For Dr. Abby DiMatteo, the long road to Boston’s Bayside Hospital has been anything but easy. Now, immersed in the grinding fatigue of her second year as a surgical resident, she’s elated when the hospital’s elite cardiac transplant team taps her as a potential recruit.

But Abby soon makes an anguished, crucial decision that jeopardizes her entire career. A car crash victim’s healthy heart is ready to be harvested; it is immediately cross-matched to a wealthy private patient, Nina Voss. Abby hatches a bold plan to make sure that the transplant goes instead to a dying seventeen-year-old boy who is also a perfect match.

The repercussions are powerful and swift and Abby is shaken but unrepentant—until she meets the frail, tormented Nina. Then a new heart for Nina Voss suddenly appears, her transplant is completed, and Abby makes a terrible discovery: Nina’s heart has not come through the proper channels.

Defying Bayside Hospital’s demands for silence, Abby plunges into an investigation that reveals an intricate, and murderous, chain of deceptions. Every move Abby makes spawns a vicious backlash and, in a ship anchored in the stagnant waters of Boston Harbor, a final, grisly discovery lies waiting…