The year is 1999. Returning to practice after a suspension for stealing opioids, a young Scottish doctor takes the only job he can find: a post as a senior house officer in the struggling east London hospital of St Luke's. Amid the maelstrom of sick patients, over-worked staff and underfunded wards a darker secret soon declares itself: too many patients are dying. Which of the medical professionals our protagonist has encountered is behind the murders? And can our unnamed narrator's version of the events be trusted?