New York, 1896... Un meurtrier sème les cadavres d'adolescents atrocement mutilés sans provoquer la moindre réaction des pouvoirs publics... Révolté par tant d'indifférence, Theodore Roosevelt, alors préfet, fait appel à John Schuyler Moore, chroniqueur criminel, et Laszlo Kreizler, spécialiste des maladies mentales, pour élucider ces crimes atroces. En les étudiant, ils pensent pouvoir brosser le portrait psychologique de l'assassin et l'identifier.

Some things never change. New York City, 1896. Hypocrisy in high places is rife, police corruption commonplace, and a brutal killer is terrorising young male prostitutes. Unfortunately for Police Commissioner Theodore Roosevelt, the psychological profiling of murderers is a practice still in its infancy, struggling to make headway against the prejudices of those who prefer the mentally ill - and the 'alienists' who treat them - to be out of sight as well as out of mind. But as the body count rises, Roosevelt swallows his doubts and turns to the eminent alienist Dr Laszlo Kreizler to put a stop to the bloody murders - giving Kreizler a chance to take him further into the dark heart of criminality, and one step closer to death.