"Jacob Have I Loved" is a coming-of-age novel that follows the story of Louise, a twin sister overshadowed by her talented and beloved sibling, Caroline. Set in a small fishing village on the Chesapeake Bay during World War II, Louise struggles to find her own identity and pursue her dreams amidst the challenges of family dynamics, societal expectations, and the limitations of her environment. As she navigates the complexities of adolescence, Louise must confront jealousy, resentment, and the search for self-worth, ultimately discovering the strength to forge her own path and claim her independence.

Set in the 1930s on the Eastern Shore of Maryland, the novel follows the life of a struggling African American family living in a small fishing village. The narrative centers around the hardships and resilience of the family, particularly focusing on the mother, who is determined to ensure that her child survives the harsh realities of poverty, racism, and a lack of access to proper healthcare. The story is a poignant exploration of the human spirit and the community's fight against systemic oppression, capturing the enduring hope for a better future amidst the dire circumstances of the Great Depression.

Set in early 20th century Baltimore, the novel follows the life of Miss Susie Slagle, a boarding house owner who rents out rooms to medical students. The narrative is full of colorful characters, including the students themselves, who bring their own unique stories and perspectives. The book provides a vivid depiction of the time period, exploring topics such as gender roles, class distinctions, and the challenges and triumphs of pursuing a medical career.