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A traveling businessman is snatched off of an Upper East Side street in broad daylight–or so it appears to the nine-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.