So many events happen and new people are introduced in this book. Lady Callandra has decided to marry Dr Beck and the two of them are headed to Austria. Sir Oliver Rathbone has discovered his love of Margaret and has asked her to marry him. Monk has taken a case that involves the river and a different class of people. Monk also meets and forms a friendship the Scruff and the River Police. Hester faces grim facts when she discovers that one of the woman under her care died from the Black Death. The clinic must be guarded and no one can leave, and all stand the chance of contacting the dreaded disease. As usual, Perry does an excellent job in describing the setting and the characters. The reader can feel the panic and fear. Again, Perry drives home the fact that many will willingly donate money to help the "heathens" in Africa, but will ignore the "fallen" women suffering in London.