From outward appearances, it seems like the Leo and Margot Lockhart family of Little Falls, New York, is a well-functioning and harmonious family unit. Yet upon closer inspection, each heart in the home harbors its secret of hurt, distrust, and disillusionment. Katherine Lockhart's innocence and sensitivity as a child are ruled by the iron hand of her Irish mother, Margot. Fear of physical retribution controls Katherine's defiance during her teen years, but her intellect resents and mentally argues with the humiliation and responsibilities heaped upon her as the eldest daughter of six siblings. Training for the nursing profession is Katherine's salvation, and it is her ticket out of Little Falls, away from her controlling mother and alcoholic father.
When the moment of truth presents itself, Margot fears exposure as a negligent wife and mother which resulted in Katherine's childhood and future years being forever compromised and emotionally altered. Little Falls follows Katherine through the darkest tunnels in life as she rises above the rape, incest, bouts of depression, and physical and emotional abuse to experience the love and joy of family as a respected matriarch in her final years.