The book follows an American pilot stranded in a dystopian London after Adolf Hitler, moments before being completely defeated, uses a biological weapon delivered by V-2 missiles, which mostly wipes out the human race.

Hoke escapes thanks to the aid of three fellow 'ABneg' survivors – two women and a German navigator, shot down over Britain long ago.

Hoke, being used to three years alone, detests his saviours and, corrupted by propaganda, is almost unable to contain himself in the presence of the German even though the war has long since ended.

The Slow Death has the same climax but takes longer to work, up to years, and weakens the subject, blackens their fingers and hands and bruises their body internally.

Victims of the Slow Death are generally much weaker and slower to react than the AB negs, however some individuals (such as McGruder, Hubble's bodyguard) seem less prone to its debilitating effects.