When you come to the end of Abraham Verghese's new novel, "The Covenant of Water," you will feel that you have lived among the Indian and Anglo-Indian characters who populate its pages for almost a century. It's that long. But it's also that immersive — appropriately enough for a book so steeped in the medium and metaphor of water, as the title suggests.

We begin in 1900 with a 12-year-old bride in Travancore, then a princely state "at the southern tip of India, sandwiched between the Arabian Sea and the Western Ghats ... a child's fantasy world of rivulets and canals, a latticework of lakes and lagoons, a maze of backwaters and bottle-green lotus ponds; a vast circulatory system because, as [the bride's] father used to say, all water is connected."

The nameless child, going from Molay (daughter) to "the bride" to Ammachi (little mother, when she takes on her widowed groom's little boy), might seem more what than who — but she quickly becomes the very heart of her husband's life and of Parambil, the vast estate that he has carved out of the jungle.

But "why here?" the young bride wonders about Parambil, "away from water?" — and we get our first view of the curse that haunts the family she has married into. The Condition, she comes to call it: an inability to survive in water, however harmless-seeming or shallow, deaths by drowning in every generation going back as far as records reach.

Like Verghese's acclaimed novel "Cutting for Stone," this one features a medical component — involving the Parambil family but also a young Scottish doctor who comes to India for training, and stays — so The Condition migrates from the world of folklore to the realm of science.

Meanwhile, we follow the family through the particulars of love and sorrow and the benign and grotesque turns of fate (the grotesque seemingly having the upper hand), along the way acquiring prodigious knowledge about the history of South India, the Saint Thomas Christians of Kerala, physiology, language,and the practices of cooking, making art and medicine — some of the surgeries so minutely described that you might feel prepared to perform them yourself. (But don't.)

These details emerge naturally from the preoccupations and circumstances of Verghese's characters (Here, for instance, is the Scottish doctor gazing at a lovely woman: "The brow, the nose, the ramp of her upper lip with its Cupid's bow giving way to the vermilion border of the lower lip, then gliding over her thyroid cartilage, her cricoid, to the tender hollow above her breastbone"), which is what gives this book, so epic in scale, such intimacy and immediacy.

These lives, so finely drawn and intensely felt, are at once singular and inextricably bound together within the immensity of fate and faith — like "the water that connects them all in time and space and always has. The water ... first stepped into minutes ago is long gone and yet it is here, past and present and future inexorably coupled, like time made incarnate. This is the covenant of water: that they're all linked inescapably by their acts of commission and omission, and no one stands alone."

Ellen Akins is a writer and a teacher of writing in Wisconsin.

The Covenant of Water

By: Abraham Verghese.

Publisher: Grove Press, 724 pages, $30.