On the surface, the Steen Psychiatric Clinic has always been one of the most eminent institutions in London. But when its administrative head is found with a chisel in her heart, and a weird wooden phallic symbol in her arms, the terrifying truth begins to emerge.

In the midst of an explosive mixture of psychiatry, sex, and drugs, the unenviable task of analyzing the clues falls to Superintendent Adam Dalgliesh - clues that lead him to a diabolically cunning killer bent on proving that the first slaying was no Freudian slip.