A psychological novel of sexual slayings, lost love, the twisted nature of truth, and of ghosts in the real and figurative sense If You Could See Me Now tells the story of Miles Teagarden, a thirty-three-year-old recently widowed English professor from the East Coast of the United States, who in the summer of 1975 returns to the Midwestern town of Arden, Wisconsin, which was once home to his maternal grandmother, now deceased.

Miles is struggling to complete his doctoral dissertation in order to keep his position at an unnamed educational institution in the East, and hopes the isolation of the Mississippi River farmland known to him in his youth might aid him in his goal.

Immediately prior to the novel's start, Teagarden has just lost his estranged wife due to drowning, and finds himself less than welcome upon his arrival in the Wisconsin town in which he intends to spend a summer writing.

Teagarden experiences what he describes as "olfactory hallucinations", which cause him to assign certain imaginary smells to people he encounters, odors such as blood, water, tooth decay, or various chemicals.

He relates having experienced a supernatural event in the form of a ghostly stagecoach spilling down a dangerous stretch of roadway one night in the recent past, and acknowledges that he harbors an unquenchable obsession with his San Francisco-born cousin, Alison Greening, a year his senior.