Don't Move by Margaret Mazzantini trans John Cullen

A knife in the heart of Italy

Margaret Mazzantini has taken Italy by storm with this novel about a rich, accomplished man redeemed from emptiness and futility by his love affair with an ugly woman. Don't Move is written in the first person through the eyes of Timoteo, a surgeon in a Roman hospital, a man who "splits open and roots around" in the bodies of strangers "without joy and without compassion".

Timoteo lives the rich, full, vacuous life of a successful professional at the turn of the 21st century. He has a handsome flat in town, a beach house, an elegant, full-breasted wife, Elsa, as vacuous as himself, a circle of elegant friends whom he and Elsa meet at parties then afterwards take apart as clinically as Timoteo slices through the flesh of his patients.

He might have lived out his life like this, "thinking about life - that's it, thinking about buying something or eating something", had his car not one hot day broken down somewhere on Rome's squalid, bedraggled periphery. In the boiling heat he walks the few hundred metres to the nearest bar, drinks a coffee and a glass of water.

Then an unprepossessing youngish woman helps him out. She tells him there is a mechanic nearby and takes him to the workshop. The public telephone is broken: she says he can use the phone at her flat, which he does.

He goes back to the bar to wait for the garage to re-open. But "I wasn't used to intervals", and while he waits he drinks too much vodka. Then he goes back to the flat of the girl who has helped him, and rapes her.

It appears to be an isolated act of darkness in the surgeon's otherwise well-ordered life. But he cannot get this nameless, hapless girl, her voice "toneless as the mew of a cat", "neither beautiful nor very young", out of his mind.

He has paranoid visions of her tracking him down, denouncing him to the police, lying in wait at the hospital. With his best friend Manlio, he cannot resist raising the subject of prostitutes, then drops it. He feels compelled, quite soon, to visit her again. And he rapes her again, only it's not rape because she doesn't resist. "I rubbed her face against my stomach," he says. "Right there, where the thought of her caused me pain... Heal me, heal me."

It has the nasty ingredients of a trivial and squalid menopausal affair, but Timoteo leaves one in no doubt that his love for Italia (as she turns out, enigmatically, to be called) is emotionally the most important thing that has ever happened to him; perhaps the only important thing that has happened to him, emotionally. Raping her, visiting her compulsively, lurking outside her home, taking her incognito to a conference of surgeons: doing these things, "I became the reckless boy I'd always wanted to be but never was".

Recklessness is just the means by which Timoteo obtains the food he needs, the soul food symbolised by the wonderful tomato sauce that Italia cooks for him. What is it that he needs exactly?

Love, obviously, but love as the only conceivable encounter - in an age of spiritual death - with authenticity, with the something in life that goes beyond "buying something or eating something".

Mazzantini's book has sold a million copies in Italy. The film, starring her husband Sergio Castelitto as Timoteo and closely faithful to the novel, has also been very successful. Don't Move is written in a harsh, jagged style, and the narrative device that keeps it taut is that Angela, the teenage daughter of Timoteo and Elsa, has had an accident on her motor scooter. As Timoteo and his colleagues toil to save her life, he makes her this full and frank confession.

The book therefore has something of the tension of a thriller. But despite this, and despite its carnality, Don't Move is at heart a religious book, describing the dark detours and the bleak and desperate terrain modern man must hack through to achieve something approaching religious experience. Part of the novel's shock effect in Italy is due to the notion that the object of such momentous, earth-shaking love could be a woman who is "neither beautiful nor very young". This, in the country that has taken the cult of beauty to unknown extremes, is startling stuff.