In the first of a series of books set in the fictional Furr County in eastern North Carolina, the Calhoun family awaits the birth of a child while also preparing for the death of a family member. Carson Calhoun is in failing health and, along with his friend Titus Paine, makes plans for the next generation. Despite his medical training, young Dr. Eugene Austin cannot prevent the deaths of his elderly patients and ends up with his reputation in tatters.