Autumn, 1916. America is preparing to enter WWI, but at Tamarack State Hospital, the danger is barely felt. Here in the crisp, mountain air where wealthy tuberculosis patients recover in private cottages and charity patients, mostly European emigres, fill the sanatorium, time stands still. Prisoners of routine and yearning for absent families, the inmates take solace in gossip, rumour and secret attachments.

One enterprising patient initiates a weekly discussion group, but his well-meaning efforts lead instead to tragedy and betrayal. The war comes home, bringing with it a surge of anti-immigrant prejudice and vigilante sentiment. Andrea Barrett pits power and privilege against unrest and thwarted desire in a spellbinding tale of individual lives in a nation on the verge of extraordinary change.