The novel starts by describing the lives of children at a school called Hailsham. It seems the school is more of an orphanage. The highlights in the children's lives are the art exchanges and the sales. At the art exchanges, the children can buy the art of other children, paintings or poetry, and the best works are chosen by Madam for her collection. It is a great privilege to have your work chosen by Madam. Every month a van comes with odds and ends and the children get to buy goods like clothes and toys for their own collection.
As the story unfolds, it becomes clear that these children are human clones, created solely for the purpose of providing real humans with body organs. They leave the school and go out into the world as carers or donors. Carers look after donors until it is their turn to become donors.
We follow Kathy, a 31-year-old carer, as she meets her ex-schoolmates from Hailsham who become the donors she cares for. The novel explores what it is like as a human clone, to know what your future will be. Kathy and her fellow clones search for their human pattern, the person they were cloned from. They daydream about leading a normal life, having an office job. Instead they are destined to four donations, where their organs are given away one by one until they finally complete. They are shunned by humans, who are naturally repulsed by them. Kathy and her friend pay a visit to Madam, and learn how their artwork was shown to the world, to prove that they have souls.
As we follow their seemingly mundane lives, we learn to feel for them and realise that like Kathy and her friends, it is our thoughts and emotions that make us truly human.