LETHAL PRACTICE
by
Peter Clement

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A Fawcett Gold Medal Book Published by The Ballantine
Publishing Group Copyright 1998 by Baskerville Enterprises Ltd. All
rights reserved under International and Pan-American Copyright
Conventions.

Published in the United States by The Ballantine Publishing
Group, a division of Random House, Inc., New York, and simultaneously in
Canada by Random House of Canada Limited, Toronto.

http://www.randomhouse.com

Library of Congress Catalog Card Number: 9793255

ISBN 0449002810

Manufactured in the United States of America

First Edition: April 1998

10 9876543

Chapter 1.

"I'm going to die, aren't I, Doc?" Christ, they always seemed to know.
"No, sir," I lied.

"Your lungs are filling with fluid. We're going to give you medication
to clear them out." Openmouthed and gasping beneath the oxygen mask, the
patient was frantic for air. All the muscles in his chest and abdomen
heaved with every attempt to breathe, but each breath was shallow and
ended with an ominous gurgle. His skin felt clammy and had turned the
color of a dead fish's belly. I guessed he was about fifty, though he
looked almost twice that age now. We were in the resuscitation room, a
large, tiled chamber, cold, full of echoes, harsh light, and harsher
verdicts. Crouched over the patient's left arm, Susanne Roberts, head
nurse, was struggling to find a vein and get in an IV. "Damn," she
muttered. "Get Ventolin and eighty milligrams of Lasix. I'll try to get
a line in his right arm." I was already reaching for a tourniquet as
Susanne moved fast to follow my order. The patient's skin was slippery
cold. I moved my fingers to his neck and found a pulse. It was very
faint and rapid, but at the wrist, there was nothing. Shock. "And
dopamine!" I yelled after Susanne. She and I had run this race together
a lot of times during the fifteen years she'd  worked in the ER and,
like familiar sex, she'd know exactly what I wanted. The patient's
respirations were getting faster, the gurgling louder. He was literally
drowning in his own fluids. An IV, the drugs, and intubation might empty
the lungs in time but, then again, might not. I tourniqueted his right
arm but got no bulge at the vein site. I'd have to make a blind try. I
anointed the chosen spot with alcohol and went in. Still nothing. His
chest was heaving harder now. He could no longer utter syllables. I
advanced the IV. Blood started to come back up the catheter. I was in,
but he was looking bluer. The cardiac monitor showed extra beats.

Susanne was back at my side with the drugs. "I got a line," I said.

"Give me the IV." She passed me the clear tubing that dangled from
overhead sacks of fluid. I shoved the tip through the blood running from
the end of my needle catheter and opened the line. The skin bulged with
overflow from a broken vein. Shit. When it goes wrong, it really goes
wrong. His eyes began to roll. "Call ICU stat, please, and inhalation
therapy." I spoke in that phony, calm tone we use when we're losing it.

I've always wondered if it fools anyone. Susanne hit the phones, and I
abandoned trying for an IV, reaching instead for the intubation tray.

The man's lungs were filling up much faster than I'd expected. Bloody
foam started bubbling out of his mouth. Too late for medication. My only
hope of saving him now was to pass a tube down his airway and blow the
fluid back out of his lungs with pressurized oxygen. Susanne finished
her terse conversation, then started hooking up the tubes and equipment
we'd use. The overhead PA screeched, "ICU and inhalation therapy, stat}
Emergency department!" Now the whole hospital knew we were in trouble.

So did the patient. He dropped his head, seized, and quit breathing.

"Call ninety-nine!" I yelled. The code would bring the cardiac arrest
team. The heart monitor showed the jagged dance of ventricular
fibrillation. Susanne was shoving a board under the patient's shoulders
as I grabbed for the paddles, then set the machine for two hundred
joules. Susanne slapped some lubricant on the man's chest and turned
back to the phones. The current hit him with a loud thwack, arched him,
but left the heart dead. I shocked him again. The jolt hit, but still no
response. I tried a third time. Nothing. The inhalationist arrived.

"Move in!" I commanded. She was already at the man's head, pulling off
the clear mask and tubing we'd applied earlier. She plopped a black
ventilating mask on his face and attached it to a rubber bag that she
squeezed to give him a few puffs of oxygen. Next she reached for a
laryngoscope, flicked it open like a switchblade, and went into his
mouth. Foam and vomit spilled out. She grabbed a suction catheter and
probed through the mess in the back of his throat. Noisily it sucked the
debris clear. After reopening his airway with the blade, she smoothly
slid a long, curved tube into his trachea. "Got it," she reported
matter-offactly. After she hooked up the bag and began forcing air into
the guy's lungs, more bloody foam came bubbling up at her with each
puff. The oxygen was pushing out what had clogged his breathing. She
grinned cockily. "Having a good day. Dr. Gamet?" "Smartass," I said,
smiling. Susanne was pumping his chest. The ventilation and cardiac
massage began to pink him up a bit, but the monitor looked like the
stock market ticker on Black Tuesday. We still didn't have an IV line. I
heard the crackling of the PA. "Ninety-nine, emergency! Ninety-nine,
emergency!" the anonymous voice called, requesting help for us again. As
much as I may need it, I hate it when help arrives. Everyone in the
hospital with nothing better to do shows up. They all come thundering
in, and my job changes from resuscitator to traffic cop. The first
through the door was James Todd. As always, his clothes were disheveled
and the expression on his face was intense. A lot of the interns adopted
that overworked and earnest appearance because they hoped it would
compensate for what they didn't know. Just looking at one of them made
me feel exhausted. Todd was buckling up his belt as he came toward me.

He'd probably heard the call in the can. "Dr. Todd, good to see you. Can
you get me a central line?" Todd had a reputation for magic hands. Under
the clavicle is a major vein that passes to the heart. I knew he'd have
a needle in it with no trouble. With a quick nod, he started gloving up
while I hoped he'd washed after finishing at the toilet. As I waited, I
broke open a few ampules of diluted epinephrine and poured them into the
endotracheal tube. The inhalationist resumed bagging. Normally this
would have forced the epinephrine all the way down to the small air sacs
in the lungs and through their walls into the bloodstream. But in this
man fluid was pouring back from the bloodstream into these very sacs;
the way was blocked. I had Todd, Susanne, and the inhalationist stand
clear while I shocked him again. Just as I feared, it didn't work. Two
medical students rushed in, and I got them busy drawing a blood gas. The
noise level was rising. A third came in and I stationed her at the door,
telling her not to let anyone else get by, but almost before the words
were out of my mouth, the priest, a regular in the ER from nearby
Blessed Trinity Church, darted under her arm. "Is he Catholic, Earl?"
the priest asked, trotting with me back to the patient. When I merely
shrugged, the priest reached over my shoulder, touched the patient, and
started muttering the last rites. Real confidence boost, that one.

"Ready," Todd said. He had his line. At my order, Susanne broke open
another ampule of epinephrine and injected the contents through our IV.

I recharged the paddles, placed them, and fired. The patient arched as
before, but this time the scribbled line on the cardiac monitor
untangled itself and formed the steady, organized pattern of a
functioning heart. I put my fingers to his neck; there was a pulse
again. "Could I have a blood pressure reading, please?" Susanne pumped
up the cuff on the patient's left arm and listened with her stethoscope
while slowly deflating the bulb. "Ninety over sixty." Everyone relaxed a
bit. Still a long way to go. I ordered some small Xylocaine boluses, one
to use immediately and another in ten minutes to prevent any more
defective rhythms. Susanne hung up a drip without my even asking. The BP
rose to 110/70. The room was quiet except for the rush of air with each
squeeze of the respirator bag and the welcome steady beep from the
monitor. It's always like this at the end of an arrest, whatever the
outcome. I broke the spell. "Get this patient up to ICU before he
crashes again." For the last twenty years it's been my job to take
patients like this and try to make them better. Trouble is, I'm no St.
Dude, and whether they are routine problems, potential miracles, or
already lost causes, they all come through the door together. We do
triage to sort out those people who have seconds from those who have
hours. I'm forever behind, it's always catch-up, and in a chaotic
profession of desperate moves with precise skills, the fear of failure
never leaves. By the time I get to them, they inevitably have the same
unspoken prayer in their eyes. "It's come to this, and you're all I got.

Doc. Please be good." I accompanied him and the nurses for the short
elevator ride up to ICU. It was Sunday evening, and only a resident
would be there. Sometimes the resident had enough experience to handle a
difficult case until a staff supervisor could be called in from home,
but I wanted to make sure. Though my patient was making it out of the
ER, the real trick now was for him to get out of the hospital alive. At
first, after the stark glare of emergency, the shadowy darkness of
intensive care made it hard to see. A hushed place even in the daytime,
the ICU at night is a gallery of backlit souls, each hooked into a wall
of blinking red and amber lights and bound in a tangle of tubes and
wires. The curtains that divide the cubicles hang like shrouds. Now and
then a soft beep gets the attention of the nurses. The monitors at their
dimly lit station flicker in fluorescent green and show a dozen jagged
lines furiously writing the fate of each fragile heart. While I huddled
with the young resident, the nurses quickly signed over to their
counterparts and returned downstairs. It took me five minutes, however,
to explain the case to the increasingly nervous trainee spending his
first night on duty in the ICU. By then I needed a stretch, so I decided
to walk back down the three floors to the ER. As I headed for the
staircase, I noticed that the hallways glistened from a fresh mopping,
then spotted a deserted mop and pail near the door of the doctors'
lounge. I glanced at my watch; it was only seven p.m. Less than three
hours on the job, I thought, and already one of the housekeepers was
occupying an overstuffed leather chair in the sanctum forbidden her
during the regular day hours. Each to her own perks. Around the corner,
I literally ran into our esteemed chief executive officer and
two-hundred-pound resident souse, Everett Kingsly. He grunted with
surprise and let me know in one breath what he'd been drinking. He
normally had a well-groomed mane of white hair, but now it had become
tangled and tufted into peaks like whipped meringue. His white beard,
full more from neglect than by design, stuck out in wiry bristles that
made me itch. Overall, he looked as if he'd been caught in a windstorm.

"Dr. Garnet!" He said my name as if he were identifying an out-of-place
signpost. "Evening, Mr. Kingsly," I replied, quickly steadying him, then
stepping aside--considerably aside. He had that aroma of alcohol-soaked
sweat that inevitably gives secret vodka drinkers away. "Yeah," he
answered after what seemed like a lot of thought. "Can I help you?" I
asked. He gave me a hurt look and gazed off into the space behind me. He
appeared to take a reading on the next wall extinguisher, then lurched
toward it. He was hanging on to this latest handhold, surveying the next
leg of his journey, when I left him. I was feeling guilty for not
helping him at the moment, but I had to get back to emergency. I did a
quickstep to security and told the guards on duty where they could pick
Kingsly up. "Christ, someone should do something about that guy," I
heard one of the guards say as I turned to head for the stairs. "It's
the second time this month."

"Somebody said he tried to paw Agnes from housekeeping last week."

"Kingsly's an alcoholic. Why don't they--" The stairwell door swung
closed behind me, cutting off their conversation.

That guard was right though: While the rest of the world had given up
the three-martini lunch, Kingsly had become increasingly devoted to it.

Over the last year he'd deteriorated. Some days he was a dead loss after
lunch in terms of hospital business--but a menace to reasonably
attractive women of any age who dared to go near him. This weekend he
must have been drinking at home and come into the hospital ...  for
what?

To grope some woman on staff? I felt another twinge of guilt at my
increasing impatience with Kingsly. Eight years ago he'd been a vigorous
administrator and an enthusiastic supporter of making me the new chief
of emergency. "New blood! New ideas, that's what the place needs," I
remember him declaring shortly after my appointment. It was pathetic
he'd become such a liability to the hospital now, but someone definitely
should have done something about his drinking months ago--and, since no
one else had done so, I suspected the others he worked with were as
shamefully preoccupied with their own problems as I was. It was almost
eleven-thirty. I'd taken care of a cut hand, a few sprained ankles, and
four dozen other minor cases that had accumulated in the waiting room
during the resuscitation. For the Buffalo area, this was quiet, even on
a Sunday night. The few ambulances that did arrive brought mostly
elderly patients with the flu. Serious, but not life-threatening.

Nevertheless, I was feeling the fatigue of keeping the cases all
straight in my mind, and I was glad my shift ended at midnight. At
twelve-twenty my replacement still hadn't arrived. Kradic! The other
evening-shift physicians had complained that he'd been turning up later
and later. I'd talked to him, but he'd only scoffed. He was almost
always so damn belligerent that the only way to make him admit any
problem, let alone correct it, was to hit him head-on with undeniable
evidence. So when one of the other doctors came down with the flu the
day before and asked me to cover for him, I hadn't been reluctant,
because of Kradic. If he was late, he damn well couldn't deny it to my
face. "Think you'll get home tonight?" Susanne asked, coat on and
heading out. The grin on her face gave me less than even odds. Even my
resident had disappeared, probably to get some sleep, but at least there
weren't any patients waiting to be seen. Forty minutes later Dr. Albert
Kradic sauntered in. He was tall, a bit overweight, and had a pasty
complexion from working nights. He kept his black hair combed flat
except for a bit in the front that he let fall forward over some old
acne scars. He was in his late twenties, but he looked older, and
judging by the expression on his face, I could tell he hadn't expected
to see me. I decided to fire first and fire loud so the nurses could
hear. I knew Kradic had money problems, badly needed this job, and was
fanatical about his reputation. I didn't think that in front of all the
regulars on the night shift he'd have the nerve to deny he was
repeatedly late. The smirks of those nurses could make even him cower.

"Dr. Kradic, you have a problem starting at midnight?"

"What do you mean? My alarm didn't go off, is all." He had the nerve.
One of the nurses snorted and Kradic shot her a hard glance. Christ, I
thought, they'll be at each other worse than usual now. Whenever spats
between staff got out of hand, they invariably sent me notes later, each
side complaining about the other person's offensive behavior. I'd have a
few on my desk in the morning for sure, especially with Kradic trying to
find out who had squealed about his being chronically late. But tonight
I was too tired to prolong the encounter. "Make sure it doesn't happen
again," I snapped, and started right into sign-out rounds. I kept the
synopsis on each case short and fast enough to cut off any attempt
Kradic might make to come up with more alibis. Five minutes later I was
out of my white coat and lugging my briefcase toward the front entrance.

My feet hurt, my back ached, and I needed a week of sleep. The security
guard was just opening the door when my escape was thwarted by the PA.

"Ninety-nine, administration! Ninety-nine, administration!"

Shit!

The night air flowed cool and fresh through the stillopen door. I could
keep walking  ...  let the others take care of the arrest.

But I'd never sleep.

Resentfully, reflexes taking over, I charged back to the ER and met the
nurses coming from the resuscitation room with a crash cart. A
startled-looking Kradic tried to wave me off.

"You stay here and manage emergency!" I told him. I turned to the
nurses. "Meet you there!" I ran for the stairs. They would follow with
the arrest team in the emergency elevator and arrive thirty seconds
behind me. This was our automatic protocol for any cardiac arrest not in
an admitting area.

Climbing the steps two at a time, I wondered who'd be in administration
this time of night. Then I thought of Kingsly. Perhaps the guards hadn't
found him earlier and he had knocked himself off during one of his
attempts at sex. As I entered the carpeted hallway unique to the
administrative part of the hospital, I wasn't surprised to see the
hushed gathering of cleaning people, porters, and security guards at the
far end of the corridor outside Kingsly's corner office. Still puffing
from racing up the stairs, I slowed to a brisk walk and prepared my mind
to run an arrest. However, as soon as I stepped into the large and
windowed reception area that was the antechamber leading to Kingsly's
inner office, my nose told me there would be no use offering life
support, basic or advanced. Mixed with the stink of feces and sour urine
was the odor of early rot.

A clutch of pale, wet-eyed cleaning women in greens huddled in the
doorway, staring into the office, cloths pressed to their noses. The
scene inside matched the smell. On the floor, in the middle of a thick
powder blue rug in front of a mahogany desk, lay Kingsly, nearly naked,
a mound of white belly below a purple face.

Two other women were alternately gagging, pumping his chest, and trying
to blow air through his gaping blue lips. There was vomit running out
the side of his mouth, but whether it was his own or one of the
rescuers' I couldn't tell. His undershorts, the only thing he was
wearing, were halfway down his crotch and sodden with excrement. Some
had bulged out between his legs. Jesus, what a mess.

I moved to his side and felt for a carotid pulse in the neck. None, and
he was cool, even in the stifling heat of the room, which I absently
noticed. His two resuscitators were still pumping, blowing, and choking.
They had obviously been taught CPR, but the leap from training to the
real thing wasn't usually this bad.

With him long out of his misery, I was about to put the women out of
theirs and stop the arrest when I noticed something odd. Every time the
woman pumped, a thin jet of bubbly blood squirted out onto his abdomen.
I knelt down and stared. The blood came from under a recently formed
scab the size of a blueberry that was just to the left of the tip of his
sternum and had lifted loose. Under the scab, with each press on the
chest, the small silver end of a broken needle rose out of the ooze and
then receded back into Kingsly's innards.

More bubbles and thin jets of blood appeared with every chest
compression. The bubbles indicated the channel of the wound was deep,
burrowing at least into the lung. The jets of blood told me that unless
the man had been trying to turn himself into a voodoo doll, someone had
driven a cardiac needle into the center of Everett Kingsly's heart.

**skip**Chapter 2.

Despite the atrocity on the floor, I was almost unable to accept what
I'd seen--that Kingsly had been killed-- and I dreaded pronouncing it
even more. I gently put a hand on the shoulder of the woman next to me
to stop her attempts at CPR. Her companion made a few more futile puffs
into Kingsly's flabby mouth, then pulled back.

They were both visibly shaken.

"You did everything you could," I said as I helped them up.

"Are you sure?" one of them asked.

"Absolutely," I answered, patting her arm.

I ushered the women to the door, where other comforting hands waited,
and saw the cardiac arrest team racing with their cart down the
corridor. I waved them off.

Then I blanked. What to do now was not familiar.

Death yes, but not the management of what I'd discovered here. I was
still the only physician in the room and, therefore, in charge of the
body. But being the only person who knew that Kingsly had a broken
needle in his heart left me thinking back to old detective novels for
guidance. I figured blurting out that he'd been stabbed wouldn't help.

More people were peeking into the office from the outside reception
area. A security guard pushed to the front, saw Kingsly, and went a
little pale. Two nursing supervisors caught him as he swayed and helped
him to a chair. "Don't touch anything" was what I finally said, trying
to sound authoritative. One of the night supervisors gave me her
who-do-you-think-you-are look and dropped a dust cloth over Kingsly's
partly exposed privates.

Somehow, it didn't help.

I tried again. "I want this room cleared now, please, and someone find
our chief of pathology and tell him to get here fast." After they'd had
their peek, and a whiff of the body, everybody was eager to get out
anyway.

Two orderiies came and helped the still-woozy guard to a couch in the
reception area. The supervisors took turns with the phone on the
secretary's desk. I was just leaving Kingsly's office when I thought
again about how hot it was. I glanced at the thermostat mounted beside
the door frame. It was set at the very top; the room must have been at
least a hundred degrees. Unthinkingly, I turned it down.

"Did anybody turn up this heat?" I shouted to the people in the
reception area. I got only incredulous stares. Was it always so hot in
there? I wondered. I didn't recall from my previous visits, but I had
kept those as rare as possible. Or had the heat been jacked up to
prevent the loss of body temperature that would reveal time of death?
And then I cursed myself. While pompously ordering everyone else to
touch nothing, I'd gone and fingered the very dial that might have held
a killer's prints.

As I closed the door, I saw Madelaine Hurst, associate director of
nursing and the chief night supervisor, arrive and walk over to her
assistants. The one on the phone immediately hung up, and I watched as
they began talking to her in hushed voices. She was senior, discreet,
and, I figured, best able to handle the next step. She was also the
sister of Paul Hurst, former surgeon and now the medical vice president
for the entire hospital.

I went up to them. "Miss. Hurst," I interrupted, "I need a private
phone, and then I need you to get the medical examiner for me. After
that call the police--in particular a senior officer from their homicide
department." She looked at me like I was nuts. "The only person I'm
calling is my brother--which I've already done. He'll be here any
second." She didn't add "so you'd better watch out," but I still felt
like a kid in a school yard.

"Please, just do what I asked," I said in a low but forceful tone.

She backed away as though I'd let out a bad smell, but went to the
secretary's desk and started dialing. I spent the next fifteen minutes
arguing with groggy clerks at the medical examiner's office, being put
on hold, and quarreling with Miss. Hurst over calling the police until
she suddenly shut up. Her brother had arrived. He had obviously dressed
hastily, because his raincoat hung open over a wrinkled white shirt and
baggy pants. His normally pale complexion had become even more pasty and
shone with a sheen of perspiration.

"Oh, Dr. Hurst, thank God you're here." In public Madelaine Hurst always
addressed her brother formally.

"Poor Mr. Kingsly has died in there. He's lying on the carpet with most
of his clothes off, and now Dr. Garnet is making me call pathology, the
medical examiner, the homicide squad ...  "' She let the indictment hang
there, in the air, while Paul Hurst slipped his arm around her shoulder
and joined his sister in frowning at me.

Just then, thankfully, Robert Watts, chief of pathology, entered the
reception area with his usual sense of quiet command.

"Where is he?" he asked calmly.

Tall and gray-haired. Watts retained his ease even during the toughest
crises. He stood there, glancing first at Hurst, then at me, ready to
get down to business.

Hurst, clearly annoyed with me, said, "Sorry, Robert, but Garnet here is
out of--"

"Gentlemen," I interrupted. "If you will step in here, you can see the
situation yourselves." I opened the door to the office and showed them
Kingsly.

It took Watts thirty seconds to agree with me that we had cause to
suspect murder and must notify the medical examiner. Hurst's whining
wasn't going to change the law. Watts was also pretty sure the medical
examiner would order us to call the cops immediately, but he went out to
phone the city morgue and speak personally to the chief pathologist.
Being a colleague. Watts might rate more attention than I'd gotten
earlier from the clerks.

Hurst hung around in a sullen silence to make sure I didn't cause any
more harm to the hospital's good name.

He'd cover up the murder of his own mother to avoid a scandal, and this
was going to be a tabloid special.

"What do you think happened?" I asked gently. The sooner he accepted the
truth about Kingsly's death, the better he'd help everyone at the
hospital deal with it.

Starting to analyze the gruesome situation would give him the start of
the objectivity he was going to need  ... or so I hoped.

"Lord knows" was all I got in reply.

Watts returned. "The medical examiner's seeing to it that the chief of
detectives is sent over. We can do the autopsy here, but he wants his
own man on-site to take special forensic samples. Finding clues to a
murder isn't what we usually do."

"Murder?" Hurst winced. "Surely you're jumping to conclusions!" He
looked around for corroboration. Watts and I looked at Kingsly. Hurst's
shoulders slumped.

"Should we just wait here?" he asked.

Watts glared at him. "Wait in the reception area if you want." "Robert,"
I said, "when I came in here, the room was hotter than Hades. I think
someone must have turned the heat up to try to obscure the time of
death."

"How do we know it wasn't suicide?" Hurst asked, pathetic now, still
staring at Kingsly's corpse.

Hurst's question startled me, but Watts stepped over and gently took his
arm. "Look, Paul, maybe it would be better to wait outside." He spoke in
that tone we too often use while dealing with geriatric cases; it
inferred feeblemindedness and was grossly insulting, but Hurst didn't
seem to notice. He let Watts and me guide him out of the room and sit
him down in a chair by the secretary's desk now commandeered by his
sister.

She'd been sternly snapping off a string of orders over the phone,
presumably to the floor nurses, when the sight of her brother being so
acquiescent must have sparked her hurried good-bye and quick move to
comfort him.

"Paul, are you all right?" "It's awful," he said almost to himself, as
if she weren't even there. "Just awful."

"Paul!" She stroked his hands, then awkwardly touched his cheek.

Finally he seemed to notice her, "I'm fine, really, I'll be all right,"
he said weakly. But he continued to slouch in the chair where we had put
him while his sister made nervous fluttering movements. By the time she
finished, she had also realized her brother was no longer in charge.

She looked to Watts and me for orders as angrily as if we had just
staged a coup d'etat.

Watts continued the takeover. "Miss. Hurst," he asserted, fully formal
now, "would you please get your brother a cup of tea? Dr. Garnet and I
will stay here and wait for the police." She grudgingly nodded and left,
but on the way out she gave me a sullen look to make it clear I didn't
rate similar respect. Gray hair again. It conveys automatic seniority in
our business and, in this case, not wrongly. Watts's excellence with the
living reflected his years spent as a general practitioner before he
became a doctor for the dead.

We stationed ourselves at the doorway of Kingsly's office. I continued
bothering Watts about the thermostat and a time of death. "I saw him
earlier tonight, around seven, He'd been drinking and was stumbling
along the hall, so I alerted security. We can check why they didn't pick
him up or, if they did, why they didn't take him home. But the room here
was an oven when I arrived, so the heat must have been on for quite a
while before the cleaners found him." Watts looked at me intently as I
talked, probably thinking he was hearing the raving of an amateur
detective.

"Maybe," he finally said. "Room temperature wouldn't change heat loss
much though. Besides, there are other signs to estimate the time of
death. Leave that for a moment. Where's the blood?" He looked at me, saw
I hadn't a clue what he meant, and went on. "If that bit of metal in his
chest turns out to be the cardiac needle we both think it is, then there
should be at least a few spurts of blood that shot out during the time
it took the pressure to fall. Even if the stab stopped the heart
instantaneously, which is unlikely if the needle broke off, then a
stream of blood would still have sprayed all over the place for a few
seconds. Think back to the times you've put a needle in a patient with
cardiac tamponade." I did think about it. Tamponade is a condition where
the sac around the heart becomes filled with fluid. The tension prevents
the heart from beating even though the electrical impulses keep firing
to organize the pump of a heartbeat.

We would routinely get the pumping action back by sticking a special
long needle attached to a syringe into the swollen sac around the heart
to pull off the constricting fluid. If we went too far, the tip of the
needle would enter the heart muscle and set off an electrical
disturbance that if allowed to continue could degenerate into
ventricular fibrillation and a full cardiac arrest. But Robert was
right; this took time. In Kingsly's case the needle would have passed
directly into the center of his heart and set up the fatal dysrhythmia.
Unless the needle had been attached to a containing syringe until
Kingsly had died and the needle had been broken off afterward, there
should have been a lot of blood, streams of it everywhere.

"And," Watts said, "if the needle hadn't broken off in the struggle but
was intact, then whoever stabbed him simply could have removed the
needle with the syringe attached. A neat withdrawal leaves a minimal
mark and would have been the logical way to try to hide that Kingsly was
murdered. No one would deliberately snap it off after and risk the
broken fragment being found in the body."

"I suppose you're right, but once the needle had broken off, why not
just pull it out then?" He frowned at me as if I were one of his
residents and should have known the answer myself. "Because the killer
wouldn't know how deep in it was without probing for it," he explained
not too patiently, "and that would enlarge the puncture site, making the
wound obvious." He paused and looked around. "And where are his
clothes?" I shrugged. Watts had noticed the most obvious inconsistency,
which I'd completely missed.

"Probably far from here," he added, "and I bet they're covered with
blood, maybe even burned already."

"What do you mean?"

"I mean he was attacked, and broke off the syringe either thrashing to
death or struggling when he was stabbed. Blood must have been flying
everywhere, all over his clothes, the walls, ceiling, and floor." Watts
suddenly bent over the bloated belly and sniffed.

"His chest's been washed clean with rubbing alcohol." I resisted
sniffing for a telltale aroma of isopropyl.

"That's why the heat was up," he went on. "To dry him off." He shook his
head. "No, he wasn't murdered here." He glanced around the room. "But I
have a good idea how to find out where." So did I. Kingsly's lonely
killing ground would be in whatever part of the hospital the walls and
ceiling had gotten an unscheduled cleaning.

"Has anyone called his wife?" Watts suddenly asked.

"Or has she called here looking for him?" I'd forgotten the
long-suffering Mrs. Kingsly.

"I'll phone her!" It was Hurst's voice, calling to us from the chair
outside, where we had left him. He began to straighten from the slouch
he had sunk into when we'd deposited him there, and started to take back
the control he'd lost.

"Thanks, Paul," said Watts.

"I'll do it from my office." He left to perform what was probably the
worst job in medicine.

Madelaine arrived an instant later with a silver tea set and an array of
china cups. No Styrofoam here.

"Where did he go?" she demanded protectively. To her. Watts and I were
now guilty of even more than insurrection: we'd shooed away her brother
from her custody.

Moreover, we appeared to be about to steal his tea.

She didn't offer us any.

But Watts undid her with his most lethal weapon-- blarney. "Why, Miss.
Hurst, you always know the perfect thing to do in any situation." Watts
had suggested the tea, but he made it seem as if it had been her idea,
and she beamed. He helped himself, sighed in appreciation at his first
sip, and added, "I don't know what this hospital would do without you
and your brother." Only Watts had the skill to make this crap work. If
I'd tried the same line, she'd have started counting the silverware.

Instead, her protestations begged Watts for more of his nonsense. I had
to look away and chew my lip to keep a smile off my face.

"Tea, Dr. Gamet?" asked Watts, seeing my difficulty and cocking his head
away from Madelaine so only I could catch his smug grin.

As I took the cup, I glanced through the reception area window. Cop cars
pulled up. Behind me Watts chatted quietly with Madelaine. Bless him.
Sometimes celebrating the absurd was the only way through the pain and
dying.

