A major catastrophe occurs when the main character and his wife arrive in San Antonio which sets up the major theme for this second book. After getting back on his feet the main character is appointed the administrator of a mental health hospital two blocks from the famous River Walk. Prior to his taking the reins, an embedded female CIA agent is found in the hospital day room with a gigantic pair of scissors stuck in her chest. The CIA suspected an al-Qaeda cell was being formed in the neighborhood and arranged with the medical director of the hospital to place a "bogus" patient on the ward. Four patients and two nurses are deemed persons of interest by the investigating agencies. Several interesting love interests are developed and the many twists and turns that take place will leave the reader spellbound.