The book centers on the emotionally challenged Lenore Stonecipher Beadsman, a 24-year-old telephone switchboard operator who questions her own reality. In Wallace's typically offbeat style, Lenore navigates three separate crises: her great-grandmother's escape from a nursing home, a neurotic boyfriend, and a suddenly vocal pet cockatiel. The controlling idea surrounding all of these crises is the use of words and symbols to define a person. To illustrate this idea, Wallace uses different formats to build the story, including transcripts from television recordings and therapy sessions, as well as an accompanying fictional account written by one of the main characters, Rick Vigorous.
The manager of the nursing home, David Bloemker, repeatedly expresses himself in an overly elaborate style, only to have to reduce his own locutions to a much simpler form. For example, he tells Lenore that if they find her great-grandmother (also named Lenore), they will likely also find the other missing residents of the facility. Why? Because, she "enjoyed a status here— with the facility administration, the staff, and, through the force of her personality and her evident gifts, especially with the other residents [such that] it would not be improper to posit the location and retrieval of Lenore as near assurance of retrieving the other misplaced parties." The younger Lenore says that she doesn't understand all of that. Bloemker tries again: "Your great-grandmother was more or less the ringleader around here." This contrast of baroque with simple speech is employed to comic effect, as well as to advance the more serious contemplation of language at the heart of the plot.