Set in 1919, the book's first three movements consist of the erotic fantasies and case history of an imagined female patient of Sigmund Freud, Frau Anna G, a semi-successful opera singer referred to him for analysis and treatment of chronic psychosomatic pains in her left breast and ovary. Freud attempts to identify some incident in her past that would explain these pains, and elicits from her a long erotic narrative -- called "Don Giovanni", because she had written it on this musical score -- in verse and then prose. Freud draws inferences from the incidents described and discusses these with his patient, with Anna notably deducing that her father may have been unfaithful to her mother with her twin sister (Anna G's aunt). Anna is an unreliable narrator, changing key details in the account of her life she offers Freud. Only late in the treatment does she reveal that she considers herself to have second sight. Freud does not consider the possibility that either her erotic journal or her pains might arise from an incident in not her past, but her future. Following inconclusive treatment, Frau Anna G -- revealed to be Elisabeth (Lisa) Erdman of Vienna -- pursues a moderately successful musical career and marries a Russian Jewish opera singer, with whom she moves to Kiev in the 1920s. When he disappears in a Communist purge, she falls upon hard times and the third movement is set in 1941, when German troops capture Kiev. Lisa and her young son are ordered, along with the city's Jews, to Babi Yar.