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.

Called in to examine what is left of a body struck by lightning, Tempe traces an unusual tattoo to its source and is soon embroiled in a much larger case. Young men—tourists—have been disappearing on the islands of Turks and Caicos for years. Seven years ago, the first victim was found in a strange location with both hands cut off; the other visitors vanished without a trace. But, recently, tantalizing leads have emerged and only Tempe can unravel them.

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. 

Four young women have been found murdered—tortured and strangled in their own beds—all victims of the same brilliant monster. Using a skilled hand and the latest technology in forensic medicine, Kay Scarpetta begins the process of gathering the microscopic clues the latest battered body has to give.

From Atlanta's wealthiest suburbs to its stark inner-city housing projects, a killer has crossed the boundaries of wealth and race. And the people who are chasing him must cross those boundaries, too. Among them is Michael Ormewood, a veteran detective whose marriage is hanging by a thread and whose arrogance and explosive temper are threatening his career. And Angie Polaski, a beautiful vice cop who was once Michael's lover before she became his enemy.