Frank Doyle, a 77-year-old man with congestive heart failure, lies in a Toronto hospital preparing for medically assisted death (MAID), a legal procedure in Canada allowing terminally ill patients to end their lives. His wife Annie died of cancer eight years earlier, and Frank has nothing left to live for. Before the procedure begins, a stranger enters holding a phone. On the screen, a young woman with striking green eyes offers Frank a vague alternative: Come to her island, where things need not end this way. Frank postpones his death.
The next morning, a car drives Frank deep into the Ontario wilderness to a remote dock, where he meets John Salters, the stranger from the hospital. A second man arrives: Teddy Bassiano, 79, a wealthy home builder with Parkinson's disease who received the same mysterious offer. Salters pilots them by boat to a remote island, where a forbidding laboratory called Spindrift sits atop a rocky ridge. Moses Squires, a middle-aged Cayuga man who works on the island, escorts them up a punishing staircase to the entrance.
Inside, Frank and Teddy join four other elderly, terminally ill people: Madeline Dodds, 84, a former corporate financier with Lyme disease; Claire Blessings, 79, a homemaker with diabetes and a survivor of domestic abuse; Hugo Udall, 76, a former textile worker with damaged lungs; and Davey Jacobs, a man with cancer. Dr. Veronica Strauss, a bioethicist hired as an ethical safeguard, explains that the research is led by Dr. Astrid Marsh, a 19-year-old prodigy with an IQ estimated above 290.
Astrid appears, socially awkward and blunt, and tours the group through the lab. She explains cellular senescence, the body's programmed aging and decay, and introduces her creation: a bioengineered organism she calls the Hydra. Built from regenerative jellyfish elements, aggressive coral, and a fungal component, the Hydra reverses aging when implanted via a lozenge at the base of the spine. As proof, she shows them two wolves born in the same litter 14 years ago. One, Boots, received the Hydra six months earlier and now registers as four years old on an epigenetic clock, a measurement of biological age. A scan reveals the Hydra filling Boots's body in a web of blue-glowing tendrils. Astrid warns that subjects may need to remain on the island for years or decades. She shows scars on both forearms from a suicide attempt she made to prove to her corporate backers that she would rather die than relinquish control of the project. Davey refuses the treatment on religious grounds and leaves. The remaining five, after private deliberation, all consent.
Strauss performs the implantation on the five sedated subjects and on a sixth: Ingrid Chevalier, Astrid's former best friend and collaborator at the Institute for Human Advancement, a think tank for prodigies. Ingrid has lain comatose for three years in a room accessible only to Astrid. During surgery, Ingrid briefly wakes screaming before collapsing back into unconsciousness. The subjects awaken with varied reactions: Madeline seizes a nail file and stabs herself repeatedly, Hugo hallucinates his dead daughter Summer, and Teddy and Claire wake euphoric.
The subjects begin daily stem Baths, immersions in tanks of embryonic stem cells that fuel the Hydra. Weeks into the experiment, Ingrid wakes from her coma, her memories flooding back. She is horrified to learn Astrid implanted the Hydra without her conscious consent. The epigenetic clock confirms measurable age reversal in all subjects. Madeline, the oldest, drops fastest. She privately theorizes that her self-inflicted wounds activated the Hydra more aggressively and begins taking Frank for cold-water immersions, believing physical stress accelerates the organism. Frank's age finally begins declining. As the subjects grow younger, their personalities shift: Heightened emotions, impulsive behavior, and aggressive outbursts emerge. Ingrid, contemplating the Hydra's single-minded drive, likens it to the Paperclip Maximizer, a thought experiment in which an AI programmed for one narrow goal consumes all available resources to fulfill it.
Alarming developments with the wolves prompt the first crisis. Diego is found dead and partially hollowed out, its organs consumed from the inside without any external wound. Boots has undergone disturbing physical changes. The implication is that Boots's Hydra harvested Diego's body to enhance its own host. A subsequent scan reveals the Hydra has migrated into a female wolf, Dora, a capability Astrid never engineered. The possibility of autonomous spread raises catastrophic implications. Astrid orders the stem concentration in the Baths reduced by 98 percent.
The reduction triggers panic. Claire's age ticks upward, and she flies into a murderous rage at Astrid. Teddy organizes a midnight raid on the stem supply with Claire and Hugo. They eat the stem cells directly. John catches them. Hugo snaps John's neck. The three dispose of the body over the island's cliffs. Claire and Hugo then disable the boats and sever the island's underwater power cable, plunging Spindrift into darkness.
Events cascade toward catastrophe. Moses leads Frank, Madeline, and Teddy through a storm to a distant emergency generator. Moses injures his thigh, and Madeline, overwhelmed by the Hydra's hunger, involuntarily extends tendrils from her face into Moses's ears, stealing his hearing. Outside the generator shack, the now-deaf Moses prepares to execute them at gunpoint, viewing them as no longer human. The Hydra-wolf Boots appears and kills Moses. Inside Spindrift, Astrid, having decided to kill the subjects after losing control of the experiment, tricks Hugo by imitating his dead daughter's voice and poisons him. Hugo dies, but the Hydra purges the drug and reanimates him as a monstrous shell. Claire, whose consciousness has been almost entirely consumed by the Hydra, feeds on the sleeping Strauss, leaving Strauss barely alive.
Ingrid discovers security footage on Strauss's laptop, sent by a mysterious contact known as the Cheshire Cat. The footage shows Astrid deliberately smashing a jellyfish tank onto Ingrid at the Institute, the true cause of Ingrid's three-year coma. The reanimated Hugo crashes through a window. Teddy shoots Hugo multiple times, holding him as he finally dies. Astrid then stabs Teddy with syringes of pentobarbital, a lethal barbiturate, killing him. Ingrid sedates Astrid from behind, saving Frank and Madeline. Ingrid ties Astrid to the jellyfish tank and forces her own Hydra into Astrid's body, ensuring the corporate backers will find their scientist carrying the organism, too valuable to destroy but too dangerous to release.
Frank and Madeline carry MAID syringes to a beach and wade into freezing water, positioning needles at each other's throats. At the last moment, both pull away. Whether the Hydra's self-preservation instinct overrides them or their own will falters, Frank cannot determine. They return to Spindrift, rest, then walk across the frozen channel to the mainland. At a remote cottage, driven by the Hydra's hunger, they attack the inhabitant, take his snowmobile, and flee. Days later, a corporate extraction team finds three dead subjects at Spindrift, the remains of Strauss and the two hired men, and Astrid still breathing, colonized by the Hydra. Frank, Madeline, and Ingrid are unaccounted for.
An epilogue set roughly seven and a half years later finds Frank and Madeline at a crowded resort, both appearing to be in their early twenties. They live in hiding, struggling to control the Hydra's hunger. Madeline reveals she recently spotted Ingrid and the Hydra-wolf watching her, apparently tracking them. They agree to stay together and walk into the sunlight, passing an elderly couple who whispers about young love. The novel ends with the Hydra's promise of eternal youth revealed as an inescapable parasitic curse, and the question of whether Ingrid will find and stop them left unresolved.