells Big Ammachi’s story infused with compassion, presenting his characters as well-meaning people facing a barrage of challenging and in some cases devastating events. The novel’s axis centers mainly around plot, without any deep individual character building but rather a blending of archetypes.

Drawing on his own background as a doctor, Verghese weaves into the story countless gripping medical scenes and the stunning progress of medicine across eight decades. Running on a separate narrative stream, the story of Digby, a Scottish doctor enfolds, with the two narratives eventually powerfully merging.

This novel is destined to become a classic!


Thanks to Grove Atlantic, Grove Press, and NetGalley for an advanced reader’s copy.

Great read, with compelling prose by the author. Absolutely loved their last work, and waited so long for this to come out. Amazing.

I was unable to read it because the print was so tiny- this happens a lot. I would like to be offered books in Audible

This is a hefty multi-generational historical fiction spanning 77 years set in the state of Kerala in south India. Against the cultural, social and political backdrop of Kerala, the author weaves disease and medical challenges resulting in a rich and interesting tapestry for the novel. The story centers around a Christian family in which a member of each generation is plagued with the “condition.” Alongside the family are a host of other major and supporting characters. This huge network of people are all interconnected and the threads do come together finally in this long drawn out tome - so long that I couldn’t wait for it to be over, until the last few chapters when it got interesting again. I felt the number of characters in the book detracted from the story. I get the author was creating the environment for the storyline but it felt overwhelming. Part of the challenge was that I didn’t find the writing compelling enough to keep me glued to the book. It took me a long time to get to the end. Overall the book was an okay read for me but not stellar. This is my second attempt at an Abraham Verghese book - I’m not having as great a time with his works as others are. I may have better luck with his nonfiction. Many thanks to the author, publisher, and NetGalley for the opportunity to read and review this book.

The Covenant of Water follows three generations of a family in Kerala, India all in some way affected by “the condition” they cannot explain. In every generation of this family someone drowns, and they are unfortunately surrounded by water where they live.

Big Ammachi, new to this family, is shocked by her husband’s aversion to water, and does what she can within her lifetime and limited education to figure out why the drownings occur. Later her own son scares her; she prays that he will not be that generation’s victim. Eventually she pins her hopes on her granddaughter being their family’s savior. Mariamma, a girl with a gift for science, who unlike Big Ammachi, has the opportunity to get the education her grandmother craved. With the information Big Ammachi recorded, and the education she gleaned from University, Mariamma is this family’s hope to put “the condition” to rest.

Verghese’s latest novel continues to show off his medical knowledge and his humanity through his portrayal of his characters and the suffering and loss they faced. This epic tale touches on so many topics and generational events in India as a country. Big Ammachi feels very much like the heart of the novel, though there are many other characters who are equally as intriguing. The Covenant of Water is a book worth reading more slowly and reflecting on rather than zooming through.

Thank you to NetGalley, Grove Press, and of course Abraham Verghese for the advanced copy of the book. The Covenant of Water is out now. All opinions are my own.

I was so incredibly excited to read Dr. Verghese's latest book, that excitement (and how much I loved Cutting for Stone) might have set my expectation bar a bit too high for The Covenant of Water.

It is truly an epic story... the characters are well developed and utterly delightful. Verghese's writing pulls me into the story and that is what kept me reading to the finish. I did not see that final twist coming... at all.

Yet, despite all those amazing things... this book felt long. So long, it dragged a bit in several places. I think some of the dragging parts could have been edited out without impacting the fullness of the story.

For me this is a solid 3.5 star book, which I rounded up to 4. I would like to thank Netgalley and Grove Press for the copy of this book.

