Kay Scarpetta and her colleagues — Benton Wesley, Pete Marino, and her niece Lucy Farinelli — have a series of forensic cases as haunting as any they have ever tackled. Working with the National Forensic Institute in Florida, Scarpetta and Marino examine the X-rays of a man who has died from a shotgun blast to the chest. But the pellets embedded show a strange 'pinball' pattern and the two can't help but wonder if this points to suicide — or to murder. In an abandoned house in the rural South, a woman is held against her will. Her captor is unknown to her-and indeed unseen — but even in the dark, she knows that he is near. And on Cape Cod, Lucy awakens to a gray winter morning and the sure feeling that she has made a dreadful mistake.

Now freelancing from south Florida, Dr. Kay Scarpetta returns to Richmond, Virginia, the city that turned its back on her five years ago. Investigating the death of a young girl, she must follow the twisting leads and track the strange details to reveal the sad truth that may be more than even she can bear.