Jack Patterson returns to Little Rock at the request of his boyhood friend Sam Pagano, but when Jack arrives, he's abducted and taken to a remote swamp where he's beaten and lynched by men set on revenge. Clovis Jones, his friend and bodyguard, finds Jack near death and gets him to a hospital.
As Jack recovers, he learns Sam's college sweetheart, Jana Hall, is now a doctor who established and ran Arkansas's health clinics for the poor, including one in Little Rock's East End. Jana's efforts stepped on the toes of some powerful people, including someone who wants her clinics shut down, her medical practice ended, and for her to spend the rest of her life in jail. Meanwhile, someone has killed the men who tried to lynch Jack, and Jack is the prime suspect in the murders.
To make matters worse, Jack must defend Jana without the aid of his trusted assistant, Maggie, and his usual co-counsel, Micki Lawrence. Jack faces an unethical special prosecutor, a judge on the take, and the shadowy power broker bent on destroying Dr. Hall and her health clinics. Why Jana has become such a target, no one seems to know. Every time Jack thinks he has caught a break or sees a way to exonerate Dr. Hall, his adversaries or his client put a new obstacle in his path, including a second killer bent on settling an old score.
Jack's courtroom tactics fail, his client wants to plead guilty to protect her patients, and in a last-ditch effort to overcome the long odds against his client he resorts to a complicated and dangerous strategy. The strategy will either save Jana's life and reputation, or get Jack disbarred, his client put away for life, or worse—get Jack killed.