Sid Elliott has been an emergency room janitor for eight months. As he tries and fails to tell Roxanne—an alcoholic, nomadic woman whom he meets while smoking marijuana in the park—and his mother over dinner one week, it's hard, demoralizing work. Lots of blood and gore. Worst of all, every indigent person who comes in drunk and unconscious with a head injury has their skull drilled in case of hemorrhage. As Sid puts it, unconscious men don't make choices. First body, then brain. Sid is a huge man, and not a particularly intelligent or graceful one. He'd been sober—not by choice—for twenty-seven days when he met Roxanne, and it is now forty-two days. Roxanne, a scrawny former backup singer and current addict, tries and fails to match him; she lasts about a month. Their relationship ends a week after that. After Sid drops a sterilized tray to help a girl beating her head against a wall, he is transferred out of the ER and into the hospital morgue. As he moves, he remembers the darker parts of his past: his time in Vietnam, his PTSD driving a wedge between him and his parents, his poor sense of physical boundaries with his mother and three nieces, his father's death. After she relapses, Roxanne begins to pull away from Sid. One day, she's gone. Down in the morgue, Sid has a 326-pound body to move onto a slab for observation. They tell him to roll her, but he cannot bring himself to do it. Instead, he lifts her, and he makes it five steps before his knee buckles and she brings him tumbling to the ground. He wakes up in the hospital the next day.