The story of a medical doctor in the period of the American Civil War, a saga of the doctor's journey from his first posting in pre-war Louisiana to his death in Maryland in the 1870s, the novel revolves around a fanciful form of leprosy called Cain's Leprosy, including the discovery of its causes and the development of a treatment regimen. The under-nurtured Andrew, a quick study in things scientific, is a slow study in things human and barely knows how he feels about anything, particularly in his relationships with women.

After an early retirement, Evans buys acreage in rural Pennsylvania and, against the advice of others, restores the dilapidated farmhouse. As he digs into the history of this old farm he encounters a cast of colorful characters and uncovers some surprising relationships. Along the way he helps re-unite two old friends as the three of them work together to solve an old mystery.

Two sixteen-year-olds are hitchhiking in front of a rural Ohio farm when Marge spots them from the kitchen window. Frank and Marge have retired from their first careers and are happy raising cattle in a leisurely manner. Their grown and well-adjusted children live just far enough away and that suits them fine. Marge wants to help the kids. Frank doesn't want to get involved, but inevitably he is drawn into their story. Eventually he must revisit his past and confront a harsh reality.