My name is Ruby. I live with Barbara and Mick. They're not my real parents, but they tell me what to do and what to say. I'm supposed to say that my bruises and black eye came from falling down the stairs. But there are things I won't say. I won't tell them I'm going to hunt for my real parents. I'm going to be with my real family. And I'm not going to let Mick stop me.'
In Richmond, Virginia, young lovers are dying. So far, four couples in the area have disappeared, only to be found months later as mutilated corpses. When the daughter of the president's newest drug czar vanishes along with her boyfriend, Dr Kay Scarpetta knows time is short. Following a macabre trail of evidence that ties the present homicides to a grisly crime in the past, Kay must draw upon her own personal resources...