The death of Maria Cross over ten years ago by this book has always haunted Alex since. He goes back in this novel to when Maria was shot and died right there in his arms before he got to the hospital to save her. And she was carrying a baby at the time.
The "Butcher," known as John Sullivan in this book is the killer of all killers and a serial rapist on top of everything else. He wants to seek revenge on everyone around him, for the abusive past he had with his father who was a hateful man. Sullivan had actually killed him too before many others in this story. As he commits his heinous acts, he makes all of his victims promise not to tell, or he'll come back and kill them later, chopping them to pieces with a scalpel. After he does his killings, he turns around, takes a bow, and runs, never getting caught. This is what the man did who shot Maria ten years before-and Alex knows he is the one.
Capturing Sullivan will not be easy, and Alex who has been in retirement from the police force, and back into his psychology practice, decides along with his friend Sampson to try and take the monster down. That is a dangerous task, and in the process, this killer may murder them both if they don't watch their backs very carefully.