The book describes his bicycle accident when he was an art student, and subsequent experiences in hospital wards and a nursing home.

As described in the foreword: "As late as the summer of 1948, long after most people in his condition would have adopted the life of a permanent invalid, his tremendous will-power enabled him to live normally and even strenuously during the increasingly short intervals between the crises of his illness....

"[1] The foreword was by Eric Oliver, with whom the writer shared a house for the last few years of his life, and who was instrumental in the book being published by John Lehmann.

However it reflects the description in the book of the narrator's first conscious impression, when someone is trying to talk to him moments after the accident: "I heard a voice through a great cloud of agony and sickness.... Everything about me seemed to be reeling and breaking up.

[3] Riding his bicycle from his lodgings in Crooms Hill in South London to visit his uncle in Surrey on a Whitsun holiday, the narrator,[4] an art student, is hit by a car.

[5] The following chapters contain his careful observations of his hospital[6] ward, the staff, the other patients, and his visitors,[7] and he notes particular things that people say.

I felt glad that I should always have this with me till the day I died.Welch's biographer, James Methuen-Campbell, suggests that this may have been how Welch intended to finish the novel.

Writing in The Guardian, Elizabeth Jenkins called Welch's "capacity for description... astounding, [his] angle of vision unusual... his felicity inexhaustible...