This story starts as a young girl named Sara Louise "Wheeze" Bradshaw who lives on Rass Island in Maryland. She struggles to get away from her sister Caroline's shadow. Caroline is prettier and more talented and gets all the attention not only from her family, but from the community as well. In the book, Sara Louise tries not to be around her. She tends to be around her friend, McCall "Call" Purnell, with whom she crabs.
After finishing college, Sara Louise goes to work in a small town as a nurse and midwife. She eventually marries a widowed father. On a snowy, winter night, she assists in delivering twins. The mother has the first one, a boy, safely. When the second one comes out, it is a small and cold girl. Since she doesn't have an incubator, she rushes it to the fireside. She then realizes she forgot about the boy and asks about his whereabouts. He is in the basket, sleeping, where his grandmother put him. The twins remind her of her and Caroline. She tells the family to keep him warm and love him. In her mind, she does not want him to end up like her, sleeping in a basket, alone and forgotten. She finally finds her joy, happiness, and herself in this small town.