Raphael Lipkin is a man obsessed. He hears voices. He talks to ghosts. He is spending the summer at the Mountain Clinic, a psychiatric hospital in upstate New York—not as a patient, but as a visiting professional with a secret, personal quest.

A professor of literature and a Holocaust survivor, Raphael, having rebuilt his life since the war, sees it on the verge of coming apart once more. He longs to talk to Pedro, the man who rescued him as a fifteen-year-old orphan from postwar Poland and brought him to Paris, becoming his friend, mentor, hero, and savior. But Pedro disappeared inside the prisons of Stalin's Russia shortly after the war. Where is Pedro now, and how can Raphael discern what is true and what is false without him?

A mysterious nighttime caller directs Raphael's search to the Mountain Clinic, a unique asylum for patients whose delusions spring from the Bible. Amid patients calling themselves Adam, Cain, Abraham, Joseph, Jeremiah, and God, Raphael searches for Pedro's truth and the meaning of his own survival in a novel that penetrated the mysteries of good, evil, and madness.