Black Mountain, North Carolina - a sleepy little town where the local police deal with one homicide a year, if they are unlucky, and where people are still getting used to the idea of locking their doors at night. Hardly the place for a serial killer to be stalking, but that seems the most likely scenario when the corpse of eleven-year-old Emily Steiner is found, with a bullet wound to the head and several small sections of skin removed from her frail abused body. The execution of the crime bears disturbing similarities to the recent murder of young Eddie Heath in Virginia, and Dr. Kay Scarpetta, the Chief Medical Examiner on that case, is called in to bring her forensic skills to bear on this latest atrocity. Fighting the natural assumption that Emily's murderer is also the man who killed Eddie, Scarpetta's instinct for the unusual is rudely awakened when another body is found.