Whenever Alison, the wistful narrator of Mary Gaitskill's penetrating novel Veronica, describes another person, his or her appearance always comes first and always makes the most vivid impression. Of the title figure, a brassy New Yorker whom she meets in a temp agency, she observes, "From a distance, her whole face looked askew, puckered like flesh around a badly healed wound." There's a reason appearances mean so much to Alison: In her youth, her own striking beauty landed her modeling jobs in Paris and Manhattan, but that decadent career has long since passed into misery and squalor. Now in her mid-40s, Alison has seen her porcelain face cracked by age and her lithe body mangled into a painful shell thanks to a car accident that wrenched her arm and a raging case of Hepatitis C that she mistreats with fistfuls of codeine. Yet as much as riding public buses and cleaning offices have humbled her, that model's superficiality has never really left her, and it leads to withering appraisals of the dullards who cross her path.

Given Alison's bleak present, it shouldn't be surprising that her thoughts constantly drift to the past. Veronica flits nimbly through several different periods in her life, darting around in an almost free-associative tumble, which takes some getting used to. Gaitskill follows Alison as she bounces around as a teenage runaway in San Francisco, lives the cocaine-fueled high life as a model in Paris and Manhattan, and winds up at the end of the line in California, working odd jobs and taking residence by a fetid canal. Her unlikely friendship with Veronica, a woman in many ways her opposite, restores meaning to her life and also introduces a new source of pain. During the Reagan '80s, Veronica contracted the AIDS virus from her callous, bisexual boyfriend and eventually died, but her legacy still consumes Alison's thoughts.

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Writing in brisk, clipped sentences that snap like a whip, Gaitskill establishes a point-of-view that's distinctly unsentimental, bordering on cruel. Her cool impression of human nature made itself known in "Secretary," a short story about office sadomasochism that was adapted into a film of the same title, and it takes some effort to appreciate it here. Nominated for this year's National Book Award, Veronica reads like the kind of novel only an austere, awards-giving body could love, with a prose-poetic style that's as undeniably sophisticated as it is hard to crack. With such a half-formed, superficial woman as narrator, there's no clear path into the multi-tiered story, yet Gaitskill supplies plenty of extraordinary passages, including a particularly vivid description of the onset of the AIDS pandemic in the '80s New York. For Alison, for whom beauty means everything, witnessing this world of decay is especially bracing.