A traveling businessman is snatched off of an Upper East Side street in broad daylight–or so it appears to the eight year old girl who is the crime’s only witness. The perp leaves a token at the site of the kidnapping–a miniature noose. A crime scene this puzzling demands forensic expertise of the highest order. Lincoln Rhyme and Amelia Sachs are called in to investigate.

Rhyme and Sachs’ investigation takes an unexpected turn when a similar kidnapping occurs across the Atlantic in a small town outside of Naples, Italy. The killer’s M.O. is bizarre and frightening. Obsessed with music, the man records the final breaths of his victims, then uses a keyboard sampler to compose an otherworldly tune that is then posted online. The search for the killer will become a complex case of international cooperation–yet not all is as it seems, and soon Sachs and Rhyme find themselves playing a dangerous game with shadowy parties from across the globe.