The semi-autobiographical book tells of Chris, the son of a nurse who works with terminally ill patients, and his coming to terms with his selfhood and his mother.

His parents are divorced, with him describing their separation as his father saying he was "going out to buy the evening paper but went to Mexico," where he later died from "an overdose of amoebas."

Helen's latest assignment takes them to the home of Lloyd DiPardi, whom Chris describes as "about thirty years old with enough muscles to beat up anybody within a ten mile radius", but whose circle of friends happen to be teenagers.

Carmelita is terminally ill and takes up much of Helen's time, while "Pops" has mental health issues that are never fully explained.

Harold, aware of the tension, tries to defuse things between them by sharing with Chris the fact that he too was awkward and underweight, but Lloyd helped him build his confidence and eat the right foods.

One particularly humiliating ritual for Chris is her making him urinate in a milk bottle in cases where they have to share a bathroom with her patient's family.

Chris also learns from a girl he meets at one of Lloyd's parties that Carmelita had abused him physically after she had caught him in a sexual act with a stuffed animal when he was a small child.