While reporting a story from India, a New York television journalist has his left hand eaten by a lion; millions of TV viewers witness the accident. In Boston, a renowned hand surgeon awaits the opportunity to perform the nation’s first hand transplant. A married woman in Wisconsin wants to give the one-handed reporter her husband’s left hand, that is, after her husband dies. But the husband is alive, relatively young, and healthy.

While The Fourth Hand is characteristic of Irving’s seamless storytelling and further explores some of the author’s recurring themes - loss, grief, love as redemption - this novel also breaks new ground; it offers a penetrating look at the power of second chances and the will to change.