Writer Jonathan Lethem takes his readers places that they wouldn’t have imagined. It is his gift and his challenge. He succeeds masterfully in his new novel, “A Gambler’s Anatomy,” using the board game backgammon as both a central story element and a psychological substrata that shades character interactions.

Alexander Bruno, a middle-aged man of passable good looks, makes his living playing high-stakes backgammon. A streak of expensive losses in Singapore, however, prompts him to travel to Berlin seeking to regroup and pay his debt. He is grievously aware, however, that a “blot” — a blind spot — has begun to obscure his vision in one eye. Worse, he reasons, it’s causing him to lose the telepathic abilities he has long relied on in becoming one of the game’s premiere players. He is obsessed with the blot’s presence and the headaches it seems to be spawning. He fears he might be dying.

Backgammon, one of the oldest board games in the world, is played with 30 pieces called “checkers” or “men,” among other names. Opponents arrange their pieces on their own side of the board and use dice to advance their positions. Players can dominate a position on the board by holding it with two or more pieces. The weakest spot is held only by one piece, known as a “blot,” which can be captured and forced to start over again. The goal is to successfully move all of one’s pieces around the board where they are then retired. Bets are made with every dice roll, and can be doubled, requiring the opponent to either accept the doubling or forfeit the match. It is a game of luck, strategy and psychological finesse.

Bruno arrives in Berlin to play a “potential whale,” someone likely to lose a colossal sum. “Bruno had for his entire life associated backgammon with candor, the dice not determining fate so much as revealing character,” Lethe writes. Yet, Bruno often falls victim to his own character foible, a personal blindspot that allows his concentration to be broken by his sexual desires. Initially, he gathers sizable winnings, until his opponent breaks his focus by having a half-naked, masked woman bearing a tray of food enter the room. Not only does Bruno lose a prodigious amount before the evening is over, but he ends up in the hospital, his slackening vigor presaged by a nosebleed that couldn’t be staunched.

After tests, he is informed that he has a tumorous cancer growing behind his eye and that his best hope is a rare surgery performed by a pioneer in the field, requiring him to return to Berkeley, California. Berkeley happens to be where he grew up, bouncing as a boy with his sad mother from squalid apartments to homeless shelters. It’s is a place he escaped after high school with the intent of never returning.

The setup for his return is a happenstance encounter with a childhood acquaintance, Keith Stolarsky, and Stolarsky’s girlfriend at an elite club while Bruno was in Singapore. When they were kids, Bruno largely felt disdain for Stolarsky, for reasons Stolarsky again makes apparent. Bruno humors Stolarsky in a match, in part because he finds his girlfriend alluring. Stolarsky has become a wealthy entrepreneur, owning “half of Telegraph Avenue” in Berkeley, running a portfolio of seedy apartments, fast food joints and other ventures. The two men play, Bruno leaping ahead with sizable earnings until he grows either bored or distracted, causing him to lose much of his money.

Stolarsky subsequently becomes his benefactor, enabling Bruno to return from overseas to Berkeley for the surgery, which is performed by a narcissist who peels back Bruno’s face from his forehead to his mouth in order to remove the tumor. The surgery and hospital bill is paid by Stolarsky, putting Bruno deeply in his debt. After the bandages are removed, Bruno leaves the hospital wearing a hooded mask. Stolarsky puts him up in a flophouse apartment he owns and gives him a job at one of his burger joints.

Bruno now passes, in the world he grew up in and loathes, as a freak. But the blot in his vision has, indeed, been removed. Slowly he comes to sense the power of his perceived telepathy returning, with his mask giving him a powerful psychological edge, alluring and enticing his opponents, but serving as a barrier they cannot penetrate.

Lethem, who lives part time in Maine, moves his men around the board of his story like a backgammon master. Things get curiouser and curiouser before Lethem’s unexpected end game. “A Gambler’s Anatomy” is a complex unfolding of character that revolves around games of all manner and dimensions. Ultimately, the heart of the story lies not in any moral imperative, but in the question of who plays whom — and who gets played.

Frank O Smith is a Maine writer and ghostwriter whose novel, “Dream Singer,” was named as a finalist for the Bellwether Prize, created by best-selling novelist Barbara Kingsolver. Smith can be reached via his website: frankosmithstories.com.