Looking for another heartbreakingly beautiful novel

Ordinary Grace was such a book for me. So was This Tender Land, A Prayer for Owen Meany, The Cider House Rules, and Lonesome Dove. Each of those novels was beautifully told, but also tragic. What's another novel that combines these elements and that you loved? I'm looking for something gut-wrenching yet beautifully human. A novel that subtlety addresses the complexities of human existence without preaching or the use of saccharine elements (sorry, Remarkably Bright Creatures). Something that feels 100% real and that resonates deeply. All suggestions appreciated. Thanks!