While reporting a story from India, a New York television journalist has his left hand eaten by a lion; millions of TV viewers witness the accident.  In Boston, a renowned hand surgeon awaits the opportunity to perform the nation's first hand transplant; meanwhile, in the distracting aftermath of an acrimonious divorce, the surgeon is seduced by his housekeeper.  A married woman in Wisconsin wants to give the reporter her husband's left hand-- that is, after her husband dies.  But the husband is alive, relatively young, and healthy.

Random House
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Yahoo! Books: seems, at first, to be a comedy, perhaps a satire, almost certainly a sexual farce.  Yet, in the end, The Fourth Hand is as realistic and emotionally moving as any of Mr. Irving's previous novels-- including The World According to Garp, A Prayer for Owen Meany, and A Widow for One Year-- or his Oscar-winning screenplay of The Cider House Rules.  And while The Fourth Hand is characteristic of John Irving's seamless storytelling and further explores some of the author's recurring themes-- loss, grief, love as redemption-- this novel also breaks new ground; it offers a penetrating look at the power of second chances and the will to change.

Kirkus, B&N:
A handsome TV newsman has his left hand chomped off by a hungry lion, and a former lacrosse star stays in shape by hurling dog turds into the Charles River... hmmm. probably not the new Eudora Welty novel, you say?  Right you are.  It's Irving, up to his old tricks again (and are they ever getting old), aiming for the savage comic irony of his best novel (The World According to Garp) and instead recycling the arbitrary whimsy that produced his worst (The Hotel New Hampshire).  This one begins with Patrick Warrington, who's covering the Great Ganesh Circus in India for a thrills-oriented media operation reviled throughout the industry as "the calamity channel", stands too close to the lions' cage, and suffers the mutilation that will elicits gasps around the world from the many women who have loved (and will love) him.  Among the latter is Doris Clausen of Green Bay, Wisconsin, who impulsively offers a donor hand from her husband Otto (inconveniently, still alive).  Otto complies by killing himself (whether he's despairing over a Packers' loss is unclear), and all seems well-- though Doris is demanding "visitation rights" with Otto's hand.  Emminent Boston hand surgeon Nicholas Zajac (the former lacrosse player, whose own problems with women are threaded intermittently throughout the narrative) attaches Otto's mitt, whose imperfect functioning is prelude to the experiences of fatherhood and real love (as opposed to lots and lots of gratuitous sex), which finally make a man of Patrick, despite his disability.  Irving presumably means all this to be a Dickensian fable of renunciation and healing, but it's a self-indulgent mishmash of let's-see-what-weird-things-I-can-come-up-with-next plotting and complacent commentary laid on by a very heavy, omniscient authorial, uh, hand.  Recently Irving has been alternating his usual doorstoppers with slighter books like the miscellany Trying to Save Piggy Sneed and the memoir My Movie Business.  Don't be fooled by The Fourth Hand.  He's still between novels.

Random House The Fourth Hand
Ch 1: The Lion Guy
Miramax acquires rights to Fourth Hand
Irving Publicity Tour
NY Times: Losing a Hand, Gaining a Soul
NY Times: One Hand Clapping
Maxim: So That's the Sound of One Hand Clapping