John Irving seems to have discovered impatience. Typically, his lengthy, wandering novels take their time in establishing complicated worlds full of quirky people with odd histories. But his latest, The Fourth Hand, barely tops 300 pages, and feels shorter. Hand takes on the episodic structure of Irving's signature novels (A Prayer For Owen Meany, The Cider House Rules) without the elaborate plot to back that structure up; as a result, it feels random, dogmatic, and easily distracted. As usual, Irving assembles his characters out of offbeat vignettes and colorful, barely relevant details. His protagonist, television news anchor Patrick Wallingford (prone to linguistic misinterpretations, principled in a petulant sort of way, and victim of a failed marriage to an intrusive, judgmental shrew) lost his left hand in a widely televised accident. A famous surgeon, Dr. Nicholas Zajac (anorexic, resented by his colleagues, obsessed with celebrity, birds, and the ubiquity of dog feces, and victim of a failed marriage to an intrusive, judgmental shrew) wants Wallingford to be the subject of the first-ever successful hand transplant. Recent widow Doris Clausen (dedicated to the Green Bay Packers, and physically average but capable of inducing erections with an offhand sentence) is willing to donate her husband's hand for the operation, but demands "visiting rights" with it. Meanwhile, on the periphery of this triangle, Zajac's housekeeper obsesses over him and remakes herself on his oblivious behalf. A clingy, ambitious woman obsesses over Wallingford and schemes to have his baby and remodel his career. Wallingford sleeps with, or fails to sleep with, a variety of women, briefly obsessing about each of them in turn. Fourth Hand could almost be a treatise on obsession, if it weren't so clinical, and if there weren't so many extraneous factoids and overdeveloped but underutilized characters packing the space between snippets of the paltry storyline. Characters in Irving novels often have trouble understanding their own actions or relating to their own feelings; they move forward along fated tracks, getting into uncomfortable, unlikely jams and examining themselves and their neighbors with principled but baffled detachment. Fourth Hand is no exception, but in this limited space, the imbalance between desire and action is established but not explored, leaving it baldly apparent and painfully awkward. Irving compensates by lapsing into second and third person, using his authorial voice and explanatory parentheticals to tell readers what to think about current events, the modern media, and his characters' behavior. Without those lectures, the elaborate heaps of anecdotes, and the artificial distance Irving places between his subjects and his readers, Hand is little more than a mundane, not terribly believable love story. The fact that Irving is already at work on his Hand screenplay for Cider House adaptation director Lasse Hallström may explain the author's newfound rush to get to press with a work that feels half-finished. Irving's characters' motivations are far more obscure, and significantly less satisfying.