At the beginning of the novel, Hannibal Lecter has been on the run from the authorities for seven years. After escaping from incarceration in the United States, he has adopted the name Dr. Fell and taken up residency in the Italian city of Florence, and, due to a series of cosmetic procedures, he now looks completely different. Essentially, Lecter has become someone else. The different faces of Lecter point to his ability to manipulate the world around him. Yet, as this novel illustrates, he cannot entirely leave his old self behind, even if he has briefly paused his murderous tendencies. His penchant for the finer things in life means that he drives certain cars, eats certain foods, and attends certain concerts. Furthermore, his obsession with Clarice Starling means that he acquires copies of tabloids such as the Tattler to follow her career with interest. The immutable tastes of Lecter speak to a fundamental psychological profile that he will not or cannot change, even if his physical appearance is surgically altered.

For the first time in the Hannibal Lecter series, Lecter’s past is explored, and the incident with his sister, Mischa, becomes a fundamental part of his character. Readers learn that the young Lecter witnessed his beloved sister be dragged away from the barn and become victim to a group of World War II deserters who cannibalize children to survive the brutal winter.