Watts was a remarkable man, I thought. He enjoyed his role as the final
diagnostician and keeper of clinical truths. His word on each and every
physician's performance was absolute. Some saw him as a teacher and
guide. Others hated and feared his verdicts on their competence and
character. The pathologist is key in every hospital in the world, and if
he or she is a jerk, stay away, because it means incompetents in the
place can get by with murder--and probably do. Have a good pathologist
in the house and dangerous fools don't last long. Borderline
incompetents are more subtle creatures, however.

Never blatant enough to lose their licenses, they can weave and bob for
years. Sometimes nurses can keep very sick patients out of their grasp
by unofficially suggesting other doctors, but it's a good pathologist
who really keeps those incompetents in check; they can't hide their
fatal mistakes from him. And Watts was the best.

Hurst, Watts, and I looked up at the commotion coming from the entrance
to the hallway. Two so-called plainclothes detectives stood at the open
door. They were dressed almost identically in raincoats, gray slacks,
and black shoes. Probably the outfits came in sets with the unmarked
cars these guys cruised around in. No one in Buffalo reaches legal age
without the smarts to pick cops out of a crowd.

"Dr. Watts?" asked the stout one with gray hair.

"I'm Watts," Robert said.

Detective Bufort," he introduced himself. Turning to the younger and
much taller man standing at his side, he added, "And this is Detective
Riley." Watts made the introductions on our side, and we all shook hands
as politely as if we were meeting for a round of golf. Funny thing about
police. The more serious the crime, the more polite the cops. In some
neighborhoods, if you were too poor, drunk, or hostile, you could end up
down at the station being pounded with a telephone book around the ribs
for peeing on the sidewalk. But commit a murder and it's first-class
treatment all the way.

Detective Bufort and I were the last to shake hands, then Dr. Watts
invited them in to meet Kingsly.

The two officers quietly and competently took charge.

They quickly inspected the body and the room, then questioned Watts and
me. When I told them I'd seen Kingsly staggering down the hall earlier
that evening and reported it. Detective Riley made a note. I guessed he
was going to check with security and housekeeping to see if they'd found
him or if I was the last person to see him alive--besides the killer, of
course. Watts mentioned the raised room temperature and explained that
it wouldn't interfere significantly with his ability to estimate the
time of death.

"But a nonmedical person wouldn't necessarily know that," Bufort said.

"No," Watts said, "but even a killer who did know might have jacked up
the temperature to dry off Kingsly's body after cleaning it up in a
hurry with alcohol." He explained about the blood, suggesting that the
detectives confirm what he was saying by smelling.

Bufort hesitated, then gestured for Riley to do it. The younger man's
jaw muscles bulged and he seemed to bristle, but he got down on one
knee, gingerly sniffed Kingsly's chest, then nodded.

While Watts and I told what we figured had happened to the clothes and
how we thought the police could find the site of the killing, Riley took
notes. I watched the muscles in his jaw slowly relax as he wrote.

"Do you have any idea who did this?" Bufort asked when we'd finished.
Hurst and Watts shook their heads. I thought of the abandoned mop and
bucket I'd seen outside the doctors' lounge but answered, "No." Bufort
frowned at the three of us, then flipped his own notebook closed and
warned everyone in the room not to talk. "None of you should discuss the
details of what you've seen here tonight, not even with your families.

We don't want the killer to have any idea about how much we know." Hurst
cornered Watts and me before we could leave.

"We will carry on business as usual," he said, his voice hard now that
he had regained control, "including this morning's planned budget
meeting at seven." I flinched. That was only four hours away.

"And I," he continued, "will announce Kingsly's death, not you two." He
glared at Watts and me for a second. "Is that clear?"

Chapter 3.

An all-night rain had slicked down the city and left a misty halo around
each street lamp. The stoplights at Main and High streets bled their
reflections onto the shiny blacktop. It was November, my least favorite
month. No snow yet, just sodden leaves and the smells of autumn long
gone. I routinely drove to work in the dark and drove home under wet
black skies. Sometimes the hissing of the tires nearly put me to sleep,
but tonight, thinking of who had killed Kingsly kept me awake, wide
awake.

When Bufort had asked if I could come up with of any reason for the
murder, I'd immediately thought of Kingsly's reputation for hitting on
the female staff. I'd heard more and more gossip about it, escalating in
the last six months or so  ...  but I'd never received a formal
complaint on which I would have had to act. I gathered that he mostly
accosted secretaries and lab technicians, and his pawings had been
pretty feeble. Someone said he usually passed out before anything got
too far, and his victims anonymously called security to pick him up. It
was possible, but unlikely, he'd been killed by one of those poor women
trying to fight him off--clerks and lab workers didn't have cardiac
needles. Yet Detective Bufort and his team were sure to find out about
Kingsly's escapades, and would also learn that the housekeepers had
always been his particular targets. I simply didn't want to be the one
who singled them out.

Fifteen minutes from the hospital I was safely in my driveway and
bracing for the full force of Muffy's welcome.

I even took off my glasses and pocketed them for safekeeping. As soon as
I opened the door, fifty pounds of wiggling black poodle and bad breath
were all over my face. "Down, Muff! Down!" I ordered, trying to calm
her, but it did little good.

After we greeted each other, we went out for the mandatory walk, the dog
perky and jumping at her own puffs of frosted breath, me slouched with
cold and envying her endless capacity for play. Finally she finished,
and we closed up the house together.

As I entered the bedroom and undressed, Muffy immediately headed for my
pillow. I was too tired to kick her off. Hell, she'd been sleeping there
all night anyway.

Instead, I located Janet's blond hair in the dark and slipped alongside
her curled form. I snuggled up enough to steal a corner of her pillow.
Only four months pregnant, she described herself as "still disgustingly
slim, compared to most of my patients."

"Did you take out the dog?" she murmured.

"Yes."

"Did you lock up?"

"Yes." I was thinking my day was finally done, but Janet partially
rolled toward me and flopped her arm onto my face.

"Kitzle me." Roughly translated, kitzle means I'm to stroke her arm.

"I'm tired. Woof."

"And I'm carrying your child!" I kitzled.

I awoke at six to the sounds of my wife barfing in the bathroom.

"Can I help?"

"Yeah. Next time, you get pregnant!" Muffy found me a little more
useful. We made our outdoor tour together, still in the gloom and
predawn mist.

My head ached from lack of sleep and visions of Kingsly, and that
coupled with Bufort's instructions made me figure this wasn't the best
time to tell Janet about Kingsly's death.

I once swore that I would never marry a doctor. Two impossible schedules
in one relationship would never work, I'd predicted back in medical
school, with the dubious certainty I possessed in my early twenties. It
took fifteen years before I met and fell in love with Janet to put an
end to that myth. Both of us thrived on the demands of medicine, and
though we didn't see each other as often as some other couples might, it
was enough for us. I'd tried once to show her an article in one of my
journals that had suggested professional couples needed the distance
provided by work so as not to feel smothered, yet still stay close.

She had smiled, walked over to where I was sitting, and straddled my
lap. "You balance me," she'd said while taking off my glasses. Then we'd
made love, and the subject never came up again.

Back in the kitchen I wiped Muffy's paws, filled her bowls, and listened
to Janet put on her Dr. Graceton voice and phone the OR at her
hospital--we deliberately worked at different institutions. She was
halfway through setting up her operating schedule when I finished with
the dog and blew her a kiss on my way out the door. She promptly
indicated on which part of her anatomy I could place my affection. This
was one of the reasons we worked separately.

The road back to the hospital wasn't quite as deserted as it had been on
my trip home a few hours earlier, but the sound of the tires and my
opinion of the wet hadn't altered. It was usually about this time of
year when I considered a career change.

The meeting Hurst had refused to cancel was our annual slugfest to
divide up the budget for hospital equipment. I could understand why he
wanted us to carry on as normally as possible, but his rather fierce
insistence that only he would announce Kingsly's death was a little odd.
Hell, everyone would know soon anyway. I didn't even think it would take
long for word to get out that it had been murder, no matter what
Detective Bufort might want. Our gossip network was one of the fastest
east of the Mississippi.

My walk across the parking lot did little to lift my spirits. Over me
towered the lights and windows of St. Paul's. Eight hundred beds, and
from each of them I could imagine a plea by its occupant that this not
be the final stop. I shivered as I felt these entreaties add their
weight to the morning chill.

Normally a seven o'clock meeting would sputter to a start at
seven-thirty. This morning the brightly lit boardroom was positively
cheery with the smells of fresh coffee and hot danish. The usual cast of
departmental chiefs was already into second servings and exuding a
gaiety more befitting a cruise ship than our yearly squabble over money.
Obviously, they hadn't heard about Kingsly.

Hurst and the director of finance, Thomas Laverty, came in, slammed
their Dickensian-size ledgers bulging with computer printouts onto the
table, and sat down. The air changed. An odor of stale flesh and
out-of-date thinking wafted through the room as they assumed their
places.

"Gentlemen," Hurst said, "the meeting will come to order." People
coughed, scraped their chairs, and settled into the glazed trances they
normally needed to endure these sessions. I noticed that Watts was
absent. He was probably downstairs, already starting the postmortem on
Kingsly. I wondered how the rest of the chiefs would react when Hurst
announced his death.

"Okay," Hurst said. "The first order of business is the hospital
deficit. Mr. Laverty?" Son of a bitch! He wasn't going to tell them.
Incredulous, stared at Hurst, who caught my eye but looked pointedly at
Laverty. Business as usual? That was obscene. Why was he waiting? And
from the calm way Laverty started off his remarks, I could only presume
Hurst hadn't told him either.

I sat there stunned by Hurst's callousness. I caught snippets about
"services provided," "managed care plans," and "rates below what we've
traditionally charged" as Laverty droned on about deficits and
abandoning fee-for service remuneration. I couldn't tune in to a review
of issues that were standard for most hospitals in the country. Whatever
all of us thought of Kingsly, he had been a colleague, and nothing
justified pushing on with a meeting like this within hours of his
murder. My outrage grew as Laverty started showing pie charts and
announcing figures while Hurst carefully fixed his baggy eyes on first
one chief, then the next--his usual maneuver whenever he wanted to
intimidate and stifle criticism. Most hadn't the balls to challenge the
numbers anyway, and "a two-point-five-million deficit" slipped by
without pause for questions.

Laverty started a familiar review of how bigger hospitals had bought and
closed smaller indebted hospitals to increase patient volume, but I had
stopped even trying to pay attention, and his voice rumbled into the
distance.

Instead, I sank into a fugue of exhaustion and gave way to feeling sick
at heart over the murder and Hurst's brutal indifference to it. Finally,
some of Laverty's words again penetrated my fatigue.

"Therefore," I heard him say, "we have no choice but to close a hundred
beds immediately--and indefinitely." My first reaction was that I'd
heard wrong, that I'd missed something by not keeping track of his
little lecture.

I knew immediately what the impact would be. Previous closures of other
hospitals had overloaded the remaining emergency departments, and beds
everywhere in the county were scarce. As it was, we had patients waiting
one or two days in the ER before they finally got admitted. Now no one
would have rapid access to beds, and we could expect the corridors of
emergency to be littered with rows of stretchers.

But I hadn't heard wrong--the uneasy look on Laverty's face told me
that. He kept glancing nervously at Hurst, but Hurst's expression
remained hard, cold.

Murmurs of alarm started coming from the others around the table.

"What about electives?"

"We'll never get our cancer patients in."

"Christ, our gallbladders'll have gangrene by the time--"

"Are you out of your little minds?" Sean Camngton, seated next to me,
boomed. His muscular physique and red, bushy eyebrows made him look more
like a Highland chieftain than the chief of surgery.

"Oh, of course I'll accept any reasonable alternative," replied Hurst as
he made a pyramid of his fingers in front of his mouth.

Sean went red at Hurst's sarcasm, and I had to catch his arm while he
took a few gulps of air to tame his well known temper. Hurst just stared
back at him as if Sean were a besotted fool to care about our patients.

Hector Saswald, chief of anesthesia and our leading opportunist, picked
this awkward pause to test where he would be politically safe. "Uh, Mr.
Laverty, you estimated a deficit of two point five million. Are you able
to say how much we will save by closing a hundred beds?"

"Not exactly."

"Not exactly?"

"Well," Laverty said, "we can't fire anyone because of the unions, so we
won't save in salaries, but we will use less power and linen, and of
course laundry and food costs will fall. We just haven't broken out
these costs per bed vet. Haven't had a chance to get to it. However, I
can assure you the savings will be significant." We were speechless.

Saswald quickly made his political choice. "Well, that explains any
questions that I had. I commend senior management for its initiative and
leadership in solving this problem for us, and I wish to have it
recorded in the minutes that I give my full support for any additional
budgettrimming measures of these kinds they come up with." Beaming at
Hurst, he sat back in his chair.

Hurst still didn't seem to care.

The rest of us needed a few seconds to realize the jerk was serious. I
felt Sean start to tense again beside me, but I leaped to my feet before
he throttled someone.

"Mr. Laverty, let me make sure I understand what has so thrilled Saswald
here. Basically, you have no idea how much money will be saved by
closing a hundred beds, and you don't have any idea how long they will
be closed. Is that right?" Laverty stared at me as if it would have been
obvious to a half-wit the first time. "So?" was his only reply.

"So since the savings are to come from the laundry, linen, and food
normally used by the patients in these beds, you must be planning to
keep them in emergency unfed, unclothed, and sheetless."

"Dr. Gamet, I object!" shouted Laverty, flapping his hands at Hurst for
help.

Hurst responded by slamming his hand on the table as if it were a gavel.
"You're out of order, Gamet!"

"Like hell I am. There hasn't been an elective admission in medicine for
a decade--they're all emergencies and we've twice as many of them since
those other hospitals were shut down. Closing a hundred of our own beds
now and letting even more patients pile up in the ER is nuts." I looked
around for help. There were mutterings of approval and nods in unison
from less than half of those around the table. The rest of the chiefs,
the scared little political shits in the room, wouldn't even look at me.

They watched the extent of Hurst's indifference, then accepted the
inevitable and stayed silent. I felt the fight going out of me as their
inertia and my own fatigue weighed me down  ...  until I saw Hurst start
to smirk.

I slammed my fist down.

Now Sean put his hand on my arm. Everyone else shrank back. Except
Hurst.

"Really, Dr. Garnet--"

"Days and nights in emergency corridors, sir, are not funny, with the
noise and stink of overcrowding, on top of the pain and fear that
patients come to us with. That's the reasonable alternative that you and
your cost cutting have gotten us."

"That's not fair!" Hurst snarled.

"When you and the mighty minds that run health care in this county got
together two years ago, we ended up with the bright idea of closing
hospitals. Except the boys with the calculators--the experts who assured
us we could absorb the increased load and not let care suffer-- goofed!
You've done a lot of talking since, but not much has changed. Hell, some
days we're so jammed, we've had to refuse ambulances and hope nobody
died trying to make it to the next ER." I stopped myself then. The
litany of screwups was endless, and heaping it on Hurst wasn't entirely
fair. In giving vent to my fury and attacking him personally, I'd
succeeded only in making an ass of myself. Everyone at the table except
Sean started easing away from me, even my few allies from minutes
earlier, their eyes shifting or hooding over with embarrassment. Yet as
I fought to control my rage, I could have sworn Hurst looked pleased by
my outburst. I couldn't reconcile the devastated man from last night
with the cold cynic who seemed to be gloating at me now. And still not a
word about Kingsly. Why was he waiting?

"Gentlemen!" The soothing tones of Dr. Gil Femandez, chief of
psychiatry, poured onto our troubled waters.

Standing by the doorway, he must have slipped in unnoticed before I'd
started my rant. He was tall and impeccably dressed in his trademark
dark suit with a scarlet handkerchief elaborately puffed up in his
breast pocket. He wore his black hair swept back from a high, balding
forehead. A thin, carefully trimmed mustache seemed to give him three
lips.

When every eye was on him, he completed his entrance by stepping to a
vacant chair beside Hurst. "For the record," he declared pompously,
distracting everyone from my hysterics by his own strangeness, "as I
have pointed out many times, psychiatry returns funds to the hospital
from our pool to cover our own operating expenses, and therefore I feel
we can in no way be held responsible for the deficit and must be
excluded from any bed cuts. I assure you I've briefed Mr. Kingsly fully
on our unique situation." I almost blurted out Kingsly's dead, you
pompous prick, but I made myself keep quiet. I wanted to see if
Femandez's use of the dead man's name would force Hurst to finally tell
everyone. It didn't. Hurst simply gazed benignly at Femandez, then said,
"Of course. Dr. Femandez, your situation is unique. Our calculations
suggest the new measures in your department will be limited to a few
beds at most." The smug look between the two curdled what was left of
the milk in the few sips of coffee I'd gotten down.

"Speaking of Kingsly, where is our chief executive officer?" Sean asked.
"Has he permanently withdrawn from these meetings?" This wasn't an
innocent inquiry. At every meeting over the last couple of years, one of
us had made a point of asking where Kingsly was. We hadn't wanted him
present; we'd wanted him fired. So we'd taken turns putting his absences
on the record. But Hurst basically ran the hospital the way he wanted in
Kingsly's absence and had no interest in getting him fired. He was fully
aware of our impotent little game but dutifully excused Kingsly each
time to keep his absences off the record.

For this crap, we'd become doctors.

But that was over now.

Despite my orders from Hurst, I had to let Sean know.

I leaned toward his ear and quietly warned, "Stop it! Not anymore." He
gave me a puzzled look. "Wait a minute," he protested. "The guy should
be here! If he can't cut it, get him replaced! We decided"

"He's dead!" I whispered, trying to get him to shut up. "They found him
last night in his office." But it was too late.

Hurst leaped to his feet. "How dare you speak ill of the dead!" he
roared. He didn't even wait for a collective gasp before adding, "For
years I've put up with your snide remarks and outright insults about the
poor man, but this morning, it's too much!" Sean and I were frozen. The
others kept darting their eyes to us and back to Hurst. For a moment I
thought he'd snapped. His cheeks were violently red and his body shook.
Then he stiffly drew himself straighter, just as I'd seen him do in
Kingsly's office earlier that morning. But now, unlike then, his eyes
were hard and focused. This was an act, and I realized what he'd been up
to all along.

"It is my extremely sad duty," he began, in a low tone now, with just
the right tremble in his voice, "to announce the untimely passing of Mr.
Kingsly. He was found dead in his office last night." No lies there. The
expected "Oh, no," "That's awful," "How sad" broke out around the table,
but no one asked a single question about cause of death. I guessed
everyone simply assumed it was related to his drinking.

"And I am doubly shaken," Hurst continued, his voice again rising,
filling with a carefully honed anger, "by the insulting words of Drs.
Garnet and Carrington regarding our poor friend and leader." He gazed
slowly around at his audience so none would miss the look of hurt he
wore because of Scan and me. "I tried to carry on business as usual in
the way I know the man would have wanted us to, but now simple dignity
demands that we adjourn this meeting." He wearily sat back in his chair
and covered his eyes.

The better to hide his triumph, I thought.

He'd rammed through the cuts, used Kingsly's death to shut off debate,
and made Sean and me, his two most troublesome chiefs, seem like
malicious malcontents.

Tic, tac, toe.

One glance around the table told me they'd all bought it.

More futility, but I had to try. Again for the record, in case there
ever came a time when it might actually matter, I asked, "Are the
closures a fait accompli, or are you asking the chiefs to vote?" The
incredulous stares of everyone leaving the table confirmed I was the
village idiot.

The only person not looking at me was Femandez. He was staring off into
space with the relieved expression of a man who'djust gotten a negative
cancer test.

Chapter 4.

A thin, gruel-colored light seeped through the end window and down the
still-deserted corridor. It made everything look gray. As I swung into a
better lit stairwell leading to emergency, I glanced at the wall clock:
7:45. It normally took until noon before I was this mad.

It was a relief to hit the bright, familiar bustle of our department
after the idiocy upstairs. I walked through the sounds and smells of
morning signout rounds, a ritual at dawn carried out in every ER in the
world where the night people hand over their patients to the day staff.
The aroma of coffee mingled with the smell of toast, scrambled eggs, and
the overnight odor of unwashed patients. An even worse stench came from
the unemptied bedpan on a nearby stretcher.

The nursing station, a large central room, had huge windows with views
of the department and the area just outside, where ambulances rolled in
and unloaded patients.

Wide counter-tops ran under the windows and were crowded with
telephones, monitors, computer screens, keyboards, and racks of
requisition forms. A curl of messages dangled down to the floor from our
sole fax machine, but nobody had taken the time to rip them off yet, let
alone read them. Parked here and there beside the counters were chairs
on rollers, but most were unoccupied.

The nurses stood while they scribbled notes, used the phones, or read
orders and then hustled back out the open doorways that led to the
surrounding stretcher and resuscitation areas. A clutter of abandoned
half-full paper cups gave testimony to how busy they were.

In one corner, I spotted Dr. Michael Popovitch, listening intently to
the quiet murmur of our residents and interns giving report. I silently
gave thanks that this calm, bearded man was on duty today; I'd need both
his expertise and humor. He raised a finger in greeting, cocked an
eyebrow at the piles of charts around him, and returned to the liturgy
being delivered by a sleepy-looking medical student.

"Patient twenty-one is a fifty-year-old male who experienced chest pain
that woke him at three this morning ..." Susanne turned from one of the
countertop phones she'd been using. "What's this crap? Admitting tells
me there are no beds and not to expect any. They've got discharges
planned, but orders came from Hurst not to assign the expected vacancies
on the floors to us. No patient's gone upstairs since late yesterday
afternoon, and we already have twenty admitted and another fifteen--"
Then, registering the expression on my face, she stopped.

"Uh-oh!" To underline her point, on the security monitor for the
ambulance bay I could see two ambulances wheeling through the garage
doors. Within moments our latest guests were rolled in, end to end, with
all the panache of a pizza delivery. Both patients were bundled, old,
and scared.

Susanne turned from me and pressed the intercom.

"Triage!" Through the station windows, I saw Lisa Gray emerge from
behind a curtain, put down a bedpan, and approach our new arrivals with
a smile that visibly calmed them both. Behind me, the dirge from signout
droned on, unfazed." ...  pain was burning, and when he called his
doctor, a nursing assistant advised a bit of Maalox but wouldn't approve
an ER visit ..." I returned to Susanne and led her outside the nursing
station to a quiet spot in the corridor near where Lisa had received the
new patients from the ambulances.

"It's that bad, eh?" she asked.

"Yeah, it's that bad. The mighty minds upstairs have decided to close a
hundred beds to balance their books."

"What?" I might as well have hit her.

"Are they nuts," she screeched. It wasn't a question.

Two attendants rolled in another ambulance patient.

Lisa, still smiling, met them. Incredulous, Susanne sagged against the
wall. I changed topics.

"You know about Kingsly?"

"Yeah, not many will weep for that lech. Was it his heart?" Her cold
indifference to the man's death made me flinch. I shrugged since I
didn't want to lie and walked quickly back into the nursing station
before she could ask any more questions.

Hospital telegraph had gotten out the news Kingsly was dead, but for the
moment only a few of us, the murderer included, knew he'd been killed. I
for one intended to keep it that way. The ER had enough problems without
my letting the secret out and getting in hot water with the police.

Yet it was Susanne's callous remark that burned at the back of my brain.
I didn't blame her. Tragically, I knew, it was how most hospital
personnel would react. What stung me was the way it echoed the times I'd
also badmouthed Kingsly, and I felt ashamed. While Susanne stayed in the
hallway to help Lisa with triage, I pretended to study the admissions
list as my mind flashed to eight years ago--an era when Kingsly's
opinion still carried weight--and I again recalled his welcome
endorsement that first smile and handshake. I had to force myself to
focus on our immediate dilemma.

"When my secretary gets in," I said to the clerk, "have her call all our
docs for an emergency meeting at five." The anger in my voice surprised
both of us. "Sorry," I quickly added, embarrassed at the lapse. She just
smiled and shrugged it off, probably putting it down to stress over the
buildup of patients. "Then have her get me all the chiefs," I continued
in a calmer tone. "I want to see them at noon." But none of this
impressed any of the nurses within earshot. What we needed were beds,
not meetings and phone calls. Through the open door to the triage area I
saw Susanne roll her eyes at the ceiling as another patient was brought
in on a stretcher. Lisa had stopped smiling.

I thought of one phone call that might help. "And get me the director
down at MAS," I added rather loudly.

"I'll try and get him to back off sending us ambulances for a few
hours." With an extreme situation, I could usually bypass the brain-dead
twits who "managed" day-to-day operations at MAS, the acronym for
Metropolitan Ambulance Services, and go directly to Zak Evans, their
medical director. So far I'd been five minutes on hold.

Ambulance services in Buffalo, in all of Erie County for that matter,
were coordinated by a central dispatch system run out of city hall, but
the staff was managed by a large national corporation that specialized
in urban and rural prehospital care. Zak Evans was essential to their
operation.

He had worked emergency before the organization had hired him to solve
some serious problems they'd encountered with the competence of their
personnel. When the company first took over, it had either bought out
local ambulance fleets or made contracts with private ambulance
companies to acquire the vehicles, technicians, and paramedics needed to
serve the city. But with so many different groups involved, enforcing
standards of care had been difficult, and while most of the workers were
reasonably qualified, some were clearly not. At a few of the smaller
outfits, driving an ambulance had been little more than a better paid
plum for union truckers to haul patients instead of cabbages. They'd
received enough hours of rudimentary training so that legally they could
call themselves technicians, but they remained far from adequate. Before
the takeover, previous attempts to introduce a test of professional
competence and accountability had been seen as a threat and had resulted
in ambulances being fire bombed.

Zak was asked to pull all these disparate groups into a cohesive unit
and upgrade the county's prehospital care.

It had seemed an impossible task, but he'd successfully integrated the
better attendants and paramedics as team leaders throughout the ranks of
the service, then empowered them to ensure their members were properly
trained.

For the most part, it had worked. A few of the rogue outfits were still
on the road, but we all knew who they were, and we double-checked
everything whenever we got a patient from one of them. As for Zak, we
made him the saint of Erie County ERS.

He finally answered his phone.

"Zak, it's Earl. How are you doing?"

"Me? I'm fine, but I hear one of your great leaders bought it."

"I'm impressed, Zak. Too bad you can't get me an ambulance as quickly as
you get the inside dope."

"Hey, don't get dirty. Earl. No mystery though. It came over the police
band at dispatch." Yeah, I thought, and now it's probably all over every
ER in the city.

"What happened?" he asked, his attempt at disinterest failing. Zak
prided himself on knowing secrets. "And why are the police involved?" he
added a little too eagerly. I realized he still didn't know Kingsly had
been murdered. Maybe I had something to trade.

I hunched down over the phone so people around the station couldn't
hear. "Zak, it's terrible. This has to be kept strictly between you and
me." I also hoped my lower-voice routine would raise the exchange value
of my secret. "The mighty minds here closed a hundred beds this morning
after we found Kingsly dead. I think, well ..." I paused to give the
impression of a conspiracy. After a couple of seconds he nibbled.

"What? Tell me. You know it stays with me." Sure, until the next trade,
I thought. I had to be careful exactly how I phrased this so I could
still follow Bufort's directive, sort of, and yet get what I wanted for
the ER. "Zak, look, I need a ban on ambulances for twenty-four hours. I
think Kingsly's death was, well, suspicious." Hell, if Zak would buy a
linkage between closing beds and the mysterious death of an
administrator, it could even be useful. Might cause an outbreak of
competence elsewhere. Set a trend.

"What?"

"Yeah, and it's going to take at least twenty-four hours to sort it out
and get the beds open."

"Murder?"

"I didn't say that!" I blurted out. But here came the offer. I was
whispering now. "Of course, with your cooperation so closely tied in to
the developing situation here, we'd update you immediately on any breaks
in the case." I winced at how much I was sounding like a Scotland Yard
movie. Zak, I knew, loved British mysteries.

"He was murdered?"

"I didn't say that, Zak."

"But if I grant the ban, you keep me informed?"

"Of course." There was a pause. Then, "Okay, you've got it."

"Thanks. I owe you." My giddiness at having won a little reprieve was
shortlived. I suddenly realized only the residents were signing out.
"Susanne, where's Kradic?" She looked up from the chart she'd been
writing in at the counter. "I know you don't need this kind of grief
today," she answered, "but Kradic left early."

"What?"

"You heard me. Kradic left as soon as Dr. Popovitch got here. Didn't
even do signout rounds. Claimed he had an important appointment. He said
the residents knew the cases and could transfer them to Dr. Popovitch."
I couldn't believe he'd had the gall to leave early right after I called
him on the carpet for arriving late. That he left on a morning
overloaded with patients was doubly unforgivable. The residents didn't
know yet how to decide who was safe to send home, who wasn't, and either
way, what the best treatment plan was. Popovitch would have had to
double-check everything.

"You want my suggestion?" Susanne asked, eyeing a walk-in patient who
was bent over with pain. "Fire him!"

"I just gave him hell last night about being late!" I called after her a
bit defensively.

I was mad enough to turf him out, but I tolerated Kradic in the
department because he was a brilliant clinician.

His resuscitations bordered on miracles, the residents loved his
teaching, and he took every shift I could give him, including half of
our permanent nights. Yet with his peers, he could be abrasive,
sarcastic, and belittling.

As chief of the department, keeping the place staffed was part of my
job, and I'd give myself an even bigger problem with coverage if I made
him leave. Still, arriving late and leaving early was serious, and I
would have to deal firmly with him or discipline would go to hell.
Another walk-in patient holding a bloody towel to his head was being led
to a stretcher. Thirty percent of our admissions crawled, walked, or
taxied to our door without ambulances, and we couldn't redirect them.
Right now I was going to have to fix the mess in front of me, and fast.

I held the telephone receiver about six inches from my ear. Dr. Valerie
Jones, who shared the night coverage with Kradic, was raging at me.

