Not since Jack the Ripper terrorised London has there been such a gruesome crime scene. By all accounts acid-tongued Vita Berlin had not a friend in the world, but who did she cross so badly to end up arranged in such a grotesque tableau? One look at her apartment turned charnel house is enough for hard-bitten LAPD detective Milo Sturgis to summon The Crime Reader. But even Alex Delaware's finely honed skills may be stymied when more slayings occur in the same ghastly fashion yet with no apparent connection between the victims. And the only clue left behind--a blank page bearing a question mark. Milo is under pressure to end the bloody spree and prevent a citywide panic when he discovers a link between the victims. Meanwhile, Alex navigates the secretive world of mental health treatment, from the sleek office of a Beverly Hills therapist to a shuttered mental institution where he once honed his craft; and where an unholy alliance between the mad and the monstrous may have been sealed in blood. As each jagged piece of the puzzle fits into place, an ever more horrific portrait emerges of a sinister mind at its most unimaginable - and an evil soul at its most unspeakable. 'This one was different,' Alex observes at the start. This one will haunt The Crime Reader's waking life, and his darkest dreams, long after its end.