It is the week before Christmas. The effects of the credit crunch have prompted Dr Kay Scarpetta to offer her services pro bono to New York City's Office of the Chief Medical Examiner. But in no time at all, her increased visibility seems to precipitate a string of dramatic and unsettling events. She is asked live on the air about the sensational case of Hannah Starr, who has vanished and is presumed dead. Moments later during the same broadcast, she receives a startling call-in from a former psychiatric patient of Benton Wesley's.

When she returns after the show to the apartment where she and Benton live, she finds a suspicious package - possibly a bomb - waiting for her at the front desk. Soon the apparent threat on Scarpetta's life finds her embroiled in a deadly plot that includes a famous actor accused of an unthinkable sex crime and the disappearance of a beautiful millionairess with whom Scarpetta's niece Lucy seems to have shared a secret past....