"Why are you calling me on my time off? How dare you--"

"Valerie, I need extra help today. The agreement is, you provide us with
backup on the weeks you don't do nights." Eight years ago I'd hired
Valerie to work nights. Since then several other physicians had taken
the job with her  ...  for a year or two. They were usually recent
graduates just starting out who liked the free time during the days to
study or to set up a practice. For them the job was temporary. But Jones
stayed.

"Hey," she snarled, "I cover half the nights and any other shifts you
need me for. I sure don't deserve to be criticized for not pulling my
share of the load."

"I'm not criticizing you, Valerie, only asking for your help." She was
as prickly as Kradic, but where he got loud, Jones got sullen and
spiteful.

"Ask Kradic!" she said with mock sweetness, as though she had guessed my
thoughts.

"You know very well he's on nights this week," I replied wearily. She
had been resentful as hell ever since I hired him the previous year.
Until then she had been the solo star of the night shift. Now his
prowess with resuscitations matched her own, and she had to share the
adulation of the residents.

"Can you please come in?" I asked again, trying not to sound like I was
begging. In a pinch I'd humble myself to soothe her defensiveness,
because when inflamed she bordered on paranoid. Even though my tracking
her down at home probably made her suspicious. "Look," I started,
lowering my voice to make it sound like I was revealing confidential
information to her. "ER's a mess.

The idiots upstairs closed a hundred beds today. The overcrowding is
already unmanageable, and we need you."

"Sorry, but I have a research meeting at MAS." Christ, she was really
going to make me struggle. "I thought this was what you wanted, Valerie,
more shifts.

You're always complaining you don't have enough work since Dr. Kradic
joined our department." I listened to her breathing while I hoped that
her jealousy of Kradic would override her need to punish me.

"I can come in starting tomorrow," she said coldly.

"Why, thank you, Valerie, that will be a big help today." I hung up
before she could answer back or hang up on me.

I sat there fuming. It's hard to fault research, especially new cardiac
arrest work. But she threw it in my face whenever she could. The irony
was that I was the one who'd encouraged her to become involved with the
study in the first place.

Four years ago, Zak had enrolled MAS and Buffalo area hospitals in a
large American/Canadian trial of new drug protocols for the treatment of
cardiac arrests. They had needed emergency physicians to ride the
ambulances and supervise the prehospital portion of the study. Jones had
already worked with them on other research projects requiring fieldwork
by doctors out on the road, so I had suggested she participate in this,
their largest effort to date. Whatever I thought of her personally,
she'd accumulated more experience in emergency care studies than anyone
else in the department and was our best candidate. I'd even offered to
adjust her schedule to accommodate the additional workload, since our
own teaching program benefited when a staff member was actively involved
in research. I'd actually been pleased when she'd accepted, and doubly
so when she did well.

But I'd had enough of my departmental prima donnas for one day. I pushed
away from my desk and headed out of my office back toward the ER.

"Of course it's atypical," Popovitch yelled into the phone. "Twenty
percent of them are. But the ECG and enzymes confirm an inferior MI and
he's on streptokinase.

You shouldn't have withheld the ER visit in the first place! You guys
are supposed to manage care, not withhold it!" He slammed down the
receiver and then turned to the openmouthed residents and quickly
assigned each of them to a new case. When he'd finished, I motioned him
to join me in the corridor and told him about the bed closures.

This got me more than another arched eyebrow.

"Jesus Christ! If it isn't HMO gurus, it's our own damned
administrators. What are you going to do?"

"Declare war!" I proclaimed dramatically even though I didn't have a
single idea about my strategy or tactics.

Popovitch just shook his head, then ran off down the hall to deal with
the rising chaos.

I checked with Susanne to see if I could help her with any immediate
problems. She had one.

"It's another DOA from the streets. That's about the sixth derelict
we've gotten since summer. I gave MAS hell, but they insist they're
spreading them around. They claim there are a lot of them lately." She
handed me a sheaf of forms. "If you do the paperwork, I can at least
find him a bed. The morgue always has room." She gave me a sly smile.
"Your patient is waiting in Room C, Doctor," she told me, and then got
out of the way before I could hand back the forms she'd given me.

Sounds weird for a doctor, but being alone with a dead body gives me the
creeps, and this was my second in less than twelve hours. It's nothing
to do with medicine. As long as there is even a spark of electricity
left in some remaining cell, there's still life somewhere, and we can
try to treat. But a corpse is just too  ...  too final. I find myself
holding my breath. It's illogical because, unlike Kingsly's corpse, I
usually see one long before the decay sets up an odor.

The cadaver in front of me was middle-aged going on eighty. Sleeping on
sewer vents, eating garbage, and guzzling cheap booze had mapped his
face with broken red and blue lines. They spread over the gray and
yellow parchment that had been his skin like an atlas of the winter
alleys and dark streets that had got him here. Once he hadn't been like
this, but it was hard to imagine when he still might have had enough
hope to avoid such a pathetic end.

Masked and gloved, I shivered and got on with it. I had to declare
formally the absence of respirations and pulse.

There were no gross traces of violence or trauma, and death was probably
due to natural causes, if the living conditions that killed him could be
called natural. It would take an autopsy to determine the cause of death
for certain, but the autopsies mandated by law on Jane and John Does
were often cursory  ...  to say the least. Even health care for the dead
was overbudget.

I quickly checked the DOA for local abscesses or thrombosed veins
indicating repeated self-injection but saw none. Eager to get back
outside, I was giving the rest of the body a hurried exam when I spotted
a tiny speck on the man's chest.

In normal circumstances, I never would have noticed so small a mark, let
alone given it a second glance. Dark, innocuous, it might have been a
mole, a bit of dirt even, or an insignificant scab. It was the location
that set off the alarms. This man had a mark just left of the
xiphoidstemal junction, the lower tip of the breastbone--the usual site
for an intracardiac injection.

I stared at it, wanting it to vanish, but there it remained. It was
nothing near as big as the scab I'd found on Kingsly--this was merely a
dot--but the location was exact.

I felt increasingly uneasy as I leaned down for a closer look. I still
couldn't tell what it was. I took a breath, lifted my mask, and blew on
the mark in case the speck was a balled-up piece of fabric or some other
foreign material that had ended up stuck there by chance. The spot
didn't move.

It might yet have proved to be a particle of dirt that would lift off
with a wet Q-Tip and reveal intact skin underneath, but I didn't want to
disturb anything until I was sure this wasn't something Watts should see
first.

Scanning the rest of the skin for similar marks, I found a few
sebum-filled pockmarks on his face and neck that were blackheads, and
benign moles on his extremities. I started to relax, but went back to
the original mark. The surrounding skin seemed to be flat, not rolled or
raised as was common with blackheads. I looked at the spot from the side
and was able to see a slightly rounded elevation in the center. It could
be a mole, but then again, maybe not. Feeling foolish, I gingerly
pressed down on the man's stiffened cold chest with the palm of my hand
to verify that nothing poked or bubbled out from under the mark as had
happened with Kingsly.

Nothing did.

Thank God! I thought, embarrassed at having been so easily spooked by
something that was probably as simple as a mole. As I exhaled, I
realized I'd been holding my breath again.

I was tempted to lay the matter to rest myself and confirm with a Q-Tip
if it could either be washed away like sebum or dirt or was fixed like a
mole and couldn't be removed, but I still refrained from touching it. If
it came off and was a scab. Watts and the police would have my head for
interfering with the site before they checked if there was an underlying
puncture mark and needle track--first by gross examination with
magnification under a bright light, then microscopically after excising
the area and mounting slices of the tissue on glass slides. Better leave
it for Watts, I decided, feeling silly to bother him about a thing that
was sure to be trivial. The idea of this guy being killed the same way
as Kingsly was preposterous.

At the door I deposited my mask and gloves, picked up the death
certificate, and returned to the nursing station, where I found a quiet
corner to fill out the forms. On the second page was an outline of the
human figure, front and back, to let me indicate any significant marks
on the man's body. I made a dot in the drawing at the left lower tip of
the breastbone, drew a small circle around it, and marked it with an
arrow from the margin. There I wrote, "Attention Dr. Watts: Pigmented
lesion vs. small scab at left xiphoid-stemal junction. Check it out?" I
was sure going to be red-faced if it turned out to be dirt.

As I wrote, the familiar sounds of the department getting busy pattered
in the background.

"Portable chest in three, please."

"Right."

"Triage at the desk."

"Has CMU called for the MI in bed three yet?"

"No, and the streptokinase is nearly through."

"Still stable?"

"Sort of. His BP's a little low, but I kept the drip going."
Concentrating on the blanks that reduced the end of a life to a few
hasty scrawls, I tried to ignore the chatter around me. But I knew it
meant we had a heart attack patient in danger of going into shock from
the drugs we were giving to dissolve the blood clot in his coronary
arteries.

"CMU on line four; they've no more beds."

"What!" Now I also knew they had no room for that heart attack patient
in the cardiac monitoring unit.

"Ambulance in the corridor."

"Triage at the desk, stat!"

"V. tach. in bed five!"

"Shit!" Ventricular tachycardia is a potentially lethal cardiac rhythm.
Another patient was about to arrest.

"Ninety-nine, emergency! Ninety-nine, emergency!" Christ, I wondered,
could this day be real?

I threw aside the uncompleted forms and ran to help Popovitch.

The cardiac arrest in bed five made it, but during the resuscitation the
condition of the heart attack case in bed three had grown worse, much
worse. He'd been unattended and gone hypotensive on his streptokinase
drip while all the nurses in his area were helping us two beds over. By
the time they got back to him, saw what was happening, and stopped the
drip, he was in shock.

We gave intravenous volume to try to regain his pressure without
overloading his already damaged heart, but he remained hypotensive.

Pale, scared, and young, "the cardiac" became a name.

Donald Cummings, denied a cardiac bed and proper monitoring in order to
save money, now required an even more expensive level of care in the
ICU, and would probably end up with nothing more than a monitored dying.
The good news, for a cynic, was that the ICU did have a vacancy. The man
I'd resuscitated the night before had died.

My rage at reducing Donald Cummings to economics was replaced by dread
as I faced his wife. She was white with fear and trembled as she held
her husband's hand and gently stroked his head. Her courage was as limp
and frail as his heart. I felt dirty when I finally walked away to go to
my office.

My secretary was out for coffee, but she'd obviously been busy.

The first note I saw on my desk confirmed that most of the chiefs whom
I'd asked to attend the meeting at noon would be there. Then there was
the message to call Bufort. The detective apparently had phoned while I
was trying to resuscitate Cummings, demanding to see me immediately. He
could damn well wait his turn. So could the reporters. All three of them
who'd called to get a quote from me about Kingsly's death. Probably
wanted a lot more than a quote. I tore up those messages.

The morning's correspondence had been screened, prioritized, and stacked
to one side. That signaled it would be mostly calls to meetings and
minutes of previous meetings mixed with a few cranky letters of
complaint-- the stuff of a routine paper-shuffle and even less inviting
than a meeting with Bufort.

I looked at the wall unit of files. When I had first chosen emergency
twenty years ago, it was because of the allure of high-risk medicine,
the chance to literally raise the dead and be part of the medical elite
on the front line of care. It also meant freedom. The cowboys who worked
in the pit seemed excused from the stuffy social conformity that
dominated the rest of the profession. We could do a few shifts, then
head off to a rock concert in a VW bus and not get shunned by the
hospital elders as long as we performed well in the ER.

Now everything had changed. The profession in general was much freer,
largely as a result of medical schools recruiting people from a wider
range of backgrounds and encouraging women to join our ranks in equal
numbers.

The all-male bastion crumpled, and medical thinking reflected ideas from
the arts as well as the sciences. And I was a respected chief,
forty-eight years old, and weighed down by looking at the paperwork from
seven years of talk. Had any of it done anything? So much pointless
chatter recorded in dusty stacks of minutes, and yet we still slid into
more cuts, more compromise. I'd skip these sessions altogether, but it
was a constant fight to limit the harm being done, and that morning I'd
failed. Donald Cummings had overcome his HMO trying to deny him a visit
to the ER, only to pay the price of the bed closures.

It was a far cry from how I had thought medical practice would be back
in the shining time of beards and long hair.

I leaned out of my inertia toward the phone, intending to get my call to
Bufort over with, but I'd barely picked up the receiver when the door
opened after a perfunctory knock and the good detective himself strode
into my office, two uniformed policemen trailing him. "Dr. Gamet," he
said without preamble, "I want your files of departmental meetings and
personnel records. Now, please!" The demand was like a club slammed on
my desk ... Or maybe right into my midsection.

"What on earth--" I began, half rising out of my chair.

"You heard me," he snapped. "The minutes of your departmental meetings
and your personnel files!" He came up and stood directly opposite me, my
desk still between us. I got the rest of the way to my feet, and the two
uniformed policemen moved to either end of the desk, as though I might
make a run for it.

"What are you doing?" I asked, looking from one cop to the other and
then back to Bufort. He put both his hands on the desktop, leaned
forward, and said, "Well?" It took me several seconds to gather my
thoughts enough to answer. "The ER minutes are filed upstairs with all
the other minutes of meetings held around here.

You can get them there." Why the hell hadn't Kingsly's staff just given
them to him?

Bufort stared at me.

I was regaining my wits quickly now. "As for my personnel records, those
are confidential. They contain among other things the record of any peer
review or disciplinary action a physician has been subjected to. I'm
bound by hospital bylaws to protect that information from unauthorized
scrutiny. You would need a subpoena, and it would have to be for a given
individual. You can't just go fishing through a whole department's
confidential files."

"You refuse?" he asked, still staring at me without blinking.

"You know I have to," I answered, growing a little impatient at his
obvious attempt to intimidate me.

At first he didn't reply. His expression showed nothing--not anger, not
disappointment, not even resentment.

But the widened blacks of his eyes warned me he was pumped with
adrenaline. I felt my stomach knot as I waited for his next move.

"There's one file you could give me permission to see."

"Oh, whose is that?"

"Yours." I didn't believe I'd heard him correctly. He'd spoken very
softly, but with an edge in his voice that startled me.

"Pardon?"

"You could let me see your file," he repeated, still in a quiet tone,
but I noticed that his beefy cheeks were flushed.

A chill went through me. Before I could speak, he spun around and left
the office, his two policemen in tow.

I was left standing behind my desk, trying to figure out what had just
happened. Bufort must have been told he could have any minutes he wanted
without having to ask me. And more than anyone he would know he couldn't
go through confidential files for the asking.

Then I got it. He hadn't wanted minutes or files. He wanted me, my
reactions. He'd been checking me out.

He'd wanted to see how I'd react to him going after old minutes and
private files, particularly my own. But why? I felt another twinge of
alarm. However crude his bursting in on me had been, he must have had a
reason. What had he found or heard about me that interested him?
Remembering the parting look on his face was giving me the willies.

My fretting was cut short.

"Ninety-nine, emergency! Ninety-nine, emergency!" I'd started to run out
the door when I heard "Cancel ninety-nine, emergency! Cancel
ninety-nine, emergency!" This meant the arrest code was called off for
some reason. I slackened my pace but was still pretty brisk in covering
the remaining ground back to the ER.

Susanne met me with an outstretched palm to slow me down. Without my
asking, she explained. "One of the cleaning men walked in on the DOA you
left in C."

"I left?"

"Yeah. Our cleaning guy just took a staff CPR course. Saw the body,
called ninety-nine, and started mouth-to-mouth."

"On a corpse?"

"You know civilians. They can't tell how long somebody's been dead.
Hell, they're taught not to quit until a medic or someone qualified says
so."

"Where's he now?"

"In the can, barfing. The corpse is on the way to the morgue." She
shoved a sheaf of papers at me. "Now, for God's sake, do the paperwork
so they don't send him back." It took less than a minute to finish
signing off on the forms, but then I hesitated. Looking at my note about
the mark on the derelict's chest after Bufort's astonishing behavior, I
wondered if making a fuss about such an unlikely possibility might draw
his attention even more in my direction. Would he see my note as a
feeble attempt to send the hospital's pathologist on a wild-goose chase?
If I could have erased the entry and had Watts check out the mark first,
I would have. I even wondered if I should document the inappropriate
attempt to resuscitate a long-dead corpse. To a trained doctor or nurse,
it would have been inconceivable to start CPR on an obvious DOA. I
certainly had never imagined that an inexperienced civilian with recent
CPR training could walk in on one of our bodies and start pumping.

But the same thing had happened with Kingsly. We never would have
noticed the blood coming out from around the broken needle if the two
cleaning women hadn't started CPR on a body that had obviously been dead
for hours. If such a scenario was inconceivable to a doctor or nurse in
the ER, could the person who murdered Kingsly have made the same
assumption--that by the time Kingsly's body was found it would have been
so evidently beyond resuscitation that CPR would never even come to
mind, let alone be tried? An experienced resuscitator, trying to get
away with Kingsly's murder, would never have guessed that a course for
the nonmedical staff in CPR would give him away.

Chapter 5.

Watts scowled at me. "Look, why don't you leave the detecting to the
real detectives?" He'd had to delay Kingsly's autopsy until the forensic
experts who'd initially gone over the body for evidence could return
from the medical examiner's office. With his other work backed up, he
was not thrilled by my surprise visit. I'd taken the half hour remaining
before my meeting with the other chiefs to slip down the back staircase
that connected to the morgue and the morass of tunnels leading to
Watts's office in the basement. In the old days at the beginning of the
century, a corpse could be dug up at the cemetery, brought to this back
door, and then end up on the dissection table, no questions asked and
twenty-five dollars forfeited to the grave robber. A generation of
friendly family doctors had learned anatomy on such grisly remains.

"Please answer my question," I said. "What would you have put on the
certificate as Kingsly's cause of death if one of those women hadn't
started pumping him and exposed the needle? Even with his clothes
missing would you have started looking for a needle hole in his chest?"
I waited; he was still reluctant to answer.

"Come on, Robert, what would your first thought have been? Kingsly
naked, reeking with booze, found dead?" He took another moment, but then
went along with my invitation to play what-if.

"Finally" was all he said at first.

I waited for more.

"Yeah, me and everyone else in the hospital would say he finally did it.
Drank and then screwed himself to death, or, at least, died trying to
screw. He never actually raped anyone, at least not according to what I
heard."

"Would you expect his clothes to be where he fell, or even be surprised
if you'd found him nude?"

"If we didn't know he'd been murdered?" He thought a minute, then
answered slowly, "No, probably not. I've heard the guards have found him
with half his clothes missing a few other times. The women he'd hit on
sure as hell never came up with them." Watts thought a bit more. "I
might wonder about most of his clothes being gone, but I can't say I'd
make much of it. No, I wouldn't be surprised. I'd have thought he
finally started an MI with his sexual exertions someplace earlier, made
it back to his office, and collapsed."

"What about the thermostat being turned up? Would that make you
suspicious?"

"Not necessarily, if I wasn't suspicious in the first place. I'd likely
figure he'd felt cold, being nude, and had jacked up the heat before he
arrested."

"So, with all of us thinking that way, could the actual needle and its
mark have gone unnoticed if no one had pumped him?"

"You could count on it. Same thinking as this morning. We all saw how
Hurst would have grabbed any chance to cover up and prevent a stink at
the hospital. He would have explained it the same way, but in this case
we probably would have agreed with him."

"The point is, Robert, not to think of the setup from Hurst's mentality
but from the mentality of the killer. To count on all these presumptions
is to know about the hospital.

I mean really know. The way you and I do. Only someone intimate with our
secrets and foibles would set up this play, dump Kingsly's nude body in
his office with a needle fragment buried in his heart, and still
consider it a good plan to cover up a murder."

"What are you getting at?"

"To think like that, it's not just someone who knows the hospital. It's
someone so experienced in CPR he never even thought anyone in a hospital
would attempt to resuscitate an already stiffening corpse." Watts gave
me a skeptical look.

"Come on," I said. "There was every chance of it being called, even by
yourself, a freaky but natural death."

"Okay, Sherlock, so the killer knows the hospital and CPR. Is maybe even
one of us. That's at least five hundred doctors, well over a thousand
nurses, and God knows how many other trained staff members." I'd already
figured how to narrow that group down considerably, but I needed the
postmortem on Kingsly to be sure. The problem was, if we found what I
expected, I was going to have a hell of a lot more trouble with Bufort.

"Maybe," I mumbled, getting up to leave. "By the way, we got another DOA
that gave me something of a surprise. When I was checking him, I found a
mark at his left xiphoid-stemal junction."

"What!"

"Relax, it's probably a mole. But given what I found on Kingsly, I'm
afraid I overreacted and noted it on the form, asking you to verify it."
I thought he'd make some parting crack about making moles into
mountains.

"Earl, you don't need a goddamn pathologist to diagnose a goddamn mole,
no matter where the goddamn thing is located!" he exploded, shocking the
hell out of me.

"Robert, I'm sorry. Don't bite my head off. I was just being careful,
obviously too careful. Let's forget about it." Watts took a breath.
"Sorry, Earl, this killing's got to me too. I shouldn't have jumped all
over you like that.

It's just that it's doubled my work, and I'm behind as it is. The last
thing we need around here is someone of your experience and background
seeing needle marks every time you spot a mole." He smiled, then added,
"We all need to relax, and just do what we normally do. Think horses,
not zebras, remember?" It was an old saying from medical school. It was
meant to keep the overactive imagination of untrained students from
galloping off after uncommon diagnoses.

I grinned at him, feeling pretty sheepish. "Thanks, Robert," I said,
then let myself into the warren of tunnels and catacombs outside his
dissection room.

Dripping noises mingled with silence; cobwebs mixed with a lot of dust;
a jumble of pipes and wires ran overhead.

Some of these drooped down in tangles and resembled malignant varices,
enlarged tortuous vessels dissected open and left hanging. Several
layers of fuzzy mold riddled with scurrying eight-legged life, grown fat
on droppings from Watts's table, covered the pipes and wires.

This was where his next two patients waited to receive their final
medical act, shrouded, silent, and parked on stretchers. Then I realized
one of them might have been our DOA. Watts would declare him yet another
victim of the street, and my embarrassing note would disappear onto some
dusty shelf. At least I didn't have to worry about Bufort's reaction to
it now.

The tunnel stretching in either direction was occasionally pocked with a
dim pool of light that added more gloom than illumination. I gratefully
fled back up the stairs to the comfort of the noise, confusion, and
bright lights of my own department.

Entering my office, I managed to jostle my secretary, who was on her way
out with an armload of paper.

"Why, it's Carole Lament," I exclaimed playfully, bowing as I held open
the door to let her pass.

"I'm glad to see you too." She laughed. It was a shared joke. We
sometimes went the better part of a day without seeing each other, only
a string of notes and phone messages connecting us. Then we'd have a
chance encounter and quickly update each other in a shorthand possible
only after years of working together. "I'll be back in a minute," she
called over her shoulder. "I need to talk to you." Carole Lament was
singly the person who had sustained me most through my time as chief.
She kept the department afloat from day to day. More than a dozen
doctors, all our residents, and a team of nurses and clerks deferred to
her to coordinate staffing and keep the schedule covered. By slowly
taking over most of these logistics, she had freed me to concentrate on
teaching, medical matters, and standards of care.

Managing an ER is primarily a matter of managing people: knowing who to
stroke, who to push, who to nail to the wall. Yet it was Carole who was
the keeper of everyone's secrets. She got them in bits and pieces as she
made up the schedule. She knew who was in love, whose marriage was
ending, who'd just been dumped, who had a sick child. All of it, even
joy, could distract a physician and sabotage patient care. So we watched
who wanted more time off, who wanted less, and why. From these requests
and the reasons for them--revealed to Carole, not to me--we knew who I
could ask to do what and when. Brusque at times, efficient always,
Carole had a soft shoulder that was obvious nonetheless and encouraged
people to confide in her.

"You heard?" I asked when she came back in the door, unencumbered by
paper.

"About the bed closures, yes. About Kingsly, a bit. Is it true what
they're saying?"

"What's that?" She lowered her voice. "That he was murdered?" The gossip
network had finally gotten through.

"I'm afraid so."

"How?" After my recent encounter with Bufort, I felt no compunction
about defying the pompous jerk's previous order not to discuss the
case--it was pointless now anyway--so I told her what I knew. But I left
out Bufort's little visit. I didn't want her worrying about me.

We got down to business. Although most of the chiefs had agreed to
attend the meeting, Carole told me that some of them had complained
about the short notice. I thought this over for a minute. "Before you
leave for lunch, please tell them to meet me in the center classroom.

I want them to walk through the mess out front." She smiled. We both
knew it would save me a few hundred words. I also hoped it would soften
their reflexes to resist.

I was wrong on both counts. After I'd told the chiefs my plan,
three-quarters of them thought I was as nuts as the scene out front
they'd just been made to witness.

"Dr. Garnet, you can't close emergency!" declared Arnold Pinter, a new
and very insecure chief of medicine.

Usually he slouched; now he was sitting bolt upright, looking nervously
around the table. There were murmurs and nods of agreement from most of
the others, but a few weren't so quick to react. Arnold seemed puzzled
by the lack of unanimity. "Can he close emergency?" he asked.

"I don't know," Sean Carrington said, "but maybe he should." Sean was
chief of surgery and had come straight from the OR, still in greens. He
was peering at Arnold over the operating bifocals he used while
performing delicate procedures.

"He can't stop emergencies!" Hector Saswald insisted.

As always, he was looking for approval. When it didn't come, he moved to
protect himself from being politically incorrect. "And I want it in the
minutes that I said you can't close," he declared piously, jabbing his
forefinger at me.

"There are no minutes, Sas," I said.

This seemed to upset him even more than closing theer.

"What exactly do you hope to achieve?" asked the chief of geriatrics. He
was a rather humorless man, though brilliant at assessing mental
competence. The doubtful frown on his face made me feel he was checking
my capacity to develop even the vestige of a plan.

"Look," I answered, "we all know how closing beds is crap, dangerous
crap. I just had another cardiac go sour because we were playing ICU
down here, and I'm not willing to go along anymore. Besides, it's the
goddamn idiots upstairs who need shutting down. They don't seem to know
their budget for carfare let alone for running the hospital. What I'm
after is a complete review of the finances of this loony bin and an end
to these clowns shutting down care every time they screw up."

"You can't do that!" It was Arnold Pinter again. This time his voice
cracked. The thought of bucking administration seemed to terrify him.

"One of the real problems, Arnold," I said, trying to control my
impatience with this annoying little man, "is that you allow your guys
to fill up the beds with soft admissions who are on fee-for-service
plans, and then your department dawdles with those patients as long as
the premiums allow because it's easy money and little work. The nurses
let you get away with it because it keeps the hard cases waiting in
emergency and out of their hair." It wasn't blatant fraud, and it was
never picked up on the chart audits that were meant to prevent outright
billing abuses. It was simply what could be gotten away with if the
chief of medicine was a wimp.

Of course, Arnold started to deny it, but Sean leaned in from the other
end of the table and cut him off. "What's more, Arnold, you've got the
nerve to let other medical cases pile up in my surgical beds, and I end
up canceling admissions for the OR." A brief look of fear crossed
Arnold's face as he found himself caught between us and caught dead to
rights.

He slumped in his chair, a field mouse within the hawk's shadow, and
began his patented squirming.

"I've told you, Sean, many times, that I don't have the staff," Arnold
said. "Ten of my specialists have resigned in the last year, and with
the resident cutbacks we have too big a load. I can't move cases any
faster. We're spread too thin, and it's going to get worse." Good old
Arnold, the prince of whine. Maybe he was hoping we wouldn't expect much
of him certainly nothing hard, if he seemed pathetic enough.

He was wrong. Sean came at him with the keenness of a scalpel edge
slicing through bloated flesh. "Look at the stats!" he snapped. "You
admit a lot more pneumonias and keep them longer when you're paid
fee-for-service than when it's by managed care." Arnold got a bit white
at this shot. He didn't say it, but his questioning expression asked.
Don't we all have to diddle a few extra bucks when we can? He shrugged,
then looked around at the other chiefs and turned his palms up to the
heavens. "What do you want, Sean?"

"What I want, my dear Arnold," Sean said, "is for you to stop running a
patient's stay here as a private pet farm to make money." A look of fury
flashed across Arnold's face. He flew out of his seat and stood eye to
eye with the muscular surgeon. Fortunately the PA interrupted.

"Dr. Carrington, OR, stat! Dr. Camngton, OR, stat!" Sean gave Arnold a
wicked grin and left without another word.

Arnold slowly recovered his composure and settled back into his chair. I
looked at the hostile expressions on the faces of the remaining chiefs,
sighed, and said, "You don't have to do anything. It would be better if
we had your support, but I'm putting it to our docs tonight, and they'll
decide. We'll be the ones who close and who take the heat. Hurst can
stop us only if he opens the beds and orders an audit." I felt even more
weary as I realized how alone <we were going to be during the long fight
ahead.

I'd nothing left for diplomacy.

"It's this simple," I continued, my voice getting harder. "We're doing
it. You can consider this meeting formal notification. I'm not here to
negotiate with you." There wasn't much left to say. Arnold looked
deflated, and the rest of them seemed either resigned to my decision or
relieved that I'd taken responsibility for it myself.

No one had even mentioned Kingsly. Obviously, the hospital gossip about
his murder hadn't reached these upper echelons yet. As they rose to
leave, I was left wondering if one of them could be the murderer. Each
knew the hospital, but so did a few hundred others. Yet I had my hunch,
and if Watts found what I was afraid he would find at the postmortem,
then by tonight Bufort's hunt for the killer could be narrowed to about
thirty people.

The funny look on Femandez's face earlier came to mind. It still puzzled
me. I thought about him now only because he had declined to come to the
meeting, telling Carole that the bed cuts didn't affect him much, so he
didn't need to attend.

