The quaint and quiet village of Perry Hollow, Pennsylvania, has never had a murder. Until now.
On a frigid March morning, Police Chief Kat Campbell finds the body of George Winnick, a local farmer, in a homemade coffin on the side of the road. A gash on his neck has been sewn shut. So have his lips. The discovery thrusts Kat into a case that threatens her town, her family and her very life.
State Police investigator Nick Donnelly has spent the better part of a year tracking down the "Betsy Ross Killer" -- known for his skill with a needle and thread. When George Winnick seems to be the killer's fourth victim, Nick and his task force descend on Perry Hollow, determined not to let him strike again.
An obituary writer for the local newpaper, Henry Goll has spent the years since a disfiguring car accident living a life of quiet and solitude. That all changes the morning he realizes he was sent a death notice for George Winnick before he died. For reasons unknown, the killer has chosen him to play a game with life or death consequences.