I thought I liked the premise of this book, but boy, was I wrong! The author explains somewhere that this was almost unpublishable - a story that was rejected by many publishers, who cast doubt on it ever seeing the light of day. It is a difficult book. Speculative, but not Sci-Fi, because it does not really explain the speculative elements. It is ultimately a character story, and with a hard ending, perhaps shocking, certainly unsettling. The whole book is deliberately unsettling.
I vacillated between giving it 2 or 3 stars. As per Goodreads categories, three stars means "I liked it", and I can't really say I did. However, in the end, I recognised there was good writing here and an attempt to say something profound. That I did not like the character of the protagonist much is clearly the author's decision, so it is cleverly done. All the same, I can't recommend it, and as I treat 3 stars as a recommendation, it will have to be 2.