Kay Scarpetta has started a private practice in South Carolina.

She is called to Rome to consult in the murder investigation of teenage American tennis star Drew Martin.

When in Rome, Kay becomes engaged to her longtime lover Benton Wesley, an occurrence that has devastating consequences for Kay’s longtime friend and investigative partner, Pete Marino.

The timing is bad as the killer of Drew Martin, quickly known as the Sandman, spreads death and destruction from Italy to the American South.

"He was FBI right down to his Florsheim shoes, a sharp-featured man with prematurely silver hair suggesting a mellow disposition that wasn't there.