Set in rural Virginia in 1948, Miss Ophelia is a novel that explores the issues of abortion, adultery, and skin color through the reminiscences of Isabel (Belly) Anderson in the autumn of her life.

A strong-willed and free-spirited eleven-year-old in the last summer of her childhood, Belly reluctantly leaves her home in rural Pharaoh and goes to Jamison to help her strict Aunt Rachel recover from surgery. Belly has two reasons for deciding to go to Jamison: She's lonely when her only friend becomes pregnant and is sent away, and she hopes that she'll be allowed to take piano lessons from her mother's childhood friend.

In Jamison, Belly blossoms into a young lady, confident of her ability to be away from her devoted mother. But Belly's friendship with Miss Ophelia teaches her more than how to play the piano. She learns a terrible secret about her beloved teacher - a secret that forces her to grow up and learn what it really means to be an adult.