“Every man before he diesshall see the Devil.” English Proverb, 1560

Frank and Bob Bletcher hike across a remote snow-covered mountaintop in the spectacular North Cascades region of Washington State. Their trip is cut short when Frank receives an important page from the FBI.

Frank travels to the Bureau’s Behavioral Sciences Unit. There, Agent Babich reviews the facts behind the disappearance of convicted serial killer Dr. Ephraim Fabricant, who escaped–or was removed–from a hospital room while recovering from the affects of anesthesia (Fabricant had donated a kidney to his dying sister). Years earlier, Fabricant had brutally murdered five nurses in Cedar Falls. Thanks to Frank’s profile, he was eventually convicted of his crimes. But Frank had argued against sending Fabricant to the gas chamber, as he felt it was more important for the FBI to study the inner workings of a serial killer’s mind. A judge agreed with Frank and Fabricant’s life was spared.

Peter Watts discovers that Fabricant had exchanged wedding vows with a female pen-pal he met during his prison stay. Watts and Frank interview the brunette woman, Lucy Butler, at her house in Virginia. Butler insists that neither she nor any of her friends has been in contact with Fabricant since his escape. She does reveal, however, that she and her husband plan on having a child. The men notice incoming e-mail on Lucy’s computer. Frank realizes the e-mail message (a quote from the Bible) pertains to his own street address. He immediately telephones Catherine, and is relieved to hear that both she and Jordan are safe. Frank asks his wife to search through the mail. Catherine discovers an envelope containing Polaroid photographs of an Asian judge. Frank realizes the man, Judge Park, has been murdered. Meanwhile, inside a featureless room, the mysterious Brunette Nurse who helped engineer Fabricant’s escape from the hospital (whose face we cannot see) removes the metal staples that bind Fabricant’s kidney incision.

Armed with a search warrant, Watts and Frank return to Lucy Butler’s home. Their research revealed that Lucy had been accused of killing her young son with strychnine (the same poison used to murder Judge Park). Lucy counters that she was found innocent of the charges. During the hunt for clues, a detective discovers that Lucy’s home was rented to a tenant named Robert Davies. He disappeared shortly after allowing Lucy to move in with him. Fabricant stumbles into an emergency room, his hospital gown drenched in blood.

Doctors realize that someone removed his second kidney-and did so without anesthesia. Frank realizes that someone placed his home phone number on Fabricant’s hospital bracelet. As a thunderstorm rages, Catherine discovers a human kidney inside the kitchen refrigerator. She then encounters a man with long brown hair, who bears a striking resemblance to Lucy, standing at the top of the stairs. A terrified Catherine searches for Frank’s gun. Suddenly, Bletcher steps out of the shadows. He tells Catherine that Giebelhouse is with Jordan outside, then phones Frank with the news that his family is unharmed. Catherine warns Bletcher that an unidentified man is still in the house. As Bletcher searches for the intruder, he discovers Lucy standing at the top of the stairs. A flash of lightning illuminates her face-but it has transformed into the visage of a beast. Shortly thereafter, Giebelhouse discovers Bletcher’s dead body hanging from a wall stud, his throat cut.

Fabricant tells Frank that the “base sum of all evil” removed his second kidney. He warns that the same unspeakable evil knows who Frank is. Later, Lucy Butler is arrested on a traffic violation. But without evidence, police are unable to detain her. Frank takes Jordan to the remote mountain top where he and Bletcher had gone hiking.