In "The Anatomy Lesson"—Philip Roth's rich, satisfyingly complex conclusion to his Zuckerman trilogy, of which "The Ghost Writer" and "Zuckerman Unbound" formed the first two parts—the writer Nathan Zuckerman has a pain….

It is a pain that has forced Zuckerman to give up writing and spend most of his time lying on the floor in his apartment on a play mat….

Does Zuckerman learn anything from his mysterious ailment, as Tolstoy's Ivan Ilyich did from his? Do the cemetery and hospital settings of the final scenes of "The Anatomy Lesson" suggest that Zuckerman has come to terms with death and suffering like the protagonist in "The Death of Ivan Ilyich"? It's difficult to say.

Zuckerman is not Philip Roth of course; art is not to be confused with reality…. Moreover, there is a perceptible distance between the narrator of "The Anatomy Lesson" and its protagonist, most distinctly at the end, where Zuckerman's determination to escape his separateness as an artist becomes just strained and ridiculous enough to suggest that Mr. Roth is treating it ironically, if not with outright ridicule.

Still, we do get an awful lot of Zuckerman in "The Anatomy Lesson." He can be passionately articulate in his rage against his tormenters, and he can be a wildly funny-black comedian in his role as Milton Appel the purveyor of sex. But he can also be a little tedious in his endless self-absorption and scab-picking.

Moreover, as with the two great precursors Mr. Roth's trilogy so consciously evokes, "The Portrait of the Artist as a Young Man" and "The Magic Mountain," there is sufficient ambiguity of tone to make it difficult to judge exactly how much distance lies between the self that created the book and the self that the book creates. In the case of Joyce and Mann, it helps to know that they went on to write books in which the selves that dominated the earlier works were reduced to relatively insignificant characters. One cannot be so sure that Philip Roth will do the same thing. Clearly enough, he would like to. But it remains to be seen whether his next book will prove "The Anatomy Lesson" to be the last installment of the Bildungsroman his body of fiction has seemed so far.