In a military hospital for wounded veterans of the Iraq war, ex-Marine Jeremy Witherspoon, called Spoon by his comrades, is trying to come to terms with his life-changing injuries. The hospital specialises in treating "metal heads", those with severe head trauma whose injuries require the insertion of a metal plate. Spoon passes the long hours in bed trading war stories with his fellow patients and recounts his complicity as a witness to a brutal crime of war in Ramadi, and his coercion in a cover-up when threatened by a private contractor who goes by the nickname Skank. When the wounded Skank appears at the hospital, he bluntly threatens Spoon to keep his mouth shut about Ramadi. One by one, Spoon's friends on the ward begin dying in mysterious ways, and he knows he must defeat Skank or die himself. This powerful, heartbreaking novel about the aftermath of war creates a vivid world populated by odd characters who struggle with being outcasts and victims. The young narrator mingles his quirky slang about the war with eloquent and often lyrical emotion.