Edgar Drake, a forty-one-year-old English piano tuner, accepts a commission from the 1886 British War Office to tune an Erard grand piano located in a colonial military outpost in Mae Lwin commanded by Surgeon-Major Anthony Carroll. Edgar leaves the squalor, fog and drizzle of London, as well as his middle class life and his wife Katherine, childless for eighteen years, for a journey by boat, train, carriage and horse to the exotic, intoxicating beauty of Burma.

En route, Edgar is surrounded by stories--a tale by the deaf Man With One Story, rumors about the legendary, eccentric Carroll's peace-making with the local Shan via music and cultural exchange, and socio-historical treatises about the Burmese, internecine wars, and British imperialism. The journey becomes a search for the meaning of home and purpose in Edgar's life. It is an adventure far beyond his prior imaginings and dreams.

The clash of cultures, British and Burmese, civilian and military, wealthy and poor, rule-bound and individualistic, is explored throughout the text. For example, a tiger hunt led by several British officials ends in disaster. Edgar meets Burmese culture on both grand and personal scales: street theatre; appealing, poverty-stricken children; the garb and cosmetics of various tribes; and, ultimately, the allure of Khin Myo, an educated Burmese woman who guides him to Mae Lwin and Carroll.

Carroll, a renaissance physician with a Victorian fervor for botanical and medicinal classifications and investigations, asks Edgar to assist him in his clinic. Common infectious diseases are diagnosed and treated by this forward-thinking physician, and he also performs finger amputations on the mangled hand of a boy without benefit of anesthetic. Other maladies are treated with local remedies and prayer. Meanwhile the delirium of malarial fever descends on Edgar.

Edgar does finally meet and treat the ailing, badly out-of-tune Erard piano. Edgar's expertise is required--his aural excellence and perfect pitch, his delicate yet callused hands, and his willingness to be innovative in the repair of a bullet hole. But what Edgar cannot be prepared for--intrigue and deceptions, fascination with the lush beauty of Burma, and his own shifting priorities and secret longings--is ultimately what sets his fate.