New York City medical examiners Dr. Laurie Montgomery and Dr. Jack Stapleton are back in Robin Cook's most heart-pounding tale yet. A twenty-eight-year-old skater fractures his leg, and within twenty-four hours of his surgery, he dies. A thirty-six-year-old mother has knee surgery to repair a torn ligament and twenty-four hours later; she's dead. Despite institutional resistance, M.E. Laurie Montgomery investigates and comes to suspect that the deaths are not only related - they're intentional, involving frightening ties to both developing genomic medicine and the economics of modern-day health care. The need for answers becomes more urgent when Laurie is pulled into the nightmare as a potential victim.