The protagonist, Dr. John Berry, learns that his friend, an obstetrician named Arthur Lee, has been accused of performing an illegal abortion that led to the death of Karen Randall. Berry sets out to clear his friend of suspicion. Unfortunately for Lee and Berry, Lee is known in the medical community as an abortionist. Berry also has a personal stake in the outcome of the case: Berry helps Lee disguise medical samples to hide the fact that Lee's dilation and curettage patients were pregnant. In the course of his investigation, Berry runs up against the powerful Randall family, an established Boston medical dynasty. He also gathers a portrait of Karen's past, psychology, and character.