Set among the apple orchards of rural Maine, it is a perverse world in which Homer Wells` odyssey begins. As the oldest unadopted offspring at St Cloud`s orphanage, he learns about the skills which, one way or another, help young and not-so-young women, from Wilbur Larch, the orphanage`s founder, a man of rare compassion and with an addiction to ether. Dr Larch loves all his orphans, especially Homer Wells. It is Homer`s story we follow, from his early apprenticeship in the orphanage surgery, to his adult life running a cider-making factory and his strange relationship with the wife of his closest friend.