When Caroline Rhodes agrees to return to Ascension Medical Center for the summer, she has no idea she'll be walking into an Emergency Room marked for murder. But two days after her arrival, a female employee is found dead, smothered with a lavender silk pillow. Caroline's persistent questions concerning the murder earn her a warning from ER doc Chan Daley. As me sainted mother used to say, quips the doctor, man who stands beneath tail of elephant must prepare for much dung to drop on head. But Caroline is willing to risk the fallout when a second death results in the arrest of the ER's nurse manager. Determined to clear her best friend of a charge of murder, Caroline forms a strange three-way pact with an aging Mafia boss and the administrator of Ascension Medical Center. As if murder isn't enough, Caroline must investigate charges of sexual harassment against a doctor while also coping with a heat wave that sends residents of suburban Niles, Illinois flocking to the hospital for relief. The last thing Caroline and the ER needs is the arrival of an irate cab driver with a dead passenger, a litter of hungry puppies, and a plastic shopping bag full of dead fish. Add to that a medical resident who can't stay on his feet and you're looking at the kind of problems that send most people scurrying for cover. But not Caroline Rhodes. Aided by her friends from the little town of Rhineburg, Illinois, the veteran ER nurse proves once again that attention to detail is the key to solving any crime.