A CONSTELLATION OF VITAL PHENOMENA. By Anthony Marra. Hogarth. 379 pages. $26.

In “A Constellation of Vital Phenomena,” a brilliant debut novel by Anthony Marra, the reader is asked to consider the possibility of finding biblical mercy, unshakable devotion and astonishing joy in the bleakest, most terrifying circumstances.

The story opens in 2004 in Eldar, a small Chechen hamlet, on the morning after 8-year-old Havaa’s father is abducted and his home is burned to the ground by “the Feds,” aka the Russian military. Because she was trained to hide in the forest on her father’s command, Havaa escaped being taken with her father and is now in the tenuous protection of her neighbor, Akhmed, a doctor who prefers art to medicine.

Knowing she cannot stay in their village, home to a ruthless Chechen informer, Akhmed hatches a desperate plan to take Havaa to Hospital No. 6 in Volchansk and implore a surgeon he knows only by reputation to hide the girl. “I’m going to ask if you can stay with her,” he explains to Havaa on their 11-kilometer trek.

The surgeon, Sonja, Dr. Sofia Andreyevna Rabina, who once skillfully closed a rebel commander’s chest with dental floss, turns out to be a domineering, ethnic Russian who lives on amphetamines and sweetened condensed milk.

In response to Akhmed’s plea for sanctuary she says, “And I need a plane ticket to the Black Sea.”

He strikes a bargain. “The girl will stay with you and I will work here until a home is found for her.” She fires back, “No one will take her.” To which Akhmed promises, “Then I will keep working here.” If only things were that simple.

Sonja, who has learned to resent and mistrust everyone, tests Akhmed, asking him what he would do with an unresponsive patient. Akhmed fails miserably, saying, “First I would have him fill out a questionnaire to get a sense of his medical history along with any conditions or diseases that might run in the family.”

Because Sonja is the only physician left in the hospital, she accepts this thin peasant doctor. “We need someone to wash dirty sheets anyway. She can stay if you work.” Sonja has Akhmed amputating legs by the next day.

For those unfamiliar with the First and Second Chechen Wars and the routine savagery perpetrated against civilians by both the Russian military and Chechen insurgents, a story based on the protection of one little girl, wanted for alleged actions taken by her father, might seem a bit of a stretch.

According to human rights groups, Chechnya has been the scene of massive human rights abuses since 1994. They have documented the Russian military’s practice of kidnapping, beating and torturing those they suspected of aiding Chechen rebels as well as their families. The author fully develops characters that are invested in the cruel reality he paints that makes this story of a hunted 8-year-old child plausible to the reader after only a few pages, even if he cannot find Chechnya on a map. And yes, it is hard to find.

Though the story mainly takes place over five days during the Second Chechen War, Marra frequently revisits incidents that occurred during the First Chechen War to trace his characters’ present predicament back to its grim origins, and to illuminate their interlocking destinies. This way, we discover that Sonja had made it out of Chechnya to a residency in London and a Scottish fiance, only to return after the first war to find her younger sister, Natasha.

Now, Sonja has seen enough PTSD to recognize it in both herself and her sister, but she is unable to mend either of them. Sonja is mostly numb to her emotions except for her unremitting capacity for exasperation, and regards her patients as the sum of their healthy parts.

Natasha, who had been forced into prostitution and heroin addiction, resents this on the patients’ behalf, most of whom are too injured to take exception to their treatment. Natasha characterized her sister’s treatment of a patient in pulmonary distress as showing “the respect a plumber shows to blocked septic tanks.”

While appreciating Sonja’s surgical skills, her sister’s lack of empathy still worries Natasha.

“To work in these circumstances, a surgeon must reduce each patient to her body, but this was an attitude shared by traffickers, pimps and johns populating Natasha’s private perdition.”

Natasha’s hyperaware vulnerability, concealed in a deadened demeanor, makes her one of the most sympathetic characters, so finding out that “her hope for rescue had taken so long to die” is a heart-wrenching realization. In addition to Sonja, Natasha, Havaa and Akhmed, the author gives us secondary characters that are intricately layered, and together help tell a haunting tale that is as multifaceted and troubling as Chechnya.

Marra gives us an abundance of death and suffering: “The funeral begins for a man the moment he steps from the prisoner pit into the hands of his torturer. No body. No shroud. No friend or neighbor who had known the summoned in any but this desperate condition.”

But his novel is about life, the struggle to endure even when that’s no longer likely, and the soulful urgency to safeguard others more defenseless than us.

The title of Marra’s novel is a description of life from a Russian medical text: “A constellation of vital phenomena.”

Reviewer Virginia Friedman is a writer and filmmaker from Charleston.