The following version of this book was used to create this study guide: Lethem, Jonathan. A Gambler’s Anatomy. Doubleday, 2016.

A Gambler’s Anatomy is a novel presented in a mostly linear structure. The protagonist, Alexander Bruno, is a world-traveling professional backgammon player. He makes most of his money playing against wealthy, overconfident backgammon enthusiasts who crave a challenge. Bruno has recently come under the management of Edgar Falk, a wealthy man involved in various international criminal activities. After Bruno suffers a surprising loss in Singapore, Falk send Bruno to Berlin to play against a wealthy real-estate speculator named Wolf-Dirk Kohler.

On the morning of the game, Bruno wakes up with a mysterious blot in his vision, and on the way to the game, he meets an attractive woman named Madchen. She is about 50 years old, like Bruno. Bruno ends up losing the game against Kohler, and during one of the rounds, Bruno suffers a nosebleed and collapses. At a hospital, x-rays show that Bruno has a cancer-like growth called a meningioma pressing against the front of his brain. One of the doctors tells Bruno that he must go to California to see a surgeon with an innovative new surgery that can help him.

The narrative briefly jumps backward to show Bruno’s time in Singapore. In a high-end social club, Bruno runs into old high school acquaintance Keith Stolarsky and his girlfriend Tira Harpaz. Stolarsky is a wealthy property owner in Berkeley, California where he and Bruno went to high school. He is unruly and tackily dressed, which contrasts with the refined and coolly reserved Bruno. The next evening, Bruno plays backgammon against Edgar Falk’s business associate Yik Tho Lim, and Bruno loses badly.

The narrative then resumes where it left off. Bruno is flown to his old hometown of Berkeley, where he has not been for 30 years. Stolarsky has paid for the plane ticket. He gives Bruno food, lodging, and spending money, and he says that he will pay for Bruno’s medical expenses. Among Stolarsky’s properties are several fast food restaurants on Telegraph Avenue and the apartment building in which he lets Bruno stay.

Bruno goes to meet the surgeon, Noah Behringer, at a hospital in nearby San Francisco. Behringer is an aging hippie who used to mostly practice medicine at music festivals, but he is confident in the surgery. The surgery itself is shown through Behringer’s eyes, and once Bruno becomes conscious afterwards, he says that he himself saw the surgery through Behringer’s eyes and mind. Bruno realizes that the removal of the meningioma has unfortunately returned his telepath powers, which came to him when he was 11 and which he learned to block out. Behringer does not believe Bruno, and Bruno is discharged from the hospital. After the surgery, Bruno wears a post-surgical mask to hide his face.

Bruno then returns to Berkeley and spends his time wandering aimlessly. He becomes acquainted with several of the locals, including Beth Dennis, who works in the Stolarsky owned retail store Zodiac Media, and Garris Plybon, who works in the fast food restaurant Kropotkin’s Sliders. Plybon greatly dislikes Stolarsky and espouses anarchistic rhetoric, but Kropotkin’s is secretly owned by Stolarsky. Plybon and Bruno are aware of this, but Bruno promises Plybon that he will not tell anyone. Later, Bruno calls Madchen on the phone, as they exchanged phone numbers when they met. He explains his situation, and Madcehn agrees to come to Berkeley to help take care of him. Meanwhile, Tira makes sexual advances on Bruno, and they have a brief sexual encounter.

Just before Madcehn arrives, Stolarsky tells Bruno that he must work for him to pay off his debt. Bruno agrees to work at Kropotkin’s Sliders. Madchen arrives soon after, and she comes to bruno’s apartment to help take care of him. Bruno says that he and Madchen need to escape Berkeley, but first he goes to his shift at Kropotkin’s Afterwards, he and Madchen have a meeting with Beth and Plybon in which they plot a protest against Plybon. Bruno participates in the protest, but it is ultimately ineffective. Madchen decides to work a shift at Kropotkin’s during the protest, and when Bruno returns to see her, she is gone. Plybon tells Briuno that Stolarsky took her to his house. Bruno goes to confront Stolarsky, but Stolarsky forces him away at gunpoint. In a final act of rebellion against Stolarsky, Bruno leads a group of bystanders in acts of arson on Stolarsky’s various properties.

Bruno finds himself in jail, and Tira Harpaz bails him out. She reveals that Bruno’s arson only helped Stolarsky, as it allowed him to collect insurance money. She then says that Stolarsky no longer has any use for Bruno, so Bruno is being sent away. Tira gives Bruno a plane ticket, which has been paid for by Edgar Falk. The novel ends with Bruno once again under the management and control of Edgar Falk. Under Falk’s direction, Bruno uses his telepathic powers to cheat at games of poker against wealthy poker enthusiasts.