When leg-breaker Hutch Holtz rolls up to a rundown apartment complex in Portland, Oregon, to collect overdue drug money, a severed hand is the last thing he expects to find stashed in the client’s refrigerator. Hutch quickly realizes that the hand induces uncontrollable madness: Anyone in its proximity is overcome with a boundless compulsion for violence. Within hours, catastrophic forces are set into motion: Dark-op government agents who have been desperately hunting for the hand are on Hutch’s tail, more of the city’s residents fall under its brutal influence, and suddenly all of Portland stands at the precipice of disaster. . . .

But it’s all the same for Katherine Moriarty, a singer whose sudden fame and precipitous downfall were followed by the mysterious death of her estranged husband—suicide, allegedly. Her trauma has made her agoraphobic, shackled within the confines of her apartment. Her son, Nick, has moved home to care for her, quietly making his living working for Hutch’s boss.

When Hutch calls Nick in distress, looking for someone else to take the hand, Katherine and Nick are plunged into a global struggle that will decimate the walls of the carefully arranged life they’ve built. Mother and son must evade both crazed, bloodthirsty masses and deceitful government agents while exorcising family secrets that have risen from the dead—secrets, they soon discover, that might hold the very key to humanity’s survival.