Fiftysomething novelist Alma Huebner is finding many excuses not to work on the book for which she's already received a hefty advance. She is staying home in Vermont while her husband, Richard, a manager for a humanitarian aid association, has been assigned to work at an AIDS clinic in Alma's native Dominican Republic. The story she is considering is that of the 1803 Balmis Expedition, which brought smallpox vaccine from Spain to its possessions in the Americas and the Pacific in the first major public health project in the New World. Alma relives the expedition through the account of Doña Isabel, the mistress of the Spanish orphanage whose wards were the carriers of the vaccine. When interwoven with Alma's contemporary tale, it mirrors Alma's experience as her husband's clinic is overtaken by rebels and he is taken hostage.
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