When patients of surgeon Jack Lansing are murdered one by one, his town in the Pocono Mountains of Pennsylvania is gripped in terror. And when it appears that he and his wife are the ultimate targets of the killer, Jack must face the fact that events in his past, for which he was unwittingly responsible, are the cause of the rampage.

At first oblivious to the gathering storm, Jack finally wakes up to the danger confronting him. He decides that he, alone, must undertake the mission to eradicate the evil threatening not only his life, but the lives of those he loves.

Two other strong-willed men - one, a psychopathic killer who blames Jack for frustrating his dreams of professional success; the other obsessed with a woman he can't have - are out to destroy Jack and his family. Unknown to each other before they begin their plans of retribution, they meet under unusual circumstances and interact in a way that keeps Jack, the police and the reader guessing until the very end.