FBI profiler Sophie Anderson is struggling to move beyond a case that six months ago nearly cost her her life and even now threatens her sanity.

She is increasingly haunted by her ability to experience the minds of killers in the throes of heinous crimes; her talent is uncontrollable and unpredictable. But these intensely sickening flashes often serve as invaluable clues in tracking down criminals, and Sophie is compelled to suffer the horrors in her head in order to see justice done.

When Darren Carter, a Tucson police detective and friend, asks her to come to Arizona for a vacation, she's relieved to take a break. But that vacation abruptly ends when bodies start showing up on a university campus and she and Darren are pulled into the case. The horrifying methodology, the deliberate body positioning and the distinctive red heart scrawled on each victim indicate to Sophie that a new serial killer has laid claim to the area. However, Sophie is puzzled by the fact that certain signature elements are different in each killing. Even more confusing is the fact that the FBI database has a record of many of the signatures--but they have been used by different serial killers.

As the bodies continue to appear, Sophie must hone her terrifying skills to try to track down the killer--or killers.