Dr. Leo Mulcahy, a Vietnam War veteran, is preparing to retire from a busy medical practice in Boston and take a long-awaited trip to Vietnam with his wife, Claire, when he learns he has a chronic blood disorder. After he travels to his hometown, Egg Rock, to attend a bon voyage party thrown by his beloved cousin, Portia, Claire tells him that Portia has a bad feeling about their trip. Still, they leave on the long journey across the world without any idea that Portia's foreboding feeling is spot-on. When Claire suddenly dies in their Saigon hotel bed, Leo experiences the most dreadful day of his life. After boarding a plane to escort her body back to Boston, he must deal with more medical challenges. Haunted by his memories of the war and life with Claire, Leo decides to visit Egg Rock again, this time to contemplate moving back. Will his choice turn out the way he hoped, or will the past come roaring back in unexpected and terrifying ways? Almost Island is the story of a retired doctor whose quiet life is upended by forces too dreadful to imagine after he decides to visit Vietnam years after he served during the war.