A terrifying new serial killer begins stalking the streets of Boston, using his vast medical knowledge to systematically torture and kill vulnerable women, a modus operandi which has earned him the nickname "the Surgeon".

The story opens up with the death of Elena Ortiz at the hands of the Surgeon, and Thomas Moore is sent to investigate.

Rizzoli and Moore note that both had no contact or connection whatsoever, and are perplexed by these two murders.

Meanwhile, the Surgeon begins targeting his third victim, Nina Peyton, and Cordell continues to save lives, starting with Herman Gwadowski.

The Surgeon received a RITA award Romance Writers of America in 2002 for Best Romantic Suspense Novel.