Claire Boehning faces a bleak future when her privileged life ends abruptly in Cassella's second novel (after Oxygen). Addison, her biochemist husband, created a lucrative drug that secured the family's fortunes, but when tests on a new drug go awry and Addison's backing disappears, he loses everything. After the couple is forced to move from Seattle with daughter Jory, 14, to live in a rural, ramshackle house originally bought as a fixer-upper project when money was not an issue, Addison travels in search of new investors. Claire, meanwhile, searches for a position as a doctor, a profession she left after Jory's birth. But with her lack of experience and board certification, she finds few opportunities until she lands a job at a nonprofit clinic that serves poor, uninsured migrant workers. There Claire meets Miguela Ruiz, a Nicaraguan native with a mysterious background, and as the Boehnings struggle to reclaim some piece of their past life, Ruiz affects them in unexpected ways. Cassella (a real-life doctor) takes a hard look at a faulty health-care system to illustrate the power of money and class in this timely and multifaceted novel.