Undaunted by a mysterious disease killing workers, Teddy Roosevelt stakes his presidency on building the Panama Canal.

The day Teddy Roosevelt learned McKinley had died and he was now president of the United States, he made up his mind he would cut a canal through the Isthmus of Panama. No small task. The French had tried and failed with more than twenty thousand dead. Roosevelt wasn't alone in wanting to see a canal. The Wall Street financier, J. P. Morgan, wanted it too, and so did revolutionaries in Panama. Morgan wanted a shorter route for his ships and was willing to secretly finance the insurrection against Colombia, whose territory Panama was. Not everyone was wild about America in Panama. A radical young patriot with ancestral roots going back four hundred years would do anything to stop the Yankees, including murder. There was another more insidious obstacle, a mysterious disease killing workers.

The president sends Colonel Goethals to Panama to direct construction. Goethals thinks he knows how to avoid the terrible landsides that ruined the French. He also sends Major William Gorgas, the epidemiologist that rid Cuba of yellow fever during the Spanish American war. Gorgas requests the support of Captain Garrett Hay, the Secretary of State's nephew, who served in Cuba as a doctor. Gorgas also wants to send a civilian scientist, Hiram Walker, who is married to Emma, Garrett's former much younger lover, who deserted him years earlier without a word. They meet again aboard the Athena on their way to Panama. Neither is quite sure whether their love affair is over.