An investigation into the murder of a pregnant teenage girl is complicated by county prosecuting attorney Bell Elkins's separation from the daughter who is living with her ex, Sheriff Nick Fogelsong's strange behavior and a person from her past.

"Royce Dillard doesn't remember much about the day his parents--and one hundred and twenty-three other souls--died in the 1972 Buffalo Creek disaster. He was only two years old when he was ripped from his mother's arms. But now Dillard, who lives off the grid with only a passel of dogs for company, is fighting for his life one more time: he's on trial for murder. Prosecutor Bell Elkins faces her toughest challenge yet in this ... story of vengeance,...

"The first drug overdose comes just after midnight, when a young woman dies on the dirty floor of a gas station bathroom. To the people of the small town of Acker's Gap, West Virginia, it is just another tragedy. It is sad--but these days, depressingly familiar. But then there is another overdose. And another. And another. Prosecutor Bell Elkins soon realizes that her Appalachian hometown is facing its starkest challenge yet: a day of constant heroin...

Pulitzer Prize-winning author Keller welcomes readers back to West Virginia and a ragged chunk of what was once a high stone wall. This is all that remains of Wellwood, a psychiatric hospital for the poor that burned to the ground decades ago. And it is here that Bell Elkins--prosecutor turned private investigator--makes a grim discovery while searching for a missing teenager: a dead body, marred by a ghastly wound that can only mean murder.