This is the first time in my reviewing career that I’ve chosen not to share my review of a Galley I requested myself. However, in this case I didn’t feel that it would be fair to write a full-on review, as my thoughts reflect more so on me than the book, and the reasons I couldn’t finish it are unlikely to apply to most readers.
A novel about family, history and especially medicine should be completely up my alley, as I’m a medical doctor myself. That’s also the root of my “allergy” towards Verghese’s writing on medicine. His identity as a doctor, and his love for the profession as a whole shine so clearly through everything he writes. I’ve watched interviews of him describing medicine as the Greatest Profession, and emphasizing his “privilege and fortune to be able to practice the most worthy profession in the world”. It’s a view I see often in the works of doctor-authors, but it’s also a one-sided and self-aggrandizing look at medicine that I strongly dislike. I love my job, but it’s far from perfect or “the Greatest Profession on Earth”. Same goes for medical advancement within the past century that the author marvels at. We’ve come a long way, but we also have such a long way to go. If anything, what doctors need, in my opinion, is a bit more humility. It bothers me how much of that is either missing, or feels disingenuous in Verghese’s narrative.
Additionally, as a fellow medical doctor, some of the medical situations and “lessons” Verghese teaches aren’t so new and refreshing to me as they would be to non-medical professionals. I can imagine how they would feel unique to someone outside the medical field, but to me it was so repetitive and overly-long that I couldn’t bring myself to finish it.
Again: this review won’t be shared on socials or my blog, as I genuinely think this might be a great book for other people and I don’t want to keep them away from it. It just got very deep in my specific allergy-zone.

Wow! This book was incredible. It is emotional, and long and detailed. At times you are transported into the pages. A must read!

Beautifully written novel that spans many decades. This book is expansive and it takes a long time to all come together. The descriptive writing had me immersed in the world of Southern India so the length did not feel like a barrier.

Many, many thanks to NetGalley for allowing me to read this spectacular book by Abraham Verghese. His previous book, Cutting for Stone, was indeed one of my all time favorites.

This saga takes place in the southern part of India very near the coast. It spans several generations of a family who keeps secret the "Condition" where family members are more susceptible to drowning. It's a tale of arranged marriages, the caste system, and abject poverty.

Several main characters emerge from around the globe and its interesting to see how the author weaves their lives together. There's a power play between Christianity and the traditional Indian gods and goddesses as well as the paradox of transportation traveling through unchartered territory. Politics, revolutions and massacres from the Partition are evident in the city of Madras. Through electricity the small village listens in awe to Ghandi.

A beautifully written book dealing with the heart and soul of family , extended family and friends! Bravo!

One of the most beautiful novels I have ever read, Abraham Verghese is a truly gifted story-teller.
A stunning saga of three generations in Kerala in southern India, the novel traces one family's story from the turn of the century to the 1970s. Over the course of this period, British and then independent India undergoes various historical events which we are able to experience along with the loves and losses of the rich cast of characters. But it is so much more than a historical fiction! It is about connections between characters, as they explore love, grief, trauma, hope, and self discovery, and of course medicine.
I was intimidated to pick up a 700 page novel, but I am so glad I did.

This book shouldn’t even require a review. Anything written by the brilliant storyteller Abraham Verghese should just be required reading. My only complaint is the wait in between books.
This book was bittersweet….my mom and I would frequently discuss Cutting for Stone through the years, and she passed before she could read this. I felt as though I was reading it for us both.

"The grandmother is certain of a few things: A tale that leaves its imprint on a listener tells the truth about how the world lives, and so unavoidably, it is about families, their victories and wounds, and their departed, including the ghosts who linger; it must offer instructions for living in God's realm, where joy never spares one from sorrow. A good story goes beyond what a forgiving God cares to do: it reconciles families and unburdens them of secrets whose bond is stronger than blood. But in their revealing, as in their keeping, secrets can tear a family apart."

Epic and sprawling, Abram Verghese proves once again that he is a truly literary physician-author. His writing is infused with such grief, sorrow and complexity that it is obvious how his career as a physician influences his writing. It feels messy and authentic. In this book, we follow three generations of an Indian family as they try to live and untangle this 'curse' that hangs over them. For me & those that enjoy this book I think you will find the plot less important than the characters. We've got an incredible matriarch to root for as well as a whole cast of other family members and characters that are richly written. The book takes place across seven decades starting in 1900--historical details like British colonization, the impact of WWII on India, and subsequent Independence and unrest-- add to, but never hijack the writing. He tackles tough themes including death, grief, addiction, caste, independence, and belonging.

For me, this doesn't edge out Cutting for Stone, but the same craftsmanship is evident here. He does a great job weaving all these disparate strands into a jaw-dropping moment toward the end of the book. I think people might have squabbles because it's long (over 700 pages!!) and there is quite a bit of medical jargon which might become tedious for some readers. But for me, Abraham Verghese is still an all time favorite author, one of the best living physician-authors and I will happily continue to purchase and read whatever he writes.

