Photo of South Park by Allan Ferguson used under a Creative Commons license.
Andrew Sean Greer, The Confessions of Max Tivoli (Farrar, Straus & Giroux, 2004).
When he was born in San Francisco in 1871, Max Tivoli appeared to be a tiny 70-year-old man. As he aged and matured inwardly, his body grew younger in appearance. This novel is narrated by Tivoli late in life, by which time this older man inhabits what appears to be the body of a young boy. Greer uses Tivoli’s reversed condition as a window on aging, memory, and loss. This is also a love story, but one of lovers fated by opposite trajectories. The premise could have come off as a gimmick in other hands, but Greer carries it off with skill. The novel takes place mostly in San Francisco (in part in South Park), and is a window of a different sort on the city of a century ago.
Google Book Search has an excerpt and various links. Links to several reviews can be found here. The NEA has a long passage, and on WBUR you can listen to Greer read from the novel and explain his inspiration. Mark Sarvas interviewed Greer at The Elegant Variation. And here are reviews from David Kipen (San Francisco Chronicle), John Updike (The New Yorker), Edward Champion (January Magazine), Max Gussow (The New York Times), Christopher Farah (Salon), Veronica Bond (Bookslut), Kevin Holtsberry (Collected Miscellany), Lizzy Siddal, and The Critic. Michael Rawdon didn’t like it at all.