The stream-of-consciousness novel tells the story of a psychiatrist Zack Busner and his treatment of a patient at Friern Hospital in 1971 who has encephalitis lethargica and has been in a vegetative state since 1918, when she was a munitions worker. The patient, Audrey De'Ath, has two brothers whose days fighting in the First World War are interwoven into her own story. Busner brings her back to consciousness using a new drug (L-Dopa, which was used for the same purpose by Oliver Sacks in the 1970s).
Self has indicated that the book will be the first part of a trilogy, against his own initial expectations. The second part of the trilogy is Shark (2014)