“They asked me to describe the pain but the pain defied description, on a scale from one to ten it demanded a different scale.”

So begins “Small Rain,” the new novel by literary sensation Garth Greenwell. It begins with a nameless narrator having a medical emergency and ends up exploring no less than the nature of love itself and the very meaning of our shared humanity.

Reviewers are describing “Small Rain” — published this month by publisher Farrar, Straus and Giroux — as “profound,” “a triumph of genuine vulnerability,” and “an exquisite addition to the literature of illness.”

Greenwell’s first novel “What Belongs to You” in 2016 established the 46-year-old Iowa resident as a force in contemporary American literature: That book won the British Book Award for Debut of the Year, was longlisted for the National Book Award and a finalist for other major laurels including the PEN/Faulkner Award. Plus, it was named a Best Book of the Year by more than 50 publications across nine countries. His second work, “Cleanness,” also garnered critical praise — it was a finalist for the Lambda Literary Award, and was cited as a top book of the year by numerous outlets including the New York Times, the New Yorker, TIME, NPR and the BBC.

Love, carnal desires, emotional intimacy and distance — that’s the terrain Greenwell mines in both “What Belongs to You” and “Cleanness.” But the scale of “Small Rain” feels even more intimate and personal. Greenwell renders to devastating effect the way illness makes you defenseless, how dehumanizing the medical process is even as it saves your life, and why at the end of the day all that truly matters is being with the one you love.

“What makes me want to write a book is feeling utterly bewildered by something that I have witnessed, or something that has happened to me,” Greenwell said in a Zoom interview for the Southern California News Group’s virtual program Bookish.

“I did have a medical crisis like the narrator’s in the summer of 2020,” Greenwell said. “I wasn’t in the hospital as long as he was, but after spending, I think, about eight days in the ICU, I just felt like something had happened to me that I couldn’t understand. And it’s that feeling that makes me feel like I need to write a book.”

Most of the story of “Small Rain” transpires over a few weeks during the height of the COVID-19 crisis in 2020, while the narrator is confined to his hospital bed. Being a patient strips the narrator of any personal agency, which is made all the more acute because of the pandemic-era restrictions that limited human contact.

“That was one of the things I wanted to explore, because, weirdly even though, you know, being ill is such a central and profound human experience, I actually think it’s underreported in literature,” he observed. “It’s a fascinating experience to find oneself as a patient and be embedded in the bureaucracy and the scheduling of a hospital, and also just having to sort of allow oneself to be cared for by others. I wanted to try to capture what that feels like.”

The nameless narrator of “Small Rain” shares some parallels to the life of the author himself beyond the hospital experience: Both share a home in Iowa with a poet husband. Greenwell’s real-life partner is poet Luis Muñoz, who runs the Spanish-language M.F.A. program at the University of Iowa, and to whom he dedicates this novel.

But even if it was, like his two previous novels, sparked by personal experience, that’s not to say “Small Rain” is in any way a nonfiction personal account in the way a memoir would be.

“I think there are great books that are memoirs, and I think memoir is 100 percent art,” he said. “I don’t think memoirs are lesser than novels, but I think that for me, for the particular tools I have for my sensibility, I need the tools of fiction. I need to be able to invent. I need to be able to be very free in the way I treat the material of my life. This book, it’s not a transcription. All sorts of things are made up.”

Even if interviewers seem fascinated by the elements of autobiography found in his fiction, Greenwell, frankly, isn’t.

He recalled an interview he did after the release of his first novel “What Belongs to You”; the main character of that book is a young American English teacher in Bulgaria, as Greenwell himself had once been.

“I remember this British interviewer asking me about, like, ‘How much of this is real,’ and I sort of gave my typical answer, and then she said, ‘Look, really. Just tell us.’ But I’m actually so baffled by that question,” he said. “Because, you know what it’s like? Oil paints are made with flax seed oil. It’s like pointing at an oil painting in a museum and saying, ‘How much of that is flax?’ Experience has been pulverized, it has become a medium. So if someone points to a page and says, ‘How much of this is true?’, there’s no way for me to answer that question.

“It’s just that for my sensibility, there are things that are so complex, so difficult to think about, that they defeat all of my other tools for thinking, and that’s when I need art. And what I mean is, I need the pressure of scenes. I need the pressure of syntax. I need the pressure of sort of patterns of imagery; I need all of these resources of language that are not just about what something is saying or what the words mean, but instead about how language can affect our senses.”

It’s fair to say Greenwell is a master sensualist on the page, drawing the reader into the physical experiences of the characters, whether it be a visual appreciation of a common sparrow’s beauty, the soaring emotion evoked by the sound of an opera singer’s voice, or even the burning pain of an IV needle shoved into a vein.

“When you use an image, the non-verbal parts of your brain associated with sight or with smell light up,” explained Greenwell, who has taught creative writing at the Iowa Writers Workshop and Princeton, among others, and is a Distinguished Writer in Residence at New York University. “That aesthetic use of language is what I need to understand my world.”

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