The novel follows the life of twin brothers born from a secret union between an Indian nun and a British surgeon in Ethiopia. Their mother dies during childbirth and their father disappears, leaving them to be raised by two doctors at the mission hospital where they were born. The story spans several decades and continents, and explores themes of love, betrayal, medicine, and the complexity of family ties. One of the brothers, a gifted surgeon, flees to America after a political revolution in Ethiopia, while the other remains and struggles with the challenges of practicing medicine in a developing country.