Ruso and Tilla's excitement at arriving in Rome with their new baby daughter is soon dulled by their discovery that the grand facades of polished marble mask an underworld of corrupt landlords and vermin-infested tenements. There are also far too many doctors--some skilled--but others positively dangerous.
Ruso thinks he has been offered a reputable medical practice only to find that his predecessor Doctor Kleitos has fled, leaving a dead man in a barrel on the doorstep and the warning, "Be careful who you trust." Distracted by the body and his efforts to help a friend win the hand of a rich young heiress, Ruso makes a grave mistake, causing him to question both his competence and his integrity.
With Ruso's reputation under threat, he and Tilla must protect their small family from Doctor Kleitos's debt collectors and find allies in their new home while they track down the vanished doctor and find out the truth about the heiress's dead father--Ruso's patient--and the unfortunate man in the barrel.
Downie's uneven seventh Gaius Ruso mystery (after 2014's Tabula Rasa) takes the former medical officer; his wife, Tilla; and their infant daughter, Mara, from second-century Britannia to Rome to start a new life. Things don't get off to a good start. Their accommodations are vermin-infested, and the doctor, Kleitos, who was to send Ruso some patients, isn't home when Ruso calls on him. Then Ruso gets a note from Kleitos, explaining that he is going to be out of town for a bit and inviting Ruso to take over both his house and practice. Hope turns to disappointment after Ruso learns that Kleitos has taken all his medical supplies with him. Meanwhile, a smelly barrel dumped in front of Kleitos's door turns out to contain the corpse of an unidentified man, which doesn't inspire confidence among prospective patients. Downie's trademark humor is in evidence, but her superior plotting skills aren't, in an entry that downplays the historical background.