Young Billy lives with his father and stepmother and younger half-brother Ned. Billy is a loner, and different from other children. He thinks a lot, and has a greater imagination. He also has a streak of meanness, and when he is given a magical stick, with a dead bird tied to it, he finds that he can make things happen. Occasionally, Billy will make something good happen, but most of the time his desires, in the form of poems, are mischievous to downright cruel. After crippling his brother, causing his Grandma's hair to fall out, and stopping his step-mother from drinking by making her vomit every time she tastes alcohol. Billy's odd obsession with bizarre games in his mind, starting with bowling pin armies and ending with his visions over the stick, fuel his imagination and need to keep using his "powers". He gifts members of his family with good health, but his father dies in an accident. Staying with his stepmother, he becomes a Doctor and has an affair with his step-sister, and decides that as a medical professional he can use his "magic". But, will he use it for the good of mankind, or will his tendency towards cruelty lead him down a more sinister path? Only the "confusion" at the end of the story stops this from being a 5 star book, it just seemed a little like Mr. Disch didn't quite know how to finish it.
This is a great book, jumping large time frames at times, and long on prose occasionally, but still manages to be a quick read for medical thriller lovers.