Dr. Abraham Verghese’s The Covenant of Water follows the life and times of a South Indian Malayali Christian family (present-day Kerala) spanning from 1900 to the 1970s. As the novel begins, we meet twelve-year-old Mariamma preparing for her wedding day. Her groom is a forty-year-old widower with a young son – the owner of a vast expanse of land in Parambil. Unbeknownst to her at the time of marriage (and revealed to her after a tragic loss) is the fact that her husband’s side of the family is plagued by a “condition” that has caused several family tragedies related to drowning across generations. We follow Mariamma or Big Ammachi as she is called and her family through the following decades, and how the condition impacts the lives of those whom she holds dear. Parallel to the Parambil narrative we also follow the stories of Digby Kilgour a Scottish doctor who joins the Indian Medical Services in British India as well as Dr. Rune Orquist who devotes his life to the care of leprosy patients. Though the different threads of the story might seem a tad disjointed, the author weaves these threads into an expansive, breathtakingly beautiful narrative.

The novel deals with themes of family, tradition, legacy, grief, love and sacrifice and also explores sensitive issues such as colonialism, discrimination and addiction. I enjoyed this story – the characters, the setting, the elegant prose and descriptive detail, the history of the Parambil family, the portrayal of India and Indians under British rule and how India transitioned into an independent nation and the social and political changes that followed. The author draws upon the spice trade in India and the history, culture, traditions and rituals of the Malayali Christian community in India. The author also incorporates how the advancement of medical sciences has contributed to gaining insight into illnesses that were once difficult to define into the narrative. The author’s writing is descriptive and he pays great attention to detail. There are several characters and subplots woven into this narrative and while the volume might appear a tad intimidating, this story was not ambiguous or too complicated to follow.

There are a few minor issues that I should mention. First and foremost, this is an extremely lengthy novel (730+ pages). Those who follow my reviews will know that I don’t find lengthy novels daunting and I’m more than happy to be swept away by a long, fulfilling read as I was with this book, but I feel that this story could have been shorter. Though the author brings all the threads of this story together in a satisfying ending, the multitude of themes, characters and subplots do not allow all the themes to be explored with equal depth, which is understandable. A few significant historical details from the period are mentioned but not explored beyond how they immediately impact the characters in question. There are several descriptive scenes of medical/surgical procedures in the course of this story, which might not make for interesting reading for those not interested in the same. The narrative does suffer from minor repetitiveness but not so much that would lose interest in the story.

The Author has taken inspiration from his mother who jotted down facts about her life and family history in a forty-page manuscript in answer to her granddaughter’s questions. It is evident from his writing that the author has poured his heart and soul into this novel. Evocative, insightful, heartbreaking yet hopeful, The Covenant of Water is a memorable read.

Many thanks to Grove Atlantic and NetGalley for the digital review copy of this novel. All opinions expressed in this review are my own.

This flows a little bit differently from Verghese's last book, Cutting for Stone, but it is still a beautifully written, compelling novel. It took a little patience for me to be fully invested in it -- I was immediately swept in by the first section, then had to be patient as I made my way through the next after a change of characters. But as always, Verghese has a knack for creating and developing incredible characters with depth. There is so much beauty in his stories. I have also read one or two of his nonfiction books, which I also enjoyed. I waited for a long time for a follow up novel to Cutting for Stone (not a sequel, just a next novel from the author) and I was so happy and delighted to be able to read an early copy of this book! I hope it isn't too long before he writes his next book!

I loved "Cutting for Stone" so I was excited to get an advance copy of Abraham Verghese's new novel. "The Covenant of Water" is a sweeping intergenerational saga about a family in a tiny Christian community in Kerala. I absolutely loved it.

It's quite a tome-- somewhere in the 600-700 page range. Once you pick it up, you will be in it for the long haul. There may be times where it feels like the plot is meandering, or is taking you down long, possibly irrelevant asides. If you're patient and just enjoy the writing and the characters, you'll be well-rewarded. The disparate storylines come together beautifully at the end. It was a joy to experience the methodical and careful plotting that Verghese sets out in this novel.

