The year is 1895, the place is London. Recently qualified doctor Eleanor Bramwell has an observational position in the East London Hospital, but faces resistance from the almost exclusively male medical profession, especially Sir Herbert Hamilton, the scalpel-happy head surgeon. As it happens, Sir Herbert has high hopes of securing funding for a new ward from Lady Cora Peters, who owns a property in Thrift Street. After agreeing to examine her friend, Lady Cora's sister-in-law Victoria Carstairs, who thinks she is pregnant, Eleanor makes a terrible discovery. The repercussions result in her banishment by Sir Herbert from the hospital, and it looks as if her only option will be to take private patients referred by her father. But Lady Cora is not the delicate flower Sir Herbert mistakes her for. She has seen Eleanor's success at saving the crushed foot of a labourer, Daniel Bently (and Sir Herbert's later erasure of this achievement), and is impressed as well by her efforts to save Vict

The Thrift is not yet fully operational, but an emergency patient, Frank Harrison, is brought in with a serious burn on his arm. When he returns the next day asking for more morphine, Eleanor realises he has a more serious ailment. He is suffering from a strangulated hernia, but turns violent when she asks to examine him. Meanwhile Robert provides his daughter with her first private patient, a Miss Peggy Heart, but Eleanor is not amused to discover that she is in fact a music-hall singer whom her father is seeing socially.

When Harrison collapses in the street, Eleanor is at last able to convince him that he urgently needs an operation. She is eager to perform it herself, as she has not previously had any surgical experience (apart from amputating Daniel Bentley's toes), but requires the services of a qualified anaesthetist. Joe Marsham fits that description, and when Eleanor presents her case as an emergency, he agrees to assist, though he has anbitions to be a surgeon himself. L

A young boy, Tom, is brought into the Thrift with injuries suffered when he fell from a ladder after being sent down a sewer. His employer had abandoned him, and it was only one of the other workers who rescued Tom. The poor little waif soon has Nurse Carr completely charmed, but Daniel Bentley and Dr. Marsham have reason to believe that the little scamp is less innocent than he appears. Eleanor, meanwhile, is called in by neurologist Dr. Hunter to examine his housekeeper, Mary Warner. Eleanor confirms Hunter's diagnosis that Mary's heart is enlarged, and she cannot carry on with her normal work. Eleanor is flattered when Dr Hunter seems to be taking a personal interest in her. Later, when Dr. Hunter summons her to examine Mary again, they discover her in her room, dead. Lady Cora tells Robert that she has heard rumours that Hunter appears to be in distressed circumstances, and Hunter seems unusually anxious to get Eleanor's signature on the death certificate. Then at the club, Ro

Robert is pursuing research in electrotherapy, and receives the enthusiastic backing of an octogenarian member of his club, who not only wants to finance the experiments, but also to be a subject of them. While canvassing the East London slums looking for tuberculosis cases, Eleanor comes across a Bertie Armstrong, a costermonger living with a pregnant woman, Annie, whom Eleanor assumes is his wife. Bertie refuses treatment, though he is obviously very ill. Eventually Eleanor discovers that he is a member of a distinguished military family, the Stuart-Armstrongs. When Bertie collapses at the Thrift, Eleanor takes him to his brother, Andrew, who has not seen him for six years, and seems pleased and relieved to have him home again. Andrew also introduces Eleanor to Sylvia Stuart-Armstrong, Bertie's wife of eight years. When Bertie continues to act beligerantly, and demands to ""go home"" to Annie, Eleanor must make some difficult decisions.

The Thrift has been in operation for some months now, and the strain of too much work with too few staff is beginning to show. Lady Cora is acting as administrator, but she is feeling decidedly unwell. When a 16-year-old labourer, Wilf, is brought in to the Thrift after an accident and cannot feel anything, a broken neck is suspected. Lady Cora has learned of a contraption called an X-Radiography machine, and approaches Sir Herbert at the East London Hospital to beg the use of one. Sir Herbert is warned by the radiographer, but overexposes Wilf to the X-rays and burns him horribly, though Wilf cannot feel it. Back at the Thrift, Nurse Carr believes Wilf when he says he thinks he can feel his toes, but Dr. Marsham thinks he's imagining things, and this leads to sharp words with Nurse Carr. Lady Cora has called in Sir Herbert for help with the Thrift as well as for medical advice for herself. For Lady Cora he diagnoses, without bothering to examine her, a spastic colon and prescribes

Robert, not yet accustomed to his new duties at the Thrift, has forgotten to deal with the payroll. Instead, he has gone to a bare-knuckle boxing match at his old regiment, where he is trying to do some match-making for his daughter with young-ish Major Stuart Hyde, who is about to resign his commission and resume civilian life. When a Private Stebbings (who is being thrown out of the Army as a troublemaker) tries to interrupt the match, he is struck down by one of the boxers with a single punch. Dr. Bramwell cannot bring him round and Stebbings is taken to the Thrift, where it is discovered he has a brain injury requiring emergency surgery. Robert's matchmaking efforts are a success and, after a time, Eleanor accepts Major Hyde's proposal of marriage. Romance may be in the air for Kate, as well, when she catches Daniel Bentley's eye. Stebbings, however, whose temper has not been sweetened by brain surgery, brings everything crashing down when he attacks Eleanor at the Thrift. Though s