A new administrator is hired to ease the transition when overcrowded and landlocked Perrine Memorial Hospital is bought out by a behemoth hospital system that covers much of the Pacific Northwest and promises to build a new hospital in Twin Falls. But Marcus Manning, a good ole boy with roots in Twin Falls, far from making anything easier, manages to earn the enmity of medical staff and employees alike as he ruthlessly goes about eliminating anyone who might oppose him in his quest to become not only CEO of Perrine Memorial, but CEO of the entire system. Unwisely, he starts his campaign with pathologist Toni Day, who blows the whistle on Marcus's twisted campaign of lies, blackmail and sexual abuse until the medical staff finally considers firing him, but is saved the trouble by someone with a more permanent solution ... of cyanide. Toni, as one of the prime suspects, is forced to solve the mystery of Marcus's murder to keep herself out of jail, and as she delves further into the private lives of those involved in Marcus's life, finds herself forced to kill in order to save her life and finally learn the truth.

It is the middle of the night when pathologist Toni Day receives a call from the coroner informing her that the notoriously sleazy local attorney, Jay Braithwaite Burke, has just been found dead in his Mercedes in the middle of a snowy interstate. Unfortunately, everyone at Perrine Memorial Hospital where Toni works knows Burke. Over the years, he managed to talk nearly the entire medical staff into investing into his hedge fund. After it was revealed they had all foolishly invested in a Ponzi scheme, the feds moved in and he disappeared. Now, two months later, Toni is about to perform his autopsy.

It is no secret around town that many might have wished the attorney dead, including Toni and her husband, Hal. As she delves into Burke's autopsy, Toni already knows they have few clues to go on; when she learns the man bled to death, she suspects it was a homicide. To complicate matters further, Burke's partner also dies in suspicious circumstances, and Burke's widow and children are left homeless by a series of house fires. With a brutal schedule and doubts about her husband's faithfulness, Toni's life is already complex enough.

But when a mysterious illness casts a bloody pall over the holiday season, Toni must rely on her pathological expertise to unmask a killer and rescue herself and everyone she loves from a bloody death.

Dr. Antoinette Day-a young, successful pathologist known to her friends and colleagues as Toni-has no idea what awaits her when Dr. Sally Shore arrives at Perrine Memorial Hospital in Twin Falls, Idaho, to fill in for a colleague recovering from a heart attack. Toni's life is about to become a living hell.

Dr. Shore is supposed to see patients, perform surgeries, and take turns covering the emergency room until the regular surgeon recovers from his quadruple bypass. But unfortunately, she uses her temporary opportunity to discredit Toni and tarnish her reputation with her medical colleagues. When the visiting surgeon is conveniently murdered-her lifeless body found in Toni's office-Toni is the obvious suspect. But Toni is not going down without a fight. Forced to solve the murder in order to save her future, Toni's life becomes even more complicated when her ex-boyfriend starts stalking her and threatening her husband.

In this riveting murder mystery, a stubborn pathologist must rely on more than just her microscope as she delves into a complicated murder mystery, soon discovering that it is not just her freedom at stake-but her life.