B.J. Johnson is back home in Tennessee, but when the challenges of raising a son alone and never having quite enough money mix with the fear of hearing voices in her head from a past she can't remember, it all becomes too much.

After the hospital in the spring, the constant voice of an intruder in her brain screaming "help me..." is slowly swallowing B.J. into a helpless life of growing terror.

On Painter's Island, a remote landfall in the Mississippi River, the past and the present begin to collide in a brutal mix of madness, unspeakable desires, and sinister nightmares of evil as B.J. stops at nothing to find out the truth.