Forensic investigator Lincoln Rhyme travels to the world-renowned spinal surgery center in North Carolina, hoping that a complex operation using a new technique will give him greater freedom of movement. He is aware that the outcome of the operation could be fatal for him.
But even before the operation, the local police department asks Rhyme and his assistant Amelia to use their forensic skills to find two women kidnapped by a mentally unstable teenager known in those parts as the Insect Boy. A cat-and-mouse game amid the desolate swamps of North Carolina leads to terrible consequences that no one could have foreseen.