When Liz Maguire, youngest member of the faculty of the psychiatry department at the Bethsaida Medical Center (BMC) was asked by Dave Meyers, chair of the department to work with him on marriage therapy for Bruce Howard chair of cardiac surgery and his wife Patsy Murphy Howard, she was already feeling conflicted. Marriage therapy for the very wealthy was not why she had obtained her social work degree. Her own marriage was already on shaky grounds because of her decision to leave her comfortable life as a Colombian Embassy wife and mother in DC to work with Baltimore's poor immigrant community. Why should she take on this new challenge when she was pretty sure that Dave himself didn't want to do marriage therapy for the affluent ever again?

But Dave had an ulterior motive, obtaining Bruce's strong support in upcoming battles in the medical school for space and money, and if the price was listening to complaining spouses, he would pay it. He wouldn't pay it alone. He planned to see Bruce for private therapy, while Liz would manage the tempestuous Patsy and the Murphy/Howard clan, and he kept increasing the pressure on Liz until she finally agreed to do it. That decision would cost her dearly when Liz became a prime suspect in the murder of Anna Murphy, Patsy's sister-in-law, a Colombian native with ties to the Cartagena drug cartels and to Liz's husband Luis.

How Liz dealt with Anna's murder and her challenging relationship with Patsy and her clan while simultaneously managing the stresses of marriage, motherhood and the petty jealousies of life in an academic health center form the basis for The Cartagena Connection.