In her latest novel, Christine Schutt once again proves herself an astute observer of human nature, this time detailing the random intimacies of the senior class of the Siddons School in Manhattan’s Upper East Side. Students of the world of privilege, these girls are the product of society’s elite, with a few exceptions.

Obsessed with choosing the appropriate colleges to suit their ambitions, the girls are caught in a unique emotional quandary when one of them, the lithe, beautiful Astra Dell, is struck with a devastating disease that threatens to extinguish her young life, her dancer’s limbs and lush red hair useless in fighting an enemy that attacks from within, wracking her body with pain, fever and huge doses of radiation.

His wife taken by a freak accident, Mr. Dell stands helplessly by while his daughter lies in her hospital bed. Longing for the comfort and certitude of his wife, Mr. Dell is gratified to see a steady stream of visitors who pay homage to a usually exhausted, sleeping Astra. One of the bright stars at Siddons, Astra’s contemporaries cannot ignore her absence, haunted by the occasional thoughts that break through their self-interest, daily complaints and preparation for graduation.

Like a dark cloud, Astra’s illness casts a pall over her classmates’ equanimity, although not all are able to bear the harsh reality of the stark hospital environment. Astra’s table is littered with an excess of good wishes, cards of every shape and size, a reminder of the world outside the isolation of Astra’s battle to reclaim her life.

The most frequent visitor is Marlene Kovacs, a weed among the elegant, long-stemmed roses that are her Siddons’ classmates. Marlene’s motives are obscure; she feels more significantly connected in Astra’s presence, even compelled to steal the poignant, honest notes sent by Astra’s best friend.

That friend, Carlotta Forester, drifts from her mother’s home to her father’s empty apartment, mirroring the barely-tethered days of the beleaguered Astra. Anna Mazur visits with another teacher, the impressionable students’ favorite bachelor; Anna wants more from Tim Weeks, who remains uncommitted in the face of her need. Then there are Suki and Alex, or SukiandAlex, who walk the New York streets in hopes of encountering the object of their puerile fantasies, Alex making a video of senior activities for their sick friend.

The cast of diverse characters are satellites to the long-suffering, remarkable Astra, a pale, hairless ghost of what the real world portends. Contrasting the constant chaos of adolescence on the cusp of the future with Astra’s dilemma, Schutt seamlessly marries these girls to the unpredictable, indifferent threat of random fate, a clear, precise vision of privilege marred by tragedy.