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The cloistered grounds of the convent have traditionally represented a place of faith and peace. Now, that peace is shattered as two nuns are found, one dead, one mortally wounded. The killings appear to be without motive, without an obvious suspect, and are further complicated by the murder and mutilation of a third woman. Together, medical examiner Maura Isles and intense, moody homicide detective Jane Rizzoli, both introduced in earlier Tess Gerritsen novels, uncover an ancient horror that connects these terrible slaughters. As long-buried secrets come to light, Isles finds herself drawn inexorably towards the heart of an investigation that strikes closer to home—and towards a dawning revelation about the killer's identity too shattering to consider.

One

They called her the Queen of the Dead.

Though no one ever said it to her face, Dr. Maura Isles sometimes heard the nickname murmured in her wake as she traveled the grim triangle of her job between courtroom and death scene and morgue. Sometimes she would detect a note of dark sarcasm: Ha ha, there she goes, our Goth goddess, out to collect fresh subjects. Sometimes the whispers held a tremolo of disquiet, like the murmurs of the pious as an unholy stranger passes among them. It was the disquiet of those who could not understand why she chose to walk in Death's footsteps. Does she enjoy it, they wonder? Does the touch of cold flesh, the stench of decay, hold such allure for her that she has turned her back on the living? They think this cannot be normal, and they cast uneasy glances her way, noting details that only reinforce their beliefs that she is an odd duck. The ivory skin, the black hair with its blunt Cleopatra cut. The red slash of lipstick. Who else wears lipstick to a death scene? Most of all, it's her calmness that disturbs them, her coolly regal gaze as she surveys the horrors that they themselves can barely stomach. Unlike them, she does not avert her gaze. Instead she bends close and stares, touches. She sniffs.

And later, under bright lights in her autopsy lab, she cuts.

She was cutting now, her scalpel slicing through chilled skin, through subcutaneous fat that gleamed a greasy yellow. A man who liked his hamburgers and fries, she thought as she used pruning shears to cut through the ribs and lifted the triangular shield of breastbone the way one opens a cupboard door, to reveal its treasured contents.

The heart lay cradled in its spongey bed of lungs. For fifty-nine years, it had pumped blood through the body of Mr. Samuel Knight. It had grown with him, aged with him, transforming, as he had, from the lean muscle of youth to this well-larded flesh. All pumps eventually fail, and so had Mr. Knight's as he'd sat in his Boston hotel room with the TV turned on and a glass of whiskey from the minibar sitting beside him on the nightstand.

She did not pause to wonder what his final thoughts might have been, or whether he had felt pain or fear. Though she explored his most intimate recesses, though she flayed open his skin and held his heart in her hands, Mr. Samuel Knight remained a stranger to her, a silent and undemanding one, willingly offering up his secrets. The dead are patient. They do not complain, nor threaten, nor cajole.

The dead do not hurt you; only the living do.

She worked with serene efficiency, resecting the thoracic viscera, laying the freed heart on the cutting board. Outside, the first snow of December swirled, white flakes whispering against windows and slithering down alleys. But here in the lab, the only sounds were of running water and the hiss of the ventilator fan. Her assistant Yoshima moved in uncanny silence, anticipating her requests, materializing wherever she needed him. They had worked together only a year and a half, yet already they functioned like a single organism, linked by the telepathy of two logical minds. She did not need to ask him to redirect the lamp; it was already done, the light shining down on the dripping heart, a pair of scissors held out and waiting for her to take them.

The darkly mottled wall of the right ventricle, and the white apical scar, told her this heart's sad story. An old myocardial infarction, months or even years old, had already destroyed part of the left ventricular wall. Then, sometime in the last twenty-four hours, a fresh infarction had occurred. A thrombus had blocked off the right coronary artery, strangling the...

"[Gerritsen] has an imagination that allows her to conjure up depths of human behavior so dark and frightening that she makes Edgar Allan Poe and H. P. Lovecraft seem like goody-two-shoes."