Dr. Kay Scarpetta returns to Richmond, Virginia from freelancing in South Florida at the request of the recently appointed Chief Medical Examiner to solve the murder of a 14 year old girl, but she finds that nothing is as she left it. Her former lab is being demolished; the chief isn't really the one who requested her; and a glamorous FBI agent meddles with the case.

Lawyer Penn Cage returns to defend his best friend since childhood for the murder of a young female student, with whom his friend was intimate, at their old alma mater, St. Stephen's Prep.

Retired Detective Inspector Frank Elder's solitary life is disrupted when his estranged wife calls to tell him their seventeen-year-old daughter, Katherine, is running wild after being unbalanced by the abduction and rape Frank feels he should have prevented.