When I first started reading this I found it hard to follow, four different story-lines and I was confused, couldn't figure out what was going on nor who was who. My advice is to just enjoy the story let it lead where it takes you, don't try to figure out where it is going. Eventually that is what I did and soon found myself feeling like I was in the dark underbelly of New York at the turn of the century. The atmosphere of this novel is very dark, a part of the city that is inhabited by baby sellers, children for hire, dog boys who clean out privies, opium dens, freaks of all kinds and a journey to the insane asylum. Not a pretty, clean spruced up city.
The characters though are amazing, full of depth, flawed and anguished, searching for a better life. Capable of great kindness and a great capacity for love. The twists, seriously did not expect most of them, couldn't have guessed for all the money. They kept coming, especially in the last third of the book, and I was amazed at the author who put this all together. Totally different from any other book I have read.
A very good read, though dark, be warned and some of the things are not easy to hear or read, though not horribly graphic. Found it memorable and am very glad to have read it.