Garth Greenwell has won the PEN/Faulkner Award, given annually to an outstanding work of fiction written by a U.S. permanent resident, for his novel Small Rain.

 Greenwell’s book, published last September by Farrar, Straus and Giroux, follows a poet in Iowa recovering in an intensive-care unit after experiencing an infrarenal aortic dissection. In a starred review, a critic for Kirkus wrote of the novel, which was longlisted for the National Book Critics Circle Award, “Greenwell—such a finely tuned, generous writer—transforms a savage illness into a meditation on a vital life.”

Bruce Holsinger, Deesha Philyaw, and Luis Alberto Urrea, the judges for this year’s award, said in a statement, “Garth Greenwell has wrought a narrative of illness and identity in visceral detail, conveyed with a precision of language that steals the breath.…Even as the narrator’s body succumbs to needles, scans, blood draws, and bureaucracy, the novel affirms the power of art, love, and connection—if not to heal, then to soothe and salve. Small Rain is a dazzling, gutting, unforgettable novel.”

Greenwell, who was shortlisted for the PEN/Faulkner Award in 2017 for What Belongs to You, said, “I wrote Small Rain as a way of testing, in the wake of a sudden and bewildering health crisis, my protagonist’s faith in art as a source of durable meaning, of transcendence. I am immensely grateful to the judges for this honor, and immensely moved to see my book included among such excellent writers.”

The PEN/Faulkner Award was established in 1981. Previous winners include E.L. Doctorow for Billy Bathgate and The March; Ann Patchett for Bel Canto; and Claire Jiménez for What Happened to Ruthy Ramirez.

Michael Schaub is a contributing writer.