In the first section of this novel, we read of two tales of death. A young boy named Johnny Smith falls on the ice while skating, blacks out for a few moments, then comes true with a half-remembered prophecy of death. The prophecy comes true, but Johnny doesn't remember making it. Subsequently, a man named Greg Stillson, a Bible salesman, kicks a dog to death in a potential client's front yard. These two people will later meet, and the stakes will be higher, but these first chapters predict the extreme circumstances of these men.
John Smith later grows up to be a well-liked teacher, with a girlfriend named Sarah, a relationship which may be becoming more serious. One night, Johnny and Sarah visit a carnival, and Johnny has an amazing stroke of luck at the Wheel of Fortune, predicting numbers with excellent prescience. But he feels ill afterward, and instead of going home with Sarah instead takes a cab back to his house. He never makes it. The cab crashes, sending John Smith into a four-and-a-half-year coma.
The moral questions weigh heavily and give the novel terrific depth. Johnny is forced to choose between the life of one and the lives of millions. In theory the decision is easy, but in practice it is a terrifying choice. Drama on the human level becomes intertwined with Johnny's devastating worldview, the result of which is a strong, resounding novel about responsibility and morality.