The novel is set in Kyiv as Ukraine reeled from the aftermath of WW1, the collapse of the Russian Empire and communist occupation. Like his previous novel The Girl from the Teddy Bear Dr Seraphicus is well ahead of its time with the first gay relationship in Soviet literature and its exploration of sexuality. Dr Seraphicus had to wait over twenty years to be published abroad.

The novel's hero, Dr. Seraphicus is a strange man. He is physically imposing but shows no interest in other people and lives alone in a single room in an appartment house and immerses himself to the exclusion of all else in his academic work at the university.It was not always that way and as a student he lived with Korvyn and they were known by their fellow students as husband and wife. Now he seems to have no interest in sex with either sex and shuns attempts by women to get to know him. He meets a six year old girl in the park who captivates him and announces that he wants a child but without the involvement of a woman despite the impossibility of this being able to happen.
Korvyn, Dr Seraphicus' only friend meets and falls in love with the literary translator and femme fatale Ver. When Ver meets his friend, the reclusive and odd Dr Seraphicus she sets out to seduce him. Despite his best efforts to resist Ver Dr Seraphicus is totally smitten and falls head over heels in love with her. Whether this love is platonic or sexual is not made clear.
The name Dr Seraphicus is taken from a Balzac character Seraphita who is a hermaphrodite. This might give some indication of Dr Seraphicus' sexuality.