Hugh of Singleton, fourth son of a minor knight, has been educated as a clerk, usually a prelude to taking holy orders.

However, feeling no certain calling despite a lively faith, he turns to the profession of surgeon, training in Paris and then hanging out his sign in Oxford. A local lord asks him to track the killer of a young woman whose bones have been found in the castle cess-pit. She is identified as the impetuous missing daughter of a local blacksmith, and her young man, whom she had provoked very publicly, is in due course arrested and sentenced at the Oxford assizes.

From there the tale unfolds, with graphic medical procedures, droll medieval wit, misdirection, ambition, romantic distractions and a consistent underlying Christian compassion.