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The story follows John Alan Muro, whose 16th birthday coincides with Virginia's secession from the Union in 1861. Muro dreams of attending medical school in Philadelphia, but the war forces him to remain in the South. Muro is pressed into early service at Charlottesville General Hospital to treat the influx of wounded soldiers. He faces professional and social backlash after saving the life of a Northern Lieutenant, an act of compassion that pits his medical oath against local wartime loyalties. Amidst the chaos, he persues Lorrie Wigfall, the niece of one of his mentors. This book explores the "inner wreckage" of war, focusing on the domestic and medical struggles of the Confederacy rather than the battlefield.