Packer's main characters, Claire and Eliot, are a couple in their 60s who've been married for almost four decades. For the past eight years, Claire has been battling cancer and Eliot has been a diligent caretaker. Caretaking, he reflects, is a daily amalgam of "Helping, soothing, driving, phoning, cooking, listening, tending, waiting, learning, remembering, deciding, forgoing. A lot of forgoing." When the novel opens, Claire and Eliot have just walked out of their final appointment with Claire's oncologist final, because there's nothing more to be done.
Elsa works at a care facility for elderly people and lives with her mother and younger brother; they are all stuck in the kind of limbo that comes with unresolved family mysteries. One day, Elsa encounters Franck once more as a voice. It seems that an alien presence may be able to return him to his home planet, if Elsa is prepared to help them out with a little favour: