Set against the background of current social and political events, most notably the Iraq war, the novel offers profound insights into the nature of work, science, art, family and love.
At the heart of the story is Perowne's encounter with a disturbed and disturbing young man called Baxter. Baxter suffers from a degenerative mental condition which even the most advanced brain surgery cannot cure.
Along with an associate, he invades the Perowne household, in the middle of a family gathering. He assaults Perowne's father-in-law, holds a knife to his wife's throat, and threatens to rape his daughter. Baxter is eventually overcome and thrown down stairs, suffering a brain haemorrhage which, ironically, Perowne's skill as a surgeon is able to relieve.
Baxter's genetic make-up, however, means that the decline in his mental and physical functioning will continue. Towards the end of the novel, Perowne, looking out from his comfortable home on to the London square which is sometimes a stopping point for drunks and junkies, reflects on the extent to which the genetic code we inherit shapes, or perhaps even determines, our lives.
He thinks: "It's a dim fate, to be the sort of person who can't earn a living, or resist another drink, or remember today what he resolved to do yesterday. No amount of social justice will cure or disperse this enfeebled army haunting the public places of every town."
Perowne's perspective is a scientific one and, in the novel, it is counterbalanced by the different perspectives of his son, a musician, his daughter, a poet, and his wife, a lawyer.
But the scientific perspective is one that, arguably, we need to take more seriously in education. It is partly a matter of being better informed about genetics, neural pathways and brain functioning.
How many of us have even a rudimentary understanding of these matters? They have implications for all teachers, not just those dealing with youngsters with additional support needs. They help to explain the mechanisms of learning, memory and social interaction, as well as the causes of learning dysfunction and socio-pathology.
It would be interesting to survey teacher education courses to see how far, and in what way, such topics are represented in the curriculum. I suspect the coverage would be very thin.
But the significance of Perowne's perspective extends much further. It raises difficult questions about the degree to which people can be held fully responsible for their own actions. Where an accident of genetic inheritance predisposes individuals to behave in a certain way, how meaningful are the liberal orthodoxies about rights and responsibilities?
Certainly people deserve to be protected from those who would harm them, but the basis of constraining the offenders might have to be justified in ways that involve re-thinking traditional legal concepts.
The world of education is not short of soft rhetoric overlaying hard problems. Nowhere is this more evident than in the frequent invocation of "social justice". What kind of social justice is possible for those who suffer from what Perowne, thinking of Baxter, calls "that unpickable knot of affliction"?
To some extent the ideal of social justice may be just a comfortable story that those of us who have been dealt a reasonable hand in the inheritance stakes tell ourselves when we encounter the pain, aggression and unpredictability of some of the individuals who have been less fortunate.
Walter Humes is professor of education at Aberdeen University.