"Will your surgeons support us, Sean?" Carrington and I were having
coffee together in the surgeons' lounge. It was two p.m., and I'd
arranged to meet him there when he was between cases again. He looked
relaxed and at home stretched out on a couch, still in his greens with a
surgical mask hanging loosely on his chest. He'd been operating since he
left my meeting.

"I think so," he replied. "A few will be worried about the damage to
their incomes, but I haven't heard any other bright ideas to save us
from Hurst and his cuts, and in the long run, that will cost them a lot
more." Half of the major surgery done in the hospital came from
emergency. Obviously, our closure would affect the incomes of his
departmental members. Even in this room, a few of the other surgeons
who'd been reading newspapers had put them down and were leaning forward
to try to hear our conversation.

"In any case," Sean added, "I'll support you, and I'll talk to the
others." He stretched, sat up, and leaned closer to my chair. In a near
whisper, he asked, "What's this I hear about Kingsly being murdered?"

"How'd you find out?"

"It's all over the hospital--rumors, cops beginning to poke around. How
come you didn't tell me?"

"Those same cops told me to keep my mouth shut."

"Well, now that it's no longer a secret, you can open your mouth." We
had another cup of coffee while I told him what I knew. Again, I omitted
that Bufort had singled me out for special attention. Not knowing why
he'd done so was making me increasingly uneasy, and I wasn't going to
fuel any rumors about myself. I had just finished the story when a nurse
stuck her head into the room and called over to a gray-haired woman in
greens, "Your case is ready. Doctor."

"Sean, is that Phoebe Saunderson, the gynecologist?" I asked as the
middle-aged woman left the lounge.

"Yep."

"I thought she'd retired from practice years ago." He shook his head.
"Became the VP medical of a hospital in the east end of Buffalo. After
five years she asked to come back to St. Paul's."

"And she can still operate?"

"Sure."

"After being away from it for five years?"

"Absolutely. She had to work like crazy to catch up on all the new drugs
and the latest in reproductive endocrinology, but apart from a few new
techniques and instruments, cutting is cutting. Once you're a surgeon
and know how to operate, it's like riding a bicycle--you never-really
lose the technique." The same nurse who had summoned Dr. Saunderson now
poked her head through the door and called Sean.

"You know," he said as he got up, "I bet even old Hurst could still
wield a pretty mean scalpel." My meeting at five that evening with my
own staff was brief. By five-fifteen we decided, nearly unanimously, to
withdraw our services and shut down emergency in twenty-four hours if
the closed beds weren't immediately reopened. I suggested we should
consider issuing a press release warning of our hazardous overcrowding
in the ER.

It would condemn the administration for its irresponsible action and
request that patients use other emergency facilities until we could make
our own department safe. I said I was going to sleep on the wording of
the press release and we'd take it up tomorrow. Then I explained that I
would warn our sister hospitals, since our closing would increase their
loads. In spite of the added burden to the other ERS, I expected we'd
get support from their staffs. Finally somebody would be doing
something. I'd inform MAS what we were up to. They would have no choice
but to continue diverting ambulances to other institutions.

Initially, the younger physicians were reluctant to go along with the
plan. Not having the established reputations or financial security of
the older doctors, they balked at putting their jobs at risk.

"You guys can walk out of here and probably find a new position by
tomorrow night," one of them said pointedly. "We don't have your
options." But then I explained about Arnold Pinter's "pet farms" and
excessive lengths of stays upstairs.

"Do the math!" I said. "We admit twenty-five fee-for service patients a
day to medicine, on average. I doubt they all really need to come in,
but even if they do, our length-of-stay data show we keep each of them,
again on average, two days longer than a managed-care patient with the
same diagnosis. That's sixty beds. Two times thirty.

By getting internal medicine off its ass, and these soft admissions out
two days earlier. Hurst could close fifty beds and we'd never miss them.
And that was just one department. Cut length of stay in the rest of the
hospital, maybe we'd have our beds, and he'd have his budget." As I
talked, it all seemed so logical, I suddenly wondered why he hadn't done
it this way himself. It would have taken a lot longer and been a lot
more work, but it wouldn't have caused the chaos we were in now. And if
I could figure out a way to balance the books that wasn't disruptive, so
could he. Whatever else he was. Hurst wasn't stupid. So what was so
urgent about cutting costs that he had to put patients at risk for it?
And if something else mat important to him was at stake, how hard would
he resist backing off?

At least the rest of my department seemed persuaded by the logic of what
we were about to impose on him. As I looked around the table, I could
see they were talking to one another more freely now, nodding approval,
and clearly excited by our chances of winning. All except Kradic. He
seemed nervous. He obviously didn't agree, yet for the moment he kept
silent. I wondered if he'd heard how angry I was at him for having left
too early this morning.

Just then Jones entered the room. Research must be finished for the day,
I thought sarcastically. She was tall, thirty-something, and wore her
red hair in a ponytail.

This evening she was dressed in a green track suit that matched her
eyes. Cute, until you got to know her. She mumbled something about
traffic and took a seat, but the slight flush still in her cheeks made
me suspect she'd gone for her daily run rather than be on time for our
meeting. Not wanting to rekindle our fight on the phone, I ignored her
and again glanced around the table. "Any more comments?" I asked.

There were no takers. We voted. Secret ballot.

I collected the papers. One against (Kradic?) One abstention.

Jones?) The rest were in favor of closing down.

Before I could adjourn, there were a few questions about Kingsly. While
most of those present had heard the rumors that he'd been murdered, no
one seemed aware yet that he'd been killed with a cardiac needle. But
they'd all been told I'd discovered it was homicide, and they wanted to
know more. My explanation that the police had instructed me not to talk
about the case was met with catcalls, a few raspberries. So much for
respect for the chief of the ER.

We were starting to leave when I saw Popovitch take Kradic's elbow, say
a few words into his ear, and then walk away. Kradic caught my eye,
quickly looked down, and shuffled out the door. I don't know what
Popovitch had said, but from the stunned look on Kradic's face I was
pretty sure he'd be staying for sign-out rounds.

I looked across the table at Jones and my resentment from this morning
rekindled. I was undecided whether to confront her now or continue to
ignore her. I must have had a pretty unpleasant expression on my face,
because when she glanced up and saw me watching her, I could have sworn
she turned pale.

The speed of rumor and the reaction from Hurst were equally swift. His
page for me arrived at five-twenty.

"What have you done?" he shrieked as soon as I picked up the phone on
Carole's desk.

I didn't bother putting it to my ear. Carole started to muffle her
giggles.

"Exactly what you heard." I was trying to speak into the mouthpiece and
keep the earphone as far away as I could. It wasn't far enough.

"I'll have all of you suspended immediately!" Obviously I was up against
a tactical genius. "We've just done that for you." Then I hung up fast
...  before Carole and I laughed ourselves to tears.

I'd dropped in on Watts again to see if I could get a preliminary on
Kingsly's postmortem. Instead, I found him still gloved and garbed in
protective gown, mask, and cap.

He was stooped over Kingsly's freshly opened and eviscerated corpse with
a pile of broken and bent cardiac needles strewn about in the body
cavity. Even for this place it was a sight. Watts was too involved to
notice my arrival.

"Those needles better not be on our budget," I said, announcing my
presence. Out of habit I had grabbed a mask on my way in. I didn't
intend to handle anything so I didn't stop for gloves.

"It can't be done. Can't use a cardiac needle like a stiletto. And look
at this." He was about to show me some other detail of Kingsly's innards
when a quiet knock interrupted, and we turned to see detectives Riley
and Bufort on the threshold.

"Ah, gentlemen," Watts greeted them like a fine host welcoming dinner
guests. "Come in. Please put on a mask from the counter over there and
take a seat. I was about to get started with Dr. Garnet here." He had
obviously invited them down to demonstrate, with considerable relish,
his exceptional skills.

In contrast, my resentment toward Bufort returned full force. I had an
overwhelming urge to demand that he explain himself and his behavior
earlier in my office, but I held back and merely glared my disapproval
at him instead. He seemed as though he couldn't care less. But Riley
nodded at me and smiled, then looked somewhat puzzled. I wondered if he
was even aware of what had happened before with Bufbrt.

The two detectives pulled up the only stools in the dissection room and
positioned themselves for the best, though distant, view of Kingsly's
inner secrets. I noted how at ease they were with the gaping remains.
Watts made some opening comment about our two professions being similar
and that this was a room where we solved puzzles and answered riddles of
death. He absently gestured to a row of labeled tubes and specimen jars
neatly lined up on the gleaming countertop behind him. They were filled
with various fluids and pieces of human tissue, presumably Kingsly's.

Watts then began to walk while he spoke. "When you came in, I was just
starting to explain to Dr. Garnet that while the murder weapon was
indeed a cardiac needle in the heart, there are a few big unanswered
questions. First, a cardiac needle can't be plunged in." To make his
point, he handed Detective Bufort an unused needle about a foot long,
gleaming and sharp but flimsy.

"When we teach residents," Watts continued, "they all start out trying
to hold the needle at the far end. They place the point on the skin and
push; if we let them continue, it would just bow and break. Perhaps Dr.
Garnet would like to demonstrate the proper technique that is necessary
to successfully insert a cardiac needle." Feeling like a magician's
assistant and not wanting to spoil Watts's show, I slipped on a green OR
gown and donned a pair of rubber gloves, took the needle from the
detectives, and stepped to Kingsly's right side. With my left hand I
held the tip of the needle a few centimeters from the end and steadied
the rest of the shaft with my right. With a slow but hard and steady
force, I punctured the skin at the bottom of what remained of Kingsly's
breastbone. Aiming for the inside of Kingsly's left shoulder, I slid the
entire needle into what would have been Kingsly's heart, if Watts hadn't
already taken it out.

"Whoever got that needle into Kingsly's heart," Watts said, "had to use
that technique. It means Kingsly had to stretch out on the floor--or
stand there and cooperate-- or that he was already out cold. Now look at
this." He turned and took a large Tupperware container off a shelf
behind him, then flipped open the lid. A small shower of formaldehyde
and pieces of God knows what sprayed our way. He extracted a dripping
hunk of meat about the size of a small melon, which I recognized as a
human heart, presumably Kingsly's. Watts identified the chambers for the
benefit of the detectives and pointed out the long, spindly guy wire
sticking out of the muscle.

"This is the track the needle took entering the heart." He picked up
another guy wire and poked it into the needle hole just below where I'd
performed my own demonstration.

"This marks the route of the needle when it first entered the skin. By
alignment, it started perfectly on course for the center of the heart,
but the two vectors don't match. The track in the heart is skewered
upward." Riley caught on immediately. "Could he have been stabbed
twice?"

"No evidence of it. I'll have more after I get my tissue samples back
for microscopic examination. And of course we'll do the usual
biochemical screen, but I'll bet his blood alcohol level will make
embalming redundant." Bufort had seemed to study his hands throughout
most of this. I'd already gotten a taste of a ruthless streak lurking
beneath that rather gray exterior, but what he said and did next alerted
me to an even more formidable threat--his shrewd and cunning intellect.
"What you are telling us. Doctor," he began without looking up, "is that
the victim, though inebriated, felt what must have been expert hands
inserting the needle into his chest and then managed to sit up, or, if
he was standing in the first place, buckled forward as he fell. Either
way, he would first bend, then snap the needle as it was driven home."
It was clearly his show now. "In other words, this was not a woman
grabbing the nearest handy weapon to fight off a man who was trying to
maul her. No, this was a deliberate, almost surgical act of murder." He
paused, presumably to let our own thoughts catch up with his.

Even before he spoke, I felt what was coming with an unwelcome chill.
"It seems likely, gentlemen, that our killer is a physician; moreover, a
physician skilled in inserting cardiac needles." Exactly as I'd been
expecting, and dreading, Watts's findings put every member of my
department on a very short list of suspects.

Bufort continued. "In a general hospital like yours. Dr. Gamet, how many
doctors would be expert at needling hearts?" I hesitated. The question
sounded offhanded, but it felt more like an opening gambit than a
sincere request for information. He still hadn't looked at me, and I
sensed that at the least he was setting me up for another round of
intimidation.

My hesitation must have gone on long enough to make Watts uncomfortable,
because he answered for me. "Outside of ER there are only a handful of
doctors expert at needling hearts," he said matter-of-factly. "These
specially skilled physicians are found in specific areas. The OR, ICU,
and cardiology together might include a few dozen individuals with the
ability to have murdered Kingsly--though not every one of those doctors
would still be performing the procedure routinely enough to have
achieved the perfect entry path we observed here." But most physicians
on my staff could. By far the greatest number of doctors with such skill
would be in emergency, and it was the most probable place for Bufort to
look for the killer. Yet instinctively I felt protective about the
ER--it sickened me that our entire department was about to fall under
police scrutiny--and I felt a surge of annoyance at Watts for being so
coldly forthright with Bufort. Almost immediately I knew it was
irrational.

What else could Watts have done?

But as troubled as I was about emergency, I was even more unnerved by
the growing silence in the room and by Bufort still not looking at me.
The stares of Watts and Riley added to the tension. In those uneasy
seconds I slowly became aware I'd just given Bufort a firsthand
demonstration that I, too, had the skills of me killer.

While continuing to gaze at Kingsly's eviscerated heart, Bufort began
speaking again very softly, very politely. "Dr. Garnet, it is early in
the investigation, and I haven't had much time to discover what goes on
in this hospital, but it occurred to me that the motive for Mr.
Kingsly's murder might be connected to some issue, problem, or conflict
in the administration here. I thought there might be some reference to
such difficulties recorded in the minutes of meetings he attended." He
paused, still eyeing the grisly specimen on the table before him, then
added, "Unfortunately, according to the records I looked through
upstairs, the man didn't seem to go to many meetings." While Bufort
talked, his partner's unblinking stare remained on me. I suspected this
was an interrogation technique they used often, a practiced routine
intended to put the person they were questioning on edge. It worked.
Even Watts was looking a lime uneasy, glancing from me to Riley, then to
Bufort as the detective continued speaking.

"But the records did show something very curious. Dr. Garnet. The only
two people who appeared to care about his absences were you and Dr.
Carrington, the chief of surgery." He suddenly raised his head and
stared right at me. "In fact," he added, getting off his stool and
walking around to my side of the table, "for the last couple of years,
the two of you have repeatedly demanded his absenteeism be recorded." He
stopped in front of me, his face a few inches from mine. "Why was that?"
he asked almost in a whisper.

I instinctively drew back, uncomfortable at his closeness, and again
ashamed of my behavior with Kingsly.

"Well?" he snapped impatiently, leaning a bit more into me.

I was quickly realizing I'd better choose my words very carefully. I
tried to swallow before answering, but my mouth had gone dry. "Because,"
I croaked, "we both felt very strongly that the presence of the chief
executive officer at our meetings was important for the hospital." "Oh,
really?" he asked sarcastically. "Dr. Hurst told me it was because the
two of you were trying to get rid of Kingsly as chief executive
officer." At first I was too stunned to answer.

Then I felt a burst of rage against Hurst for insinuating that I had a
possible motive for murder. Yet surely Bufort hadn't taken him
seriously. It had to be a joke. But Bufort's cold stare was anything but
funny. "Come on!" I protested with rising alarm. "We wanted him fired,
not dead." Even having to explain myself against such an outrageous
suspicion left me feeling resentful and astonished.

I still half expected Bufort to crack a smile, poke me in the ribs, and
admit he'd only been kidding.

Instead, he said, "Don't try to keep things from me. Dr. Garnet. If you
do, you'll get in trouble you can't get out of." Then, apparently
feeling his job of unsettling me was well and truly done, which it was,
he backed away and went out of the autopsy suite without saying another
word. Leaving me hanging like that must have been a well-used tactic
too, except that Riley seemed genuinely caught off guard. He looked
embarrassed to be alone with Watts and me after his boss's performance.
He left fast.

"Holy shit" was Watts's professional opinion.

I probably looked a little unprofessionally shocked myself, because he
immediately tried to cheer me up.

"Don't worry. If they do nail you for the old bastard's murder, you'll
be a hero, and we'll all bring you cake." I managed a weak "Thanks,
pal." On my way out through Watts's anteroom, the scurryings and
scuttlings in the corners seemed more menacing than usual. After
Bufort's behavior tonight I thanked God Watts had prevented me from
drawing attention to the doa.

Chapter 6.

The cold mist felt soothing against my face but did little for my
jumbled brain. Just on the edge of the hospital parking lot were a half
dozen police cruisers; a small fleet of plain-looking vehicles was in
the section reserved for doctors. If I'd known which one was Bufort's,
I'd have had it towed. I'd been dodging a couple of reporters who'd
barged into the ER in the late afternoon, and I was relieved to see
there wasn't a gauntlet of their tribe to run on the way to my car. As I
unlocked my door, I noticed that all the lights in the finance office
were on. Odd, I thought. Laverty and his staff usually left at four.

All the way home, I kept trying to trivialize the risk of Bufort
concocting a murder charge against me, but the black thoughts stayed.
And I still couldn't fathom why Hurst had suddenly become so ruthless,
even by his usual seamy standards. Had he tried to implicate me in
Kingsly's murder because of my blow-up with him that morning over the
bed closures? It was certainly strange that within hours of Kingsly's
killing, after tolerating our financial mess for years, he'd launched
massive and sudden cuts that went way beyond simple economic sense. Or
was he retaliating against my threat to close emergency? In either case,
his behavior seemed driven by something more than a desire for balanced
books. Whatever he was up to, he obviously had no qualms about doing me
professional or personal damage in the process.

And then came the question I'd been trying to avoid the most but had to
face: Could someone in my own department be the killer?

There were fifteen of us in emergency, and I dreaded the inevitable
thoughts and suspicions that were bound to surface once Bufort and his
team started questioning everyone.

Lose trust in a person working in a high-risk area and immediately his
effectiveness plummets. Support and backup, freely given, are what keep
patients alive. One of my professors had called it a magnificent
dependency that can perform miracles, and it had a lot to do with what
kept me addicted to ER work. If Bufort managed to clog that synchrony
with doubt and fear, our team could fall to pieces and become
uncoordinated, even deadly.

One thing was certain: All this was going to undermine emergency's fight
for beds. The moral high ground I'd charged up to go against Hurst would
be muddied with the slimy innuendo and suspicion he'd pushed my way.
While Bufort stalked each one of us. Hurst would have the perfect excuse
to stall and keep his deadly closures in force. "How can we believe
emergency?" he'd say. "A killer lurks in their midst." It wasn't a
logical dodge, but it would work when no one wanted to listen anyway.
Worse still, he might be right.

I figured it would be hard to sleep this night. I opened my window. The
familiar sound of my tires on the pavement only reinforced my dark mood.

Janet's car was in the garage, but I knew she must have already gone to
bed, because only the kitchen light was left on. After a wagging, slurpy
welcome by Muffy, I snapped on her leash and stepped back outside. She
tugged me down the porch steps, but then I turned away from our regular
route. I was going to need a much longer walk than our usual circuit if
I'd any hope of quieting my nerves. Muffy immediately bounded and pulled
ahead in anticipation of different spots and new smells.

Two blocks from our home was the middle section of a golf course. I'd
never played the game in my life, but I appreciated the green space, and
sometimes in the winter, when it was closed, if it was late enough so no
one could see me, I did a little trespassing to stroll the links and
give Muffy a run. She sensed where we were headed and nearly choked
herself straining against her collar.

The boundary was marked by a line of well-spaced evergreen trees and
shrubs. Entering the property was a simple matter of stepping between
the branches and ignoring the Strictly No Trespassing! signs. I stopped
at the edge of the fairway and looked around. Even at night, there was
enough city light reflected off the underside of the clouds to make it
possible to see. Muffy could hardly contain herself.

Off to my right and down a gentle slope the open grass stretched at
least three hundred yards to a distant green backed by a ring of dark
trees. I could see me black shapes of surrounding sand traps. The only
sound was the noise of the city in the background. We were alone. I
reached down and set Muffy free.

She took off like a bullet, charging over the dewsoaked ground with the
happy abandon she always showed in a wide-open space. I strolled along
behind her while she ran in ever-expanding circles, my shoes quickly
becoming soaked in the wet grass.

I tried not to dwell on Bufort and Hurst but found myself worrying about
ER coverage and Jones instead. Would she use her research as an excuse
not to come in to work again tomorrow, to punish me for  ...  for what?
Hanging up on her this morning? Ignoring her at this evening's meeting?

For having hired Kradic in the first place? I was finding it
increasingly hard to cope with her tantrums.

Before coming to St. Paul's, she'd moonlighted working nights in a
variety of hospitals. She'd been competent but insecure and lacking in
the confidence I would have expected from a physician of her experience.
The cardiac research with Zak, however, seemed to give her a
self-assurance in the ER that I hadn't seen before. In addition to
providing some very respectable work for the study, she appeared to have
parlayed all those obscure night shifts and years of experience on the
road into the self-assurance I looked for in an ER veteran. Of course,
her added exposure to cardiac arrests had quickly made her our most
skilled resuscitator.

Unfortunately, her success had also made her rather aggressive. She'd
lorded her new level of skill over the rest of the department as though
we deserved punishment for having made her feel inferior somehow in the
past.

And work. She'd craved it. I couldn't give her enough shifts. It seemed
her new prominence in the department was like a drug to her, and she
needed to show off her skills as often as possible to maintain the fix.
Then I'd hired Kradic, and she'd had to share the spotlight.

My shoes started to squish, and the bottoms of my trousers were wet and
dragging in the grass. Muffy continued her joyous gallop by heading down
the fairway in great sweeping curves. I was about to call her back when
she stopped dead in her tracks and stared intently toward the distant
green, still several hundred yards away.

A lone figure was standing there, completely motionless.

But around its feet two black shapes swirled in small circles, then
scurried back and forth, moving incessantly, like shadows on the ground.
The stillness of the figure was eerie. It seemed to be looking back up
at us.

Without warning or a sound, the two shadows began hurtling up the
fairway toward us. I had to blink to be sure they were real--their speed
made them almost translucent in the dim light. But they were real,
speeding at us like a pair of dark torpedoes. Muffy growled, then
barked. I heard a returning snarl.

Dogs!

Muffy was twenty yards ahead of me, perfectly still but ears up, and
poised to charge.

"No, Muffy!" I screamed, but it was too late. She raced away toward the
oncoming animals.

I started to run after her, yelling her name and hollering, "Stop! Come
back! No!" but in seconds she was way ahead of me, becoming little more
than a shadow herself. With mounting panic I watched the three shapes
hurtle toward each other, separated by less than a hundred yards and
closing.

I kept running after her, frantically waving my arms at the figure on
the green. "Stop them! For God's sake, stop them!" I implored at the top
of my lungs. "Call off your dogs!" Whoever it was continued to watch,
and didn't respond.

Now I could see the dogs: Dobermans. They could tear Muffy to pieces.

Fifty yards.

Shit! I had to break Muffy's rush.

My throat burned from yelling and I was breathing hard as much with fear
as from exertion. They were almost at each other.

Twenty-five yards.

I stopped running, took a deep breath, and let out a roar as loud and
fierce and full of rage as my poor vocal cords could muster.

Muffy whirled around to see what beast was coming at her from behind.
The two dogs, still ten yards away from her, also stopped, but as their
heads went down and I heard their low growls continue, I suspected
they'd been more surprised than frightened.

"Get back here, you dumb dog," I screamed at Muffy, trying to shock her
into obedience. It worked. Her tail, head, and ears drooped, and she
slunk toward me, looking nervously at the growling animals behind her.

They didn't run off, but they didn't approach either.

They started circling us, keeping their heads toward us, showing their
teeth, snarling.

When Muffy got close enough, I grabbed her collar and pulled her to my
side. Being careful not to hit her, I began twirling her leash over my
head like a whip, the metal clasp on the free end.

"Get away! Get back!" I screamed at the circling Dobermans. I
accelerated the circling of the leash over our heads until I could hear
the metal tip whistling through the air. Muffy stopped cowering and
began lunging and barking at the dogs. It was all I could do to hold her
with one hand and circle the leash with the other.

Suddenly one of the dogs skirted around behind us.

Muffy tried to turn and face the attack, but her collar twisted in my
hand, choking her and knocking me off balance. I managed to direct the
twirling leash down and behind and felt it connect. The incoming animal
screamed in rage and pain and continued to yelp as it pulled back and
joined its partner. I was getting ready for them to come at us again,
but above the growling and barking, I heard the sound of a whistle--like
a policeman's or a referee's--come from way up the green.

The Dobermans immediately broke off their attack, spun around, and raced
away toward their master as fast as they had come.

I held Muffy tightly. She was trembling as she barked, straining to give
chase.

"No, Muff, good girl, they're gone. It's okay," I reassured her, though
I was by no means certain we were out of danger. Trying to calm my own
shaking, I watched the two distant shapes run up to the figure and begin
their previous pattern of prancing around its feet.

I wanted to scream, "You fucking idiot!" but I was terrified the dogs
would be sent after us again. I quickly connected Muffy's leash and
started back up the slope from where we'd come. She resisted, whined,
and stood on her hind legs to get a final look before we left. When I
next glanced back, the green was deserted.

All the way home I kept checking over my shoulder and listening for the
padded sound of galloping dogs on pavement. Muffy, on the other hand,
trotted along beside me, happily sniffing out the bushes as usual, our
ordeal apparently forgotten. I was not so sanguine.

Once we were safe in our kitchen, Muffy raced on upstairs to get the
best spot in bed. I began to feel anger more than fear, and wanted to
report the incident to the police. That idiot had nearly let his dogs
kill us.

I was about to dial 911 when I had second thoughts.

What was I going to complain about? I'd been illegally on a private golf
course with my dog unleashed and had been chased off. The creep on the
green might even have been a night watchman. I knew I wasn't the only
person in the neighborhood to use the fairways as a dog run, despite the
property being posted. There even had been flyers distributed
door-to-door requesting we keep our animals away.

Maybe the owners of the club had finally gotten fed up with warning us
and had resorted to letting their security staff scare us a little. It
was dangerous and stupid, and the idiot who'd been there tonight ought
to be charged with reckless behavior, but I put down the phone.

I certainly wouldn't be taking Muffy there anymore, I thought, still
angry, but beginning to feel a little foolish as well.

I awoke to heaven. My head was being stroked, and I could smell coffee
on my bedside table. I opened my eyes and sleepily smiled up at Janet,
who had one hand on my forehead and one hand holding her own cup of
coffee. The light was dim outside the window and invited dozing off
again, just for a few moments.

I slid into a rush of last-minute dreams denied by too much missed
sleep. A large ambulance was driving toward me, bringing Kingsly back,
rotted, all in parts. His fluids seeped out the side panels and blew
into liquid plumes.

Yet I could hear his screams. Piercing screams that overwhelmed the
noise of the siren. Screams that kept coming from the yellow bulk
looming up over me, a shadowy figure at the wheel.

I woke to my own scream. Janet was long gone, and the telephone was
shrieking in my ear. I fumbled the receiver and managed a dry

"Hello."

"Nice hours. Doc. Wish / could sleep in." It was Susanne, fresh and
saucy as ever.

"Oh, God, what time is it?" I'd obviously slept more than a few minutes.

"Eight-thirty, and we're fighting World War Three here while our
fearless leader sleeps."

"Bad?"

"Real bad."

"I'll be there in thirty minutes." I'd barely hung up and was halfway to
the shower when the phone rang again.

"Hello!" I answered impatiently, expecting it was the ER.

I heard only static, the kind of noise produced by a car phone.

"Hello," I repeated, more politely this time.

The noise seemed to change. At first I thought it was more interference
on the line. But it became a whisper, barely audible.

"Hello! Who is this?" I demanded. "Speak up. I can't hear you." The
raspy voice became louder. "I know. Doc. I know it's you. You've had
your warning. Back off!" Then I was listening to a dial tone.

The noise level in the ER matched my frazzled state of mind. Stretchers
were end to end in every corridor.

Susanne rushed by and muttered, "We're not doing well," keeping her
reputation for understatement intact.

All around me nurses and doctors yelled orders and patients cried for
help. Ventilation bags, oxygen masks, and IV sets were tossed to
residents waiting alongside still-witreated cases. At first I thought
there had been a disaster, a train crash or a downed plane. I tried to
huddle with the clerk; she was besieged with calls for ECGS, X rays, the
lab, and beds, always for beds. While still listening to someone on the
phone, she mouthed my answer.

"We're getting ambulances again." Zak! Shit! I'm not sure if I said it
or thought it.

I was down the hall and in my office in seconds, but there I found more
unpleasant surprises, two to be exact.

The first was a foot-high stack of computer printouts, which meant added
hours of work going over them.

The second surprise was embarrassed to be caught going through the
first.

Jones jumped back from my desk. "A lot of paperwork," she sputtered
nervously.

Annoyed, I let silence work her over. It took ten seconds until she
caved in.

"I brought you the latest numbers on my magnesium sulfate resuscitation
study." She added a thin folder to the pile she'd been sneaking a peek
at.

"Find anything interesting?" I knew I sounded cold and sarcastic.

She looked startled.

I wanted her to see she was over the line. I brushed by her to get
behind my desk and let her stand there looking uncomfortable while I
called Zak and wheedled another ambulance ban.

He demanded payment. "Any news on the murder front?"

"I can't talk now." I whispered, hoping I could still imply goodies to
come. Apparently it worked. After we'd exchanged a few sentences, Zak
said he'd direct his ambulances to other ERS until noon. I hung up
before he could change his mind.

"I meant your study, Valerie," I said, turning swiftly back to her,
hoping to get her even more off balance.

Her thin shoulders lowered a notch. I felt pressed to get back outside,
but I knew how important the work was to her. Maybe if I gave it a
moment's attention now, I'd get her on my side, at least for the rest of
the morning. I was dangerously distracted as it was and needed to avoid
another fight with her.

