Cohen's hardcover debut pits New York City's finest against a serial mutilator who dishes out a fate literally worse than death. The first victim, paroled carjacker Freddy Lopez, is dumped on the Upper West Side minus hands and mouth (though whoever operated on him has thoughtfully furnished his cheek with a new blowhole, such as it is, for the purposes of breathing and eating). But it's not until the second casualty that ""Dr. Sigma,"" as Lt. Brent Kramer dubs his quarry, really hits his stride: Jerome Lewis, another man with a record, is found hugging a Brooklyn lamppost--hugging it for nine hours, since his rescuers can't figure out a way to separate his arms, which have been surgically attached to each other over a period of weeks, as if some demonic expert in plant grafting had decided to, uh, branch out. Even before he hears about a third victim, carjacker Rusty Blake, it's obvious to Kramer that he's up against a vigilante with impressive medical credentials, but where among the survivors of carjacking victims can he find the perp? It's a question that's much less interesting than Dr. Sigma's clinically detailed mutilations. Cohen stages some cruelly amusing scenes courtesy of Marshall Stanley, the fast-talking agent who persuades Lewis and Blake not to undergo corrective surgery but to market themselves instead as the Hoopers; unlike Stanley, though, the Sigma-hunters--Kramer; his egghead buddy Nigel Atkerson; Sally Chu, the NYPD computer programmer who affects a garter belt for her sessions with Atkerson; horticulturist Dr. Becker Instlokrownctjz, who just may have taught Dr. Sigma; and James LeRoy Washington III, the former pickpocket who agrees to serve as bait for Dr. Sigma's latest experiment--are a dull lot who deserve nothing better than to end up strapped to separate tables in Sigma's secret lab, like players in a demonic game of Sardines. Horrifically grotesque mutilations given a sadly earthbound treatment.