In the chaos of the emergency room an old man sits, patiently waiting his turn despite his bruised and battered appearance. His presence goes largely unnoticed until, in the final moments of his stay, he is found dead in the ER lavatory.

At almost the same time, Julia Clancy is rushed from her horse farm to the same hospital emergency room, the apparent victim of a heart attack. According to Julia, all she needs is a good, solid breakfast to get her back on her feet, but the cardiology team has other ideas, like scheduling her for bypass surgery. As Julia's niece, Sarah Dean, English professor and sometime amateur sleuth, becomes involved in her care, she finds there is more to worry about than her aunt's medical condition. It turns out that the old man's death was suspicious - and Aunt Julia was the last person to see him alive. While the authorities dismiss Julia's observations as the ramblings of a sick old woman, Sarah knows her aunt well enough to take her seriously, and embarks on an investigation of her own.