In the early 1950's, Milan, Georgia is a racially divided town where secrets are plentiful and the meaning of justice is muddled. J. T. Malone, a 40-year-old pharmacist who failed his second year of medical school, is diagnosed with leukemia and told he has only 12-15 months to live. In some ways, Malone's last year of life parallels the declining fortunes of the town's leading citizen, Judge Fox Clane, an overweight and elderly former Congressman who suffers from diabetes and a previous stroke. Judge Clane's wife died of breast cancer, his only son committed suicide, and his daughter-in-law died during childbirth. He raises his grandson, John Jester Clane, and aspires to restore the grandeur of the South in conjunction with redeeming his personal hoard of Confederate currency.

Judge Clane hires Sherman Pew, a "colored boy" and orphan, as his personal assistant, but Sherman eventually resigns from the position when he can no longer tolerate the Judge or his prejudice. Sherman moves into a house located in a white neighborhood. A group of townspeople including the Judge plots to get rid of him. A local man bombs the building and Sherman dies. Shortly after his death, the United States Supreme Court announces its decision supporting school integration.

The Judge is infuriated and goes on the radio station to express his opinion, but he has not prepared a speech. Instead, he begins babbling Lincoln's Gettysburg Address. The radio station cuts him off. Malone has been listening to the Judge on the radio, but his wife turns it off. Integration no longer matters to Malone. Near the end of his life, Malone finds solace in the renewed love for his wife, Martha. He finally appreciates the order and simplicity of life. The pharmacist dies peacefully in his own bed.