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In 1933 in the Shenandoah Valley, there isn't a place for Lum (brief for Columbia), a 33-year-old intersex woman. She travels by schedule in one branch of the family to another, assisting with food preparation, childcare, and housework. Always an outsider, even in her own family, Lum secretly gathers postcards of folks like the Dog-faced Lady, imagining their testimonies, and nurtures her lifelong friendship with Smiley, an African-American man who offers furniture, assorted items, and a little moonshine. She makes friends with another outsider, a Melungeon man from an isolated community high in the mountains, who is fresh out of prison. Moments from Lum's childhood and young adulthood are interspersed with chapters taking place in 1933, when Lum is 33 years of age. But Lum's world changes whenever a local banker becomes ill and needs health care. Sent to assist, she sorts an unlikely friendship with the curmudgeonly old man. At the same time, the federal government highway supervision comes scouting land, wanting to choose the family farm for a new scenic highway. Lum's family members don't want to market, and they're not by yourself. As tensions above the highway escalate toward assault, so when loyalties are analyzed, Lum takes a bold step to set-up an unbiased life.