This novel is the third and last volume of a trilogy with Genesis and August. It is set in a world like ours, but more advanced in regards to stem cell research. People have stem cell banks and it is possible to use these to re-grow organs in order to prolong healthy lives. Only the brain cannot be regrown in this way.
18-year-old Theo had an accident in which his body has remained intact, but all his brain function has been permanently destroyed. Scientist Dr. Huxley sees this as the unique chance to try to copy the information of Theo’s twin-brother Rene’s brain into Theo’s brain. In order to go ahead with the procedure, he needs Rene’s assent (Theo and Rene are orphans, so Rene is Theo’s only living close relative) and an assessment of Rene’s mental state in order to determine if he is fit to make such an ethically ambiguous and risky assessment. Since this procedure has no precedent, it is unclear what will be the outcome for either of the boys.
Rene is now in the same hospital as Theo to see his brother and to be assessed by Maggie, a hospital psychologist. He tells her the story of his life as a twin: the identical twins as children swapping roles at times and pretending to be each other, their parents’ death and their growing apart over school and girls as teenagers. Rene was academically stronger and more thoughtful and sensitive than his brother. Theo was more popular with his peers and girls, but also more selfish and somewhat controlling over Rene. Rene often looked up to his brother, while Theo used Rene’s feelings of guilt for being academically stronger, in order to manipulate Rene. When Theo had a one-night-stand with Emily, the girl Rene had recently started to see, Rene decided to stand up to his brother and, in revenge, applied to the same drama school that Emily and Theo wished to attend, even though Rene was not particularly interested in learning drama. Because he studied hard, he was admitted (and so was Emily), but Theo was not. Theo was devastated and his life began to unravel, while Rene moved in with Emily and experienced great happiness in their relationship. After a while, feeling guilty and in order to help Theo, Rene returned home and even offered to swap roles with Theo, so that he could spend a day with Emily pretending to be Rene. They went ahead with their plan, but on the day of the swap Theo was electrocuted.
Maggie, the hospital psychologist, has confused the twins’ names and not told Emily that it is not in fact Rene, whom she thought she had been spending the day with and is now in a coma, but Theo. She notices this mistake only when Rene comes to the point in his story where he talks about swapping places with Theo that very day. Both Maggie and Rene tell Emily, who is sitting in a hospital waiting room. She is at first unbelieving, thinking, Theo was trying to trick her, then shocked and hurt. She leaves and comes back with a journalist, planning to expose the identity mistake and the ethically extremely ambiguous procedure Dr Huxley is planning to undertake. Both Emily and the journalist only get a brief chance to talk to Rene, but manage to advise him against the procedure. The journalist is removed by hospital security and Emily leaves angrily.
Rene, Dr Huxley and Maggie have a meeting, in which Maggie testifies that Rene is capable to make the decision whether he wishes to do the procedure or not. Rene now has half an hour left to make his decision, before Theo will be dead. The doctor and psychologist leave him alone, but Maggie indicates that she would like to talk to Rene in private. They secretly meet and Maggie advises him not to go ahead with the procedure and warns him of the dangers of two bodies waking up with the same identity and the possibility of an exchange of the two identical looking boys after the procedure.
After Rene remembers a running race at the beach with Theo (it is important here, that it is not Rene, but Theo who won this race – Rene has clearly learned that they need each other and it is more important that they can be together than who is “winning” in their competitive relationship), he makes the decision to go ahead with the procedure as it is the only way to at least save some part of his brother, i.e. his body. Before it is done, Emily returns and gives Rene a secret cut in his armpit which Rene can hide from the doctors. Since both boys after the procedure will wake up not just looking identical, but also with exactly the same memories, in fact Theo thinking he was Rene, this will be a way for them and Emily to know who of the twins is who after the procedure, as both boys will remember the pain of the cut, but only Rene will have the scar.
The plan is that after the procedure, Rene can return to his normal life, but Theo will be sent away for a year so that both can make new, different memories and so regain different identities. The procedure is successful, but in diary entries (printed on opposing pages, one in bold print, the other in normal print) each boy now describes what is happening after they have woken from the anesthesia. Their reports are almost identical, but then it is Rene (with the scar) who is taken away by the doctors, not Theo.