The book begins with the story of Carla Reed, a 31-year-old kindergarten teacher and mother of three who experiences headaches, strange bruising, white gums, and exhaustion. The author learns about Carla as he is heading into work at Massachusetts General Hospital in Boston. His beeper informs him to see a patient with leukemia when he arrives. Leukemia, a cancer of the white blood cells, is “breathtaking” with regard to its pace and acuity. Ten months into his two-year fellowship in oncology, the author already feels drained and inured to the death around him.