Dublin, Ireland, October 1885. The fragile peace within the Fitzgerald family is threatened when Dr Jacob Smythe becomes one of Will's patients, angering his mother. But in attending to the elderly gentleman's needs, Will inadvertently reunites Sarah with an old adversary and Isobel discovers she and Dr Smythe have an unexpected and tragic connection.
When Alfie receives a card on his twenty-ninth birthday, the recognisable handwriting and cryptic message shatters his hard-won personal contentment. Has a figure hoped long gone from his life returned to Dublin to wreak a cruel mischief on all those who banished him? Is Alfie's ambition of becoming a doctor about to be derailed when he has less than a year left at Trinity College?