What does it mean when we think of ourselves or someone else as a good person?  This is the question coursing throughout this novel, and Katie Carr tries to answer it in every aspect of her life.  It is a calculation that figures prominently in her thoughts about what it means to be good as a doctor, a parent, a neighbour, a wife, and a member of society.  Carr evokes and challenges the pieties of middle-class "goodness" in each of these categories, and punctures ostentatious claims about being good that are unlinked to sacrifice and actions.

Hornby's Carr does not try to write an auto-hagiography and nor is it a confessional: an acrid sarcasm and a keen psychological observation underlie her meditations on her marriage and adultery, raising two children and working as a general practitioner.  In terms of her medical experience, physicians may find her relationship with her patients rather stereotypical, but perhaps the most interesting change Katie undergoes is in her relationship with one of her most "difficult" patients, when she tries to live up to the moral demands of a “good” profession rather than complacently incorporating into her identity the assumption of beneficence.