A young Scottish healer finds herself entangled in the dangerous political and personal intrigues of a Russian aristocratic household on the eve of revolution. Rose Gowrie arrives in St. Petersburg in 1912, expecting a simple position as a companion to the young Ariadne Denisov. However, her unique healing abilities draw her into the inner sanctum of the Denisov family, where she must navigate the secrets of an aged Princess and the fragile health of the Tsarevitch. As she ascends the Red Staircase, she encounters forces that threaten her safety and challenge her understanding of her own purpose within this volatile society.

This novel is recognized for its evocative portrayal of the Russian imperial setting and its successful integration of historical detail with personal narrative. The work earned the Romantic Novel of the Year Award from the Romantic Novelists' Association in 1981, highlighting its appeal to readers of period-specific romantic drama. The narrative structure relies on the tension between the protagonist's outsider status and the insular world of the Denisov household. The book is often cited for its ability to maintain a sense of foreboding as the historical backdrop of 1912 Russia looms over the characters' private lives.