New York, 1896: Reporter John Moore is summoned to the East River by his friend, psychiatrist Laszlo Kreizler, a brilliant pioneer in the new and much-maligned study of society's "alienated" mentally ill. At the river, Moore and Kreizler view the horribly mutilated body of a young male prostitute from one of Manhattan's infamous brothels. Supervised by the police commissioner, the newsman and his "alienist" mentor embark on a revolutionary attempt to identify the killer by assembling his psychological profile. Their dangerous quest takes them into the tortured past and twisted mind of a murderer who has killed before...and will kill again.