As Dr. Obie Hardy, family physician and part-time medical examiner, travels down a rural Virginia road, he thinks he is about to investigate another routine death. But, as he pulls up next to a mobile home, he discovers there is nothing ordinary about the case at all. Mohammed and Anne Thacker are dead-the victims of a murder-suicide apparently fueled by drugs.

Dr. Hardy moves from one death scene to another, and he and county deputies uncover links between the victims, eventually exposing a web of corruption that leads Detective Bruce Duffer to target local cocaine dealer Skeeter Richards, who is quickly expanding his territory. Meanwhile, Dale Gregory, a local contractor, is struggling with his wife's adulterous, narcissistic lifestyle. On the verge of financial ruin, Dale has no idea that his wife is planning his murder. Even so, she seems surprised when his remains are identified in the ashes of a suspicious house fire.

As Duffer and Dr. Hardy are propelled into a dangerous investigation with an outcome no one anticipates, the pair must rely on their instincts and a string of puzzling clues as they attempt to capture a killer before he strikes again.