From The Historical Novels Review, May 2023:

Fourteen years after Verghese’s success with his first novel, Cutting for Stone, he brings readers another impressive family saga. From 1900 to 1977 in southern India, we follow a girl known only as “moloy” (daughter). At the age of 12 she must leave her home to marry a 40-year-old widower and became mother to his son. This begins her life as Big (for her tiny size) Ammachi (mother) and matriarch to her Malayali family.

Big Ammachi’s courage and resilience is the backbone of her family. Her husband has carved out a large plantation from untamed land. He is a quiet, gentle man, and their arranged marriage, consummated years later, grows into a beautiful, touching love story. Through heartbreak and happiness, we follow her children, grandchild, extended family, and their faithful pulayan (lower caste) Shemuel and his family – all live on the sprawling plantation in Parambil. Life is difficult, and Big Ammachi and her husband ceaselessly labor to build a life. But for generations, the family has been overshadowed by a mysterious phenomenon: many have died from drowning.

In another storyline, we meet Digby Kilgour, a Scottish physician traveling to India after joining the Indian Medical Service to gain surgical experience denied him in Scotland. Digby is a dedicated, compassionate doctor. He is also a compelling character, who loves deeply and meets tragedy. He is devoted to the people of India and takes on the challenges of treating leprosy patients.

Verghese, also a medical doctor, adds texture into his characters and novels with fascinating medical storylines. How does Digby’s life relate to Big Ammachi’s family? Verghese eventually ties both together in surprising ways. What causes these inexplicable drownings that have plagued Big Ammachi’s family? Whether coincidental, a curse, or scientific, Verghese does not disappoint. Words fail to encapsulate this grand, sweeping, emotional novel; it must be experienced.

Janice Ottersberg

I never got around to reading Abraham Verghese's "Cutting for Stone" although it's been on my TBR pile for awhile, but I jumped at the chance to read an ARC of "The Covenant of Water". It caught my attention from the start: it is 1900 in South India and a young girl of 12 is sent from her home and into an arranged marriage to a much older widower who has a young son. I was pleased when the young girl, who eventually came to be known as "Big Ammachi", and her husband fell in love, but I don't think I was prepared for never got around to reading Abraham Verghese's acclaimed novel "Cutting for Stone" even though it's been on my TBR pile for a long time. However, I jumped at the chance to read an ARC edition of "The Covenant of Water".r the amount of tragedy that came their way or the amount of tragedy there would be throughout the book. For me, there were a lot of characters and storylines to keep straight, and just when I thought a storyline had disappeared, it would resurface and I'd have to flip back and remind myself who some of the characters were. There were some parts, too, that I found a bit rambling and superfluous, but eventually, the story came together. It was a little exhausting, Still, I am looking forward to hearing Abraham Verghese speak at an upcoming author interview and I can appreciate all the research he did when writing this book. Thank you to netgalley and Grove Press for the ARC ebook edition of this novel.

This was my first foray into Abraham Veghese's writing - and I now I finally understand why I so frequently see one of his previous works, "Cutting for Stone" be recommended. His writing is not only beautifully evocative, but for me it proved to be quite absorbing. It wasn't long until I found myself quickly immersed within the book's setting in Kerala, and continued to consistently lose myself for a little while every time I picked up "The Covenant of Water" again.

Some readers admittedly be daunted by the length, especially combined with the fact that this book frankly isn't all too focused with its plot. But for me, it proved to be a slow-burn that worked, between the enveloping atmosphere, plus all that I was able to learn along the way, from the culture of the Kerala region, the Saint Thomas Christian community of India, and also far more about medicine than I could have anticipated.

Overall, just an absolutely lovely reading experience. This is unmistakably a prime candidate next time the academic library I work at updates our popular reads section.

I could not WAIT for this book to be released. Cutting for Stone is one of my top 3 books of all time. I love this author's beautiful prose and the multi generational story. In the Covenant of Water, we follow many characters and story lines but they all come "home" to the same developing town in Southern India. This common setting kept me anchored with the many tragic story lines. The town and the landscape became a beloved character for me. Through the tragedy, the author gives us glimpses of humanity and joy that are brilliantly intertwined. The characters in this book are mostly "good people" with good intentions. I loved that. The long ARC of the story allowed me to really sink in and digest lifetimes of hardship, love, birth and death and so many aspects of the human experience. I loved the medical and historical story lines as well!

5 stars - Thanks to NetGalley for this ARC!