Forensic pathologist Kay Scarpetta has returned to Virginia as the chief medical examiner. She and her husband Benton are headquartered five miles from the Pentagon, in a post-pandemic world that's been torn apart by civil and political unrest.
Just weeks into the job, Scarpetta is called to investigate a woman's body which has been shockingly displayed on railroad tracks. As Scarpetta follows the trail, it leads unnervingly close to her own neighbourhood... At the same time, two scientists are found dead in a top-secret laboratory in outer space.
Scarpetta is summoned to the White House Situation Room and tasked with finding out what happened. But even as she's working the first crime scene in space from the ground, an apparent serial killer strikes again. And this time, Scarpetta could be in greater danger than ever before...