Set in a near-future United States, the novel follows Dr. Jean McClellan, a cognitive linguist and mother of four, living under a regime that has silenced American women. The government, controlled by President Myers and his unofficial adviser Reverend Carl Corbin, architect of the fundamentalist "Pure Movement," has fitted every woman and girl with a wrist counter limiting her to 100 spoken words per day. Each word past the limit delivers an escalating electric shock. Books, pens, and e-mail have been banned for women.
Jean's husband Patrick, the president's science adviser, asks their six-year-old daughter Sonia only yes-or-no questions at dinner so the girl will not waste words, while their 17-year-old son Steven and 11-year-old twins Sam and Leo talk freely. Jean uses her last daily word, "Goodnight," on Sonia, then hums her to sleep because bedtime stories are no longer possible. Through flashbacks, Jean recalls her Georgetown roommate Jackie Juarez, a sociolinguist who warned for years that female representation in Congress was collapsing and the religious right was consolidating power.
Jean traces the regime's rise through incremental steps: women's passports invalidated, fundamentalist ideology mainstreamed in schools, and a televised panel of "Pure Women," female spokespersons for the movement, blaming feminism for social decay. When the counters went on, uniformed men stormed Jean's university and tased her colleague Lin Kwan for resisting. Jean tested her own counter by speaking freely and was knocked flat by the shocks. She conditioned Sonia with treats to stay silent, a Pavlovian strategy she considers her worst act of parenting.
Steven has been radicalized. He wears a blue "P" pin symbolizing the Pure Movement and volunteers at girls' schools to demonstrate the counters. He announces plans to marry the neighbor girl, Julia King, at 18 under a government incentive program. After Steven and Julia are caught having sex, uniformed men drag Julia from her home, fit her with a zero-word counter, and send her to a labor camp. Julia's mother, Olivia King, records a looping message on a Dictaphone, sets it out of reach, and lets the counter's shocks burn through her hand to the bone in a suicide attempt.
The plot accelerates when Bobby Myers, the president's brother, suffers a skiing accident that damages Wernicke's area, a brain region responsible for language comprehension. Bobby produces only meaningless speech, the hallmark of Wernicke's aphasia. Reverend Carl has Jean's counter removed and asks her to lead the cure effort. Jean distrusts him but sees an opportunity, negotiating three conditions: Sonia's counter removed, Sonia excused from school, and Lin assigned to the project. The president agrees.
Jean reports to a government lab under the nominal leadership of Morgan LeBron, the incompetent young scientist who replaced Lin as department chair. The team includes Lin and Lorenzo Rossi, an Italian biochemist with whom Jean had a secret affair. After their reunion, Jean realizes she is pregnant; a gynecologist confirms she is about 10 weeks along, the timing aligning with an afternoon with Lorenzo. Jean and Patrick have not been intimate in months, making the paternity unmistakable. Lorenzo gives Jean a forged Italian passport for escape, but Jean cannot abandon her children.
Jean, Lin, and Lorenzo notice the lab's expensive equipment could not have been installed in the three days since Bobby's accident; the project was planned months earlier. Searching Patrick's study, Jean finds a classified envelope listing three project teams. Her White team develops an "anti-Wernicke serum," the cure. The Gold team's goal omits "anti," reading simply "Develop, test, and mass-produce Wernicke serum." The Red team explores the serum's water solubility. Jean realizes the government is reverse-engineering the cure into a biological weapon capable of inducing aphasia in entire populations through contaminated water supplies.
Jean watches Poe, the lab's intimidating security officer, stun Del Ray, a resistance contact who serves as the neighborhood mailman, on her front porch. Del had been retrieving the classified envelope from the McClellan mailbox, which Patrick used as a dead drop for the underground. Patrick confesses he has been funneling classified information to the resistance since watching a colleague executed at Fort Meade. He tells Jean to flee with Lorenzo and acknowledges he knows about the affair.
Jean asks Patrick if he would kill to end the regime. He says yes. Jean replies that they do not need to kill; they only need to take away the regime's voices. She retrieves hidden research proving the anti-Wernicke serum works. Patrick confirms the serum can be reversed to cause aphasia and is already water soluble. An all-staff meeting at the White House on Monday will gather the president, Reverend Carl, the Joint Chiefs of Staff, and other senior officials. Patrick plans to dose the water, coffee, and champagne.
At the lab, Jean confirms the serum on mice, then injects it into Delilah Ray, an elderly botanist who had a stroke affecting Wernicke's area. Within 10 minutes, Mrs. Ray speaks coherently for the first time since her stroke. Morgan, however, demands Jean produce the weaponized reverse serum by morning, revealing his leverage: Jackie, Lin, and Lin's partner Isabel Gerber are imprisoned in the sub-basement wearing zero-word counters, and Morgan will have one executed if Jean refuses.
Jean mounts a counter-operation with Sergeant Petroski, a young guard whose infant daughter faces a future of silence. Lorenzo creates a smoke-bomb diversion while Petroski frees Jackie, Lin, and Isabel. Lin performs a craniotomy on a sedated chimpanzee as a trial run. The plan is to use the reverse serum on Morgan next, surgically inducing aphasia, but Morgan regains consciousness before the procedure. He seizes a syringe of the lethal serum and holds it to Lorenzo's neck. Jean talks Morgan into summoning Petroski. Jackie grabs Petroski's loosened sidearm and passes it to Jean, who shoots Morgan dead.
Poe reveals himself as an undercover resistance operative. He leads the group, including Steven, whom he rescued from detention in the building, out past security using a presidential-seal letter. They reach the Rays' farm, where Patrick and Jean's younger children wait.
Monday morning, Patrick drives to the White House with the remaining vial in his briefcase. Poe accompanies him but returns alone: Patrick came running out of the White House and was shot by rooftop snipers. Patrick died smiling, Poe says. At a funeral held at the farm, Julia King, freed from her labor camp, reunites tentatively with Steven.
Jackie stays to lead the resistance and coordinate midterm elections promising unprecedented female representation. Jean cancels a prenatal test to learn the baby's sex; the decision to leave no longer depends on whether the child is a boy or a girl. She travels with Lorenzo and all four children through Canada, then flies to southern Italy near her parents. Lorenzo prepares the anti-Wernicke serum for Jean's mother, who had a burst aneurysm in the same brain region. The novel closes with Jean watching Italian women talk with their hands and voices. Sonia chatters freely and wants to be a veterinarian. Steven has warmed to Lorenzo. Jackie writes about the transformation back home. Jean plans to return one day, but not yet.