The narrator of Elizabeth Strout's new novel has a peculiar voice for a twice-married, successful writer and mother of two grown daughters. She sounds like a little girl.

Indeed, readers may wonder at first whether they have inadvertently picked up a novel aimed at young readers. But soon it becomes clear that Lucy Barton is a trauma survivor.

Her family was so poor they lived in a garage for her first 11 years; children in their tiny Illinois farm town taunted her on the playground, "Your family stinks."

Her father was sexually deviant. Her mother, who may have been an abuse victim as well, tells her, as her breasts develop, that she's starting to look like a neighbor's cow.

Lucy understands she didn't have a normal childhood - "that huge pieces of knowledge about the world were missing that can never be replaced" - yet she bristles when anyone else suggests it.

The book is structured as an extended flashback as Lucy recalls a period of her life when, as a young wife and mother, she was hospitalized for nine weeks for a mysterious ailment. Her mother comes to New York to visit her, staying in her hospital room for five days.

During that interlude they gossip about friends and relatives. The mother talks only about the ruined lives and failed marriages of others, incapable of acknowledging the hurt and suffering in her own family. When Lucy wants to discuss why she was locked in the cab of her father's truck with a long brown snake, her mother feigns innocence: "I don't know anything about a truck," she says.

Later, Lucy will write sketches about this visit and show them to another writer, who will tell her that they're very good but that "people will go after you for combining poverty and abuse." What she's actually written, the writer says, is "a story about love."

Well, yes and no. Strout, whose short story collection "Olive Kitteridge" won a Pulitzer Prize for fiction in 2009 and was later made into an HBO miniseries, has written a strange and affecting story about poverty and abuse - and how it's possible for them to co-exist with love.