In the mid 18th century James Dyer is born unable to feel pain. From a poor family wiped out by smallpox, he grows up a freak of nature to become a brilliant but heartless surgeon. Then, en route to St Petersburg in 1767 to inoculate the Empress Catherine against smallpox, he meets his match - a strange woman with supernatural healing powers who introduces him to pain. Driven mad by the shock, he returns to London and the Bethlem hospital for the insane. In a wonderfully evocative and exciting style Andrew Miller takes us through Europe at a time of enlightenment, vividly portraying the life of a cold, insensate man as he discovers love and, eventually, compassion.