It's June in Montreal, and Dr. Temperance Brennan, who has left a shaky marriage back home in North Carolina to take on the challenging assignment of Director of Forensic Anthropology for the province of Quebec, looks forward to a relaxing weekend in beautiful Quebec City. First, though, she must stop at a newly uncovered burial site in the heart of the city. The remains are probably old and only of archeological interest, but Tempe must make sure they're not a case for the police. One look at the decomposed and decapitated corpse, stored neatly in plastic bags, tells her she'll spend the weekend in the crime lab.

Terror stalks the streets of Bayou Breaux, Louisiana. A suspected murderer is free on a technicality, and the cop accused of planting evidence against him is ordered off the case. But Detective Nick Fourcade refuses to walk away. He’s stepped over the line before. This case threatens to push him over the edge. He’s not the only one. Deputy Annie Broussard found the woman’s mutilated body. She still hears the phantom echoes of dying screams. She wants justice.

Eve Dallas is a New York police lieutenant hunting for a ruthless killer. In over ten years on the force, she’s seen it all - and knows her survival depends on her instincts. And she’s going against every warning telling her not to get involved with Roarke, an Irish billionaire - and a suspect in Eve’s murder investigation.

He slips into their homes at night and walks silently into bedrooms where women lie sleeping, unaware of the horrors they soon will endure. The precision of the killer's methods suggests he is a deranged man of medicine, propelling the Boston newspapers and the frightened public to name him "The Surgeon". The cops' only clue rests with another surgeon, the victim of a nearly identical crime. Two years ago, Dr. Catherine Cordell fought back and killed her attacker before he could complete his assault.

Forensic pathologist Dr. Kay Scarpetta has come almost full circle, returning to Virginia, the state where she launched her storied career, as the chief medical examiner. Finding herself the new girl in town once again after being away for many years, she’s inherited both an overbearing secretary and a legacy of neglect and potential corruption.