It is the first novel featuring Capt. Jean-Luc Picard to be set after Star Trek Nemesis. The plot concerns an attempt to stop a plague on a Romulan colony called Kevratas, and the relationship between Picard and Dr. Beverly Crusher. It also describes Dr. Crusher's first encounter of a similar plague as a teenager on the colony of Arvada III. A faction of the Romulan Star Empire wishes to keep the plague alive in an attempt to undermine newly appointed Romulan Praetor Tal'aura. Picard will be faced with working alongside allies new and old, as well as an enemy from the past who has a way of turning up when Picard least expects.
This book also includes characters Doctor Carter Greyhorse, a scientist whose past has landed him in a penal colony, along with Pug Joseph, a former member of Starfleet turned merchant, both of whom served with Picard aboard the USS Stargazer.