Set in rural Maine in the first half of this century, it tells the story of Homer Wells, an orphan who is raised and mentored by Wilbur Larch, the doctor at the orphanage. Dr. Larch teaches Homer everything about medicine. Yet though his capacity for kindness is saintly, Larch is also an ether addict. He and Homer come into conflict, which is typical of many father-son relationships, but in this case their conflict is intensified by their disagreement about abortion. The result is that Homer leaves the only family he has ever known. Homer's new life provides more excitement than he could have imagined, especially when he falls in love for the first time. But, when forced to make decisions that will change the course of his future, Homer realizes that he can't escape his past.

Based on his novel The cider house rules.