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Patrick, a 50-year-old professor of American studies, drinker, and womaniser, has been given six months to live. In a rural part of Cambridgeshire, a teenager dies in a motorcycle accident. When his heart is transplanted into Patrick's chest, the lives of two strangers are forever conjoined.
Patrick makes a good recovery from surgery, but has the strange feeling that his old life "won't have him". He discovers that his donor's name was Drew Beamish, and becomes intensely curious, not only about Drew but what shaped him: his family and culture, the ancestor who took part in the famous Littleport riots of 1816, and the bleak yet beautiful landscape of the Fens. Patrick longs to know the story of his heart.