In Act 2 of King Lear, the king is talking to the Earl of Gloucester, saying infirmity affects all of us, high and low: "We are not ourselves/ When nature, being oppress'd, commands the mind/ To suffer with the body." This is one of the epigraphs Matthew Thomas chooses to set the stage for his magnificent first novel, We Are Not Ourselves. What can mental illness do to a person? How do others deal with it? These are important questions that this enormous book, in size and depth, asks. It's also a masterful portrait of a mother and wife, Eileen, in all her strengths and weaknesses.

It's 1941. Thomas introduces us to the Irish-American Tumulty family of Woodside, Queens, New York: Mike--or "Big Mike"--his wife and their daughter, Eileen. They live in a four-story building with a sylvan, tree-filled cemetery on one side, the elevated 7 train and the city on the other: "The asphalt, clapboard, and brick breathing with life and the dead holding sway over the grass." The three of them sleep in twin beds in a room that "resembled an army barracks." Mike, who has a "terrible charisma," is a hard worker and part-time bartender who loves his beer and whisky. When he's been drinking he isn't especially violent, though he could be ornery and sullen. Eileen wants to do anything she can "throw her restless limbs into with abandon." Instead, she has to take Irish dancing lessons, arms tight to her side.

In 1952 her mother loses a baby. Physically, it nearly kills her. When she comes home from the hospital, she begins drinking, soon heavily. Older now, Eileen goes to nursing school in Brooklyn. By 1965 she's in a master's program in nursing administration at NYU and begins to look forward "to the day when she would take another man's name." That would be Ed Leary. He's in graduate school, a scientist. Her heart "kicked once like an engine turning over on a wintry afternoon" when she meets him. Besides, he "could dance like a dream." He was as Irish "as anything, but she decided she could marry him"--Eileen aspires to a bigger world than she's in, and Ed will provide the means.

In 1967, now married, Ed and Eileen move into the second floor of a three-family apartment in Jackson Heights. She's thrilled that part "of the dream she'd conceived for her existence had been fulfilled." But she knows there's more to come; that little restless girl is now a restless woman. Ed is a brilliant neuroscience researcher and Eileen sees big things to come in his life--and hers--but he turns down a great research opportunity to teach science at Bronx Community College. Eileen isn't pleased but deals with it. At 31, she wants a family, and when pregnant, a "new lightness entered her spirit." She has a boy, naming him Connell. She "would breathe his baby smell and wonder how she could ever have lived without it." This part she was going to enjoy: "She was going to fill up her heart with it enough for years."

In 1981 she loses her mother to cancer; her father dies two weeks later. Ed has the opportunity to become dean at his college but turns it down--teaching in the classroom is too important. Eileen is infuriated--this wasn't part of her plan. When the house they're living in goes up for sale, they buy it and move downstairs. Ed is 50, and thinks he needs to relax more--"I've earned a rest." He starts to lose interest in teaching, and even cancels a class--formerly unthinkable.

Their neighborhood is changing. When they moved in, it was Irish, Italian, Jewish and they knew everyone on the block. Now it's Colombians, Koreans, Pakistanis. Most of the stores Eileen loved are gone. Ed is changing, too--he's been behaving strangely, and Connell asks if his father is unhappy. No, of course not, he's happy, Eileen assures him, he's just getting older. When Connell is 14, Eileen suggests he sit in on one of Ed's classes, to see what college is like. It doesn't go well--Ed stands in front of the class as if he is talking to no one, going on and on. Hands go up. He ignores them, lectures further. "Dad!" Connell yells, "Dad!" Ed stops, asks a student where they left off, then just cancels the class. "You seemed confused," Connell says. Ed replies that he's just tired.

Now the book begins to slowly spiral downward. Eileen thinks Ed is depressed; they're in a rut. Maybe a move to another house would make all the difference. Eileen finally gets the house she always wanted but Connell begins getting into trouble and Ed's personality is deteriorating. Eileen ignores them as things fall apart.

