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 acquire 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 an ideal situation, until the new battles start–with local politicians, with entrenched interests, with someone whose covert attempts at sabotage are clearly meant to run her out of town. And that’s even before the murders and other violent deaths begin. A sixteen-year-old tennis star is found nude and mutilated near Piazza Navona in Rome. The body of an abused young boy is dumped in a desolate marsh. A woman is ritualistically murdered in her multimillion-dollar beach home. Meanwhile, in New England, problems with a prominent patient start to hint at interconnections among the deaths that are as hard to imagine as they are horrible.

Scarpetta has dealt with many brutal and unusual crimes before, but never a string of them as baffling, or as terrifying, as the ones facing 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.