Stutley Tillinghast lives a solitary life, ostensibly as the minister of a remote rural parish in Rhode Island. For many decades now, what little human contact he allows himself has been brief, frenzied and bloody, and always ends in a shallow grave in his cellar.

You and I would have a name for what he is, but he prefers not to use it – he has needs, and when they become unbearable, he fulfils them.

Then the girl arrives – 19 years old, she has travelled from the UK to find him. She seems to have his surname, and her resemblance to him is uncanny. She is sick – very sick – and Tillinghast recognises her symptoms all too well. Which means he also knows what she needs…