Asabia Stagawalt is struggling to establish himself as a psychotherapist in a small town, but his attempts are complicated by the murders of two elderly women in a local nursing home. Josef Jabonsky, the son of one of the murdered women, is a friend of Asa’s. Josef has become a suspect in his mother’s death, but Asa cannot imagine his friend harming anyone. The stress and suspense are intensified by the possibility that the deaths of the women may be the result of someone with a fear and hatred of old people, suggesting that a serial killer may be targeting not only the local nursing home’s guests but other old people living in the Slate Belt region of eastern Pennsylvania.