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The opening chapters of Caroline Leavitt's 11th novel, "With or Without You," have a bit of a black-and-white-movie feel. I could see Cary Grant as Simon, the handsome rock star, and Joan Fontaine as Stella, the lovely wife he accidentally puts into a coma with one ill-fated night of drinking and pill-popping.

We watch him keeping vigil by her bed in the hospital, sadly strumming his guitar with his hair falling into his eyes, as her best friend Libby, the pretty doctor who doesn't think much of his self-centered musician ways, gives him the cold shoulder. Rosalind Russell, maybe?

It's hard to run a love triangle with one of the players unconscious — and since the publisher's description of the book spills this detail, it's not a spoiler to reveal that Stella wakes up after a couple of months. And in fact, the feel of the book is ultimately less romantic melodrama than psychologically detailed domestic realism. We spend about equal time in the head of each of the three characters as they deal with the radical changes in their lives.

Simon was about to get a big second chance to make good on his early pop-star promise when those misbegotten red pills in his pocket derailed his travel plans. Now his cruel father's predictions of his failure loom larger than ever.

Stella was on the verge of deciding she had outgrown their marriage, and their onetime agreement not to have children. When she wakes up, she won't even remember why she chose a green comforter for her bed. Libby, who was planning never to recover from the childhood trauma she sublimated into her work as a doctor, will find herself on the couch of Dr. Sheep.

In the hands of another writer, like Amy Sohn or Emma Straub, these bougie New York types might have been subject to a touch of satire. But Leavitt is not an ironist. She takes her characters and their troubles very seriously, more like Celeste Ng or Joshua Henkin. But there's also a splash of near-magical realism, when Stella returns from her coma with a gift of creativity and insight that verges on the superhuman. A little touch of Alice Hoffman or Elizabeth Berg, you could say.

What I like best about Leavitt — her signature, perhaps — is her fearlessness with plot. I'll take a good coma story with a miracle recovery anytime.

University of Baltimore professor Marion Winik is the author of "The Big Book of the Dead" and host of the Weekly Reader podcast. Visit her at marionwinik.com.