In October of 1918, the world, still in the midst of a massive war in Europe, is experiencing a new challenge-a pandemic of what came to be known as the Spanish flu. But Cotella Barlow, living in an isolated county in Appalachian Virginia, has only heard rumors about it. Cotella, known as "Telly," makes her way in the world taking care of the families of new mothers who are "lying in" after their labors and deliveries. She travels home to home, eeking out a living, loved by many but always conscious of the stares and winces caused by her disfiguring condition.Until she enters the home of her next "momma," who, days before delivery, is dying in a strange new way, her husband missing, and her four other children frightened, uncared for, and hungry. Telly must meet the challenge with no knowledge of the outside world that is shutting down while people suffer, die, and quarantine.