"Half of the bodies brought to my morgue are that of children, dead from starvation, exposure or wounds inflicted on them in life." - Dr. Peter Ainsley

London 1868 – The newspapers call him The Surgeon, a killer targeting pauper children in Limehouse district leaving their bodies discarded in death as they were in life. Discouraged by the lack of physical clues Dr. Peter Ainsley joins Scotland Yard's Inspector Simms as he scours the city to learn where the children came from and how they fell into the clutches of one of London's worst criminal minds.

When clues emerge connecting the children to a foundling school, the matron's son, Elliot Holliwell falls under suspicion but without enough evidence Simms and Ainsley are forced to monitor him from a distance.

Frustration mounting, Ainsley throws himself into his work apprenticing an orphaned boy in the trade of morgue porter but when the adolescent fails to report to work one day Ainsley can no longer hold back and decides to approach his number one suspect with or without Scotland Yard's blessing. Nothing during his medical training could have prepared him for what he finds and when Ainsley finally catches up with the child killer neither of them will ever be the same.