Television reporter Patrick Wallingford becomes a story himself when he loses his hand to a caged lion while in India covering a circus. The moment is captured live on film, and Patrick (who wears a "perpetual but dismaying smile--the look of someone who knows he's met you before but can't recall the exact occasion") is henceforth known as the lion guy.

Before long, plans are made to equip Patrick with a new hand. Doctor Nicholas M. Zajac, superstar surgeon, indefatigable dog-poop scooper, runner, and part-time father, is poised to perform the operation. But the donor--or rather the widow of the donor--has a few stipulations. Doris Clausen wants to meet the one-handed reporter before the procedure, and insists on visitation rights afterward. Irving weaves these characters and a panoply of others together in a smart, funny, readable narrative. Often farcical, The Fourth Hand is ultimately something more: a tender chronicle of the redemptive power of love.