Meet the Malcolms. They've just moved in to a home they can't afford, they're trying to climb a social ladder that they don't belong on, and both are chasing careers that are just out of their grasp. They want a child, but every time they try, every attempt they make, fails.

Charles Malcolm, successful bestselling writer of cutting-edge, timely pop-science books finds himself staring at the blank screen. Unable to top himself yet again, he descends into writer's block, and finds himself taking long walks through Boston's historic cemeteries, his dog at his side. Janet Malcolm finds herself chasing partnership at a high-powered law firm while facing her latest medical results--she can't have children.

Desperate, Janet will try anything to have a baby. Charles watches as his wife seems to change before his eyes, spending more time with the mysterious and alluring couple next door. Then, one day a miracle occurs--Janet is pregnant. Charles is elated. Why wouldn't he be? But... was it a miracle? Charles realizes that he can't remember certain periods of time, and has horrifying glimpses of memories--cult members, blood, and some... thing, from the deep ocean, risen, hungry, red-eyed. As his new infant son grows ever larger, he begins to suspect that the boy may not have been conceived naturally.

As Janet slips into madness, Charles begins to doubt everything in his life, from the people around him, from his next door neighbors, to his own wife, and finally--to his infant son.