Billie Wright, a 37-year-old reproductive endocrinologist from small-town Wisconsin, has spent 15 years building a life in New York City, where she runs Hope Fertility, a clinic she founded with her colleagues Lesli Green and Greer. As the novel opens, Billie travels to the Hamptons with her boyfriend, Dean Holt, a trauma surgeon at Bellevue Hospital, to meet his parents. Dean proposes on the beach, and Billie says yes. Inside, she discovers he has secretly flown her parents in from Wisconsin to celebrate, deepening her love for him.
The next morning, Billie receives a voicemail from Mick O'Leary, her high school and college ex-boyfriend, asking her to call back in a serious tone. Dean notices her unease, but Billie defers.
A flashback traces Billie's history with Mick. They met on the first day of high school in Wisconsin, where Mick, a popular football player whose family owns an orchard, sat beside her in advanced algebra and teased her about her full name, Wilhelmina. Billie confided her crush to Erin Callahan, her best friend since childhood. Erin, raised by her single mother Joan, encouraged Billie to be patient. Over the following years, Billie and Mick grew close. Mick confided about his younger sister Maeve, who has Down syndrome, and his mother's alcohol addiction. When Mick began dating another girl, Billie was heartbroken and started seeing a classmate, Paul Morgan. Senior year, Mick broke up with his girlfriend and confessed he had always had feelings for Billie, but she told him it was too late. Unable to suppress her own feelings, Billie broke up with Paul. She and Mick got together, sharing their first kiss at his family's orchard. On prom night, which they skipped, they slept together for the first time and declared their love. Billie chose to attend the University of Wisconsin-Madison with Mick instead of Yale, where she had also been accepted.
Their college years were happy, but senior year brought a difficult choice: Billie was accepted to Columbia Medical School, and Mick encouraged her to go, though he could not follow because of his commitment to Maeve and the family orchard. Medical school consumed Billie. She befriended Lesli and threw herself into studying. The long-distance relationship deteriorated as Billie canceled visits, skipped their friend Lucy's wedding before a critical licensing exam, and accepted a summer position in New York instead of returning home. Mick told her they needed to break up. Back in Wisconsin, they said goodbye in person, and Mick refused even friendship, insisting on a clean break.
Billie channeled her grief into her career. During her third-year clinical rotations, she found her calling in obstetrics and gynecology. She matched at Columbia for residency and befriended Greer, a Harvard-trained intern. The three women began planning to open a fertility clinic. During Billie's fourth year, Erin called with the news that she was pregnant by a stranger she had met at a bar in Chicago. Erin decided to keep the baby, and Billie promised to support her. At the 20-week ultrasound, they learned the baby was a girl, and Billie suggested the name Phoebe, which Erin adopted. When Erin went into labor, Billie flew home to be at her side.
The narrative returns to the present, more than 11 years later. Billie calls Mick back, and he tells her that Erin was killed the previous evening in a car accident. Russ Kowalski, Erin's on-again, off-again partner, was driving drunk when he struck a telephone pole. Phoebe, now 11, is staying with Joan, whose Alzheimer's has worsened considerably.
Billie flies to Wisconsin for the funeral, where she sees Mick for the first time in years and delivers a eulogy, addressing Phoebe directly and promising she will not be alone. Afterward, Joan pulls Billie and Mick aside and tells them Erin wanted them to have custody of Phoebe, though no written documentation exists. Over the following days, Billie bonds with Phoebe. Mick apologizes for past bitterness, admitting he used Maeve and the orchard as excuses not to follow Billie to New York and that blaming her was easier than facing his own fear.
Back in New York, Dean supports taking Phoebe in. They fly to Wisconsin for Phoebe's spelling bee, where Dean and Mick meet for the first time. Tension flares when Dean asks Mick whether he would step back if they pursued sole custody. After Joan wanders away from the house and is found by police, the fragility of the living situation becomes clear. Phoebe tells Billie she wants to move to New York because everything in Wisconsin reminds her that her mom is gone. After hearing Phoebe's wishes, Mick reluctantly agrees, believing she may belong somewhere bigger.
That evening, Billie reads Erin's pregnancy journal and discovers cryptic entries about someone called "M." One entry describes M. panicking about whether he could be Phoebe's father. Billie confronts Mick, who admits he and Erin slept together once while drunk, after he and Billie had broken up. Billie is furious at both the act and the years of concealment. Mick insists Phoebe is not his, based on Erin's assurances, and admits he never took a paternity test because Erin refused one.
Billie tells Dean everything. He insists on a paternity test, but when Mick takes Phoebe for the test, they learn it requires consent from a parent listed on the birth certificate or a court-appointed legal guardian. Billie decides to file for temporary guardianship, which requires her to relocate to Wisconsin for 180 days. Dean, having just accepted the chief of trauma position at Bellevue, calls off their engagement, telling Billie he loves her but cannot wait while she co-parents with her ex. Billie returns the ring.
With the support of Lesli and Greer, Billie regroups. She attends Russ's sentencing hearing and delivers a victim impact statement; he receives 10 years for homicide by intoxicated use of a vehicle. A judge grants Billie temporary guardianship for 180 days, and she settles into Joan's house, establishing a routine of school pickups, homework, telehealth appointments, and visits to Joan at a nearby memory care facility. Mick helps regularly. After he reveals that he and his girlfriend Lena have broken up, the dynamic between Billie and Mick intensifies over the summer through shared meals, lake days, and quiet evenings.
On Labor Day weekend, with Phoebe away on a trip with friends, Mick takes Billie to dinner and then to the orchard. Sitting on his tailgate, he tells her that loving her has been the one constant of his life and that he will follow her anywhere. They kiss.
An epilogue set three years later finds Billie, Mick, and Phoebe, now a family, packing to move to New York City. After the court order expired, a judge granted them joint custody, and a paternity test confirmed Mick is not Phoebe's biological father. Joan has since passed away. They are relocating to an Upper East Side apartment, with Phoebe enrolled in a school that Dean, who has stayed in touch, helped arrange. On the drive east, they stop at Niagara Falls, a site Billie and Mick visited on their first road trip, and take a family photo as a rainbow arcs through the mist. Billie reflects that home is not a place on a map but love and belonging.