"We finished the first phase last month," she said, "and the initial
..." I tried to focus on what she was saying and ignore the feeling in
my stomach of a fist that kept tightening. I was aware they'd gotten
ambiguous results so far. Magnesium sulfate, cheaper than other cardiac
agents, had shown initial promise, but hadn't panned out as the wonder
drug some earlier California studies had suggested it was. As she spoke,
her disappointment showed. Still, to give her credit, negative finds in
medicine were important, and the material was timely and fascinating.
Even talking about it, her voice reverberated with a quiet authority
that I hadn't heard much in our recent exchanges, and her prickly
defensiveness was momentarily gone.

"Fabulous for torsade de pointes," she concluded. "Compared to the old
magnesium sulfate protocol, our new version improved survival rates by
twenty percent.

Not much advantage for V. tach. or V. fib. though." She shrugged, then
added, "It's too bad." I agreed. Torsade de pointes was a lethal but
rare form of abnormal heart rhythm. I'd only read about it and in twenty
years had never seen a case. The usual killers were ventricular
tachycardia and ventricular fibrillation.

"But for unstable angina or Mis it might be promising," she continued,
sounding enthusiastic. "The study's going to be extended into a second
phase, and we're going to see if magnesium sulfate protects these
patients against going into V. tach. or V. fib." Trying to keep myself
from glancing at my watch, I responded, "Hope so." I meant it,
especially for patients with unstable angina, a condition preceding a
heart attack where the blood supply to the heart is increasingly shut
off by clogged arteries, but the heart muscle isn't yet permanently
damaged. To reverse the process and prevent the impending heart attack,
or MI, we use oxygen, nitroglycerine, bed rest, blood thinners, and
sometimes surgery, but the patients often die anyway from the deadly
rhythms Jones had mentioned. If magnesium sulfate could protect these
patients against V. tach. and V. fib., it might improve survival rates
and prevent Mis. In some cases its use would avoid the need to use
thrombolytic agents costing three hundred to three thousand dollars a
dose. Magnesium sulfate cost thirty cents a dose. It was a lot safer
too.

But right now I had to deal with the ER. "Keep me informed," I added,
stepping to my closet, where I exchanged my jacket for a lab coat.

"I see you finally got the case breakdowns per shift you've been waiting
for." She casually gestured to the printouts, adding, "Everybody's dying
to see them," as if that excused her own prying.

Again I resented her snooping. I was too anxious to have much patience
anyway. "Since I haven't had a chance to look at them myself, I've no
idea what they are," I answered rather coolly. "I haven't been through
my mail yet. Now, if you'll excuse me, I've more calls to make, and they
obviously need you in the ER. Tell Susanne we won't be getting
ambulances for the next three hours." With that I ended what had been
probably the nicest moment I'd had with the woman in recent months.
Neither of us mentioned our conversation on the phone the previous day.
She tried to smile. And failed. I noticed that once again she was
wearing something green underneath her lab coat, this time with earrings
to match. But her attempts to be stylish had always seemed a bit obvious
and did nothing for me. At the door she rather pathetically asked,
"Please give me any feedback you might have on my study."

"Of course." I sighed after she left. Difficult was Valerie Jones's
middle name. At least she was here to work with Popovitch.

Over the next ten minutes I made the usual calls to admitting, got Sean
to cancel elective surgery, and managed to convince a few of our
off-duty doctors to come in and help out for an hour or so. When the
enraged surgeons whose cases I'd bumped started phoning back to scream
at me, I switched the line onto my answering machine. As they recorded
their fury, I leaned back in my chair and tried to think what the hell I
was going to do about the whispered warning. Back off from what? Even if
I wanted to take it seriously, how could I when I didn't know what the
hell I was supposed to be involved in?

It had to be about Kingsly's murder. And though it could have been
anyone--the voice was impossible to recognize--the first person I
thought of was Hurst. He'd already given Bufort the idea that I had a
motive for the killing, but I'd thought his insinuation had been a
tactic, a despicable move designed to tie me up in Bufort's
investigation.

Did he really believe I was the killer? / know it's you! He had sounded
livid last night after learning I was ready to close the ER to fight his
bed cuts. You've had your warning. Back off! The thought of Hurst being
so desperate chilled me. And what was making him so desperate?

You 'we had your warning. Was he threatening to give Bufort even more
ammunition against me, maybe even try to frame me for the killing? I
felt a surge of panic as I had another idea direct from the depths of
paranoia and not enough sleep--the dogs. The attack on the golf course.
You 'we had your warning.

I started to hyperventilate. No! That was off the wall. I fought to
control my breathing. I had to be rational about this> Should I report
the call to Bufort? Or would it only make me more suspect in his eyes?
I'd have to think this through when I was calmer. Meanwhile, I had no
choice but to focus on the ER.

As I pushed out from my chair, I considered the stack of printouts on my
desk that Jones had been sneaking a look at. Normally they would have
offered a perfect bureaucratic escape from the mounting craziness
outside.

She'd seen enough to spot the reams of numbers and diagnostic codes that
were our first ever breakdown of which doctors saw what problems on what
shifts and with what outcome. And she'd been right about another thing.
All of us were nervous and yet irresistibly drawn to this measurement of
our skills, victories, and disasters.

It was like a book of judgment, beyond excuses and denial. Some called
it quality assurance. Some called it Big Brother.

It was actually paper shuffling I'd been looking forward to, but my
moment with our truths would have to wait. I locked the printouts in my
desk drawer to prevent any of the other doctors from taking a premature
peek.

Then I headed for me mess out front. On my way back to the nursing
station, I glanced into the resuscitation room and saw Popovitch at the
right arm of a very pale woman who was sweaty and having a lot of
trouble breathing. He had just threaded a long Swan Gantz catheter under
her right clavicle, through the subclavian vein, and on into her heart.
It was a more complex version of the technique James Todd had used on my
patient Sunday evening.

As I watched Popovitch's practiced hands secure the line, the
association between skills like his and the skills used by the killer
spread over me like a stain of blood.

While he was reassuring the gray-faced lady that the tip of the catheter
would measure the response of her heart to the medication he'd given her
to clear her lungs, I was wondering how many others besides myself would
end up on Bufort's list.

Popovitch looked up and saw me watching him. Thank God he had no idea
what I'd been thinking. "By the way," he began, "I took care of that
matter of Kradic leaving early." He gave his patient a final check and
joined me in the doorway.

"Michael, am I going to get an angry note?" He winked. "I certainly hope
so," he answered, whistling the Godfather theme right after he brushed
past me and started down the hall.

The next hour took all my thoughts away from suspicion and murder.

The ambulance ban I'd reinstated was helping. The staff could face the
pandemonium knowing it wasn't going to get worse. The surgical beds I'd
commandeered and the reinforcements I'd called in cheered Susanne even
more.

"Thank God," she said. "Oh, and you too, of course."

"Good to see you smile, Susanne, even if you are such a smart--"

"Never mind!" She shoved a file in my hand. It was for a forty-year-old
man bleeding from both ends. He'd heard daily aspirin would prevent
heart attacks but had given himself a GI hemorrhage by
overenthusiastically dosing himself. When I found his stretcher, he was
pale and smelled fecal. Black diarrhea poured from his rectum while
brown vomit the color of coffee grounds stained his pillows and
nightshirt.

"Oh, God, I'm going, I can feel it. Don't let me go!

I'm going!" His head thrashed around.

"It's okay. We got you." Two IVS raced fluid into his depleted veins. I
felt for a pulse at his wrist. Not much, but it was there. "You've
already got a pressure," I told him as I jacked up the bottom end of his
bed to rush the blood in his legs toward his heart. "This will boost it
eygn more." His oxygen mask had slipped to his forehead; I slid it back
over his nose and mouth. Two sacks of type 0 blood arrived and were
being hung up on IV poles. For the moment his pressure was holding, and
some IV cimetidine would probably keep him from bleeding. Hopefully. We
didn't have a monitored bed for him if he went shocky again.

While writing my own orders at a free place on the counter, I could hear
Popovitch behind me arguing with a junior neurosurgical resident. "Look,
a thirty-five-year-old woman has the most severe headache of her life
right after making love and is now slowly losing consciousness.

This isn't a postcoital snooze. She needs a CT of the brain in minutes
and most likely neurosurgery in the hour or she'll die." CT is a
specialized X ray used to diagnose hemorrhages of the brain. It had to
be done quickly and with a staff radiologist or neurologist present to
assure it was interpreted correctly.

The resident stalled. "My staff man doesn't like it when I interrupt his
rounds upstairs." Popovitch lost it. "Your lady has a subarachnoid
bleed.

If you don't get your staff man stat and she deteriorates, he will kill
you. If he doesn't, then I will. If after that there is enough of you
left to have a career, we'll both finish that for you as well." The CT
was under way within three minutes.

"Good teaching, Michael," I said over my shoulder.

"If he reports me, flunk him." I heard the nurses out in the hallway
greet Sylvia Green, one of the doctors I'd called in to help. Recently
back from her second pregnancy leave, she was another veteran known for
her technical skills. She could get an IV line on anyone no matter how
flat or inaccessible the veins. Her help was welcome anytime, doubly so
today.

After passing through the confusion and entering the nursing station,
she gave a single comment. "Jesus Christ!"

"Sylvia, a nice Jewish girl like you," chided Susanne, handing her a
chart.

"Yeah, I know. After ten years in a Catholic hospital, I swear like a
shiksa." Sylvia grabbed the file, smiled hello at me, and went to find
her patient.

Twenty minutes later the resident who'd reluctantly obeyed the ultimatum
to get a CT was back in the department, proudly showing everyone the
films of the subarachnoid hemorrhage he'd "picked up in the ER."
Popovitch gently handed him the phone and suggested he get on with the
transfer to neurosurgery. We got to hear him proudly arrange for
life-saving "burr holes" and explain to some wide-eyed students how
these would relieve the pressure of accumulated blood on the brain.

Popovitch gave me another wink.

Within an hour the place was calm. Well, relatively calm.

Jones had even managed to discharge a couple of patients with abdominal
pain. Instead of lying in the corridor with nonacute abdomens and
borderline blood results while waiting for a trial of oral liquids, they
would do their "observation" at home and be reexamined tomorrow morning
in a follow-up clinic. Ironically, they were safer out of the ER. Should
something go wrong, a vigilant family member would pick up a change for
the worse and get the patient back to us faster through the front door
than one of our busy nurses might notice them go sour in a rear
corridor. With this degree of overcrowding we were in danger of finding
patients dead in beds.

Susanne had a mental filter like mine--get to the important stuff;
ignore the crap and she showed it now.

"Oh, I forgot," she said. "Hurst's secretary called and left a message.
You're to meet him in the boardroom at ten-thirty." I stiffened. I was
going to have to be very careful in my dealings with Hurst. From now on
there would be no business as usual, and I'd have to decide whether I
should report my suspicions about him to Bufort. I glanced at my watch:
10:40.

"Susanne!" So much for time to plan. Now I'd have to improvise my way.

"Hey, we needed you more. You can't save lives from the boardroom."

"I'm in enough trouble"

"So what difference does it make? And before you run off," she added,
stopping me as I was halfway out the door, "we got another DOA last
night, a bag lady. MAS figured we'd still have room in the morgue." My
mind was already preoccupied trying to piece together a way to confront
Hurst in front of Bufort, but I tried to pay attention. "Another one?" I
asked. Two DOAS in as many days was unusual. "Any idea what killed her?"

"Probably exposure, alcohol, whateverlike the rest."

"Is the paperwork done?"

"Yeah. We sent her right down to Watts. Funny, he seemed hot to do a
full post on this one. Go figure."

"Really?" I winced again at the dressing-down I'd gotten from Watts for
my stupidity over yesterday's DOA, then remembered something.

"Dr. Watts thinks if the numbers of vagrant DOAS really are up all over
the city," she explained, "the medical examiner's going to push for
thorough autopsies to find out what's killing more street people than
usual." Deaths could be caused by new batches of lethal crack or bad
hooch. It was important to find the latest poison of choice and issue a
strong warning. If Watts was willing to add another extensive autopsy to
his workload when he was already so busy, it was because it was a hell
of a lot more legitimate than chasing after moles. Even for autopsies
handled in a pretty cursory fashion, many of the DOAS were sent straight
to the city morgue.

"Did he say anything about the one from yesterday?" I asked.

"Not specifically, but it was getting two within twenty-four hours that
seemed to get him so stirred up." Despite the ban, two more ambulances
rolled in.

Susanne turned to real work, and I headed off to my meeting with Hurst,
trying to plan my next move with him and Bufort as I went.

I was surprised to see it was the detective himself who had the floor.
He paused politely as I took my seat. From the pole axed look on a few
of the chiefs' faces, I presumed he'd just announced that Kingsly had
been murdered.

The others in the room looked appropriately somber, but their lack of
surprise probably meant they'd heard the gossip. Hurst, however, was
taking a showy look at his watch and all but tapping the dial to make
sure none of those assembled missed the outrageously late hour of my
arrival.

"I'm late because emergency's a mess!" I snarled, unable to control my
anger at him. I noticed some of the chiefs exchanging concerned looks,
probably afraid that we were going to continue our fight from yesterday
morning.

Bufort seemed kinder. "I was just running through what we discussed in
the morgue, Dr. Garnet." He sounded respectful, as though we were
colleagues and I was his chosen confidant. But it was bull. I knew
Bufort was mocking me with his politeness. The little smirk playing at
the corners of his smile made sure I remembered what he could put me
through if it suited him.

I felt livid with both of them, but took a seat without saying anything
more.

Bufort continued speaking, describing the problems of investigating a
homicide in a hospital. Just conducting brief interviews with everyone
who'd been on duty Sunday night had taken over twenty-four hours. The
site of the actual murder was still unknown. Combing Kingsly's office
for prints or other traces of the killer had been fruitless. It was
particularly confounding that the body had been washed. When he got to
the autopsy results and how the killer clearly knew how to needle
hearts, everyone shifted away from me.

He advised us his department would issue a brief press release later in
the day, but if reporters approached any of us individually, we were to
refer them to the police or to the hospital spokesperson. We definitely
were not to discuss any details of the case with the media.

Despite the urgency in his voice as he chronicled all the difficulties
they were facing, that annoying little smile kept reappearing. Whatever
game he was playing, he looked exceptionally pleased with himself. As if
he had an ace up his sleeve.

On the other hand, Riley was sitting at the back of the room, staring up
at the ceiling tiles. Even from where I was sitting I could see his jaw
muscles repeatedly quiver and tense. I'd begun to suspect this younger
detective had little patience with his boss's preening. If Bufort was
the kind of man who demanded stroking from his underlings, he certainly
hadn't gotten any show of adoration from Riley--at least not in my
presence.

In any case, even without his junior's encouragement, Bufort built to
his climax. "And so, gentlemen, we must expand our investigation, and as
you can see, we need your help." He didn't look very needy to me.

"Detective Riley will arrange a meeting with each of you to discuss any
new information you may have, any further thoughts since our preliminary
interview, any rumors you've heard about the killing of your CEO. We
particularly want to hear about possible motives for Kingsly's murder."
I repressed the urge to shiver. So, Bufort was going to open up the
hampers and turn over the carts and spill our dirty laundry all over the
place. I felt sick; so did the other chiefs, judging from the
expressions on their faces.

But Bufort clearly was pleased with himself. I squinted at him. Damned
if his hands didn't seem to be fidgeting as if he were trying hard to
keep them from rubbing together in glee. The stocky detective with the
big ego could have been funny--if I hadn't already experienced the
menace that accompanied his determination to jump to conclusions. Was he
me kind of cop who, right or wrong, was more concerned with getting a
conviction than finding out the truth? If so, then my own innocence, or
anyone else's, might not matter much to him. As I watched him stride out
the door, I couldn't help worrying about how thorough or scrupulous his
investigation would be once he settled on the first available suspect
and saw a chance to keep his solution rate intact-- especially if Hurst
was trying to feed me to him.

I decided telling Bufort an anonymous caller had whispered know it's you
wasn't a good idea right now. He might agree. Nor was I any more
encouraged by the troubled expression on Riley's face when he looked
over at me before he rose slowly from his chair and walked out the door,
shaking his head.

The other chiefs continued to look tense, and a few talked quietly
together as they got up from the table.

Hurst left the room without a glance at me. There wasn't the slightest
hint of the kind of malice I'd felt listening to that whisper on the
phone. Still, even if Hurst couldn't get me charged with murder, he
probably was angling to get me to resign. In fact, he was probably
tempted to accept resignations to get rid of all of us. With
troublemakers like me gone, he could approach the young guys and offer
them their jobs back. Then he could reopen emergency with a staff of
novices who didn't oppose him. But even he must know emergency couldn't
survive the loss of all our experienced physicians. At the very least,
he'd have to do a lot of explaining, especially when our sister
hospitals made him look like an idiot by snatching up our best doctors
before the next shift.

On the way back to the ER, I stopped at the vending machines near the
front of the hospital and pushed enough buttons to win myself a hot
chocolate. I didn't have a clue who had killed Kingsly, let alone why.
Nor could I figure out what Hurst was really up to, but for the moment I
had to stop dwelling on it and try to face my more immediate worries in
the ER.

The machine whirred and sputtered out my order.

Trying not to spill the hot brown liquid, I had turned toward emergency
when I saw what was left of the Cummings family approaching me in the
corridor. Their vigil was finished. A brother supported his brother's
wife. She was clutching one of those obscene plastic bags that hold a
patient's belongings when it's over. At their side walked two small
girls.

I froze, wanting to escape, but on they came until they were right in
front of me.

Mrs. Cummings tried to speak, failed, and my own mouth went dry. Then
she swallowed harder and reached for my hand.

I flinched and almost jerked it away. I knew what was coming.

"Thank you," she managed to whisper. "I know you did all you could." The
little girls watched me from behind their mother's skirt. Despite
myself, I imagined first one, then the other of the girls held high in
her daddy's warm, comforting hands. Now Donald Cummings's hands drooped
cold and purple from the stainless gleam of an autopsy table-- and we'd
put him there. The charts of his case would probably show we were
watching his blood pressure while waiting for a bed, because shock was a
risk, but an acceptable one, with streptokinase. Yet on this day we
hadn't caught the drop, and two little girls had lost their dad, all
within the standards of conventional care--if you didn't count Hurst's
bed closures as the real reason it happened.

Mrs. Cummings still held my hand. I gently withdrew it, mumbling words
of consolation. Then, I have to admit, I fled.

I didn't have the stomach to face the ER at the moment, so I went to my
office by a back corridor.

Carole had begun storing our interminable memos, minutes, reports, and
written recommendations--good intentions on paper--in her computer to
save space, but the changeover had produced more printouts than I'd ever
seen before we'd started putting shelves of words on disks. Her desk was
scattered with these leavings, but she was out, probably generating even
more copies of copies.

I was glad for the moment alone.

I leaned back in my chair and thought about the reams of numbers and
coded outcomes of the ER study that now lay locked in my desk. There I
would probably find a small number of catastrophes like Cummings, and a
few cures. But mostly there would be draws, stabilizing patients by the
book and buying them the time they needed for healing.

I entered Cummings's name in our mortality review list. The recorded
verdict would be "unexpected" and, depending on the size of the guy's
original infarct on postmortem, probably "unavoidable death." The delay
in getting a bed in the cardiac monitoring unit would be noted; the
importance of monitoring blood pressure while using streptokinase would
be reiterated. Then memory would fade until the cuts exacted another
life. In a way. those cuts were as much murder as plunging a needle into
Kingsly's heart. The computer printouts held all our ghosts  ...  except
one.

Paper wars, paper cuts. The injunction arrived at 11:10 forbidding any
organized withdrawal of service.

Hurst! The son of a bitch had thrown lawyers into our mess. And I'd been
stupid enough to be caught by surprise. The injunction would take hours
to unravel.

Worse, we would need even more lawyers.

The server, a little man in a big-shouldered raincoat, smirked at me.
"You weren't expecting that, were you?" I was stunned; he actually liked
his work. As I held the unfolded legal sheets in front of me like a
scroll, I realized all at once where he was headed.

I ran out of the office and into the ER yelling, "Hey, you!" Nurses and
patients recoiled as if I were the latest psycho dumped on the ward. But
I was too late. The little guy with the Joan Crawford shoulders was
disappearing out the far door. Popovitch and Jones, papers in hand,
looked as if they were about to have heart attacks.

There ought to be a law against serving a doctor legal papers in the
middle of an emergency shift, especially one from hell. Our instincts
and training keep us making the right moves. Undermine those instincts,
introduce self-doubt and second-guessing, and the result can be lethal.
Nothing but nothing gets a doctor hesitating and second-guessing faster
than the shock of being slapped with legal papers.

"Look," I said to Popovitch and Jones, "relax. It's politics. It's about
not withdrawing services for want of beds.

Go on being doctors and let me handle this shit." Their expressions made
me feel like the idiot I was for leading them into this, getting them
named.

"I know, I know! Another fine mess I got you into." Before they could
say anything, I lifted the injunctions out of their hands.

"Popovitch, go on a diet or share your food with Jones.

You two are beginning to look like Laurel and Hardy." Their groans
accompanied me halfway back to my office.

Now I was in over my head.

Working emergency always meant seizing control.

With blood, pain, or a bubbling, choking airway, I had a move for it,
knew what to do, could react fast. My greatest dread was freezing up.

I actually had a recurrent dream. I would be ineffectively struggling to
intubate through a bloody tangle of vessels, nerves, and smashed
windpipe when I'd receive the ultimate condemnation from a Greek chorus
of residents.

"You don't know your stuff!" As far as sorting out legal entanglements,
I very definitely did not know my stuff. The stand against closing beds
was right, but all I'd accomplished was to galvanize Hurst into taking
legal action. The injunction could have as big an impact on morale and
concentration in the ER as I'd feared the murder investigation would.
Damn Hurst!

He'd upped the cost of our defiance to a risk of fines, contempt
charges, even prosecution. None of the doctors would go against that.
Even if they threatened to resign through legal channels, it would take
ninety days' notice, and I shuddered at the thought of how much damage
and death might be caused by ninety days of these conditions.

What number of "preventable morbidities or mortalities" would it take to
force Hurst to back down?

My instinct--one I hadn't felt in years--was to call for help. It was a
reality of residency: Go as far as you can, and then get backup. It was
harder later, after becoming staff, to admit to needing help. I'd seen
experienced doctors actually kill a patient by not asking for support.
As a result, 4'd learned to fear such arrogance, and was pretty much
ready to admit when I wasn't cutting it.

And right now I was not cutting it.

If it wasn't too late already, I had to alert the other doctors who
hadn't yet received summonses. I fantasized an army of Joan Crawford
raincoats shouldering through the city to find them.

Outside my window a distant siren warned of the rapidly approaching noon
deadline when the ambulance ban would expire. I looked at the clock on
my desk. 11:15. I wished Carole would get back.

The phone rang. I let the answering machine get it and listened to the
message.

"Carole, this is Dr. Hurst's office. Please tell Dr. Garnet that
Detective Riley wants to see him as soon as possible." So much for
"arranging convenient times." I literally turned a few circles and
wondered what to do first. The phone rang again, but it was my private
line.

Only one person knew that number.

I picked up. "Hi."

"Sure of me, are you?" Janet's voice was an island of calm.

"No, just really glad to hear from you."

"Bad day?"

"Eleven-seventeen and I'm down to plan Y."

"Let's see, that's the one where I work and support you in the style
you've become accustomed to."

"Hey, I'll raise your kid."

"You'll make the kid a bum, just like his father, or at least like his
father was until I saved him and made him respectable."

"Yeah! You made me so damn respectable, I got this job and all the
trouble I'm in."

"I'm the girl in trouble here."

"I love you."

"That's the kind of talk that got me in trouble."

"I thought you seduced me."

"Yeah, well, your virtue will remain unsullied tonight.

I'm sleeping over in the case room. I've two ladies in early labor.
They'll keep me here till dawn, so I'll relieve one of the guys on call.
He'll owe me when I've got a new man in my life and want to spend the
night with him."

"Janet!"

"Oh, didn't I tell you? Had an ultrasound this morning.

Saw a little thing amajig hanging down. It looked just like his
father's--you know, the one that got me in trouble.

Bye now." Carole couldn't for the life of her understand the goofy grin
on my face when she came into the office while I still held the
receiver.

My mood didn't change even as I went out the door to meet with Riley and
Bufort and endure their attempt to hang a murder charge on me. It kept
up when Sylvia Green, scared and waving her injunction, listened
skeptically to my reassurances. Hell, it even endured the two ambulances
that roared in twenty minutes before the ban expired, and it wasn't
altered at all by the resulting bedlam.

I was going to have a son.

Chapter 7.

"Dr. Garnet, let's review the statement we took from you on the night of
the murder. You said you saw the victim alive but inebriated on your way
back from the ICU. What time was that?" Riley asked, showing no trace of
the uneasiness I'd witnessed earlier. We were in a small, empty
classroom. Riley was seated in front of me. Bufort was leaning against
the back wall.

"As I said, about seven o'clock."

"Are you in the habit of being here that late?"

"I was on duty. The shift ends at midnight."

"Then why were you still here at one in the morning?"

"Sign-out takes a little while, especially if we're busy."

"Were you?"

"Not especially. But my replacement was late that night."

"Who was that?"

"Dr. Kradic." And so it went. Riley scribbling away as if he hadn't
questioned me already; Bufort hovering in the corner, like a spider
watching a protege weave a beginner's web.

"And what did you say Kingsly was doing?"

"He was walking down the hall on Second Main.

That's the center block on the floor above the administrative suites."

"So he had come from his office?"

"Probably."

"Was he in the habit of being here so late, especially on a Sunday?"
They must know by now. "Unfortunately, yes. He had a drinking problem.
Lately he'd gotten worse, and was sometimes known to stay late and,
well, maybe have a few belts in his office. I figured that Sunday he'd
been drinking at home or out at a party somewhere before he came in."

"Did anyone ever have trouble with him when he was intoxicated?" Despite
Bufort's previous warning against keeping secrets, I decided to
minimize. I still didn't want his men hounding the women it was rumored
Kingsly had tried to paw. "He was pretty harmless. I've heard he made a
few feeble moves on any skirt he fell over, but nothing serious.
Besides, the postmortem results showed this was not the random stab of
some woman defending herself against one of his advances."

"What did you do to help him?" Bufort suddenly asked.

The nearness of his voice made me jump. He'd moved up to stand directly
behind my head.

"I told the guards at the door. They usually got him home okay."

"I know that! They didn't find him. I meant what did you doctors do to
help him? He was an alcoholic. Who was treating him?" I was stung. I'd
prepared for questions about a murder I hadn't committed, not for a
grilling about my indifference to Kingsly's problem. "I don't know," I
answered lamely.

"How could it be that this obvious alcoholic was allowed to continue in
his job without help?" Bufort's tone was hard, accusing.

"I told you, I don't know. To be honest, I feel damn guilty about it
now, but I guess I was just too wrapped up in my own problems with the
ER." I was hearing my words at a distance; the truth of my admission
unsettled me.

"Hell, Doctor, if we had a cop in his shape, he'd be pulled from his job
for treatment. Any half-decent corporation would have yanked this guy.
Yet he's been allowed to screw up here, a total incompetent from what I
gather, in the middle of a sea of healers--and not one of youjwthered to
help him?" His disgust fed my own. I suddenly felt compelled to explain
how we ended up so callous--not as an excuse but because I needed to
explain it to myself.

"Look, I know it was unforgivable." I was finding it hard to keep my
voice from shaking. "But maybe others here felt as I did--his drinking
was his business. He had a family. I suppose that if I gave it any
thought, I'd have guessed his wife or someone was taking care of him.

He'd made such a mess of the hospital's budget, however, I saw him more
as an adversary that needed firing."

"You never thought of going into his office yourself and urging him to
get help? You never thought of organizing your colleagues for an
intervention?" I felt my face go hot. "No" was all I could say, but the
question bored into the heart of my guilt.

"He was one of your own, Doctor. Why didn't you help him?" He let the
question hang.

I sat, silent, taken by surprise at the extent of the remorse and regret
I felt. Then I began to feel angry.

Bufort was peeling away my defenses, layer by layer, like a malevolent
therapist.

"Would you answer me. Doctor?"

"I told you, I'm not proud of what I did--or, rather, what I didn't do."
It felt like I was being skinned alive by this cop.

By now he was in front of me. He leaned toward my left ear and said very
quietly, "You mean you didn't have time for a drunk in your busy,
important schedule."

"Hey, you're getting out of line!" I said sharply.

He reared back in a sarcastic show of surprise. "Oh, really? Since you
couldn't get rid of him, you all seemed to prefer him ineffectual and
inebriated on the sidelines." I finally lost my temper. "This is really
too much!" I instinctively looked over at Riley for help. I watched the
muscles in the corner of his jaw tighten.

Riley cleared his throat. "Look, maybe we should get back to the night
of the murder." There was a pause, cold as ice, before Bufort said, "I'm
in charge of this interrogation, Riley." He began pacing behind me so
I'd have to keep turning my head to see him.

Across from me, the side of Riley's jaw bulged again.

He got up and walked over to a desk at the front of the room. There he
half sat, half leaned on its large top, fiddling with a piece of chalk
from the sill of a nearby blackboard.