It's now that the brilliance of this powerful novel manifests itself. As readers we see the telltale signs of Ed's descent into darkness, and its effect on him and the family is poignant, powerful and brilliant--writing at its best. Watching what they go through emotionally--"When nature, being oppress'd, commands the mind/ to suffer"--is almost too hard to bear. But Thomas presents it beautifully, filling tragedy with love and affection. Without a doubt, this expansive, heartfelt novel will provide a fulfilling and rewarding experience for any reader. --Tom Lavoie

Photo: Beowulf Sheehan

Matthew Thomas was born in the Bronx and grew up in Queens. A graduate of the University of Chicago, he has an MA from the Writing Seminars at Johns Hopkins University and an MFA from the University of California, Irvine, where he received the Graduate Essay Award. He lives with his wife and twin children in New Jersey. We Are Not Ourselves is his first novel.

The story of writing We Are Not Ourselves is a special one--tell us about it.

I submitted part of the novel to my last workshop at UC-Irvine after spending two years handing in short stories that never quite jelled--in part because in many of them I was working through material that would eventually find its way into the novel in radically reduced form, a sentence or two of a 20-page effort. I entered post-graduation life without anything close to a finished manuscript; in fact, I was just beginning. I found work as an adjunct instructor at a handful of colleges all around the Los Angeles area while fighting for time to write. I moved to New York and cobbled together adjunct work, but it wasn't enough; I had no health insurance, so I took a full-time sabbatical replacement job at my old high school, and that led to a job the following year at Xavier High School, which became my home for the next seven years.

I worked on the book during the school year when time allowed and heavily during vacation weeks and in the summers. At my job, I found an unused room on a floor set aside for storage and disappeared there occasionally during free periods to write.

A stroke of luck brought me an affordable apartment and made it easier to stay in the city. Later I got married. We saved our money, lived frugally, and I kept working, but the end wasn't in sight. My wife took the extraordinary step of telling me to take a year off to finish my book, which was an act of heroism, as she had just delivered twins. I think we were both afraid of what it would be like if I never finished my book, how it would affect the psychology of our family. It was a major gamble, but what's worth doing in life that isn't? I signed with my agent in March 2013 and he sold the book a month later.

One of the novel's great achievements is its detailed portrayal of believable characters--Eileen, of course, and Ed, Big Mike and so many others. How hard was it to get these characters just right?

Getting the characters right involved a mixture of intention and openness to suggestion. The interactions between characters often suggested the need for a scene I hadn't anticipated, and then the new scene in turn revealed things about the characters I didn't know. I don't mean to suggest, in some anti-Nabokovian way, that I believe characters control everything, because I admire the autocratic insistence with which Nabokov commands his "creatures." I tried to practice it myself--to decide in advance the facts of their lives, the dates and places of their births, their hair color, where they went to school, what they did with their time, what they wore, how they spoke, and I either researched these things or dreamed them up. I wrote them down, not for use in the book necessarily but more in the way an actor prepares to perform a role by entering the reality of the life from the inside. But there is the need to shape a plot, and I found I had to let the characters guide me in that. The next moment in the scene, even the next big movement in the work as a whole, often presented itself when I stopped trying to engineer specific outcomes and just let characters be.

Everything in this novel is deeply felt. Is there a strong autobiographical element in the novel?

Some of the basic facts of the biographies of the characters--their professions, birthplaces, rough ages--overlap with some of the facts of the lives of the people in my family. But the novel began to improve when I allowed the characters to be characters and sloughed off the need to memorialize people--my father in particular--that had led me to attempt the impossible reproduction on the page of the fathomless humanity of any individual person.

I also faced the dilemma of possible readerly conflation of character with author. This gave me pause when I allowed Connell to make choices I wouldn't have made. I decided to go at that problem head-on by putting him through the wringer, being a little hard on him. I remembered something Jim Shepard said to us once in class: be tough on your characters and your readers will be easier on them. They will say, Hold on a second, this isn't as bad a guy as you're saying.

