The 'book of the dead' is the morgue log in which all cases are entered. For Kay Scarpetta, however, it is about to have a new meaning. Fresh from her battle with a psychopath in Florida, Scarpetta moves to South Carolina and opens a private forensic pathology practice. A string of brutal killings shatters her dreams of a quiet life.

Chief medical examiner Kay Scarpetta is the reluctant star witness in a sensational murder trial when she receives shocking news. The judge?s sister has been found dead. At first glance, it appears to be a home invasion, but then why was nothing stolen, and why is the garden strewn with dead plants and insects? Although there is no apparent cause of death, Scarpetta recognises telltale signs of the unthinkable, and she knows the worst is yet to come....

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.