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And like Joyce, Self is exuberantly, ostentatiously allusive — toying with phrases from King Lear to Kant to the Beatles — and he also shares Joyce's rhythmic, ungrammatical style: The narrative is laced with snatches of songs or slant rhymes (Busner walks "sea-sluggishly through the greeny-briny.")

But the opening line of the novel is the most telling allusion. Busner walks through the hospital singing the Kinks song "Apeman" in his head: "I'm an apeman, I'm an ape-apeman," goes the chorus. The first verse continues: "I'm no better than the animals sitting in their cages in the zoo," a philosophy that's evident in the sheer physicality of the novel — it luxuriates in the grisly details of battlefield wounds and bed sores and bad sex and old age.

Umbrella is also deeply uncomfortable with medicine and technology. The influence of R.D. Laing — the controversial existentialist psychiatrist who posited that mental illness might be a social construct — is clear throughout the novel. Self delights in subversions, merrily punching holes in sacred institutions like medicine, warfare and industry. He skewers psychology's over-analysis of basic human instincts: One sex scene has Busner narrate, "Only when we touched did she unlock, did her synovial fluid flow, so that I felt her muscular rigidity liquefy into spasticity."

Umbrella is exactly what Virginia Woolf called Ulysses in her journal: "egotistic, insistent, raw, striking and ultimately nauseating." It may not be beautiful, but it is extraordinary.

Read an excerpt of Umbrella