Bufort now came around to where I could see him better. "Here's my
point. Doctor," he started to say. "It seems everyone in your hospital
conformed to a norm of indifference--sort of the hospital's way of
institutionalizing an acceptance of Kingsly's alcoholism." He sounded
like he was reading from a textbook. "It certainly seems to have freed
all of you from any thought of taking the trouble to help him." By the
expectant look on his face, I figured he wanted a reply, so I confessed,
or surrendered, or maybe did a little of both. "Yes, I see what you
mean." But admitting my complicity didn't end the ordeal. I tensed as he
leaned toward me. "So who gains? Who does it serve to have the
administrative head of this place continually out of it? Who could
profit by that?" The obvious name came to mind. It was the perfect time
to tell Bufort about the phone call and my suspicions about Hurst. I
could throw in my story about being chased by the Dobermans and let the
detective make whatever he wanted of it. But even after what I'd just
been through, and as tempted as I was to subject Hurst to his own ordeal
by innuendo and whispered allegations, I balked. I balked at resorting
to the same underhanded level of treatment he had used against me when
he first pointed Bufbrt my way. It wasn't altruism. Being anything like
Hurst just revolted me too much. And whatever I thought he was up to, I
had no proof. Until I did, if I was going to stop Bufort from subjecting
me and the rest of my staff to similar cheap shots and accusations, I
couldn't very well indulge in them myself. "I don't know!" I finally
answered, my dread about Hurst and what he was capable of in full force.

The rest of the interview was mundane. Bufort asked me if I knew why
anyone would murder Kingsly. I said no. Then he wanted to know if
outsiders could get into private areas of the hospital at night. Sure, I
told him.

Sometimes street people hid out in the basement to keep warm or waited
in washrooms till after visiting hours.

Security wasn't our highest priority in the ER. On the contrary our unit
was--had to be--open, free-flowing, and constantly chaotic. Again I
thought he was getting a little offtrack, given that the killer was
probably a doctor, but I supposed he had to account for all
possibilities.

He finished by requesting a list of the doctors I'd seen in the hospital
that night, particularly between seven and midnight or so. I presumed
this was the estimated time of death that Watts had given him. I said I
had seen only the residents scheduled to be there. He didn't have any
questions about them as I'd feared he might, and for that, at least, I
was grateful.

He didn't once ask me if I'd killed Kingsly, or even allude to the
possibility. It seemed he'd convicted me so far only of being a total
shit as a doctor  ...  and as a human being. I felt deprived of a chance
to hear his suspicions and answer allegations about me as a killer.
Perhaps he'd even figured I'd feel that way, and not asking was part of
his game to keep me off balance.

Riley wasn't any help either in determining how seriously he considered
me a suspect. After his reprimand from Bufort, he'd sunk into an
unreadable silence on his perch at the front of the room and had given
his jaw muscles a good workout.

One point Bufort congratulated me on. During their search of the
hospital, they hadn't found the room yet where the walls and ceiling had
been given an unscheduled cleaning, but a sweeper had reported that when
he came on duty Sunday at midnight, he had found a mop wet and recently
used in his basement locker. They were checking it for traces of blood
and other bodily fluids that had leaked out and squirted out of Kingsly
as he died.

Outside our department window, the afternoon light had dimmed to thin
smoke. I was still stinging from the dressing-down I'd received from
Bufort hours earlier, but where my own failure to help Kingsly's
alcoholism was inexcusable, it was passive. However, if Bufort's line of
reasoning was right. Hurst may have deliberately counted on Kingsly's
drinking going untreated to maintain his control over the hospital. The
prospect of our medical vice president being that ruthless no longer
surprised me.

I found Sean Carrington talking to some residents near our X ray-viewing
box. He'd just plopped an odd film of spindly bones on a lighted screen
and was eliciting some very puzzled expressions from his audience. I
paused to watch, but when he saw me, he grinned and said, "Go away.
Earl, this is private. Shoo, shoo!" I knew what he was up to.

Recently I'd heard he'd taken to buying racehorses as a tax writeoff and
that his latest nag pulled up lame after her first meet. Sean had wanted
to shoot her there and then. but the track authorities said he couldn't
do that. He'd have to pay a vet for arthroscopic surgery--$1800 plus
boarding fees. Sean had looked up the fee for the same procedure on
humans: $1200. Now he was trying to snag an orthopedic surgeon who was
unfortunate enough to be passing by.

"Marty," he called, "come here and look at this knee for me." Marty
squinted at the films for a few seconds and then gave. his opinion.
"This is not a human knee."

"So, can you operate on her?"

"Is this one of your horses?"

"Yeah, so what? Will you operate on her?"

"I'm cheaper than the vet, right?" He started turning away.

"No, no, it's your skill. I love this animal so much, I wouldn't trust
her life with anyone but you." Marty chuckled. "Who's going to give the
anesthesia, you?" A demonic light came into Sean's eyes. "Anesthetic
death! Sure! Who'd know?" He turned to one of the incredulous residents.
"You want to earn fifty bucks?

Look, give me an hour. You just stand there. We don't say you're a vet,
but we don't say you're not. It'll be over before you'd be expected to
actually do anything. Now, we get a scope from day surgery, just to look
good, and I'll get some pentobarbitol syringes  ..." The rest was lost
to me as he slipped his arm around the shaken resident and led him to a
corner where, obviously, he intended to sell him on his plan.

Funny, I always found his zany performances a breath of relief compared
to the pompous demeanor that masked many of our less competent yet more
proper practitioners of the healing arts. But today his flash left me
empty. He hadn't been physician enough to help Kingsly either  ... and
his callousness about the horse disturbed me.

The sound of Carole's long fingernails clicking on her keyboard blended
with the steady patter of rain on my own office window. Here too, very
little light got through the opaque square of glass. Grime or design, I
couldn't tell.

The dirt on the outside pane curdled into a greasy sludge.

When Carole and I were using our desks at the same time, our two tiny
adjoining offices were cramped, but that happened so infrequently, we
rarely found it a problem. We usually left the door between us open so
we could easily speak to each other without getting up.

Carole had given me my messages when I came in. A number of the doctors
had dropped by, wanting a look at the ER study. She'd even walked in on
Kradic and Green hovering over my desk, much the way I'd surprised Jones
earlier that morning. Obviously, Jones had been telling everyone about
it, and until I sorted out those statistics, the whole department was
going to be nervous waiting for the results. It was a good thing I'd
locked up the printouts.

But for now I had to deal with the injunctions. I managed to get through
to a lawyer at our malpractice agency in Albany. It was an insurance
company that specialized in defending doctors against lawsuits. After a
few minutes of assuring ourselves we each had equal meteorological
misery, the lawyer listened to my recital of our plight and a half-baked
plan I'd put together. He said he'd get back to me the next day with a
legal opinion.

After we hung up, I let the rain hitting the window lull me into idle
thinking. A lawyer's emergency response time could be days; a doctor's
was often measured in seconds.

Carole stopped her typing, came through our door, and handed me a stack
of mail--mostly ads for equipment we couldn't afford, and one letter
from a national recruitment group offering me a career change and a job
in Newark. But she'd already opened and screened them, so when she
remained turned toward me, looking at her hands as she rubbed her palms
together, I knew she wanted to talk. It was what she always did with her
hands if something was going to be awkward.

"Okay, Carole, let's have it." She smiled. "You know me too well." She
took a deep breath. "I realize you don't need anything more on your
plate right now, but I've heard some gossip I think you'd better be
aware of." She paused, looked back down at her hands, and kept rubbing
them against each other. "Dr. Jones has been sleeping with one of the
residents," she said, obviously embarrassed.

"Oh, God!" I groaned. I definitely did not need this now, or at any
other time, and especially not from Jones.

Residents were strictly forbidden fruit to our staff.

Male doctors had learned that a decade ago, but in the last eight years
at least three women doctors in the department had had to be told that
sex with the students was, to say the least, inappropriate. And even
then they'd been surprised it was any of my business. "It's the whole
department's business," I'd explained. "If you split up, and there's any
resentment on either side, it can totally poison our working atmosphere.
As for evaluations, they're completely compromised, good and bad. Hell,
disgruntled residents are already taking us to court if they don't like
what we say. Don't hand them a sexual harassment case to charge us with
as well." Those women had been reasonable after explanations of that
sort. I expected no such luck with Jones.

"Who's she sleeping with?" I asked, feeling even more tired than when
I'd finished with Bufort.

"Dr. Todd," Carole answered. Looking relieved to be free of her burden,
she returned to her desk and her typing. She never told me her sources,
and I never asked.

Shit! Obviously his magic hands did more than insert central lines. At
least James Todd was a strong resident.

His evaluations from the other doctors would be positive, so we
shouldn't have any problem with having to defend our credibility there.
But I'd have to speak with Jones-- and I dreaded doing it.

I took out my frustration on the junk mail by smashing each piece into a
tight ball and hurling it into our recycling box. When I got to the
recruitment flier, I called out to Carole, "If they ever send one of
these recruitment things for a doctor in Hawaii, make sure I'm the only
one who sees it." "So, did you name names?" Sean asked. He'd popped into
my office after his own session with Bufort.

"Of course. One glimpse of the bamboo splinters and I immediately gave
him your name. Told him you were planning to murder a horse."

"Oh, really. I heard you were still his number one needier." I groaned.

"Seriously," Sean said, "is he going to start coming after your staff?"

"It looks like it." I sighed. "How about you? How many of your surgeons
regularly needle hearts?"

"Just four. The cardiothoracic surgeons. They don't actually needle them
much, but they do a lot more complicated things to living hearts on a
daily basis. Needling them would be a snap."

"What about the rest of you?"

"We were all trained to do it back in residency, but without having done
it over the years in real practice, few of us could get the kind of
accuracy Bufort seems to be looking for. At least not the younger
surgeons."

"What do you mean?"

"Our conversation the other day made me think of it.

Up until the seventies, if a patient arrested on the OR table, the
surgeon would give an intracardiac injection. It wouldn't happen often,
but over the years any surgeon from that era would get pretty good at
needling hearts." I knew where this was going. "Sean, you didn't!"

"You're damn right I did. The good Dr. Hurst is now a suspect on
Bufort's list."

"Holy Christ!"

"What? You think I shouldn't have told Bufort that Hurst had the skill
to kill Kingsly?"

"Not just to get even, Sean."

"What makes you so sure he isn't the murderer?" he asked, getting a
little testy. "Hell, you know how he's a fanatic for covering up any
scandal in the hospital. Maybe Kingsly was about to cause a whopper. And
what about this crazy agenda for budget cuts that Hurst is suddenly
ramming down our throats, literally within hours of Kingsly's death? The
speed and size of it make no sense. I tell you, Earl, Bufort should take
a damn close look at Hurst!" Sean punctuated this accusation by stomping
out of my office.

I was left totally amazed by his astonishing suggestion.

As much as I detested and distrusted Hurst, and as much as I found his
behavior ruthless, bizarre, and, lately, even frightening, I didn't
think of him as the killer. I never doubted that his first reaction to
seeing Kingsly's body was sincere. But was it? Now I was racing to a
different possibility. Had I actually witnessed a murderer reacting with
horror as his cover-up failed? And if that was true, then his attempts
to frame me for the killing were certain to continue--and have no
limits.

I'd begun to sweat. Another possibility reappeared out of my rising
fear. The dogs. You 'we had your warning! Had the whispering caller been
the figure on the green after all? Hurst? Or someone he'd hired? No! It
made no sense. Even if Hurst had killed Kingsly, he wouldn't try to
frame me for the murder and then risk killing me with Dobermans at the
same time. I had to reign in my paranoia and think clearly. Besides,
something else didn't jibe. Something even more contradictory. If Hurst
was the killer and the anonymous caller, why did he say / know it's you7
Or why would he warn me to back off?

Suddenly none of it made sense. I tried controlling my increasing panic
about what I was up against, but Sean's argument wouldn't go away, and
visions of Bufort with Hurst at his ear, pointing at me, pushed in on my
mind as oppressively as when the detective had leaned against me last
night, warning that I might get in trouble I couldn't get out of.

Damn them both! I had to stop letting them scare me. I needed to get
back on familiar ground, where I could shake off all this weird
speculation. Only one place would do.

I retreated to the ward, where I saw patients for an hour. The routine
was calming, therapeutic even, for me and, at first, for the patients.

I quickly got a young asthmatic breathing comfortably after giving him a
mask of bronchodilators. He wanted to go home, but I explained one
treatment wasn't enough.

He'd need steroids intravenously to dampen down the inflammation that
was closing off his lung. Otherwise, he'd be in trouble again and back.

By chance, all the patients I saw after the asthmatic didn't require
admission. At least momentarily I was spared the frustration of
sentencing anyone to corridor care.

Then a little old lady was brought in because the day before she'd
vomited up black liquid, but hadn't told her daughter about it until
this afternoon. The daughter had rushed her to ER and was pacing
nervously all through the examinations and tests. The mother had had an
upper GI bleed but was remarkably stable. Under other circumstances
namely, the hospital being run like a hospitali'd have medicated the
elderly woman and admitted her to a monitored bed in an intermediate
unit for safekeeping until she could be scoped the next morning. So once
again, just as Jones had done that morning, I tried medicating and
discharging a patient who should have been kept for observation and more
tests.

I tried to explain to her daughter. "If she starts to bleed again,
she'll get a faster response by you calling 911.

That'll get our attention by ambulance through the front door.:: "You're
out of your mind!" her daughter cried.

She was right, of course. "Look," I said, knowing I had to be completely
candid, "here she'll be parked unmonitored at the end of a corridor."

"You call this a hospital?" I looked around at the rows of stretchers,
where the elderly woman could slip unnoticed into shock. I remembered
another daughter's eyes.

"Not really, not tonight," I answered.

"I want to speak to your director."

"I am the director." Horrified, she gaped at my name tag. "Oh my God,
you are!" She looked around at our controlled panic and asked, "What
about another hospital?"

"Unfortunately, that's unlikely. But come, we'll check." I knew it was
futile, but I always showed families "the try." According to our
management manuals we then "share the frustration" and "demonstrate we
are not on opposing sides." The way the daughter chewed her gum and gave
me disgusted looks suggested otherwise.

I took her to the computer reserved for a citywide bed registry. State
of the art; instant documentation of no beds anywhere; all ERS
saturated.

I knew that half the hospitals lied. Some pushed the "code in process"
button to reroute ambulances during coffee break. But most of the time
it was the same as here: medical patients in beds too long, "pet farms"
all over the city. When the changeover to managed care is finally
completed, our soft fraud artist Arnold Pinter and his buddies will be
out of luck, and the beds will empty out. The trouble is, that's the way
they'll stay, and everyone will get to experience the world of withheld
care, just like Donald Cummings had.

I punched in a request for a monitored bed. Three came up. Two were
obstetrical, one was in a cardiac unitall three inappropriate.

Still convinced it was better to level, I explained my logic again, said
it'd be what I'd offer my own mother given the circumstances, and meant
it.

She took my name, called her lawyer on our phone, and then walked out,
leaving her mother with us and threatening loudly that I'd be hearing
from her soon.

It had worked better this morning.

I had the nurses place the lady as close to their station as possible,
and then looked around the department for something else to do. It was
packed with admitted patients and teeming with relatives. Cries of pain
and calls for meds or bedpans added to the confusion, but there were no
new incoming patients for the moment.

I went back to my office. Carole had left for the day. I was alone with
my options and with the gloom applying itself to the window like a coat
of paint.

I thought I'd better call Zak to make sure he'd go easy on sending us
ambulances again that night. I caught him just as he was leaving.

"Sure," he agreed. "But unofficially. Even / can't ban ambulances for
more than twenty-four hours."

"Thanks, Zak."

"So who killed him?" Right to the point. Payment.

"Nobody knows yet, except the police think it's a doctor who can needle
hearts."

"What!"

"You heard me."

"But that's your entire department!"

"Including me."

"Get serious!"

"Oh, I am serious, unfortunately." And I filled his ears with detail.

"Gee, Earl, I'm sorry," he said when I'd finished. He actually sounded
like he meant it.

While I was talking to him, I'd been absently fingering Jones's paper.
The whole project was under Zak's supervision.

"By the way," I asked, "how's the cardiac study going?"

"Pretty good!" Despite it being the end of the day, he sounded
enthusiastic. "Nothing earth-shattering," he began, "but a lot of
confirmation of existing treatment protocols, with a few minor
improvements."

"Jones just handed me her magnesium sulfate study."

"Nice piece of work, that. Too bad torsade de pointes is so esoteric." I
was about to thank him and say good night when I asked on impulse, "Zak,
have you ever had any trouble with her?" He was clearly taken aback. But
when she worked the ambulances on the research study, he was her boss.
"With Jones?" he repeated.

I began to feel a little foolish, but pressed on. "Yeah, with Jones." He
was silent for a moment. Then he asked, "What do you mean by trouble?"
So there was something. "Look, Zak, this is completely confidential. It
would help me if you could answer." "You mean trouble with her work?" he
asked, still cautious.

"With anything." He was silent again.

While waiting for his answer, right out of nowhere, I suddenly thought
that Zak had had sex with her too. That startled me, and I was wondering
where the hell it had come from when he finally spoke.

"Never any trouble with her work," Zak said slowly.

"She's become our best resuscitator over the last few years. I'd be lost
without her."

"What about her personal relationships with the staff?" I asked, still
trying to shake off my intuition that he'd been involved with her.

He snorted. "What relationships? The other doctors resent her like hell.
She's abrasive and rude, and very defensive whenever I try to deal with
their complaints about her." Just like here. Sort of Kradic in a dress.
So it wasn't only me.

"Funny though," he added, "the technicians love her.

She's always teaching them, and they can't get enough time with her on
the road. She's good with patients too.

It's the other doctors she can't get along with. And it doesn't help
matters any that her survival rates are way ahead of theirs. Why are you
asking about her?"

"I'm having similar problems. I wondered if it was a personality clash
between us."

"Well, stop blaming yourself. She's a brilliant clinician and an
insufferable prima donna. They exist all over our profession. Patients
are lucky to have them, we mere mortals have to endure them. Good night.
Chief. I'm going home."

"And I'm blessed with two of them," I muttered as Zak hung up.

I did glance quickly at the summary of Jones's study.

As she had said, there were good results for a rare condition, but no
clear-cut extra help against our common enemies.

The method and statistical precaution against chance giving false
conclusions seemed sound. Still, as I filed it, something that I
couldn't pinpoint niggled at the back of my mind. If we ever got back to
normal, I'd sit down to dissect the paper in detail.

Janet was on duty in the case room at her hospital for the night. There
was nothing more to do here. Tomorrow at noon I had private office hours
for patients from my former general practice. I'd kept them on to
counterbalance taking over emergency eight years ago. It was shelter
from the storm.

But I needed a respite now. If I didn't occupy myself with something
engaging, I'd end up dwelling on Kingsly's murder and likely make myself
panicky again. I unlocked my desk drawer and eyed the statistics I'd
hidden there earlier.

They were the perfect excuse to indulge in a guilty pleasure and a way
to keep myself calm.

I made a quick call to Janet's answering service and left a message
about where I was heading. Pocketing the computer disks I'd need, I
scooped the reports under one arm and carried them with me while I gave
the ER a final check.

"We're okay for the moment," Popovitch said goodnaturedly. He eyed the
printouts. "And good luck with the statistics, but you're going to get a
hernia lugging all that paper around."

"Take care," added Jones with a slight smile.

I didn't smile back. I still resented her snooping this morning, and
evidently talking about it later, but it was her liaison with James Todd
that troubled me most. I wasn't going to confront her on the ethics of
it tonight, but as I looked at this fierce, athletic woman, I suddenly
visualized her writhing naked with Zak, then Todd. It had been little
more than a subliminal flash, but thinking anything erotic about her at
all surprised the hell out of me, and I turned away, embarrassed,
dismissing it as part of my preoccupation about her and Todd. I wished
everyone else a good evening and left by the back door.

The parking lot was filled with more mist than cars. At the freight
entrance, an ambulance stood in a pool of sodium light, and through its
rear doors two attendants were loading a stretcher with a body bag on
it. Probably they were making a pickup for a funeral home of a patient
who had died recently. I wondered if it was Cummings. Above, the
hospital lights disappeared upward into gray. Only the administration
wing was dark except for the finance office. Like the night before, it
was still lit. I could even make out a figure moving behind the glass.
As I watched, I became aware of someone else nearby. Turning, I saw Gil
Femandez standing beside his car and looking up at the same windows.
Huddled in a raincoat, he lacked his usual bravado. It was probably the
streetlight, but I'd seen precedes with more color.

I jerked my thumb back at the window in question.

"Maybe the good Detective Bufort will fix our budget while he's at it."
I'd expected Femandez's belief in himself as a brilliant manager to make
the crack work. Instead, startled, his face drained further, to the
color of lard. He jumped in behind the wheel of his car, slammed the
door, and sped away without a word.

I stood there as his taillights disappeared from the lot.

Until then, I'd been mildly curious about Femandez's look of relief when
he first heard of Kingsly's death. It had been odd, but I certainly
hadn't wanted to read too much into it.

What counted more was the look of fear I'd just seen on his face.

Gil Femandez was terrified.

My guilty pleasure was a log home. I'd found the place years ago.
Originally it was a simple cabin more than fifty years old, lovingly
constructed on the edge of an isolated mountain lake surrounded by
eighty acres of forest. Janet liked to tell people that I had taken her
there before I ever took her on the ritual visit to Mom and Dad.

We'd modernized it with carpeting, electric heaters, a pool-size
bathtub, and, for real luxury, an indoor toilet.

Later we added a large addition and ended up with a log and glass home
well over a hundred feet long, full of spacious rooms with high ceilings
and magnificent windows.

Janet had assumed total control over the kitchen and melded a full
collection of electrical appliances with the woodstoves. The lady and
the lumberjack was what Janet called us when we were there. More
important, it was a sanctuary, a place to find intimacy and laughter, a
healing place.

It was also where I kept a computer and fax machine, and was the hideout
I retreated to if I needed to do more than an hour of uninterrupted
work.

I'd gone home to pick up Muffy and then headed south out of Buffalo
toward the mountains, all the while trying hard not to think of the mess
and horror I was driving away from. I passed through the clutter of
junkyards and failed industries that ringed the city. They formed an
urban garbage heap tossed farther and farther out. Even when I reached
the countryside there was no clear break.

From the highway I could see a jumble of trailer homes and cheap new
bungalows built up on top of the brokendown farms of the previous
generation. In turn, the grandchildren playing on this land in the dusk
would only know how to farm welfare. I caught a glimpse of an old man
staring out a window at the barren fields.

Probably he'd once made them rich with food. I was willing to bet that
in the background a TV nickered, showing pictures of starving kids
somewhere in the world.

Starving kids. Suffering kids. Corridors full of suffering people. I
couldn't shut out the images or associated thoughts. Hurst. Back in my
office I'd figured if he was trying to frame me because he'd murdered
Kingsly himself, then the whispering caller had to be someone else. But
who? And why? I'd been so sure it was Hurst telling me to back off my
attempt to close the ER. Could someone else be that angry about it? One
of Sean's surgeons upset about the loss of income? Or even one of my own
doctors? Could any of them be that crazy about money? Perhaps crazy
enough to set a pair of Dobermans on me? Dammit! I was starting to let
what I didn't know panic me again. If I was ever going to get out of
this mess, I had to stop jumping to conclusions and think clearly.

I reined in my wild thoughts and focused on something familiar. In
medicine, when faced with a set of symptoms and signs, we lay out a
differential, a list of all the possible diseases that could cause the
initial facts of the presenting sickness. Then we do tests to get more
data, and in the end we look at which diagnoses fit most of the facts
and which don't. I tried to apply that process to my current problems.

Singling out Hurst had only led to confusion. It was time to do a
differential, consider all the other possibilities, including the chance
that Hurst was neither the killer nor the person on the phone. All I
knew for certain was that he'd made sure the police included me on their
list of suspects and he was ramming through an illogical set of bed
cuts. The rest I'd assumed. Even about the warning.

Now that I was thinking diagnostically, I realized back oj(f hadn't
necessarily meant back off closing the ER. I'd have to keep an open mind
there too.

Up ahead I saw some hot-dog stands come into view.

Faded and rust-chipped, they cluttered the edge of the highway like
litter. They had Drink Coke signs from the fifties that would have been
trendy in some downtown establishments, but here they simply marked when
the progress had stopped. I couldn't buy a drink. These concessions had
closed for the winter. They looked just as dingy in summer, and I never
stopped then either.

I let my mind drift onto other possibilities. Images of Femandez's
desperate expression returned to blur in with the passing roadside and
persisted on the edge of my thoughts. I made a try at including him in
my differential.

He had looked relieved when Hurst announced Kingsly's death and not
called it murder. Then that relief seemed to vanish when Bufort had
revealed it was murder. Again behavior perfectly consistent with a
killer whose coverup initially seemed to work and then failed. Exactly
what I'd thought earlier about Hurst's behavior.

But now I wanted to think critically and avoid easy conclusions. I was
going to have to get used to thinking about murder in this familiar,
clinical way.

I continued my new application of an old skill, more for the practice
than any real hope it would get me anywhere.

There could be other explanations for Fernandez's symptoms. His apparent
mood changes could have been coincidental and stemmed from some other
unrelated nightmare. His wife might have announced she had a lover, or
one of his kids been diagnosed with cancer, or even a malpractice suit
been threatened against him. And some things about Femandez didn't fit
the diagnosis of him being the killer. Even though his initial calm had
vanished, he still hadn't seemed more obviously upset than the other
chiefs when Bufort finally did say Kingsly had been murdered. And why
was he panicking now, after Bufort had clearly indicated suspicion was
primarily on the ER and those few doctors in other parts of the hospital
who could needle hearts? Femandez might have gotten some rudimentary
training about how to administer an intracardiac injection during
medical school, but as Sean said, that would hardly be enough to give
him the means of murdering Kingsly now.

Occasionally mist drifted across the liquid mud fields on either side of
the road. Sometimes it glared in my headlights and hid the dirty
pavement snaking out in front of me.

There was hardly any traffic. In my rearview mirror I could see only a
single pair of headlights keeping a steady distance. I was glad the
driver was being cautious; I didn't want any tailgater humping my car in
a fog patch.

By this point in the familiar drive, I'd usually left thoughts of the
hospital far behind. But I kept obsessively turning over why I had an
uneasy feeling I was missing something about the murder, a connection I
was sure was there but had eluded me so far. About Femandez? I didn't
seriously think he could be the killer. But had I forced a case against
Hurst to avoid adding the real nightmare possibility to my differential
diagnosis--that the killer might be a member of my own department? Again
the thought of unchecked suspicions about my staff that I couldn't
control sent a chill down my back.

Finally the road left the sodden flatlands for some real rock and pine
turf. Climbing one interminably long hill, I was suddenly above the fog.
A full moon rippled the mist lapping around the bases of floating hills.
It was the first sky I'd seen in more than a week. I opened the window
and inhaled deep breaths of clear, frosty air. I laughed and woke up
Muffy, who immediately scented the wild.

She sat panting expectantly, ready to run out her hunting fantasies in
the night woods. I ruffled her ears and got licked in return. Thoughts
of murder started to subside.

Soon I slowed for our turnoff. It was foggy again, and remembering the
pan- of lights behind me, I quickly left the highway for the narrow dirt
road leading up to our lake. As I started the climb into the deepening
mist, I saw in my rearview mirror the passing taillights of a large
square-ended van continuing north through the night.

The road was rutted hard in the mountain frost, but I preferred it to
the mush we had left behind. Pointing up the incline, my lights tunneled
through swirls of bare tree branches awaiting winter. The beams
exaggerated the bouncing motion of the car and gave our progress the
feel of a boat plowing seas.

A few minutes later I pulled into the graveled parking area and was met
with the glare of the automatic floodlight snapped on by movement
sensors picking up our arrival. Muffy was unrestrainable. As soon as I
got my car door open, she bounded out and happily ran into the woods. I
struggled with the computer printouts and made it to. the front door
before the timed light went out and left me juggling keys in the dark.
Door open, I plopped the paper stack on a rickety antique entrance table
more suited to delicate riding gloves than the pounds of data
encumbering a modem man. But the table was a favorite of Janet's, so
there it stayed. Then I switched on the lawn lights and stepped back
outside.

The grounds were a lacy melange of vapor and backlit trees. The only
sound was from the distant creek, the rush of its swift currents defying
the coming winter to turn it into ice. Muffy trotted up and put her head
under my hand for an ear kitzle.

Our breath joined the general haze. As I turned to put her in the house,
the first flakes of a light snow began to fall. In minutes I'd chucked
my intentions to work and was asleep under a skylight framing diamonds
and mist.

I have no idea what time Muffy went on alert and roared out of the
bedroom down to the front door. But the ferocity of her bark told me we
had a night visitor. Raccoon most likely. The barking raged on. I
mumbled, "Good girl," and went back to sleep even before she finished
her tirade to scare them off. Good riddance. Raccoons made a mess of the
place.

I wouldn't call it first light. This time of year it was a lighter shade
of gloom. But it was enough to signal my sleep-sogged brain it was time
for coffee and a start on the computer with my stack of stats. The
coffee was easy--a form of yuppie instant that involved pouring boiled
water on fresh grounds, waiting a few minutes, then pressing down on a
plunger. It was the only piece of kitchen equipment Janet let me use.
She considers me so technically challenged, I'm banned from cooking.

My first sip coincided with a glimpse through the large windows that
surrounded the oversize kitchen. The lake was black, but covering
everything else was a powdering of snow. In a magic instant the brown
month had been banished and made over. It was one of the annual
landmarks of life, the first snow. It never failed to lift me from adult
routine back to childhood, inspiring me to play and infusing me with a
sense of sweet freshness in which all was possible again.

I was still wearing a smile as I lit some kindling in the kitchen
woodstove. It performed like a furnace and was the fastest way to cozy
up this end of the house. My computer room was directly above on the
second floor, and I wanted it warm up there. When the crackle and scent
of wood smoke assured me the fire was well started, I went to the front
entrance mudroom to get the printouts.