The novel confronts Alzheimer's and how it affects one family. And it does so in a serious, compassionate way. Was it hard to avoid sentimentality or mawkishness in dealing with such a difficult topic?

If a scene seemed headed in a mawkish direction, I would search for the specific details that would ground its emotions in something plausible and real. A moment that might have been full of genuine sentiment can dissolve into kitsch if a writer reaches for shortcuts or gets carried away "feeling" something the characters aren't feeling authentically themselves. And when books like The Road exist, whose every ounce of affect is utterly earned, it's a lot harder to justify weaving any sentimentality into one's own book.

Did someone in your family have the disease? Did you do a lot of research about it for the novel?

My father died of Alzheimer's in 2002. I began writing the novel a year later. I did a good deal of research into the state of medical insurance practices and Medicaid and Medicare law in the last couple of decades, and the history of the development of Alzheimer's drugs, intake procedures for nursing homes, the effects of Alzheimer's on the bodies of sufferers, the rates of deterioration and so forth. But I never wanted to write a case study. I sought to write a novel first, and a novel that had to do with Alzheimer's second.

This is a big "family" novel, in the sense that it's long, detailed and grand--like Look Homeward, Angel or The Corrections. Did you always envision this novel as "big"?

I love big, all-encompassing books. The two you mentioned are favorites of mine. I also love short books. The Lover. Flaubert's Parrot. Olesha's Envy. Tinkers. So Long, See You Tomorrow. I tried to make this book as short as I could and still tell the story I needed to tell. Once I realized that to tell it in a way that would make the effect of Alzheimer's on a family resonate, I had to go back and write the arc of this woman's whole life, so that the reader would understand why it was significant that so much was lost. I knew I would be in for a long project, and I sighed and bellied up to the table and settled in.

Eileen's husband, Ed, is a dedicated community college teacher who passes on opportunities to move up at his school. You're a high school teacher. What is it about teaching that makes you want to do it and write about it?

Writing about teaching is compelling because teaching is a job in which something critical--the molding of the minds of the young--is always at stake in the routine performance of the task. In its purest form, teaching is a vocation, and as is true with the performance of any vocation, you get back from it more than you put into it, even when you put a lot into it and even when it's not always "fun." It's a privilege to teach. It's a privilege to discuss books with developing minds. Teaching high school English is not for the faint of heart, nor for those who require a lot of sleep. The great irony of the job is that nobody (except for perhaps book editors) reads less for personal pleasure than an English teacher does. There's no time.

Were that any specific books or writers you were thinking of as you wrote your novel?

One Hundred Years of Solitude was a touchstone, in terms of how big a canvas Márquez worked on and how brilliantly he dramatized the inheritance of traits and the unconscious playing out of storylines from one generation to the next in a family--the Nietzschean "eternal return of the same" idea that Kundera also explores so captivatingly in The Unbearable Lightness of Being. After I had decided on short chapters as my form, Mrs. Bridge provided a model for how much could be accomplished using them (as well as for how to tackle the sweep of a whole life in a novel). I learned from Stephen Dixon's Interstate that it's possible to move time radically forward with a single sentence. Dixon is a master manipulator of time who can describe an individual moment with pointillist clarity for two pages and then stun you with "A year passed." From David Markson I took the idea that a concatenation of apparently disconnected bursts of storytelling can accrete meaning in ways that are no less powerful than the movements larger chapters make. Last Orders--another work that expertly manages short chapters--is an exquisitely sensitive book that never slips into sentimentality, and it provided a model for the scrupulous rendering of the emotional life of a family and a group of friends. And Kenzaburo Oe's unsparing, raw and sometimes uncomfortable A Personal Matter showed how to write from the inside about calamitous accidents of biology and their effects on a family.

Now that it's over are you ready to take on another big novel?

I'm working on a novel rooted in characters. At heart it's a family drama, though it's about a different kind of family than the one in my first book. Thank god. I spent enough time with them. --Tom Lavoie