An American author, teacher, and physician, he is known for such novels as Blue River (1992) and For Kings and Planets (1999). He was the 2010 recipient of a Guggenheim Fellowship.
He received an MFA from the Iowa Writers' Workshop and an MD from Harvard Medical School.
He co-founded the San Francisco Writers' Grotto.
His father was a violin teacher at the University of Iowa. He was born while his parents were vacationing in Ann Arbor, Michigan.
He and Paul Engle both attended the Iowa Writers' Workshop.