Muffy, monitoring me out of a half-raised eye, saw this move as
interesting to her. She arched in a leisurely poodle stretch, then
pranced to the door to be let out.

Absently, I reached for the knob, then stopped. Outside on the wooden
stoop and stone pathway the white dusting was already beginning to fade.
Still visible was a set of footprints. They came up to the door, turned,
and retreated back down the path.

Chapter 8.

I held my breath. Muffy, sensing my alarm, went still, listened, but
didn't growl. I let myself slowly exhale and tried to rationalize. My
prints from coming in? No, the snow had started just after we arrived.
Hunters were a constant nuisance, but they stayed away from the cabin,
out of sight.

The chill of the simple truth sank in. Someone had tried to break in on
me. Only Muffy had made the difference.

Her lack of concern now was reassuring. Whoever had been here was gone.
But the footsteps were a slash across my earlier mood. Isolation was
stark and beautiful, but the wilds were also a place of menace and
natural violence.

Yet in nature there was reason, usually. Bears lived in the next valley
over, but, unspoiled, they stayed away. I'd always felt more people were
killed in gun accidents than bear attacks, and so I never considered
arming myself. Against human menace, the long drive in was both
protection and a trap. Shutters on the windows and a chain gate over the
road discouraged casual vandals.

To a real creep intent on trucking the furniture away, however, we were
vulnerable. But they were cornered if seen. Our defense had come down to
a couple of beware of dog signs and letting Muffy roar her head off at
unwanted guests. Sort of security by the Wizard of Oz.

It was damned effective too. I even left the chain down most of the
time. It fooled hunters into thinking we were there, and Muffy had
actually chased them off enough times that they were too scared to find
out for sure. Those prints, however, already fading with the melting
snow on the darker stones, were mocking me. A hunter wouldn't come to
the door. A kid looking for a place to throw a party, or an intruder
with a more sinister purpose? know, Doc. I know it's you. You've had
your warning.

Back off! I felt a chill again, remembering the dogs.

But there were no paw prints anywhere.

Why would I be a target? I didn't know who had killed Kingsly, or why,
and I hadn't a clue how the murder had anything to do with me. That
hadn't meant much to the cops so far, thanks to Hurst, but it sure
should have been clear to the killer, and keeping me alive would be what
made sense, as long as whoever it was knew I was a suspect.

I was probably overreacting again. It was pretty farfetched to think the
footprints had anything to do with the murder at all. Maybe they were
made by a common thief here to steal a VCR.

Nevertheless, I put Muffy on her leash to keep her near me until I made
sure no one was still hanging around. We stepped outside. It was frosty,
but the footprints disappeared where the graveled parking area ended,
and the darker cinder road had already melted the snow. Muffy showed
little interest. The hard surface refused to even hint where the
intruder had headed. I shivered, this time because I was still in a robe
and slippers. I let Muffy off her chain. Me, I needed the warmth of
indoor plumbing.

I refused to let my paranoia chase me back into the city after coming
all the way out here to work.

Besides, the respite offered by working on the QA data for the next
three hours was the only remedy I had at the moment for my paranoia.

Carole had saved me days by entering the data for our major diagnostic
categories on a floppy disk. It was pretty routine stuff, and if I
needed anything more esoteric, I could still refer to the original
printouts.

Studies of lawsuits had identified that two-thirds of screwups came from
six types of problems: chest pain, abdominal pain, missed fractures,
nerve injuries, intracranial bleeds, and meningitis. Knowing where to
look before going in always makes the odds better to find our flaws and
to learn.

These major categories were behaving as they should.

The classic--chest pain--presented about a hundred and twenty times a
week. In this group, only four, statistically and on average, would be
real heart attacks, but the trick was to know which four, and which
weeks were not average. Sixty would be cleared right off, and be sent
home with acetaminophen for sore muscles or antacids for indigestion.
But in the remaining sixty, there would be four heart attacks and four
unstable anginas about to become heart attacks, statistically speaking.
To find one MI, it takes a workup on fifteen suspicious chest pains,
according to studies on centers that get it right ninety-five percent of
the time.

Out of more than two hundred proven Mis, we had mistakenly sent home
only five in the last year. One died at home. The other four, each
feeling increasingly worse after discharge from the ER, had made it back
to our door. One arrested in the hallway and failed to respond.

The other three had survived.

Each case was a different physician. The chart review had revealed an
error in judgment, not negligence, in all five cases. Statistically,
this was all acceptable. Individually, I felt pretty disgusted knowing
we probably would miss another five this year.

Abdominal pain shaped up miserably, as expected. Our initial diagnoses
were wrong, or right, fifty percent of the time. This was a national
average no one seemed able to better. It just was a reality that initial
presentations of abdominal pain were hard to pinpoint and required
repeated reassessments and follow-up to finally nail the problem.
Knowing this, we could act with appropriate care. Two physician numbers
popped out of the norm here. I had no idea who; a code kept identities
unknown in me raw data prepared by medical records and submitted to the
state health department. An individual physician's performance would
then be known only to that doctor and myself, after I analyzed the
statistics.

While one doctor had been correct in diagnosing appendicitis one hundred
percent of the time, another was only sixty percent accurate. The first
physician was actually the more dangerous of the two. Every patient this
doctor had diagnosed as a possible acute appendicitis actually had an
acutely inflamed appendix when they were opened. That pattern meant only
the most obvious cases had been diagnosed and the subtler presentations
had been sent home. In a good center where appendicitis was not usually
missed, a competent surgeon would usually have to open five bellies to
find four acute appendixes, and would take out a perfectly normal
appendix twenty percent of the time. The doctor whose initial diagnosis
was always right had not been referring enough patients to surgery. Sure
enough, further down in the study, this same physician had a
disproportionately high number of unscheduled return visits with a
ruptured appendix attributed to his or her code number.

The second doctor was calling everything acute appendicitis.

As a result, he, or she, wasted time, tests, and money, and had
subjected too many patients to the dangers of unnecessary surgery. Of
course, an overeager surgeon was partly to blame here too.

I also noted another problem. Too often the diagnosis for abdominal pain
was constipation. Repeatedly, I'd stressed to staff and residents that
constipation was a symptom and not a diagnosis. It could be caused by
anything from colon cancer to not enough fiber in the diet and, if it
was unusual for the patient, indicated the need for further
investigation in a follow-up exam. Obviously, the procedure bore
repeating.

And so it went--injuries and deaths caused by our mistakes and errors
dulled to the dry stuff of tables and numbers. Even then, whatever harm
we did was statistically rare enough that we were no worse than
physicians in other ERS. In other words, as long as we screwed up within
national norms, we could claim enough competence to still go out there
and perform.

And occasionally, just as rarely, we achieved those elusive miracles.
Still, I was as depressed as I was fascinated.

Looking at a year of our cumulative mistakes had a sobering effect on
me. Until I broke the code, I didn't even know my own performance. Maybe
I was the one sending home the acute appendixes.

It was ten o'clock when I shut down and got ready to leave for the city.
I'd gotten barely a third of the way through the main groupings of
possible errors.

Outside, I welcomed me frost to clear my head. At least I'd kept myself
from feeling afraid for a while. I'd grabbed an apple for a late
breakfast and balanced a final cup of coffee on the way out to my car.
The footprints had vanished to a glistening varnish on the stone
walkway. It was still cold enough that the lawn and surrounding forest
floor had stayed white.

I got Muffy into the car, and we headed down the mountain and back
toward Buffalo. The prettiness was lost, however, as I started to dwell
on those footprints again, and inevitably Kingsly's murder. Even in a
hospital where death was common, the grisly killing sickened me. Maybe
it was a delayed reaction, postponed like so many other emotions in a
doctor's life by all the practical coping we're forced to do. More
likely, I'd been trying to deny another question I feared, but Bufort's
dressing-down had finally shamed me into facing it. I could still
visualize Kingsly's pathetic body, as dissolute in death as was his
life. Would his fate have been different if I'd tried to help him? My
mood became even more morbid as I swung through shrouds of mist so
thick, the wipers had to part the droplets left by them on the
windshield. Other memories of death crowded in uninvited like silent
accusers in the fog. I remembered two little girls and their dead
father. I shook my head and tried to drive away the unwelcome visions.

The practice of medicine could rip your heart out.

Most people can mercifully ignore the parade of terrors happening to
others and trust that the odds will keep such horrors away from them.
But our job is closer to the front, and we see every day the ways life
can go horribly wrong and sink into pain and death. Some days I can't
keep the images of it all out of my head. And sometimes it makes me
think the worst.

I thought again of the footprints. Despite my previous dismissal of
their relationship with Kingsly, I now felt a lot less glib here in the
fog than I had in the clear beauty of the mountains. Because there was
yet another possibility.

If the killer feared exposure from me, then I might very well be a
target. Had the menace really faded with the melted snow? Or had those
prints marked the approaching steps of my own turn with a murderer?

It was less misty by the time I'd reentered the outskirts of Buffalo.
There was no vestige of snow here, just gray sludge. The prenoon traffic
rescued me from dwelling any further on the darker thoughts I'd had on
the way in.

I flicked the radio to a traffic report; bad everywhere. I listened to a
weatherman assure me this was the worst November in ten years for
consecutive days without sunshine. He proceeded to interview three
experts who argued with one another over the cause. They couldn't agree
on global warming, pollution, or rogue volcanoes, but all of them
predicted tomorrow would be more heavily overcast than today and warned
that record smog levels, would make breathing difficult for people with
lung conditions. Janis Joplin then rendered a little bit of therapy with

"Me and Bobby McGee." When I finally got to hear the news, Kingsly's
murder was the lead story. It was brief, contained little more than the
essential facts, and said nothing about a cardiac needle. There was a
brief statement by Hurst assuring the public that the tragedy in no way
compromised St. Paul's capacity to give proper care to its patients.

I drove directly to my private office beside the hospital.

The patients that I'd kept in my general practice put up with the crazy
demands on my time that went with becoming chief of the ER. At least
they had me where it mattered for emergencies, if I wasn't in some damn
meeting. More than this, I'd known them so long, many had become
friends.

Muffy wasn't thrilled at being left in the car. I'd call geriatrics and
see if they wanted some pet therapy that morning.

It was 11:55 when I entered the quiet of my still-empty waiting room.
Barbara O'Hara, semiretired, a grandmother, and previously secretary to
a half dozen former chiefs, was my receptionist here. It was her
judgment and interest in the patients that let me be away so much. She
looked up from her crossword.

"Coffee? Or messages first?"

"Coffee, please, and good morning to you too."

"Good, because your first appointment isn't until twelve-fifteen, and I
want to hear about Kingsly." I hadn't seen her since the murder and had
forgotten that among the many regimes she'd marshaled, she'd had a short
stint as Kingsly's secretary. When he put a move on her, she quit.

I settled into a chair with the cup warning my hands and gave her only
what I had seen on the night he was found and later at the autopsy
table. I left out my own speculations about Hurst and Gil Femandez, but
when I described how Bufort was starting to focus on the ER physicians,
she stopped me with a question.

"What about you? Do you think someone in your own department did it?"
Right to the center of what I'd been avoiding. But my instinctive answer
came without hesitation. "No. I don't, and talking to you now, I just
realized why."

"You mean besides your not wanting to believe it?" She was one cagey
grandmother. "Yeah." I smiled a little sheepishly. "I mean, Bufort is
focused on who had the means, the skills to accomplish the killing, but
not on who had the motive. I neither know of nor can imagine any
connection between Kingsly and one of my staff that could be a motive
for killing him. Until someone finds that link, if it exists, then the
fact that we can all needle hearts doesn't amount to much." She thought
for a moment and then commented. "I bet it was one of the women he
molested, because it's what I would have done, with anything handy, if
he had actually tried to force me into sex that night he came at me." It
was after that encounter that she had come and offered to work for me.
She was way overqualified, and I needed someone only part-time, but
she'd had it with the seediness of hospital politics and a lifetime of
keeping its secrets. Working for me freed her for her husband, garden,
and grandchildren. Yet now her voice had a steel in it I'd never heard
before, but it left no doubt. If Kingsly had stirred such fury in this
gentlewoman's soul, the list of possible killers could have gotten a lot
longer.

Except that secretaries and cleaning women didn't know how to use
cardiac needles.

"You know, Mrs. O'Hara, it's exactly what I thought at first. But the
autopsy didn't show he'd been stabbed blindly by someone trying to keep
him from attacking. It was done by someone with the knowledge and skill
to needle a heart." She looked a little surprised, then thoughtful, and
was about to say something when my first patient arrived.

General practice is the minutia of medicine. Blood pressure checks,
controlling angina, healing ulcers, managing pain, consoling,
comforting, and above all listening.

It's the opposite of attempts to save a life in a matter of minutes. In
general practice, patients' stories are told at the pace of life
unfolding. The visits and checkups over the years slowly reveal more
than sickness and health.

I marveled at the courage, humor, and toughness of some of my patients
who had survived great losses and yet managed to have fun between the
disasters. Calamities hit everyone, but these special few showed me that
escaping from a life of melancholy to a world of laughter and friends
was sometimes a matter of choice. Even the uneventful lives with no big
upheavals were fascinating.

Visit by visit, a glimpse at a time, I came to know who lived with vigor
and joy and who just moodily endured.

The slow pace of the afternoon was restorative. Who was healer and who
was healed blurred. As three o'clock approached, however, the distant
howl of ambulance sirens began penetrating the inner calm of my office.
Each was a reminder that emergency was still getting hit and I was due
back soon. The last patient barely got my attention.

At 3:01 my phone rang. I'd taught our doctors and nurses enough that
emergency could solve its own problems and leave me uninterrupted when I
was at my private office two times a week. Today the deal ended at
three. "You on your way?" Susanne asked. No effort wasted; no need to
identify herself.

"Nan! I got tickets to Cuba instead."

"Must be the same flight I'm on. See you." Ten seconds in the place and
I wanted to resign.

Stretchers ran double down both sides of the hall. I could barely pass.
The stench of body dirt had trebled since the day before, and the noise
was worse. There was nothing I could even pretend to do, and it scared
me. Waiting relatives were looking at me with the expectancy that here
was someone, finally, who was in charge and could allay their fears.

"Holy shit!" was all I could say. It wasn't Churctiillian.

In seconds they had reached the consensus that I was as useless as I
felt, so they went back to arguing with the nurses and doctors. That
freed me to start getting mad. I lit out down the corridor of reaching
hands and sheeted misery and blasted open my outer office door so hard,
Carole jumped and tangled herself in a Dictaphone wire.

"Get me that lawyer in Albany I talked to yesterday," I ordered while
marching into my office. "If he's not in, tell them I need him now, even
if he hasn't finished lunch." Then I dialed Hurst on my other line.

"Office of Dr. Paul Hur-- "This is Garnet in emergency," I blurted out
without letting his secretary finish. "Tell him to get down here now!"

"I'm sorry. Dr. Garnet, but he's in a meeting with senior management,
and I couldn't possibly interrupt--"

"Get him to emergency in two minutes or he can seniormanage my calling
the media and warning the public away from this meltdown!" I slammed
down the phone before the gasp. Carole was at the door indicating she
had the lawyer on the line. She discreetly reminded me of his name
before I punched the button to speak with him.

"Bill! Earl Garnet here. About that problem I asked you about yesterday.
It's really hit the fan and I've got to move. Any luck?" His answer
started with "Well, here's what I found." The next few minutes were
taken up by my saying "yeah" a lot and scribbling a few notes.

At the end I asked for a formal letter containing the substance of our
conversation and thanked him. I meant it. He'd just given me the weapon
I needed.

Back in the corridor I saw Hurst surrounded by the same desperate clutch
of patients, husbands, wives, lovers, children, and friends of patients
who justifiably had found me of no use before. While he worked his kind,
concerned routine, I caught his eye and gave a mock salute, and left him
there. I could sense his hatred pelting my back all the way out the
door, where I quickly felt a lot less cocky. I hadn't seen Hurst since
Sean had voiced his suspicions and expanded my own wild speculations
about him as well, but instinctively I feared him now. I'd no new
inkling whether he had murdered Kingsly, or was taking our usual
political skirmishes to a new extreme for some other hidden reason. Nor
had I any better idea what he was capable of doing to me, or what he was
up to. But until I knew why he had tried to make me a suspect, even
challenging him on the bed cuts could be dangerous.

I didn't have any destination at the moment, just the intent to let
Hurst simmer in the mess he'd helped create while I planned my next move
and the best way to use what our insurance agency lawyer had given me.
Suddenly I realized my name was coming over the PA. I got to a wall
phone and learned that Watts wanted to see me in his lab. I waited while
they transferred me through to his private line.

"Earl?" he said on picking up.

"Yeah, Robert, what's up?"

"Are you busy?"

"Am I ever. I've got a meltdown in the ER, and I just suckered Hurst
into an unscheduled meeting with all our angry users. Let him explain
budgets and bed closures."

"I think you'd better come down here and see something."

"Hey, Robert, I always learn from your sessions, but this just isn't a
good time."

"You've got to see this now!" he said abruptly, and hung up.

It was unusual for Robert to press. Immediately worried, I walked
quickly to the elevator, found it an inordinately long wait, and took
the stairs instead. As I descended to the basement, then trudged through
the tunnel passages that led to the autopsy room, I wondered with
increasing dread what my usually friendly mentor wanted to show me that
was so urgent.

Watts and I had grown to respect each other's clinical skills, having
met regularly about cases over the past twenty years. During the last
eight, we'd managed to kid each other through the absurdities of
hospital politics as well. In the interludes, with a comment here, a
joke there, we had become friends of sorts, not close, but still
friends. I knew he loved sailing and planned to escape to it when he
retired. His last child had left home years ago and recently had started
a surgical residency. One time, waiting for some useless meeting to
begin, he'd leaned over and announced, "My wife and I were alone in the
house for the first time in thirty years last night. It was weird."
Then, a little more than two years ago, his wife died. Colon cancer.
Widespread metastases. She was dead within three months of the
diagnosis.

I had found it hard to comfort him. His broad shoulders so bent with
pain brought a lump to my throat. What could I say? Finally, I had
ncient Irish phrase I'd heard from farmers at my father's funeral: "I'm
sorry for your troubles." His gray eyes had filled with tears, and he'd
turned away. A week later he was back at work. We never spoke of it
again.

These patches of insight made a collage more than a portrait. I didn't
really know him. But we faced pain and death together, and we exposed
our triumphs and failures to each other. Now and then, when it was most
needed, we told each other, "You did good." Watts was a guy I laughed
with, a guy I liked a lot.

He met me at the door of his autopsy suite in full protective garb and
made me stop by the lockers in the changing area to replace my white
coat with a green OR gown. I also put on a mask, pulled on a hair cap,
and slid a pair of paper slippers over my shoes. He advised me we
wouldn't be cutting tissue, so I needn't put protective goggles over my
glasses, but that I should double-glove for handling organs. Since the
resurgence of antibioticresistant tuberculosis in America's inner
cities, most of these precautions were protection against airborne
organisms as well as parenteral agents such as the viruses causing AIDS
or hepatitis. We would also practice reverse isolation on the way out,
carefully depositing our protective garb in a bin at the door, to avoid
carrying lethal strains of anything into the rest of the hospital.

Stepping into the brightly lit autopsy suite, I noted he had two corpses
there, and both were cut open. The insides of the bodies looked the
same, the postmortem having reduced them to basic colors. Their trunks
were slit from the top of the breastbone to the pubis and the halves
spread to expose two red pods streaked with yellow fat and white sinew.
The lungs were blue with pollution, and in each abdominal cavity a
purple liver and an ochre spleen lay atop a glistening tangle of
intestines. On one, the breasts had been parted and laid to each side.
On the other, a limp and bedraggled penis hung down between withered
legs.

The heart had been removed from the male, but was left in place in the
female.

Watts hadn't yet opened the craniums, but in the male, the scalp had
been given an incision around the back of I the head and peeled over his
face. A small circular bone saw lay on a nearby instrument table ready
for use. On the left-hand counter by the male were two rows of labeled
tubes and small specimen jars containing various body fluids ready for
toxicologic testing. Other bottles stood empty and would be used for
tissue samples taken ' later. An open Tupperware container in the bottom
of i one of the deep sinks held the removed heart. More coni tainers
were stacked on wall shelves and would eventually hold other vital
organs. On the right-hand counter by the female lay a complete set of
tubes and jars, still > empty. Over each dissecting table, large venting
hoods ' hummed, doing their best, but the fumes of formaldehyde and
other toxic reagents stung my eyes. And, in spite of my mask, there was,
of course, the smell of dead flesh.

But I was puzzled. It looked like he was partway through a complete
autopsy on the male, then stopped, and had done only a partial "limited
look" at the heart, lungs, and abdominal cavity of the female. I waited
for him to explain.

Watts pointed to the female. "This is the Jane Doe you got yesterday,"
he began in his familiar, professorial way.

"And this," he added, turning to the male, "is the John Doe from
Monday." He caught my surprise.

"I know," he continued, sounding abject, "I didn't take your concern
about the mark on his chest seriously. But when we got the Jane Doe
yesterday, I called the medical examiner and he confirmed there really
have been too many of these DOAS all over the city lately. He's going to
start having all the hospitals look closely at them. Since I had John
here on ice as well, the ME said to give him a thorough autopsy." He was
putting a heavy apron on as he talked.

"There was nothing unusual on Jane there." He nodded toward her corpse.
Then he leaned over John and reached into his chest cavity to what was
left of the cut-open sternum, or breastbone.

I was getting a funny feeling.

Watts was folding back in place me two halves of the chest wall he had
cut open to start the post. There, like a dancing marionette wire,
quivered a thin stylet identical to the one he'd used earlier to trace
Kingsly's mortal wound"Unfortunately, Earl, you were right. That small
mark you noticed was a scab over a puncture mark. Except the needle had
been inserted and withdrawn cleanly, unlike in Kingsly's case, so it was
even less perceptible. I doubt anyone else but you would have noticed
it, even after Kingsly's murder. I feel like a fool for having ridiculed
you, because right now we have to assume it's possible the chief
executive officer of this hospital and this dow nand-out homeless John
Doe were both murdered with a needle to the heart, and I delayed the
police finding out by forty-eight hours." It was insane. Crazy. Despite
having initially found the mark myself, I was sure he had to be wrong. I
started grasping at logical explanations. "Someone must have tried
resuscitating him prehospital and it wasn't recorded."

"That was my first thought too, but I already doublechecked with MAS. It
was a DOA picked up in an alley.

Long dead. There was no attempt at resuscitation made." Watts seemed
weary and paused, then added, "I know it's hard to accept. I've run it
over and over looking for some other explanation myself. But the entry
wound on the heart in that container over there is in perfect position.

John Doe was stabbed same as Kingsly, by an expert. Of course, I'll need
my tissue samples to confirm whether the needle went in before or after
death, but without the history of a resuscitation attempt, murder,
however inexplicable, has to be our working diagnosis. I'm just kicking
myself for not following up on your first impulse." The shock left me
nervous. Since I was a kid, a serious situation had always made me
giggle; I didn't giggle, but my next crack was its verbal equivalent.

"Maybe John and Kingsly were drinking buddies?" Detective Bufort was not
a happy man. We'd pulled him out of the hospital's finance department,
where he was hovering over a group of men uniformly dressed in white
shirts, gray slacks, and black shoes. Only the ties varied. They had
taken their raincoats off, giving a slightly new meaning to the term
"plainclothes," and resembling more the members of a firm of certified
public accountants than cops.

With all the focus on the hospital books, I realized Bufort must have
figured Kingsly's death had something to do with money. I wondered if
that was why Gil Fernandez had looked so frightened. But a dead vagrant
didn't exactly fit the financial crimes profile.

"Impossible!" Bufort had spat out as we described our find on the way to
the morgue. Having to put on full protection against airborne infections
made him even more irritable. Actually seeing the guide wire tracing the
needle stab to the heart seemed to make him angry.

"Preposterous!" He glared at Watts. "You must be wrong. This goes
against everything we've found so far in our investigation. You've
obviously made a mistake." He was nearly stuttering, he was so upset.

"My big mistake," said Watts, sounding miserable, "was ignoring Dr.
Garnet when he suggested I take a look at this mark two days ago. I
practically laughed him out of the room." He shook his head. "I can't
believe I was so stupid." Bufort swung around to face me. "You reported
this two days ago! And you didn't tell me?" "Detective Bufort!"
interrupted Watts. "I said the delay was all my fault. If it hadn't been
for Dr. Gamet being so alert--"

"Dr. Watts, I'm not interested in your very noble and entirely
predictable defense of a colleague," snapped Bufort without taking his
eyes off me. "I'm very interested in the fact that Dr. Garnet has once
again attempted to withhold information from me." His face was flushed,
and the blacks of his eyes widened until his irises became thin brown
rims.

"Now, wait a minute," I protested. "I reported a very unlikely
possibility to the hospital's pathologist--a mole or dirt on that DOA.
Why should either of us have told the police such a wild idea until it
was confirmed? You wouldn't have believed us then, and you don't seem
ready to accept the finding even now." My accusation sounded a bit
hollow, since I, too, was having trouble accepting that the derelict
could have been murdered with a cardiac needle.

Bufort turned back to Watts. "I don't accept your verdict, Doctor,
because according to our investigation so far, it makes no sense. And
with all due respect, while we appreciate the help you gave us with
Kingsly, you're not a forensic pathologist. You may be perfectly
adequate discovering why people die from natural causes, but to go so
far as proclaiming this derelict was murdered in the same way that
Kingsly was, well, clearly, you can't know what you're talking about."
Now Watts's eyes dilated, and his cold stare fixed on Bufort. Many a
poor fool, resident and staff alike, had invited his or her own
humiliation by challenging one of Watts's clinical pronouncements. He
struck the pose of a readied cobra I'd seen in previous bouts, but this
threatened to get physical. "Would you care to repeat that accusation?"
The level of menace in his voice alarmed even me, and I instinctively
placed my hand on his arm. He was shaking with rage. With deliberate
slowness Watts reached up and switched on his overhead dictating
microphone.

Bufort swallowed. He was a tough cop, pompous, close-minded and maybe
incompetent, but I suspected he was also a canny bureaucrat. A tape
recorder probably frightened him more than a gun. An official record,
even on his best behavior, could be scrutinized, picked apart, and
twisted against him by the press, or even by someone in his own
department settling an old score.

He looked from Watts to me, then very carefully said, "Let's review your
findings. Dr. Watts. And if you'll permit me to use your phone, I'll
call an officer to come down here and help me take a statement from you
and Dr. Garnet Then I'll get a forensic pathologist on this." His tone
was polite, but his expression was murderous.

The son of a bitch kept us in that room for more than an hour making a
"detailed report." It was late afternoon by the time I got out. Between
the formaldehyde fumes, the corpses starting to stink, and the cramped
subterranean quarters, I had a headache. As soon as I entered the
relative freedom of the main floor corridor, I heard my name being
called on the overhead speakers.

"Where have you been!" demanded the operator once I got to a phone. The
women in locating always sounded like annoyed mothers, but none more so
than this woman at this moment.

"In the autopsy room." There were no speakers there.

The operators didn't even want to think about what it was we did in that
inner sanctum.

There was a pause as my misbehaving was measured.

"Well, next time tell us where you're going."

"Yes, mommy. Now can I have my messages please? I promise I'll be a good
boy."

"Smartass! Okay, first: Susanne wants you in emergency, then Dr. Hurst
has been calling for you, but the most urgent seemed to be geriatrics."
Damn, Muffy had been there since the morning, when I'd had them retrieve
her from the car.

"Anything else?"

"Yes, phone your wife." Great idea. Recalling I had a life outside this
labyrinth made me feel better.

A quick call to Susanne confirmed we were still in a mess. "Forty
admitted patients," she reported, "and some are on their second day in
the corridor." No surprise there.

"And Hurst is a little mad at you for stranding him in the real world of
patients. Mad as in wanting to resurrect his long-faded surgical skills
on your carcass without anesthetic." Normally I would have laughed, but
not now. My next thought just slipped out. "They probably aren't all
that faded."

"Pardon?"

"Sorry, Susanne. Talking to myself." I certainly wasn't ready to add my
suspicions about him to hospital gossip.

"And thanks for the warning. I've no inclination to call him anyway.
What else?"

"A few reporters have been looking for you. They seem to have picked up
that you found me body." I very definitely didn't want to deal with the
press. "Oh, God!" I started. "We've been told to send all reporters to
Hurst and Bufort. And tell the rest of our staff to do the same." That
was one order I was more than glad to obey.

"I already have, on both counts. I figured they'd want it that way."

"You do good in chaos." She gave a little laugh, but then there was a
pause, which was unusual for Susanne.

I gave her time. More silence.

"Okay, Susanne, spit it out."

"No. It's nothing. Look, I gotta go, another ambulance." And she clicked
off.

Great. If Susanne can't tell me something, I worry. I added it to a
growing pile of questions.

Janet's line was repeatedly busy. That left Muffy. I retrieved her from
a regal pose on a love seat in the geriatric wing amid a clutch of
elderly admirers. She pranced along, proudly drawing stares as we headed
through the corridors for the front door and home.

It was a rare treat to be home at six o'clock, but the back lane was
already a channel of mist. Our house was even darker. Neighboring porch
lights were fuzzy glares in the gloom. There was no point going in just
to sit alone. Muffy happily accepted a chance to walk.

The lane was normally a pleasant place lined with backyard hedges and
gardens put to bed for the winter. It had once been a private road
leading to the golf course where I'd encountered the dogs Monday night.
Now it was shared by all the home owners on our block.

