Forensic pathologist Kay Scarpetta has returned to Virginia as the chief medical examiner.
Finding herself the new girl in town once again after being away for many years, she's inherited
an overbearing secretary and a legacy of neglect and possible corruption.

She and her husband Benton Wesley, now a forensic psychologist with the U.S. Secret Service,
have relocated to Old Town Alexandria where she's headquartered five miles from the Pentagon
in a post-pandemic world that's been torn by civil and political unrest. Just weeks on the job,
she's called to a scene by railroad tracks where a woman's body has been shockingly displayed,
her throat cut down to the spine, and as Scarpetta begins to follow the trail, it leads unnervingly
close to her own historic neighborhood.

At the same time a catastrophe occurs on a top secret private laboratory in outer space, and at
least two scientists aboard are found dead. Appointed to the highly classified Doomsday
Commission that specializes in sensitive national security cases, Scarpetta is summoned to the
White House Situation Room to work the case remotely, dispatching astronauts from the
International Space Station to deal with the scene and the bodies. She works the first crime
scene in space as an apparent serial killer strikes again, this time even closer to home. Almost
literally in her own back yard.