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The title 'Middle of Nowhere' describes two of its main characters. Ruby, a nurse on the night shift, has put her life on hold to make four-hour round trips to Derek, her husband, who is serving an eight-year prison sentence. The title also describes Derek, who is not only in prison but lacking a moral compass. 'I just got caught up in things,' he tells Ruby, trying to apologize. He seems to think of himself as a passive victim.
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Ruby is played in a star-making performance by Emayatzy Corinealdi, previously best known for the TV soap 'The Young and the Restless.' We learn that Ruby was in med school when she married Derek, and we're given some glimpses of their happiness (as in a standard scene of them cooking together). When Derek is sentenced to prison (for reasons that are withheld at first and then never fully explained), she drops out of school to devote herself to his life and morale. This is a decision sharply criticized by her mother, Ruth (Lorraine Toussaint). Her mother is correct.