In 1887 London, the elite of Mayfair prosper while the poor of St. Giles die. Despite being an aristocratic wife, Ellen Grenfall fights in the bowels of London to save the lives of premature infants and their mothers with her fledgling medical dispensary--a cause close to her heart after her own infant loss.
 Eight years earlier, Mark Grenfall joined the Royal Navy to escape his struggling marriage. But when he's suddenly called by his family to provide an heir, he's forced to return to London and the woman he abandoned?discovering that she is nothing like the giggling debutante he left behind. The real Ellen is a passionate, wildly intelligent woman pursuing neonatology, and he's just the man who underestimated her.
 Ellen has no use for a husband who abandoned her, especially not with a medical practice to keep her busy, but Mark's attention and support of her medical research sparks a new connection. Yet unresolved grief and a duty to produce an heir that neither feels capable of meeting endangers their fragile reunion.
 Ellen must decide if she's willing to open her heart to her husband?and the possibility of new life?and try again.