Alex Garland, the talented British author of "The Beach and The Tesseract," as well as the screenplay for "28 Days Later," has once again created a novel that is mind-boggling with its fast-paced plot and constant twists. Garland's latest work is a dreamy narrative, entitled "The Coma," that will add to his growing and intriguing repertoire.

Garland opens "The Coma" with a course of action that takes the main character, Carl, deep into the London Underground. There he is beaten unconscious by deadbeat teenage thugs when trying to help a nameless young woman. Carl is sent to the hospital where he finds himself as an onlooker in his own life in what Garland calls a "remote viewer" — a man drifting through various shards of his life just below consciousness.

Garland takes the reader into the world of amnesia and shattered memories in an attempt to discover what is real. Carl searches for the one thing that will awaken him: a visit to a friend's house, a drive in a car back to the hospital with a male nurse who seems to know him, a song by Little Richard or the opening line from "Moby Dick." The unconscious state begins to take a toll on Carl and he struggles to keep himself together.

Carl finds that the world around him is becoming fragmented in his dream state. "The windows were sash. In one pane, I could see that the glass was perfectly flat, whereas in the nest pane I could see that the glass was subtly warping its reflection." Things that once made sense to him no longer do. Thoughts of giving up flutter though his brain.

Early in the book, Garland's cinematic-style prose, evident early in the book, is not executed as flawlessly as in his previous two works. In this novel he makes the mistake of using semicolons abruptly in sentences: "…my head and chest were bandaged; I was connected to machines." These stick out horribly and hurt the novel only slightly by making it read a little choppy.

The unnumbered pages add a mysterious element to the book's combination of skewedness and alienation. The book forces readers to see things through half-opened doors and reconsider their outlook. It leads to a curious effect — a terse simplicity rather frightening in the world of padded-up books — which makes the reader want to look away. But narrative is usually more obscure than this, and at its best such simplicity suggests a direction all narrative might explore.

With "The Coma," readers get the sense that Garland has not only worked himself into a box. He also wants the reader in there with him.

"The Coma" constantly makes the reader question whether or not the narrator, Carl, is awake or still dreaming. Did he ever come out of his coma? To find out, the reader will have to travel into Carl's mind along with him, through the twists and turns of his amnesia, only hoping to break the surface.

Grade: A