The 'book of the dead' is the morgue log, the ledger in which all cases are entered by hand. For Kay Scarpetta, however, it is about to have a new meaning. Fresh from her bruising battle with a psychopath in Florida, Scarpetta decides it's time for a change of pace. Moving to the historic city of Charleston, South Carolina, she opens a unique private forensic pathology practice, one in which she and her colleagues offer expert crime scene investigation and autopsies to communities lacking local access to competent death investigation and modern technology. It seems like an ideal situation, until the the murders and other violent deaths begin. A young man from a prominent family jumps off a water tower. A woman is found ritualistically murdered in her multi-million-dollar beach home. The body of an abused young boy is found dumped in a desolate marsh. Scarpetta has dealt with many brutal and unusual crimes before, but never a string of them as baffling, or as terrifying, as the ones before her now. Before she is through, that book of the dead will contain many names - and the pen may be poised to write her own.