Fiction: An accident that should never have happened, does. A young girl riding her scooter does not stop at the traffic sign. The driver of the oncoming car almost manages to avoid her, but doesn't.
Her helmet strap is not fastened. The accident is recalled in a forensic description by the young girl's father, a man with, as the narrative reveals, an extraordinary capacity for detail.
Don't Move, written in Italian by Dublin-born Margaret Mazzantini, daughter of artist Anne Donnelly , is an urgent, often shocking and relentlessly cinematic experience. Confession, lamentation, it is a study in grief, lost opportunity and, above all, it looks at the compromised nature of relationships and the ways in which the conventional invariably crushes passion. Why? Because convention is stronger, it endures while feeling terrifies.
The narrator, Timoteo, is a surgeon. He could be the man with everything; professional status, an ego, a beautiful wife, a daughter, a highly developed sexual response and more free time than one might expect a busy surgeon to have. As he begins the hospital vigil during which his daughter's survival will be decided, he prepares to tell his story to the unconscious girl. She is the ideal audience. Except he is not telling her anything, he is not reliving the past, only that small parcel of time during which he felt he was most alive. In common with many middle-aged men, once he feels he has everything, he realises how little he really has.
This is a modern morality play. The narrator is neither a villain nor a hero. He is not even particularly likeable but as he is sustained by a powerful self loathing it becomes possible to tolerate him and even listen to his story - albeit at a remove. A tremendous distance is evident in this polished, sophisticated and brutal book. Just as Timoteo looks at his inert daughter, no longer quite his daughter, a body lying on a hospital bed, he is engaged in examining his life as if it had been lived by someone else. His is a loneliness it is almost possible to touch.
Mazzantini's study of a man alone with his regrets is powerful, if often mannered and at times improbable. Although it is easy to understand why the narrator arrives at a point in his life in which he realises he can admire his beautiful, well-groomed journalist wife, who appears as egocentric and as detached as he is, but cannot love her - it is more difficult to understand the crazed passion that engulfs him.
And it is this passion which drives the story. In order for this to work Mazzantini must ensure that her readers can believe not only in her male narrator but in his actions. She makes this difficult, as Timoteo embarks on his great passion by first committing a vicious act of rape. The fact that the sex is humiliating for the victim makes it exciting and dangerous for him. Italia is a working-class woman, slovenly, unattractive, without guile. She is a passive no-hoper, who lives in a hovel with her blind dog.
Initially both fascinated and repelled by her squalor, Timoteo becomes obsessed. Conditioned to the slick grace and stylishness of Elsa, with whom he finally decides to have a child - after all, their relationship appears to be nothing more than a union of ego and material comfort - he is not prepared for the feelings that the shabby, submissive Italia evokes. The contrasts are perhaps too obvious; Elsa is a cold, ample beauty and Italia is an ageing street child, but she is real and therein lies her appeal - and power.
Throughout the narrative it is difficult not to be aware that the character of the male narrator is in fact filtered through a female sensibility. For all the emphasis on maleness and male yearning, this is a very female book. It is hard to believe any father would submit any child to a confession of such intimacy. Even he asks himself "Why am I telling you all this?" The descriptions of ordinary detail and domestic ritual are exact and intellectualised. It is all very disciplined, too disciplined. The vigil is not really about the injured daughter. But then Timoteo, having left his lover for his pregnant wife, the lover having had an abortion, almost immediately leaves the new baby to embark on a final doomed odyssey with the fading lover.
Yet however often the reader will shrug with disbelief at Timoteo's pathetic need to stay with a wife he does not really love, or even like, Mazzantini succeeds through her characterisation of Italia. Sympathetic to the point of saintliness, Italia - poor, plain and desperate for love - accepts all with incredible understanding. The final flight and crazed operation in a poorly equipped operating theatre does reduce the later stages of the novel to a Hollywood drama in search of an ending. Mazzantini too often forces her hand.
There is also a difficulty in that Timoteo's existence is constructed on elaborate trade offs - a lover for a baby, a daughter for a dead lover - which is theatrical in the extreme. Here is a man who hardly knows his daughter, who has settled with his wife in return for her tolerance and who can lament his lover having destroyed her and that love.
As a study in an irrational violence presented as male passion, Don't Move, is a terrifying thesis acted out on one small female body. As an essay on the compromises and cowardice upon which relationships endure, it is all too familiar. But as a sad story about the way lives go wrong, and the way in which someone else invariably pays for the weakness of cowardly survivors, Mazzantini's tough, elegant, quasi-Shakespearean and very deliberate second novel is, for all its suave artifice, a queasy, near-Biblical tale of chilling truths and immense regrets.
• Eileen Battersby is Literary Correspondent of The Irish Times