The story unfolds through the perspective of a young medical student, Fettes, and his friend, Merrydew, as they attend lectures by the renowned Dr. MacFarlane. MacFarlane, a brilliant but secretive surgeon, is rumored to obtain his cadavers through illicit means – specifically, from the practice of body-snatching. The narrative follows their growing suspicion, fueled by strange occurrences and the doctor's evasive behavior, culminating in the horrifying discovery of the truth behind MacFarlane’s success and the fate of his supplier, Burke.