The epistolary story is presented as the diary of disgraced surgeon Richard Pine, who, while attempting to smuggle a large amount of heroin on a cruise ship, finds himself marooned on a tiny island in the Pacific with very limited supplies and no food. A self-proclaimed "survivor" type, his diary entries documenting his day to day activities become more and more disjointed and raving, revealing his slow mental decay and eventual insanity caused by starvation, isolation, and drug use. Determined to hold out for rescue, he goes to horrifying lengths to survive.