The Fourth Hand

While reporting a story from India, Patrick Wallingford, a New York television journalist, has his left hand eaten by a lion. Millions of TV viewers witness the accident, and Patrick achieves instant notoriety as "the lion guy".

In Boston, a renowned hand surgeon, Dr. Nicholas M. Zajac, awaits the opportunity to perform the nation’s first hand transplant. After watching video of Patrick, Dr. Zajac contacts the journalist and pledges to find a suitable hand donor for him.

Doris Clausen, a married woman in Wisconsin, wants to give Patrick Wallingford her husband’s left hand—that is, after her husband dies. When her husband later dies from a self-inflicted gunshot wound, Doris immediately rushes the hand to Boston. In the waiting room prior to the procedure, Doris has sex with Patrick, explaining that she had always wanted to have a child but was unable to with her late husband. The hand is then successfully attached by Dr. Zajac, with unorthodox visitation rights for the hand granted to Doris.

Patrick quickly falls in love with Doris, who has his baby, Otto Clausen Jr. Doris, however, will not return Patrick's love, and only allows him to touch her intimately with her late husband's hand, now Patrick's.

One year after the surgery, Patrick's body rejects his hand. After repeated visits with both Doris and his infant son, Doris again has sex with Patrick and, while at a Green Bay Packers game, agrees to marry him.

The Fourth Hand is characteristic of John Irving’s seamless storytelling and further explores some of the author’s recurring themes—loss, grief, love as redemption. But this novel also breaks new ground; it offers a penetrating look at the power of second chances and the will to change.