After thirty years of attending to the phsical and mental health of the inhabitants of Knife Island, a tiny community in the Micronesian archipelago, Dr William Moreland feels it would be of benefit to his successor, and to his colleagues throughout the Pacific, if his records were properly analysed. Only too grateful to escape the violent atmosphere of Los Angeles and recoup their emotional resources, Dr Alex Delaware and his partner Robin accept Moreland's invitation to spend a sabbatical on the island to help him in the task. But Knife Island is not the paradise of the travel brochures. The murder of a young woman has created an atmosphere of division and fear. A potential development threatens a large part of the island with environmental pollution. And Dr Moreland is not universally regarded as the saintly healer of his own mythology. Co-habiting with cockroaches the size of dinner plates and spiders more venomous than rattlesnakes, Alex and Robin discover the doctor is concealing an older and darker mystery, a conspiracy of such startling magnitude that even Alex, with his knowledge of the depths of human depravity, is hard put to comprehend, or understand why he has been invited into such a horrific web of intrigue and abasement.