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"Where the River Ends" by Charles Martin. Broadway Books. 375 pages. $19.95.

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Bottom line: The St. Mary's River propels a final journey in this occasionally surprising romance.

Charles Martin's sixth novel is a love story played out against accidents of birth and the "certainties" of breeding, an implacable, advancing cancer, and the St. Marys River in Georgia and Florida, which can be manhandled but never loses its fundamental power. The novel has some formulaic elements —- the beautiful model and the misunderstood working-class artist, to name two —- but the river, and the harrowing accounts of cancer and its treatment, are sources of surprise in what isn't an everyday romance.

One half of the human love affair is Doss Michaels, a portrait painter whose truest home has always been not the Georgia trailer park where he grew up but the wildness of the St. Marys. Abigail Grace Coleman, Abbie, is the other half, the Charleston-bred daughter of a U.S. senator. She's grown up to be the kind of model whose face and figure are instantly recognizable. The two meet when Doss rescues her from a mugger in Charleston, and they marry over the strong objections of Abbie's patrician father.

It's a happy marriage until the day Doss sees something on Abbie's breast. "And there it was. Just beneath the nipple on her left side. . . . There in the glow of the clock, my face betrayed me. She slipped her hand beneath mine, her face drained white and fear bubbled back up. And for some reason, amid all the fear and horror of the months to come, when I look back on that moment, I remember smelling that perfume."

The descent into terminal illness begins with "invasive ductile carcinoma" and advances to brain cancer. When the last few reasons to hold out any hope —- another clinical trial there, a groundbreaking study here —- are gone, Abbie takes charge of her final days by demanding a canoe trip down the St. Marys. The trip, undertaken in hurricane season, is the final item on a list of her "top 10 wishes." The list becomes an organizing principle for the novel. The plot provides opportunities to tick off items, from riding an antique carousel to doing a "loopty-loop" in an airplane. At times the predictability undercuts the effectiveness of the scenes built around the list; at other times, Abbie's joy in having another wish come true is moving.

.The pair's "escape" from the senator, who wishes to control the circumstances of his daughter's death, becomes a national news story, with Doss cast as the villain who may be intent on causing physical harm to his rich, helpless wife. The river trip is fraught with physical peril as well as the unrelenting emotional toll of Abbie's further decline.

The novel is told from Doss' point of view, with a structure that alternates between the river-trip present, and scenes from the couple's past. The river scenes are more engaging, given the inherent drama of the couple's race to get to the Cumberland Sound before they're "caught," by the senator or by death. But the past-action scenes that deal with the daily reality, and the toll, of Abbie's cancer treatments have weight. "She wrapped her legs around mine, using it as leverage to push her head up . . . The once fit thighs now gave way to bony knees, thin veins and sticklike shins. Her left hipbone, the once voluptuous peak of the hourglass, pointed up through her gown, which hung loosely over the skin. After four years, her skin was nearly translucent —- a faded, sun-drenched canvas."

Doss' love and need for Abbie is made dramatic by the lengths he goes to to be there for her, in sickness and health. We see Abbie's courage, and her love for Doss, clearly in the present day; her character is less defined in the early days of their relationship.

The river more than holds it own as a character, a "tea colored . . . blackwater" river which forms the easternmost border between Georgia and Florida. The river scenes are tight, providing suspense and a strong sense of the landscape. There are some good scenes on land, too, as Martin takes advantage of characters who gather by the river to count off more items on Abbie's list. A stop-off at Stokes Bridge, part of the "Redneck Riviera," provides strong atmosphere, as well a chance for dancing on the beach. It's one of the lighthearted moments, though the reality of Abbie's illness is always present.

The river carries the novel along.

Lynna Williams, a short story writer and essayist, teaches at Emory University.

MEET THE AUTHOR

Charles Martin discusses "Where the River Ends" 7 p.m. (Doors open at 6:30 p.m.) Sept. 16. Free. Reservations: 770-578-3502. Margaret Mitchell House, 990 Peachtree St. N.E., Atlanta. 404-249-7015, www.gwtw.org.