Iris Lockhart is busy tending to the everyday business of her vintage clothing shop and sidestepping her married boyfriend's attempts at commitment when she receives a stunning phone call. Her great-aunt Esme, whom she never even knew existed, is being released from Cauldstone Hospital—where she has been locked away for over sixty years.Iris' grandmother, Kitty, always claimed to be an only child. But Esme's papers prove she is Kitty's sister, and Iris can see the shadow of her dead father in Esme's face.

Esme has been labeled harmless, sane enough to coexist with the rest of the world. But Esme is still a stranger, a family member never mentioned by the family, and one who is sure to bring life-altering secrets with her when she leaves the ward. If Iris takes her in, what dangerous truths might she inherit?

Weaving Esme's tragic story together with Iris' modern dilemmas, O'Farrell's gothic, intricate, cross-generational tale of family secrets, lost lives, and the complex longings of women will haunt listeners long past its final page.