The year is 1889. In the morgue of a Philadelphia hospital, physicians uncover the corpse of a beautiful young woman. What they see takes their breath away. Within days, one doctor, Ephraim Carroll, strongly suspects that he knows the woman’s identity…and the horrifying events that led to her death.

Dr. Carroll came to Philadelphia to study with a leading professor, the brilliant William Osler, believing that he would gain the power to save countless lives. But Carroll and his mentor are at odds over what they glimpsed that morning in the hospital’s Dead House. And when a second mysterious death is determined to have been a ruthless murder, Carroll can feel the darkness gathering around him—and he ignites an investigation of his own. Soon he is moving between the realm of elite medicine, Philadelphia high society, and a teeming badlands of criminality and sexual depravity along the city’s fetid waterfront. With a wealthy, seductive woman clouding his vision, the controversial artist Thomas Eakins sowing scandal, and the secrets of the nation’s powerful surgeons unraveling around him, Carroll is forced to confront an agonizing moral choice—between exposing a killer, undoing a wrong, and, quite possibly, protecting the future of medicine itself.