This book is a sequence of poems about Frank Goldin, a middle-aged biochemist who is admitted to a mental hospital, Elmhurst, with the chief complaint, "I hear a thousand voices and must respond to each." In the first poem Goldin confesses his sins, but simple confession doesn't get to the root of his dilemma, the existential ambiguity that plagues him.

During Goldin's dark night of the soul, his scientific self struggles with the mysterious longing within. Dr. Hudspeth, the Elmhurst psychiatrist, directs his support to the part of Goldin that says, "I am the restless biochemical cycle / that pours out glutathione in buckets." In essence, just straighten out the chemicals and you'll get better.

Throughout the book Goldin waits for his wife Helen to visit Elmhurst, but she never appears. He ruminates over the matter of confessing that he had an affair with a woman named Da-ling during a professional meeting in Osaka. If he confesses, if Helen comes, Goldin hopes that things will return to the way the way they used to be.

However, the mysterious side of Goldin is looking for something else. He has visions of the ancient Rabbi Yehuda of Smyrna, who asks, "Why do we not even know how to ask a question properly?" After several weeks Goldin leaves Elmhurst with the feeling that he has made progress, but not in any discernible direction. Goldin concludes that he should be grateful, but he asks, "to whom?"