Solitary Pain of Deviating From Beauty : A SOLITARY GRIEF, <i> by Bernice Rubens,</i> Sinclair-Stevenson/Trafalgar Square, 240 pages; $23.95

It takes a strong stomach to read this book, and an iron heart. But for all that, “A Solitary Grief” has significance in “today’s world,” particularly this West Coast world, where physical appearance isn’t just everything, it’s more than everything; it’s our entire metaphysical context.

After reading “A Solitary Grief,” the inevitable thought comes to mind: Who should have to be subjected to this kind of reading pain? The disheartening answer: Actresses who have their cheekbones shaved, businessmen who pay to have their necks pruned and lifted, and every paying customer who ever plunked down money to a weight-loss program.

Alistair is a heartless, self-regarding, arrogant, stingy, impossible psychiatrist, married to Virginia, who bears him a child. At first, peeved that Virginia has only given him a daughter, Alistair plucks used flowers from a nearby cemetery to take to his wife.

But, when at the hospital, Alistair is informed that his daughter, Doris, has Down’s syndrome, the baby girl turns--in her father’s estimation--to a “Thing,” to an “It.” He cannot, will not, look at her face. It’s not the retardation that bothers him, but the “deviation,” the “deformity,” that makes her an abomination in his sight.

Alistair employs every possible device to avoid his daughter. He loses himself in his work (which he hates); he takes up adultery (with a dogged lack of enthusiasm). He never shows up at his daughter’s birthday parties. He never tells his parents about his daughter’s condition.

After a while, his wife--who has known for a while that she’s not married to the world’s kindest man--builds a soothing, nacreous shell around herself and little Doris. The mother loves her child, and also has her own work, and takes a lover, and soon throws her cruel husband out.

But over the months, Alistair’s internal emotional gauge has been changing. At night--even after he’s left the marriage--he sometimes enters his daughter’s room, covers her face so he won’t have to see her, and touches her body from shoulders to feet, not in a sexual way, but simply to imprint her being on his consciousness: “ . . . By the time his daughter reached her first birthday, he was deeply and uncontrollably in love with her.”

Except that he can’t look at her, or speak to her, or be in the same room with her, except when the lights are off. Alistair hates his life, his wife, his friends, himself. Then, just after his disgusted spouse has given him the boot, he is confronted, in his own office, by someone who is not exactly a patient.

A man who calls himself Esau (he of the Old Testament hairy forearms) comes sailing in and strips down to his underwear. “Am I not beautiful?” he asks. From his shoulders to his feet, Esau is coated in long, black, silky fur. And, since his own parents couldn’t bear to look at him (they’re dead now), Esau roams the streets of London, making appointments with professional men, seeking statements that, yes, despite his long black fur, he is beautiful. Generally speaking, Esau has success in this pathetic endeavor. Most people don’t readily confess it when they are physically repelled.

After their office encounter, Alistair and Esau meet on the street. Alistair, just thrown out by his wife, accepts this “ape’s” invitation, first to lunch and then to stay as a guest and a friend. What the doctor cannot bear in his daughter--that physical difference from the norm--he can accept in a stranger. Out of separate, hideous brands of loneliness, they become friends.

Then, one depressing day, Esau makes an appointment with a plastic surgeon, an apostle of beauty as we know it. “Am I not beautiful?” Esau asks, although he already knows he’s dropped in at the wrong office. The answer he receives sets off a ghoulish, heartbreaking chain of events. Humans are very strict--if very irrational--in their ideas of beauty. Those who don’t make the cut had best stand clear.

Next: Christine Bell reviews “The Scent of the Gods by Fiona Cheong (W. W. Norton).