Well, it's obvious that I'm on a totally different plane than the rest of the reviewers! Nevertheless here's my impression.
On a side trip after a medical conference pathologist Maura Isles and her party are disabled in a snow storm: murder, conspiracy and tragedy ensue. Writing style is not to my taste – third-person point of view, with only shallow follow-up of characters earlier introduced so that though there are plenty of descriptions of fear, pain and terror the overall impression is (to me) flat affect. There are great bones to the plot but the author’s choice to keep the reader (or at least to keep me) at a distance, prevents (me) from fully engaging with any character.
I can see what attracts other readers to this book - the action is vivid and non-stop, and there are plenty of unexpected twists to keep us guessing. But I like strong characterization and a tighter, continuous thread among all the elements of the plot. Clearly, from the other reviews, that's just me.