The book starts actually at the end of the book with the main character having finished his internship at the House of God. He's lying with his girlfriend, Berry, reflecting back on his year of internship. The two are vacationing in the South of France. They are enjoying a lunch of artichokes in a garden, reflecting back on the year and on the "gomers"—the elderly, demented patients he had to take care of in the House of God. Everything is reminding him of the gomers. He even sees them at a hospice and feels anxious about it.
He flashes back to a fantasy of a cardiac arrest he'd like to be involved with, involving an erotic scene with a.....
