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In the book The Last Days of Ptolemy Grey, an elderly man suffering from dementia is offered a drug that might clear his mind but speed up his demise. He begins to tell the story of how he came to be in this situation, and it becomes apparent that he’s not sure what’s real and what isn’t.
The story starts with Ptolemy Grey, a 91-year-old man who has dementia and is confused. He thinks his nephew, Hilly, is coming to visit him but it’s really Melinda Hogwarth, a drug addict who robs him. Later on the actual Hilly comes over to take him to the bank. While they are driving he gets pulled over by police for speeding but Ptolemy doesn’t understand why they stopped them because he thought they were going somewhere else.
Ptolemy learns that his son has been killed in a drive-by shooting. He is brought to the funeral by family members, where he sees his son laid out and realizes that he must find out who killed him and take revenge. Robyn Small, a seventeen-year-old girl taken in by Ptolemy’s niece, helps Ptolemy after Reggie’s death because she cares about him. She helps him manage day-to-day tasks such as cleaning, making meals, and taking care of other things like finances.
Dr. Bryant Ruben offers an experimental drug to Ptolemy that will clear his mind and fight off dementia, but it’s dangerous because he’ll only have a few weeks left to live. Robyn is upset about this offer.
The drug takes effect, and Ptolemy begins to remember his life. He starts out by remembering growing up in Mississippi. His best friend died when he was young, and Ptolemy stood outside the burning house while it happened. Later on, his uncle who raised him was lynched for helping slaves escape from their masters during the Civil War. In World War II, he went to Los Angeles where he worked as an ice delivery man before getting married twice and having a daughter named Robyn with one of them. During this time period, Coydog gave him gold that had been stolen from a white slave owner’s family; however, Coydog got killed because of this secret shortly after giving L’Pea the gold bricks.
Ptolemy meets with Nina and offers her the gold if she will tell him what happened. She indicates that Reggie’s friend, Alfred—whom she is now dating—arranged to have him killed. Ptolemy obtains a gun and meets with Alfred. He threatens Alfred and offers to give them the gold if they will tell him what really happened with Reggie.
Alfred is angry because Reggie wants to leave Los Angeles with Nina. He tries to convince him not to go, but when that doesn’t work, he has Reggie killed so he can have Nina all for himself. Ptolemy demands Alfred’s gold and then shoots both of them.
When Ptolemy returns home, he’s in worse shape than before. He has dementia and cannot remember anything that happened. Robyn and Dr. Ruben are waiting for him; they tell him that Alfred died but the police have been held off because of his age and infirmity. They also tell Ptolemy that he was right about the gold; his family is threatening to sue Robyn over it. Ptolemy goes into a hallucination where everything around him looks like it did when he was young, including himself as a young man talking with Alfred at their home in Greece on the day they received word of World War I breaking out.