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.