The story follows Elmer Bergan at four stages of her life - when she is eight, 18, 28 and 38 - all told in her own voice and in the first person. As she lives through the events of her first thirty years, events, memories, thoughts come in and out of her consciousness at different stages like a river that flows from one experience to the next and back again.

Rather than this being a story about the death of a child, it is about obsession, the need for answers when questions are all you have left. It is a character study of childhood, both in Elmer's life and in her grandparents whose relationship means they act with one another like children, her mother Laura who can't cope with motherhood, her father who's extra-curricular relationship is at odds with the family he has help to create and destroy. The novel is bleak at times but touches on the surreal nature of childhood, as well as being funny, dark and political.