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Explore this The Covenant of Water review either before or after you read Abraham Vergese’s popular book. It includes everything from reading tips to themes, an explanation of the ending, pros and cons, and more. You’ll walk away with a deeper understanding of this epic piece of fiction. Let’s unravel one of the best book reviews now.

the covenant of water by abraham verghese.

Quick Takeaways: The Covenant of Water Review

The Covenant of Water by Abraham Verghese is a long book that’s well worth the effort, especially if you are a fan of literary fiction. While lengthy, it’s not hard to read. The story comes together beautifully at the end while teaching you a lot and immersing you in the lives of the characters in the meantime.

Quick Plot Summary (Without Spoilers)

  • Genre: historical fiction, literary fiction, family drama
  • Age Rating: adults age 18 and over due to adult themes, trauma, and sexual content
  • Themes: human connection, Indian caste system, medical advancements, art as therapy, diversity, sacrifice, faith/belief
  • Publication Date: May 2, 2023
  • Pages: 736 (hardcover)
  • Accolades: Oprah’s Book Club pick, instant New York Times bestseller, one of the New York Times 100 Notable Books of 2023

The Covenant of Water begins in 1900 in Travancore, South India. A 12-year-old girl’s father has died. She sadly leaves her beloved mother to marry a 40-year-old widow and father of a young boy named JoJo.

They live together on his faraway estate, Parambril, in Kerala. There, she connects with her new stepson and learns that her new family suffers from an affliction, also known as “The Condition.” Someone drowns in each generation of this family.

As the young girl grows into adulthood, she becomes known as “Big Ammachi,” or “big mother.” Across three generations of this family, from 1900 to 1977, she and her descendants navigate life amidst their affliction, desperate to cure it.

The story alternates with the perspective of another character, Digby Kilgour, a surgeon from Glasgow, Scotland, who enlists in the Indian Medical Service.

Without spoiling anything, these storylines eventually intertwine.

The Covenant of Water Ending Explained

WARNING: There are spoilers in this section. Skip ahead to the Book Review section if you want to avoid them.

Mariamma discovers that Digby is her biological father, not Phillipose. She learns this through Phillipose’s journals and the resemblance she sees in an old photo of Digby and his mother.

Mariamma’s mother, Elsie, is alive and lives with him.

Elsie had become pregnant with her before returning to Parambril and returned to Digby’s loving arms after her birth.

Digby reveals that Elsie ran away from Parambril because she had leprosy, which Mariamma would have been highly susceptible to getting. She deeply loved Mariamma after all, so much that she was willing to sacrifice leaving her “forever.”

Now, Elsie cannot see. However, she and Mariamma press their hands on a glass window pane, palms against each other.

The Covenant of Water: Full Book Review With Reading Tips

“This is the covenant of water: that they’re all linked inescapably by their acts of commission and omission, and no one stands alone.”

-page 706 (hardcover edition)

My Review: ★★★★★



  • Exquisite prose
  • Characters you grow to know and love
  • Educational
  • Great plot twist


  • long length
  • hard to understand where it’s going at times

Don’t let the length of The Covenant of Water scare you. It’s well worth the read for literary fiction lovers, and it’s not all that hard to consume.

I had heard that the final part had a great payoff, and I agree. The reader finally learns what role Digby plays in the overarching plot, and there’s a shocking plot twist that makes it all finally make sense.

The first several parts of the book are filled with characters you grow to love, lush prose, epic historical and familial events, and educational tales of medicine that inform the reader while also entertaining.

I thought it would be very much about family going into it, but to me, it was more so about history, culture, and science in India.

My only complaint is that, at times, you have to be patient until the end, and you may forget some important characters or points in the meantime. There are several plot lines that don’t make total sense until you get there.

Overall, The Covenant of Water is a triumph and one of the most masterful literary novels I’ve read.

If you’re looking for additional resources, Oprah Winfrey hosted The Covenant of Water Companion Podcast. Watch or listen to episode one below:


  • I read about one chapter of this long book per day “to get through it,” and this tactic worked very well. You can also try more tips for reading long books.
  • I read the hardcover version of The Covenant of Water, and it was difficult to physically hold this large book at times. I have heard that the audiobook is well-narrated by the author himself. But, since this novel is rich with historical and medical details, it’s worth considering the ebook version.
  • The Covenant of Water works especially well for medical professionals, who will enjoy the scientific prose and medical context the author, himself a doctor, incorporates.
  • I generally don’t recommend The Covenant of Water for book clubs, despite the fact that Oprah picked it. It’s just too long for most book club members to read it in time for your meetings unless you give them a few months to do so.
  • In tracking the many characters, it’s most important to recall the events of the lives of Big Ammachi’s descendants, Digby, and Elsie. Pay special attention when any of their paths cross. The author’s website has a more detailed character analysis, but be forewarned that it may spoil some of the plot.

About Author Abraham Verghese


Abraham Verghese is an Ethiopian-born American author and doctor. His parents are from India. A graduate of Madras Medical College, he has served as a professor of the Theory and Practice of Medicine and Vice Chair of Education at Stanford University Medical School. His work includes the AIDS epidemic.

Verghese co-hosts the podcast Medscape Medicine and the Machine.

In 2014, Verghese received the Heinz Award, and in 2015, President Barack Obama awarded him the National Humanities Medal.

Frequently Asked Questions

Is Covenant of Water worth reading?

The Covenant of Water by Abraham Verghese is worth reading if you don’t mind long novels and enjoy historical fiction, family sagas, and/or literary fiction. It’s beautifully written and comes together poignantly at the end.

What is the point of The Covenant of Water?

The point of The Covenant of Water by Abraham Verghese is that everyone is connected and no one is alone. The author uses the medical condition of generations of one family in India in the 1900s to explore this theme.

What happened to Celeste in The Covenant of Water?

In The Covenant of Water by Abraham Verghese, Celeste dies in the fire that permanently scars Digby, who attempts to save her.

What happens at the end of The Covenant of Water?

At the end of The Covenant of Water by Abraham Verghese, Mariamma discovers that Digby is her biological father, and her mother, Elsie, is alive and lives with him. She ran away from Parambril because she had leprosy.

What is the affliction in Covenant of Water?

In The Covenant of Water by Abraham Verghese, the affliction is Von Recklinghausen Disease, which is also known as Neurofibromatosis. It’s a genetic disorder that causes benign tumors of the brain, spinal cord, and peripheral nerves.


As this The Covenant of Water review comes to an end, suffice it to say, it’s well worth your time to work through this long but meaningful and memorable read.

If you haven’t read it yet, then go slowly! That’s how I did it, and my “one chapter per day” strategy worked really well. If you have read it, then check out author Abraham Verghese’s other popular novel, Cutting for Stone, next.

Keep the conversation going! Share your thoughts or any remaining questions you have in the comments below.

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