Former South Carolina forensic pathologist Kay Scarpetta takes a case in New York in which a patient in a psychiatric prison asks to speak to her about wounds he claims were inflicted during a murder he did not commit, and after talking with the man, she starts to believe he is telling the truth and a serial killer is on the loose.

Determined to find out what happened to her former deputy chief, Jack Fielding, murdered six months earlier, Kay Scarpetta travels to the Georgia Prison for Women, where an inmate has information not only on Fielding, but also on a string of grisly killings. The murder of an Atlanta family years ago, a young woman on death row, and the inexplicable deaths of homeless people as far away as California seem unrelated. But Scarpetta discovers connections...