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LOS ANGELES — It’s tempting to read Steve Earle’s first novel, “I’ll Never Get Out of This World Alive” (Houghton Mifflin Harcourt: 256 pp., $26, forthcoming in May), through the filter of pop music; the title comes from a Hank Williams song. Yet while Williams’ ghost plays a significant role in the narrative, the motivation, Earle explains, is more complex.


“It’s about mortality,” the singer-songwriter says by phone from his New York apartment. Hence, the name of the book, a reference to the last song Williams released before he died on Jan. 1, 1953, in the back seat of a car on the road to a New Year’s Day gig in Canton, Ohio.


That lonesome death, because of drugs and alcohol, centers the novel, which revolves around a character named Doc, a physician fallen into heroin addiction, who gave the singer his final injection. Ten years later, Doc is living in a San Antonio flophouse, performing back-alley abortions, haunted by his failures and his sins.


“I’d always heard,” Earle notes, “that there was a doctor traveling with Hank when he died. When I buckled down, I discovered that Hank had been seeing a guy named Toby Marshall, who was not a doctor; he was a quack who claimed to be able to cure alcoholism with chloral hydrate. But I thought it would be more interesting if my character was a real doctor, so I went with that.”


Earle is pointing out that in fiction, reality can merge with myth in the service of a larger truth. That’s part of what he’s after in “I’ll Never Get Out of This World Alive.” Set in San Antonio’s red-light district, populated mainly by junkies and prostitutes and street criminals, it aspires to a certain gritty transcendence. The turning point comes early, when Doc performs an abortion on a Mexican girl named Graciela, who almost dies during the procedure and afterward has nowhere to go. As she regains her strength, we learn she has powers — healing powers, spiritual powers — and can transform the degradations of the neighborhood into something hopeful, even magical.


“Hank’s ghost was there from the beginning,” Earle recalls, “but I was not planning to have so many spirits. I wasn’t expecting the magical realism. The theme that shocked me was all these people seeing things.” He laughs, a gravelly rasp across the phone line, and repeats something a friend, the writer Mark Jacobson, has said of the book: “You can’t write this in English; you’ll have to write it in Spanish.”


Earle is not the only person likely to be surprised by the novel’s turn toward the mystical: His albums, from “Guitar Town” (1986) to “Washington Square Serenade” (2007), are straightforward, often political, while his 2001 book of stories, “Doghouse Roses,” touches on themes (drugs, the vagaries of the country music business) that mirror his own life.


And yet these connections also mark “I’ll Never Get Out of This World Alive.” Like Williams or Doc, Earle had a nasty addiction problem, which landed him in prison in the early 1990s. (He was paroled in 1994.) In addition, he was raised in San Antonio; a major set piece here, involving President John F. Kennedy’s visit to the city the day before his assassination, comes directly out of his experience.


“My father was an air traffic controller,” Earle remembers. “He called my mother and said, ‘Kennedy is coming in at 10. Take the kids out of school.’ I was 8. We went down to the airport to see the plane come in.” In the novel, that trip is re-created from the perspective of Doc, Graciela and others from the neighborhood.


Yet even this comes with a mythic underpinning, a touch of the mysteries. Graciela is obsessed with Jackie Kennedy and presses against the security fence to get close to her. As she does, she scrapes her wrist and starts to bleed. She and the first lady make eye contact, and something passes between them, a transference that activates her state of grace. Her cuts never heal.


Is this the stigmata? Earle acknowledges the connection but insists, “It was important that the stigmata broke all the rules.” As to why this is, he suggests that it has to do with the difference between religion and spirituality. “To me,” he says, “religion is an agreement between a group of people about what God is. Spirituality is a one-on-one relationship.” As the novel progresses, Earle weaves the contrast into the narrative, mapping a line between what we are told is true and what we know and believe.


The challenge, of course, is balance, especially for an artist working outside his primary form. It took eight years, on and off, for Earle to finish “I’ll Never Get Out of This World Alive,” writing between tours and recording sessions, backtracking and revising when necessary, getting back in the groove. “I hope it’s like the Huck Finn effect,” he jokes. “Twain stopped writing in the middle of the book and went on a lecture tour, and the difference between the first and second halves makes it the great American novel.”


But more to the point is how the novel ties into the larger pattern of his career. In late April, Earle will release his 14th studio album, also called “I’ll Never Get Out of This World Alive” and equally focused on issues of life and death.


“They were written at the same time,” he declares, “so it shouldn’t surprise anyone that they’re about the same thing” — and if this is the first time he’s tied two projects together so directly, it only highlights what he’s been doing all along. “I’ve always written stories,” he says. “My songs are stories. A lot of people wonder how to write a story in three minutes. With a book, you have to figure out what to prolong and what not to.”


Still, he admits, “Wrestling a novel to the ground was about 100 times harder than I expected. In the middle of it, I swore I’d never do it again. But now that it’s done, I’ve got another idea.”

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