Madeline Westfield, a nurse at Manhattan Memorial, is in danger. Someone tried to run her over with a car. Battered and bruised, she’s afraid that if she goes to the police, they won’t believe her. Reluctantly, she heads to the only place she can turn to: the office of Forensic Instincts (FI), a top-notch PI firm with a stellar reputation. They employ Marc Devereaux, a former Navy SEAL and Madeline’s ex-lover. She is still in love with him and doesn’t want to open up old wounds, but with her life at stake, she has no choice.

Casey Woods, FI’s owner and founder, takes Madeline on as a client, promising to use all of their resources to find her would-be killer. She is hesitant about allowing Marc to work the case, even though he is the best of the best when it comes to his job. He insists he can keep his objectivity while trying to protect Madeline and track down the culprit.

"I had not read any of the previous titles, but I got a pretty good feel for the characters and their relation to each other as Kane does a fine job of filling in the back story."

Madeline isn’t the only one at Manhattan Memorial with a problem. Conrad Westfield, her ex-husband and a surgeon at the hospital, has taken time off work to check into Crest Haven, a private health care facility. He is suffering from anxiety-related issues after his patient, Ronald Lexington, who was also his dearest friend and the former hospital administrator, dies on the operating table while he is the attending surgeon. Then someone tries to kill Conrad while he is at Crest Haven. They want the attempted murder to look like an attempted suicide.

Manhattan Memorial is having financial problems and is trying to merge with another hospital, but not everyone is in favor of the big change. This causes friction among the staff. And, to make matters even worse, Ronald’s wife files a lawsuit against the hospital and everyone who was on the surgical staff the day of her husband’s death, which includes both Conrad and Madeline.

There’s a lot going on: everything I've mentioned and more. Plus, there are a number of burning questions that need to be answered. Are either Madeline or Conrad safe? Will the FI team be able to protect them both? What will happen between Marc and Madeline? Will the hospital merger be successful, or will the lawsuit put Manhattan Memorial in complete financial ruins?

THE SILENCE THAT SPEAKS is the fourth installment in Andrea Kane’s series. I had not read any of the previous titles, but I got a pretty good feel for the characters and their relation to each other as Kane does a fine job of filling in the back story. Although parts of the narrative seemed to drag a bit, I still enjoyed this latest addition. Fans and newcomers to the series alike will be clamoring for #5 as soon as possible.