Isidore is a brilliant man, driven in equal measure by grief at his young mother's death, rage at his distant, abusive father, and his own fierce ambitions. When Isidore becomes a doctor, and a father himself, the cycle of grief continues. His son Leo is left behind too young, and also grows to be a doctor.

The story becomes Leo's, an alternately heartbreaking and hilarious account of his cross-country road trip with his younger brother as they try to understand their family, their relationship, and their own futures. An appealingly oddball character, angry at the world but angrier at himself, Leo yearns for love and simple satisfaction. Through his eyes we see the power of family both to destroy and to create, and the price and rewards of independence.