A frigid wind gusted in from the East River, snatching at Dr. Kay Scarpetta’s coat as she walked quickly along 30th Street.

It was one week before Christmas without a hint of the holidays in what she thought of as Manhattan ’s Tragic Triangle, three vertices connected by wretchedness and death. Behind her was Memorial Park, a voluminous white tent housing the vacuum-packed human remains still unidentified or unclaimed from Ground Zero. Ahead on the left was the Gothic redbrick former Bellevue Psychiatric Hospital, now a shelter for the homeless. Across from that was the loading dock and bay for the Office of the Chief Medical Examiner, where a gray steel garage door was open. A truck was backing up, more pallets of plywood being unloaded. It had been a noisy day at the morgue, a constant hammering in corridors that carried sound like an amphitheater. The mortuary techs were busy assembling plain pine coffins, adult-size, infant-size, hardly able to keep up with the growing demand for city burials at Potter’s Field. Economy-related. Everything was.

Scarpetta already regretted the cheeseburger and fries in the cardboard box she carried. How long had they been in the warming cabinet on the serving line of the NYU Medical School cafeteria? It was late for lunch, almost three p.m., and she was pretty sure she knew the answer about the palatability of the food, but there was no time to place an order or bother with the salad bar, to eat healthy or even eat something she might actually enjoy. So far there had been fifteen cases today, suicides, accidents, homicides, and indigents who died unattended by a physician or, even sadder, alone.

She had been at work by six a.m. to get an early start, completing her first two autopsies by nine, saving the worst for last-a young woman with injuries and artifacts that were time-consuming and confounding. Scarpetta had spent more than five hours on Toni Darien, making meticulously detailed diagrams and notes, taking dozens of photographs, fixing the whole brain in a bucket of formalin for further studies, collecting and preserving more than the usual tubes of fluids and sections of organs and tissue, holding on to and documenting everything she possibly could in a case that was odd not because it was unusual but because it was a contradiction.

The twenty-six-year-old woman’s manner and cause of death were depressingly mundane and hadn’t required a lengthy postmortem examination to answer the most rudimentary questions. She was a homicide from blunt-force trauma, a single blow to the back of her head by an object that possibly had a multicolored painted surface. What didn’t make sense was everything else. When her body was discovered at the edge of Central Park, some thirty feet off East 110th Street shortly before dawn, it was assumed she had been jogging last night in the rain when she was sexually assaulted and murdered. Her running pants and panties were around her ankles, her fleece and sports bra pushed above her breasts. A Polartec scarf was tied in a double knot tightly around her neck, and at first glance it was assumed by the police and the OCME’s medicolegal investigators who responded to the scene that she was strangled with an article of her own clothing.

She wasn’t. When Scarpetta examined the body in the morgue, she found nothing to indicate the scarf had caused the death or even contributed to it, no sign of asphyxia, no vital reaction such as redness or bruising, only a dry abrasion on the neck, as if the scarf had been tied around it postmortem. Certainly it was possible the killer struck her in the head and at some point later strangled her, perhaps not realizing she was already dead. But if so, how much time did he spend with her? Based on the contusion, swelling, and hemorrhage to the cerebral cortex of her brain, she had survived for a while, possibly hours. Yet there was very little blood at the scene. It wasn’t until the body was turned over that the injury to the back of her head was even noticed, a one-and-a-half-inch laceration with significant swelling but only a slight weeping of fluid from the wound, the lack of blood blamed on the rain.

Scarpetta seriously doubted it. The scalp laceration would have bled heavily, and it was unlikely a rainstorm that was intermittent and at best moderate would have washed most of the blood out of Toni’s long, thick hair. Did her assailant fracture her skull, then spend a long interval with her outside on a rainy winter’s night before tying a scarf tightly around her neck to make sure she didn’t live to tell the tale? Or was the ligature part of a sexually violent ritual? Why were livor and rigor mortis arguing loudly with what the crime scene seemed to say? It appeared she had died in the park late last night, and it appeared she had been dead for as long as thirty-six hours. Scarpetta was baffled by the case. Maybe she was overthinking it. Maybe she wasn’t thinking clearly, for that matter, because she was harried and her blood sugar was low, having eaten nothing all day, only coffee, lots of it.

She was about to be late for the three p.m. staff meeting and needed to be home by six to go to the gym and have dinner with her husband, Benton Wesley, before rushing over to CNN, the last thing she felt like doing. She should never have agreed to appear on The Crispin Report. Why for God’s sake had she agreed to go on the air with Carley Crispin and talk about postmortem changes in head hair and the importance of microscopy and other disciplines of forensic science, which were misunderstood because of the very thing Scarpetta had gotten herself involved in-the entertainment industry? She carried her boxed lunch through the loading dock, piled with cartons and crates of office and morgue supplies, and metal carts and trollies and plywood. The security guard was busy on the phone behind Plexiglas and barely gave her a glance as she went past.

At the top of a ramp she used the swipe card she wore on a lanyard to open a heavy metal door and entered a catacomb of white subway tile with teal-green accents and rails that seemed to lead everywhere and nowhere. When she first began working here as a part-time ME, she got lost quite a lot, ending up at the anthropology lab instead of the neuropath lab or the cardiopath lab or the men’s locker room instead of the women’s, or the decomp room instead of the main autopsy room, or the wrong walk-in refrigerator or stairwell or even on the wrong floor when she boarded the old steel freight elevator.

Soon enough she caught on to the logic of the layout, to its sensible circular flow, beginning with the bay. Like the loading dock, it was behind a massive garage door. When a body was delivered by the medical examiner transport team, the stretcher was unloaded in the bay and passed beneath a radiation detector over the door. If no alarm was triggered indicating the presence of a radioactive material, such as radiopharmaceuticals used in the treatment of some cancers, the next stop was the floor scale, where the body was weighed and measured. Where it went after that depended on its condition. If it was in bad shape or considered potentially hazardous to the living, it went inside the walk-in decomp refrigerator next to the decomp room, where the autopsy would be performed in isolation with special ventilation and other protections.