A traveling businessman is snatched off of an Upper East Side street in broad daylight;or so it appears to the eight-year-old girl who is the crime's only witness. The perp leaves a token at the site of the kidnapping;a miniature noose. A crime scene this puzzling demands forensic expertise of the highest order. Lincoln Rhyme and Amelia Sachs are called in to investigate. Rhyme and Sachs' investigation takes an unexpected turn when a similar kidnapping occurs across the Atlantic in a small town outside of Naples, Italy. The killer's MO is bizarre and frightening. Obsessed with music, the man records the final breaths of his victims, then uses a keyboard sampler to compose an otherworldly tune that is then posted online. The search for the killer will become a complex case of international cooperation;yet not all is as it seems, and soon Sachs and Rhyme find themselves playing a dangerous game with shadowy parties from across the globe.