A middle class African-American widow, Avey Marshall, has set off on a cruise with two of her friends from work on the "Bianca Pride," and becomes ill shortly after they have set sail. Avey disembarks in Grenada after experiencing disequilibrium, nausea, disturbing nightmares, and a feeling of being "clogged and swollen." Thus begins a journey of reclamation and healing of a past that has been largely forgotten or erased in her efforts to escape the poverty of her younger years and obtain the American dream of financial security and a white-defined respectability.

The novel is divided into four parts: Avey's growing distress on board the cruise ship, the intensification of nightmares and "visits" from her long-dead and very Afro-centric Great Aunt Cuney, and her decision to leave the cruise ship. The second section takes place in her hotel room where Avey confronts her rage and grief, not only over the death of her husband, but the utter waste in his drive for material success and the ensuing loss of their joy in each other and their heritage.

In the third section, Avey, getting lost on a walk, meets Lebert Joseph who convinces her to accompany him on the "Carriacou Excursion," an annual island festival honoring the long-time ancestors. Avey travels by small boat to Carriacou, becoming violently ill, and is cared for by a group of women on the boat, encouraging her in this "cleansing." This journey and her illness prompt Avey to think about the middle passage of slaves and the horrors they endured in countless journeys much worse than hers.

Once on the island, in the fourth section of the book, Avey is bathed and nursed back to health by Lebert Joseph's daughter, Rosalie Parvay. Finally, Avey joins the celebration (the "Big Drum"), witnessing and finally joining the important "Beg Pardon" and nation dances. This section brings the novel full circle as Avey experiences reconciliation with her past, her heritage, and herself.