Victoria has tb as a child and is sent away from her native inuit family in northern Canada on the edges of the tundra to be treated in the South. When she returns years later, the way of life of the inuit has changed, and so has she. She becomes involved with Robertson, the white man from the Hudson Bay Company and starts a family. This is radical, and her own family has a hard time with it, but of course soften with the arrival of the children.Balthazar is the doctor from NY/NJ who treats the village -- and writes in his journal, talks with the priest, his only intellectual match in the community, and uses morphine. Balthazar is the author's alter ego, as he was also a doctor who worked in the North and wrote. The plot thickens when diamonds are discovered in the region, and a South African firm approaches Robertson to help them open operations in the area. The consumption title plays both on the tb prevalent in the community, and the changing lifestyles with ever more conspicuous consumption.There are also plots with Victoria's children (Palousie and his native ways, Marie with her own consumption or perhaps anoxeria), the white schoolteachers in the area (Johanna, conservative, missing her ex; and Penny, brave and adopting the native ways and lovers, going out to live on the land), Victoria's father who teaches Palousie and Penny, Simonie who becomes Victoria's lover, and whose mother had died of TB years ago when she was sent away with Victoria.Eventually Robertson is killed over the jealousy and rage about what the South African money is doing to the town. Palousie is suspected and runs off, as well as others who had been leading a movement to stop the mine. Tagak, Victoria's brother who ends up working in accounting in the mine and had always been a failure as a hunter, is never named, but seems like a candidate for murderer. This story line drops without resolution and is a bit of a mystery why this is not resolved clearly.Eventually Palousie is discovered to be living in the South Pacific, living a native lifestyle without the horrors of the cold and reconciles to his mother. The priest has settled there, and encourages the doctor to come visit him there. All a little cozy for everyone except Marie, sent off for treatment in the South who kills herself, and Robertson, dead and no killer named.Still, overall, I liked it. The consumption threads worked well and the whole cautionary tale about consuming without regard to your health and the sustainability of the land resonated.