Dr Kay Scarpetta, Chief Medical Examiner and consulting forensic pathologist for the federal law enforcement agency ATF, is called out to a farmhouse in Virginia which has been destroyed by fire. In the ruins of the house she finds a body which tells a story of violent and grisly murder. The fire has come at the same time as another, even more incendiary horror Carrie Grethen, a killer who nearly destroyed the lives of Scarpetta and those closest to her, has escaped from a forensic psychiatric hospital. Her whereabouts is unknown, but her ultimate destination is not, for Carrie has begun to communicate.

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