A few years back he had discovered his former University roommate was telepathic. Zandor Zudenigo had literally shown up at his door one day demanding help in ridding the world of a serial killer whose thoughts he had picked up via a chance encounter. With the aid of a Vancouver police officer, Nika Mandic, they managed to capture and kill the serial killer before he could execute his next killing spree, and had hoped to bury the incident as deeply as they had buried the body.

Unfortunately, the CIA had invested in Zandor 40 years ago, and although he had slipped through their fingers then (at great personal cost, as the woman he loved died during their escape) it appears the agent in charge of that particular program is still after him. Nika had tried to do some discrete checking up on Zandor, and although her query turned up nothing, it set off an alarm and alerted the agent that someone was interested in him. He doesn't know where Zandor is, but he does know who was looking for him and who his friends were.

When Nika hurries off to warn Russell that somebody is after them, she unwittingly leads him right to his front door as the agent has placed an electronic tag on her car that allows him to follow her off the mainland onto the island where Russell lives. A bad situation is made even worse by the fact that Russell's estranged son Jesse is visiting for the first time since his mother died. How is Russell going to explain to his son about the whole situation, and how are they going to get a warning to Zandor without leading the agent right to him?

While this sounds like a fairly conventional science fiction/spy novel, Robinson has written something that has quite a bit more meat on the bone than you'd expect. First of all, the agent is not a one-dimensional bad guy. We spend quite a bit of time with him on his quest to track down Zandor, and the more time we spend inside his mind, the less inclined we are to judge him as one of the forces of evil. We begin to wonder why is this guy so intent on tracking Zandor down, and in the end, the answer comes as something of a surprise.

The hard choice of the title can be seen superficially as the decision Russell must make about whether or not to protect someone he basically barely knows; after all he's only seen Zandor once since they both graduated from college, and he wonders if it's worth putting his life and his son's at risk to do so. In another writer's hands, that might have been the case, but in this instance, the Very Hard Choices of the title refers to the way in which we make our decisions. We can choose to make our decisions based on our personal prejudices and the conventional wisdom of our peers, or we can make them based on what's right for the situation and what the evidence tells us is correct.