Ivan Aleksander, M.D., is a Tzimisce. Born a mortal man to an affluent but neglectful family, he grew up to be a talented surgeon, a gifted scholar, and a sadistic murderer. He's responsible for two unsolved serial killings, as the Tinker-Tailor, who invaded family homes and painstakingly vivisected the inhabitants and stitched their remnants back together as works of art, and as the Dollmaker, who exsanguinated and posed beautiful young men and women into detailed tableaux.

Ivan, or whichever name he happens to be using, never looks quite the same from one day to the next.