Twenty-one years ago, a young man in the midst of an intense medical residency at Dallas, Texas, found sleep difficult to come by. At first he tackled insomnia by poring over classics, including the works of masters of the large-canvas novel: Leo Tolstoy, Fyodor Dostoevsky and Gabriel Garcia Marquez. The bedtime reading culminated in Transplanted Man, a novel that has taken him 21 years to write.

It's not to say that doctor-writer Sanjay Nigam's Transplanted Man is a substitute for a sleeping pill. Anything but. The novel tracks the experiences of a medical resident who is also an immigrant born in India but raised almost entirely in America's desert state of Arizona. Not surprisingly, the book has biographical overtones, but manages to conduct a fascinating dialogue among various characters in a predominantly desi hospital in New York's Little India.

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Yet by not chronicling the travails of second-generation Indians who, predictably, are caught between a conservative heritage and upbringing in a liberal western environment, it manages to steer clear of the cliches that populate the NRI literary cottage industry.

TRANSPLANTED MAN By Sanjay Nigam HarperCollins Price: $24.95 Pages: 368

Instead, it tunes in to conversations between the hospital inmates whose only connection hitherto had been physical similarity. In that, it tries to go beyond the obvious, exploring undercurrents and subtexts. The book follows many transplanted men. It can be the Transplanted Man, the politician from India who is surviving on a donor heart, kidney and cornea among other vital organs; the young engineer who bites into his wife's posterior overcome by a belated infatuation for her voluptuous Indian looks; Johnny Walker, the mouse suffering from insomnia, which becomes the subject of a million-dollar corporate tussle; or even the "hypokinetic man". The ensemble of wacky characters tells a fascinating tale while the dialogue with Sonny Seth, the doctor who is the central character, is both riveting and revealing.

NIGAM: Biographical tones mark the novel

Nigam brings out the common traits among the largely NRI cast as effectively as the strains between the immigrants arriving from India and others who have less direct claims to the country's cultural heritage. Along the way, the novel also demolishes some stereotypes. For one, the image of a model minority community family so popular in Bollywood's fevered imagination is not in consonance with the series of extramarital escapades that seem to occur in an otherwise predictable and conservative middle-class milieu. Many episodes, including those involving Indophiles, are poignant, as individuals lurch through life seeking emotional equilibrium.

It is Nigam's second book in three years and is probably closer to his heart. Perhaps it has something to do with the nature of his residency. As he puts it: "I had all these life-threatening events thrown at me. My way of coping was to read the classics. They helped me put the pieces of life in a logical order and point to a higher meaning."

Nigam brings to the table a wealth of experience, first as a researcher at the Rockefeller University and later as professor at Harvard Medical School. It informs his writing, bringing to it a quirkiness that is missing in many other books in a rapidly growing genre.