Frank is an emergency medic and ambulance driver working night shifts for Our Lady of Mercy hospital in Hell's Kitchen, New York City. The novel begins with Frank's resuscitation of an elderly man called Mr. Burke, who has had a heart attack, and ends a couple of days later with Mr. Burke's death in the hospital. Frank is haunted by the patients he has failed to save, some of whom inhabit his experience like kinds of ghosts.

Most insistent is a teenage girl called Rose who died during an asthma attack, in part because Frank was unable to intubate her in time. He is also unable to forget his marriage, which ended because of the deadening effects of his work. And now Frank is also haunted by doubts about the value of restoring life.

He has successfully started Mr. Burke's heart, but the man is brain dead. Frank thus watches as Mr. Burke's family is first given hope and then must learn that there is none. Frank almost falls in love with Mr. Burke's drug-addicted and disillusioned daughter, Mary, perhaps seeing in her an opportunity for a mutual restoration to health.

But when her father finally dies--when the attending realizes that the patient's struggle hasn't been the "survival instinct" but rather a "fight to die"--she blames Frank, who recognizes that his purpose is not simply to keep people alive (or to bring them back from the dead), but rather that "saving lives" means preserving their value, somehow, in his memory. He walks away from the hospital, and when he gets home, Rose--her ghost, and Frank's own symbol for all the patients he hasn't resurrected--is waiting there, to forgive him.