Scrimger tells the story of Mitch Mitchell in alternating segments between his current life on the streets and his previous life as a successful doctor complete with an attractive Rosedale wife and one daughter, both of whom he loves. In his continual efforts to rise in the medical ranks, Mitchell gets involved with the formidable Leon Opara, who "sat on more boards-hospital, clinic, charity, faculty-than he had fingers to count them on.. You didn't ignore a request from him if you wanted to get ahead. And I did want to get ahead." It is this ambition that inadvertently leads to Mitchell's downfall. When Opara brings in his fifteen-year-old model daughter, Magda, for a secret abortion, Mitchell complies, but, unfortunately, her pregnancy is more advanced than he had realized. When he induces labour in the hope of a stillbirth, the baby is-albeit weakly-breathing. How Mitchell handles this situation becomes one of the governing factors in his life: he must live with the consequences of his actions. Scrimger has done a fine job of plotting, and he shows remarkable control over the novel form for a first-time novelist-although, as the dust-jacket quips, this technically isn't his first attempt at a novel, but it's "the first one anyone apart from his wife has liked." His portrayal of street life, of the consciousness of a man living such a life, is unsentimental but poignant. He inspires empathy for Mitchell and, in the process, demonstrates the power of conscience and the ramifications of choice.