The setting of What Dreams May Come begins in 1976 with the delivery of a manuscript written by a psychic from the East Coast and this is why the book is delivered to Robert Nielsen rather than the children of Chris Nielsen. The manuscript details all the events of Chris Nielsen's death and his afterlife. The setting of his death is in a hospital where there are images of pain and confusion, sounds and sights that cannot make sense, much as would be expected in an emergency situation in the hospital. When Chris dies he is able to leave his body and wander about on earth, invisible to everyone but Albert, who is assigned to be Chris's guide.