Jon McGregor’s inventive 2017 novel, “Reservoir 13,” lacked a traditional protagonist. The book’s central “character” was the collective consciousness of an English village where a teenage girl has gone missing. The rising tension from her disappearance seeped through the book like stain spreading across a tablecloth until it was completely saturated. With sublime assurance, “Reservoir 13” reimagined how a novel could be told.

McGregor’s latest is more conventional in structure and approach. It opens with a literal cliffhanger. During a sudden Antarctic squall, three members of a British GPS mapping expedition become separated. One of them, the experienced guide and technician, Robert “Doc” Wright, slips and finds himself suspended precariously above a sheer drop. “The cliff wasn’t high but he wouldn’t survive a fall.” The others, Thomas Myers and Luke Adebayo, wind up, respectively, stranded on an ice floe and hunkered down beside a snowmobile. It’s a dire and dramatic opening scene, narrated with aplomb.

During the course of his misadventures on the cliff, Robert suffers a stroke . (To avoid spoilers, I won’t say what happens to the others.) The first section of the novel – the “Lean” of the title – culminates in an extended passage rendered through Robert’s stricken mind. “He rawed the rum nubness of his face. No. Rubbed. Rubbed the rum rawness. No.” As he tries to regain his grasp of language, time rapidly runs out for him to summon help to save Thomas and Luke. “The lips flap floppy and the words not come. The shapes. The face. Numb faith. Leg numb. Weak. Hold Luke. Hold.” The first 80 pages of this novel are as gripping as anything you’ll read this year.

McGregor shifts gears for the middle section of the book. We follow Robert’s wife, Anna, as she learns of his accident and travels from England to Chile to accompany him home. Anna is a researcher specializing in “anthropogenic climate impacts.” She’s a chilly, intelligent introvert. Robert’s annual extended stays in Antarctica are the foundation of their long marriage, allowing her independence and time for work. “So, essentially, you’re going to marry him on the basis that he won’t be around much?” a friend asks Anna. “That’s correct.” In Chile, she confronts Robert’s new physical and linguistic deficits. He suffers from aphasia and needs help getting dressed, moving around, using the toilet.

Less dramatic than the opening section, the middle of the novel powerfully conveys the toll of caregiving. Anna’s work, including an important upcoming conference in Montreal, gradually fades from the novel until she is completely consumed with looking after Robert. “I don’t want to be a carer,” she tells a friend. “I never even really wanted to be a wife.” She must also contend with the needs of concerned relatives, including their two grown children, and an inquest into the incident in Antarctica. “It was too much. She didn’t think she could do it all on her own.” The “Fall” of the title is both Robert’s and Anna’s, a reminder that serious illness also upends the lives of those closest to the patient. McGregor accomplishes this efficiently and effectively. Anna can be stubborn and difficult, too, but we feel for her.

With its punctuationless title, “Lean Fall Stand” is a book about the slipperiness of language, that flexible and fallible vehicle for consciousness and communication on which we are so dependent. Even among those in the novel who have not suffered strokes, language at times is incommensurate with the job it is expected to perform. “I’m sorry. My thinking is pre-empted by my speaking,” a character says to Anna. Later, while drinking tea with her daughter, the conversation dries up. “Neither of them knew what to say, or how to say it.”

The third section of the book, which is about therapy and rehabilitation, addresses these shortcomings. And here, briefly, the novel loses its way. Up until now, the narrative has been tightly focused on Robert and those directly connected to him and his accident. But McGregor broadens this field of view to include therapists and the members of a group of stroke patients who meet regularly to learn new “communication strategies.” “We can talk around things,” the group leader says. “We can use gestures. We’ve done some singing. We can think about drawing and writing. We could even think about movement; about dance.” It diffuses the book’s narrative drive.

After that brief detour, however, McGregor returns to Robert and Anna. The final scenes, while not as exciting as the opening, offer a quiet exhilaration of their own as well as the tempered hope that, even after a major setback, we might all learn to stand again.

Jon Michaud is the author of the novel “When Tito Loved Clara.”

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