The image of those Dobermans needed no urging to come to mind. I kept
pushing away what might have happened if the attack hadn't been called
off. The intruder at our cabin didn't help my frame of mind any. I tried
to remind myself to stop jumping to conclusions, but out here alone it
was hard not to be afraid of the dark.

The fog was so heavy, I could feel its cool droplets on my face, yet it
was strangely soothing, and as Muff happily marked her favorite spots, I
began churning over the events of the last few hours.

None of it made sense. There was no explaining how both Kingsly and a
derelict could have been killed by a cardiac needle. At least I agreed
with Bufort about that.

Watts's bombshell certainly seemed to have derailed whatever solution
Bufort was on the trail of. Or worse, maybe not. I still had the
distinct impression no troublesome facts were going to get in the way of
his "solution." Heaven help the innocent, including me.

My own thinking was certainly thrown off. As much as I'd come to fear
and suspect Hurst, I couldn't even begin to imagine why he'd have any
relation to the DOA, let alone a motive to murder him. It was just as
inexplicable to try to connect anyone else in the hospital to killing a
vagrant. There had to be some other explanation.

I kept clinging to the possibility there'd been a resuscitation attempt
somewhere during which a cardiac needle had been used, but if not with
MAS, where?

Watts wouldn't issue a final report until he'd completed his study of
the other organs, subjected all the tissue samples he'd taken to an
examination under the microscope, and reviewed the results of the
biochemistry and toxicology testing that would be done on the man's
blood, urine, and stomach contents. Until then, all we knew for sure was
that a needle had been put into his heart. As Watts had said, knowing
definitively whether it had killed him or was inserted and removed after
something else killed him would have to wait for his findings. But
without there having been a resuscitation, was there any possible cause
of what he'd found other than murder?

Muffy examined a weed at the edge of the concrete, and I tried to focus
on more pleasant thoughts. My head was beginning to ache again.

It wasn't hard to start thinking of Janet coming home in a few minutes.
We were going to have an all too rare evening together, and the prospect
lay ahead of me like a life raft.

Muffy anointed a suitable bush and made a deposit in a vacant strip of
weeds nestled between a telephone pole and the gate to a neighbor's
manicured lawn. Since scooping laws were left to towns and
municipalities and nobody could decide to whom this patch belonged, we
poop troops were uncertain. So Muff and I were free, for now at least,
from any degrading bagging routine.

On the way back, she limited her pause-and-sniff checks to an occasional
passing snort and was suddenly tugging me home, pulling me hard.

A jerk on the leash set me jogging after her. Even in leather shoes the
exertion was welcome, but I was hopelessly outclassed. Trying to keep up
with her for thirty seconds left me winded and my heart pounding. I was
clearly out of practice.

Then I suddenly thought of how a derelict might have a cardiac needle
track in his heart and it be perfectly legitimate. The possible answer
was as simple as relief.

Of course! I thought. It had to be. But I couldn't check it out now. I'd
have to wait until Kradic and the night resident were on call at
midnight. More realistically, I'd catch them before they went off in the
morning. Now they'd probably be sleeping.

Muff turned the corner of our driveway and scooted up to our
well-lighted back door. Janet's car was in the garage, and the kitchen
lights promised warmth and welcome.

Muffy pranced around me in an impatient circle as I got the door open,
then ran in ahead of me to get the first hug. Already, the warm, spicy
aroma of Janet's quick goulash filled the place. I stood in line till
Muff was finished, then got a kiss.

"Miss. me?" Janet asked playfully.

"You and what's-his-name here," I said, reaching down to pat the
beginning swell of Janet's stomach. I was periodically pushed away by
the head of a jealous poodle. We started to giggle.

Janet looked at the upturned eyes begging for attention.

"Muff, you are in for a surprise." We made a little fuss over her, then
Janet shoved us both out of the kitchen and returned to preparing our
meal. Muff and I retreated to the living room, where I put on a tape of
Joe Cocker and settled down to the strains of "Try a Little Tenderness."
As that raspy voice evoked the decade when I had sworn I would never end
up domesticated. Muff sprawled out beside me, taking up most of the
couch and planting her head in my lap for a few kitzles. In the kitchen,
Janet had joined Cocker in a duet and was belting out when love grows
weary. I put my head back, smiled, and loved every corny moment of it.

This was the first real time we'd had together since Kingsly's murder,
and I knew I'd have to tell Janet about the trouble I was in. But I
resented letting that worry and dread intrude on our lives. I'd at least
wait until we finished eating.

The ordinary evening was nothing less than resuscitation of the soul.
Simple stew, a beer for me, club soda for Janet, and, by some miracle,
no calls for either of us.

After dinner we sat in easy silence in the living room and had coffee.
Janet's feet were in my lap, and I was kitzling them.

"What have you been up to?" she asked sleepily.

"You obviously didn't hear the news today. The CEO of the hospital was
found murdered in his office early Monday morning."

"What! Kingsly?" Her eyes were open wide now.

Janet had met him a few times at hospital social events.

"Afraid so. That's why I came in so late from my shift."

"Who killed him?"

"Nobody knows. There's police all over the place."

"God! That's ghastly. How was he killed?"

"This isn't in the news, and it's confidential as hell. He was stabbed
with a cardiac needle."

"Good Lord! That's weird. Who'd use a cardiac needle to kill someone?"

"That's what the police want to know."

"Who do you think it was?"

"I haven't a clue." She lay back with her eyes closed again, and I was
relieved she didn't ask any more questions for a while.

Should I volunteer the rest of it? What was the point? It was all
suspicion and unsubstantiated fears so far--the shadow stuff of
nightmares. Whispered warnings. Cops playing mind games. Dirty hospital
politics. Why upset her with vague conspiracy theories, or frighten her
with stories of Doberman attacks and intruders in the night, when I had
no real evidence any of it could harm us. I'd only be sharing paranoia.

"Is any of it going to be affecting you?" she finally asked.

"Not much," I lied. "Hurst shut down a hundred beds Monday, and
emergency's a mess." This didn't even get her eyes open. She'd come from
a family of doctors, two brothers and her father. Whenever we all got
together, there was a family rule. "No medicine!" And she had insisted
the same for us. It assured we didn't squander what little time we had
together on worries better left at work. But, of course, exceptions
slipped in now and then.

"Is that why you went to the cabin?" she asked slyly.

She knew I'd use any pretext I could to sneak in an extra trip. "The old
I-got-to-use-my-computer ploy," she added with a grin and a toe jab in
the ribs.

"Hey, watch it. You'll injure my kitzling arm."

"Kitzle me!" she ordered with more toe tickles.

I started laughing and protested, "Stop it!" That got her toes racing up
and down my rib cage and me guffawing and begging her to stop.

Then her feet fell back in my lap, and I started kitzling again,
laughed-out and content. The nightmare shadows had been driven off for
now.

Janet was a wonder in my life. We had met nine years ago in London. I
was attending a conference on emergency medicine and staying at Brown's,
a lovely hotel near Berkeley Square. It had a particularly good tearoom,
and one crowded afternoon the maltre d'hotel came over to my table and
asked if I would mind sharing it with a fellow physician from New York.
I accepted politely, expecting to be paired with some old man, but was
delighted to instead find Janet escorted to my table. She was dressed in
a sleek beige suit that matched her light blonde hair and fair skin, but
what captured my attention were her deep blue eyes and the light that
flashed from them. We extended crumpets and petit fours into dinner, and
I spent the next few hours learning she was in England on a fellowship
year studying high-risk obstetrics at King's Cross Hospital. We passed
the next week together going to art galleries and the theater.

After two weeks we became lovers. A year later she took a position at
the University of Buffalo, and we were married.

Her toes were stirring in my lap, and I increased my kitzling.

She had wanted to wait until her practice was established before having
children. I was seven years older, and already in practice for twelve,
but agreed to the delay. It seemed she needed time to feel secure enough
with me to have a child.

And little wonder. All our colleagues were divorced. But now it looked
like we were about to have it all.

"You know," I said dreamily, "an awful lot of happiness for the two of
us"--and then I eyed her tummy and corrected myself--"make that the
three of us, depended on that maitre d' in London putting us together."
More than just her toes were starting to stir in my lap.

"Things that important can't just be left to chance," she answered
softly.

"What?"

"I slipped him five pounds and asked him to put me at your table."

"You what?"

"I was feeling like I am now. Take me upstairs to bed." Her eyes opened
and were intensely blue, and not a hint of sleep lurked in them.

"It's okay for him still?" and I cupped my hand lightly over the mound
above her groin.

She put her hand on mine and pressed. "Don't worry," she whispered, "I'm
a specialist. I'll teach you the ways." Next morning I felt rested even
when I awoke at five- thirty. Then I heard the garage door closing and
felt the emptiness of the house. Janet seemed to defy the pregnancy,
daring it to slow her down. I worried when she didn't accept body
messages to rest. She scoffed that anything less than her usual workload
would drive her mad.

So that morning after showering and dressing, I sat alone with coffee
and Muff and planned out my day.

It was still dark, but first I called emergency to catch Kradic's night
resident before sign-out.

"Emergency."

"Hi, it's me. Is the resident there? I'd like to speak with him or her,
please." I'd had a bit of hesitation calling Kradic directly with my
question. Given his usual defensiveness, he'd probably think I was
checking up on him, even if, as I hoped, his answer provided a
completely innocent explanation as to why the DOA had a cardiac needle
track. And my reluctance had a darker cause. I hated to admit it, but I
was starting to take precautions with my staff. My logical insistence
that no one had an obvious motive to kill Kingsly and my best
determination to resist unfounded suspicions were being eroded. An
unpleasant wariness was creeping into my feelings about individual
physicians, especially with the ones who were difficult. Until Kingsly's
killer was caught, that uneasiness would be there.

"He's busy. But just a minute, please, I'll ring Dr. Kradic's room--"

"Hold it! Don't wake him--" But it was too late, and I was left
listening to his phone buzz, feeling stupid for not avoiding him as I'd
planned. I was relieved when there was no answer.

The clerk came back on the line. "He doesn't seem to be there. Doctor.
Should I page him?" He was probably having an early breakfast. At least
he'd better have been. "No, let me speak to the resident.

Is he still busy?" More clicks, unanswered rings, then finally someone
picked up. "Emergency, Miss. Claymore speaking."

"Miss. Claymore, it's Dr. Garnet. I'm trying to locate the sesident."

"The resident's with a patient. But Dr. Kradic should be in his room
asleep. Shall I buzz him?"

"No, I've already done that. Could you please see if the resident could
come to the phone?"

"One moment, please." This circling on hold like stranded aircraft over
a dysfunctional airport would get worse once the day really started.

Finally someone picked up. "Dr. Todd here." I didn't groan out loud, but
he might have heard me exhale with a bit more vehemence than usual.
Sleeping with a staff person wasn't anything I could officially censure
a resident for, but it sure raised doubts about his judgment and, in
this case, his taste.

I tried to sound casual. "Hi, Dr. Todd. Look, I'm sorry to bother you,
but did you or Dr. Kradic do any practice procedures on the DOA early
Monday morning? In particular, did either of you pass a cardiac needle?"

"Not me, but I wasn't there. Laura Tran covered the rest of my shift
that night. It was my fiancee's birthday, and we had a midnight supper
planned." So much for fidelity, I thought, first thinking of his poor
fiancee, then wondering if Jones knew, or cared.

Maybe it even aroused her. "Any idea where Dr. Tran is?" I asked,
refocusing on why I'd called.

"Tahiti."

"What?"

"Tahiti. She left Tuesday morning. That's why she did the switch; I'm
covering her now to add an extra day onto her vacation." We paid these
residents too much.

"When will she be back?"

"Two weeks from today." Way too much.

I hesitated, then accepted that Kradic would have to be asked outright,
whatever he might make of it.

"Dr. Todd, listen, in case I miss Dr. Kradic, could you ask him to call
me when he goes off duty this morning?" He seemed puzzled but answered,
"Sure, but Dr. Jones is here early for sign-out rounds. Do you want to
ask her?" God, no! "No, it's all right, just ask--" Again it was too
late. He'd put her on the line.

"Yes, Dr. Garnet," she began icily.

"Ah, Valerie, I was just looking for Dr. Kradic. Dr. Todd has the
message--"

"I can give it to him," she said, almost like a command to let her do
it. "He'll be down from breakfast for signout in a minute." Christ, she
was testy. Probably it was her resentment of Kradic and having to do
sign-out with him, but I never really knew what fired her nasty moods.

"Thanks, Valerie. Sorry to have disturbed you, but Dr. Todd has it
covered." I hung up without waiting for a reply.

I wasn't going to risk her setting off Kradic with a question about
needling hearts. Damn! He'd be surly enough with it coming from me, even
if I was asking through a resident.

And once again there was that unwelcome cautiousness about who I
confided in and what I said. Then, as if for finishers, a frisky
afterthought tumbled into my mind. Was Jones in early so she and Todd
could have a little morning screw before starting rounds? Shit! I was
going to have to make time for our talk as soon as possible.

I felt exhausted and had accomplished nothing. Tahiti!

What a great idea. Made me jealous. Especially since I had to deal with
the injunction issues.

Our high-priced legal protection from Albany had handed me a pretty big
card, but I had to play it carefully.

One chance to knock Hurst off his injunction crap would be all I'd get.
Today was going to need a finesse that had nothing to do with medicine
but everything to do with protecting our patients from bureaucratic
chiseling.

After three cups of coffee, two croissants, a riffle through old
newspapers, and a twenty-minute soak in the bathtub, I had my plan. I
left a message on Carole's answering machine to assemble our entire
staff that afternoon at five o'clock.

It was after six-thirty and time for Muff and me to make our tour again.
The weather had changed exactly as the experts had predicted. It was
unusually dark for this time under a black, overcast sky, and a thick
fog made it difficult both to see and breathe. The temperature must have
dropped below freezing as well, because everything was coated with an
icy film. My leather soles skidded over broken concrete while Muffy had
no trouble getting traction with her built-in four-wheel drive. I
mimicked an aging Nureyev trying to keep my balance as she tugged me
along on her leash.

I heard the car before I saw anything. If I hadn't already been lurching
into the gutter from an unexpected skid behind Muff, it would have hit
me.

Black, no lights, and exploding out of the darkness behind us--only the
roar of its engine gave me the cue to leap into my forward fall and roll
as the tires brushed my face. My left hip took the landing full force on
cement and the pain made me yell involuntarily in agony and feel a surge
of nausea. By the time I reopened my eyes, the car was past and I could
see it disappearing down the lane.

I watched in sick horror as it reached the street, spun around, and,
with another roar of acceleration, started back at me.

Chapter 9.

The pain in my hip came in waves, like the hot vomit at the back of my
throat. It took a few of these crescendos before I even started to move.
I could see the grille on the front of the car hurtling toward me,
swerving on the ice as it came. There was no time to get up. It careened
over to the side of the alley where I lay. I managed to roll farther in
under an overhanging cedar hedge and grab the small trunks at its base.
I flattened myself against them and felt the wheels whip by my back and
legs. The bushy outgrowth above had kept the car from running over me.

It sped on toward the far end of the lane and disappeared into the fog
and darkness. I let go of my handholds under the hedge, rolled back out
to the edge of the cement, and began scrambling to my feet. I supped on
the ice and went back down. More pain lanced through my hip. I sat
there, staring toward the sound of the motor, which was receding into
the murk. Then I heard the tires squeal in the distance.

Turning away, or coming back?

The motor roared again.

I realized my hands were empty. I heard the rising yelps begin like the
crescendo of a chill. They turned to screams of blind animal panic.

"Muff!" I gasped, forgetting my own pain.

I could hear the car coming back up behind me.

Muffs high-pitched shrieks were pulsing now. Bedroom windows lit up.

I was pleading, "No, please, no" as I struggled to reach her.

The car sounded as if it were on top of me. I glanced quickly over my
shoulder but saw nothing coming out of the darkness--yet.

I -pushed myself to my feet to look. Muff is black, impossible to see in
the dark. How many times had I fallen over her on a nocturnal trip to
the toilet? I thought, limping and stumbling toward her cries. I was
still unable to see her in the dim light of the lane. The noise of the
approaching car was right at my back.

The yelping weakened, but now seemed to come from a black hollow under a
cedar hedge.

I hobbled over, reached down, blindly scooped into the shadow with my
arms, and came up with her.

Over my shoulder I saw the car, headlights off, looming out of the mist
and heading for me.

I stumbled forward again. "Muff, Muff," I repeated, staggering under her
weight, looking for a safe place to leap from the narrow alley.

The car accelerated on my heels.

I planted my left foot and lunged right against a mesh of bare branches
from a tall lilac hedge. It was like going through the breakaway
protective fence behind the end zone in high school football--only this
barrier didn't break away. Muff and I crashed to the ground under a
shower of roots and sticks.

The car flew by and this time kept on going.

I was thinking only of Muff. She'd fallen out of my arms as I hit the
ground. It was even darker here under the hedge, but I crawled toward
her sounds, trying to calm her, saying her name. She was reduced to
whimpering now.

I touched her; she was trembling, shaking. She struggled toward me but
fell back. I found her head. She whimpered again, then gave my hand a
feeble lick.

I felt down her front paws. Nothing. I kept talking softly, rubbing her
head, and continued to explore. My hand slipped inside the rip in her
open belly and into her intestines before I realized what had happened.

They writhed like snakes in spasm from my touch. Her yelps wailed to
full crescendo again.

I recoiled and pulled my hand back. I couldn't see what I'd just felt,
but I tried to cradle her spilling organs from falling out onto the
dirt.

Porch lights were going on.

Muffs cries were weakening again. Someone started screaming, "Help me!
Help me!" Before I passed out, I realized it was me.

I first heard the siren as if in a dream, distant, having nothing to do
with me. It was an annoyance. I wanted to go back to sleep and I fought
coming to. Then they were shrieking in my ear, and I was awake. My mouth
was full of vomit. I was surrounded by a circle of neighbors, most of
them huddled in their bathrobes. Two ambulance technicians were trying
to move Muffy off me. The shrieks were hers, from fear as much as pain.
Through bits of sour particles I tried to yell

"No," but nothing came out. I tried again, but managed only to squeak,
"Stop!" They ignored me and continued to pull her away.

She started to writhe. Panicked, she snapped at one of the drivers.

"Shit!" he yelled, and dropped her. She shrieked again and tried to
struggle up.

I finally managed to shout, "Leave her!" The two startled techs backed
away. I was up on all fours now and crawling to her, comforting her by
saying her name, lying that it was okay. I put my hand back on her torn
and eviscerated abdomen.

The techs were looking at me as if I were mad. The older one seemed
frozen, undecided what to do. The bigger one said, "Hey, you shouldn't
move." Now the older one seemed to decide his partner was right, and
both yelled in horrified unison, "Don't move!" But I'd already broken
every basic rule on page one of their trauma manual. And apart from my
hip still throbbing, everything seemed to work all right.

Yet they were on me like a tag team, trying to pry me away from Muffy,
immobilize my neck, take my vitals, and tell me in that familiar
professional cant, "Lie back, be calm, just let go of the dog, sir!"

"Look, I'm all right. Help me save the dog. I tell you, I'm all right."

"We can't do that, sir," the older man said. "You've been hit by a car,
and we have to get you to a hospital.

They'll check you out there." His grip on me was getting tighter. Muffy,
sensing the struggle, started to writhe again.

"Guys, look at me! I'm chief of emergency at St. Paul's. I know what
you're trying to do, and I appreciate it, but I'm okay." They paused; I
was going to have to convince them to cut some major corners and violate
some biggies. In fact, they should be canned if they listened to me, and
I knew it.

"Look, no neck pain, I can move it all around; I fainted, wasn't knocked
on the head; my hip hurts but I can move it too; I'm not bleeding, and I
know what day of the week it is. I need help with the dog! Will you?"
The bigger of the two had been getting ready to strap me down.
Immobilization must have been his specialty.

The older attendant peered at me. Of the two, he had seemed the more
intent on getting me into the ambulance and to a hospital. I realized I
must be smeared with dirt and vomit. But his partner, the one with the
straps, appeared to hesitate. He looked hard at my face. I took a
chance. "Didn't I teach you prehospital care last year at the
university?" I teach them all every year at the university, sooner or
later, as part ofzak's refresher program. I hoped this guy hadn't cut
classes.

He took an even harder look. "Holy shit, it is you.

What the hell happened here?" These guys respected rank above all else,
and I was pulling it. I felt a little guilty. They should have told me
to suck rocks and gone by the book.

"I'll tell you later. Meantime, can we get my dog to the Buffalo Animal
Hospital? They're equipped for surgery there, and we can still save
her." Muffy had sensed the change, to talk from yelling, and was
quieter, but she still whimpered and shook under my hands.

The older one looked pretty skeptical, but my former student was a
little more receptive. "Gee, Doc, I don't know. I mean, we'd like to
help you, but a dog, I don't know--" His reservations were
understandable.

"Look, I'll settle it with Zak. I'll take full responsibility; I'll tell
him I forced you." The guy still looked doubtful.

"In writing," I added.

It helped. But they were still hesitating. "And of course I'll sign a
release of liability for myself," I added.

That did it. Being responsible for blowing my case was apparently their
biggest worry. I quickly signed triple forms proclaiming I was an ass
and hadn't the sense to do what they thought was good for me.

Muffy was breathing hard; each expelled breath ended in a weak whine.
The wound, as best I could see in their headlights and the gray, belated
start of dawn, looked surprisingly clean and straight. She must have
been sliced from catching a fender edge on the first pass as we both
leaped clear.

A few of the neighbors, shivering in their bathrobes, asked if I was all
right. Someone offered to go back and lock the house.

From the ambulance kit I took a large sterile pad and put it over
Muffy's abdomen. I held it in place as the other two men lifted her
gently, and, now unprotesting, onto'the stretcher. I didn't really know
if all that stuff I'd said about being all right was true. As I stood
and walked beside Muffy to the ambulance, I felt my knees start to
buckle. I hoped that neither of the attendants noticed, but I caught the
bigger guy checking his shirt pocket to make sure my signed release was
handy.

As I climbed through the rear doors, I noticed the sign on the vehicle's
side panel. This was one of the rogue private companies we kept an eye
on. But for a ride to the vet, I figured it didn't matter, and got Muffy
settled down in the back while the attendants climbed into the front.

"Siren, Doc?"

"Why the hell not?" He hit the switch.

Never had the clientele of Buffalo's leading animal hospital had an
arrival like it. We'd phoned ahead in the ambulance, so Dr. Sophie had
her team ready at the door.

She was an old friend from shared premed classes during university days.
Our arrival with full lights and siren raised her eyebrows, but she and
her colleagues swept Muffy away and into the OR. I wished my unit were
that fast.

I thanked the drivers and assured them I wouldn't forget to call Zak and
put in a good word.

After their departure I felt helpless with nothing to do.

I was smeared with Muffy's blood and juices from her innards. Awkwardly
I took a seat in Sophie's waiting room. Her other "patients" sniffed the
gore on my shirt and backed away. The owners looked miffed that I'd
gotten priority treatment. Muffy's emergency surgery had pulled most of
Sophie's staff from conducting routine visits.

"Car accident," I offered, hoping forgiveness would follow. I got a
bunch of

"Likely story!" stares instead.

I slunk down in my waiting room chair. It was a lot more comfortable
than the ones in the ER.

Finally, I had a chance to think about what had just happened.

Someone had tried to kill me. Deliberately. Savagely.

The intent of it scared me as much as having been so close to death.

I was alive only because of a fluke, a random slip throwing me half out
of the way on their first pass. There was no logical reason I hadn't
been hurt. I couldn't comfort myself much that I'd done anything to save
myself-- I hadn't had a shred of control over what had happened.

Except for sheer blind stupid luck, I'd probably be dead.

My worst fears had been true. Somehow I'd become a target and I didn't
have a clue why.

I could no longer explain away the footprints at the cabin or dismiss
the figure on the golf green as an overzealous watchman.

And the whispered warning to back off! Not knowing what it meant seemed
likely to cost me my life.

My panic was reaching new heights, and I realized I was trembling like
the proverbial leaf in the wind. So far I hadn't been able to link the
warning to Kingsly's murder. I desperately tried to think of other
explanations.

A doctor always lives with the possibility of coming face-to-face with a
wacko, and it's even more probable for doctors who deal with the
walk-ins in emergency. But in twenty years I'd never had anyone try to
hurt me.

Anger, rage, blame in the face of unspeakable loss, yes-- even threats,
but never harm.

I had heard one story of a psychiatrist I'd been in medical school with
who'd been targeted by a woman suffering erotomania. When he repeatedly
rebuffed her obsessive advances, she had used her family connections
with the mob to have his car bombed. He miraculously survived, but left
town and changed his name.

Now someone was after me, and I didn't know what I'd .done. Someone I'd
unknowingly crossed in emergency was possible, but unlikely. While I did
have more run-ins than most with discontented patients or relatives in
my role as chief of the department, as an acting clinician I'd never
been sued for negligence. I didn't take much comfort in that. It meant
only that my errors in judgment had occurred within the conventions of
reasonable care. This distinction didn't rule out personal retaliation
over somebody dying, but it lessened the danger of it. When cases did go
bad, it was usually the disease that did the damage. I don't know
why--the grief and regret remained, including mine--but I had never felt
at risk for whatever mistakes I'd committed. A bit of luck, and a lot of
being careful, had so far, it seemed, resulted in, if not forgiveness, a
lack of someone taking revenge. At least among the sane.

Psychiatric cases were another matter. Here even a slight, real or
imagined, could have catastrophic consequences.

I'd had my share of those, but again, in some context, with some
reason--a diagnosed psychosis to explain it all. There was nothing
recent, at least not that I could remember  ...  but there could have
been a patient with some impending disaster I'd missed and then sent
home. I might never know who I'd butchered--the emergency physician's
nightmare. And what about the undiagnosed psychos and sickos whom I'd
unknowingly cared for. What seething maniac had I treated for
tonsillitis and unwittingly enraged?

No. After twenty years on the line, it was a mighty big coincidence to
have randomly invoked such wrath now, little more than three days after
Kingsly's murder. The most probable reason for the attack on me had to
be related to his killing. But why, I asked myself again, would
Kingsly's murderer be after me?

Slumped in the chair in the waiting room, I'd stopped shaking, but now I
was stiffening up. I realized as I shifted in my chair that getting up
was going to be significantly more painful than sitting down had been. I
groaned as I stood. The other animals whined, much as their owners
waiting with them probably wanted to do.

I limped over to the receptionist and asked her to call in to the OR and
get an update. She looked annoyed, but she knew Sophie and I were
friends, so she grudgingly complied, punching the appropriate speaker
button and asking how long it would be. "Another thirty minutes!" blared
out of the receiver, and that was all I got before she pointedly resumed
her typing. She didn't offer to get any progress report. I hadn't the
stomach to hear the worst from the likes of her anyway, and didn't ask.

I limped back to my chair. The animals shuffled around a bit more and
then settled again but watched me nervously. The owners made huffing
noises and looked at their watches. I went back to my thoughts.

If not Kingsly's killer, then who?

The only other unusual event was my threat to close emergency. I still
couldn't believe any sane person would murder me over that because of
lost income. Then I recalled Kradic's obvious but silent rage at our
departmental meeting. Did all his unreasonable behavior hide a deeper,
deadlier flaw? Had I set him off by publicly calling him on the carpet
Sunday night? I didn't know for sure, and this frightened me. Were there
others in the department I wasn't sure of? Could I have worked alongside
a secret maniac all these years? And what about Hurst? What if he had
murdered Kingsly and was coming after me because I was the one who had
actually discovered it was murder? What if he thought I was getting too
close to something that could expose him? My previous dread at what he
might be capable of came flooding back.

I shivered some more, then stopped myself from thinking in this
direction. I wanted to concentrate on logic and couldn't give in to
groundless speculation and fears. But fear was inevitable now. Until I
knew who had tried to kill me, and why, it would pervade everything I
did.

If there was a why. Maybe the killer didn't need a reason; maybe he was
one of those zombies who killed for the sake of killing. The
professional term was a homicidal psychopath.

The animals around me must have sensed my distress again, for they
whined and shied away some more. The owners looked fed up with my effect
on their pets.

Had I been followed? I wondered, as I thought back to that night and
remembered the trailing headlights. Had Muffy spoiled the first
attempt--or hadn't she? This morning the killer hadn't seemed the type
to be put off by a barking dog. If the same person had been at my door
two nights ago and wanted me dead, a dog wouldn't have stopped the
attack. They could just as easily have killed Muffy and then me.

Perhaps the other night hadn't been a murder run after all. But then why
had I been followed? And what had I done in the meantime to up the ante?

Janet! I'd forgotten to call her, and I didn't want her to find out
about Muffy from a neighbor.

I asked the receptionist for the phone. I got an icy "Certainly,
Doctor." I was sure that the emphasis on "Doctor" was a warning to the
civilians in the room that they wouldn't be making any free calls.

Getting through to Janet's hospital was the same pain in the ass as it
had been when I called my own department, except Janet's hospital was
computerized. A cheery voice kept telling me to punch a number if I
wanted one department, another number for the floor, and a third for the
exact nursing station. When I finally got to a human voice, it was the
janitor in the case room cleaning up between deliveries.

"Doctor not here. Went home in big hurry."

"Shit!"

"Pardon?"

"Sorry. Thank you." I dialed home. Janet picked up on one ring. She was
sobbing. I had never heard her cry.

"Janet, what's happened?" I immediately thought of the baby.

"Please, come home."

"What's happened?"

"Just come home now--please!" And she hung up.

She never even asked about Muffy. Whatever had happened, it was bad.

I told the receptionist to call me at the house as soon as Sophie had
Muff out of surgery.

I got lucky with a cab, but during the ride my sense of dread increased.

Two cop cars flashing blue and red outside our front door confirmed it.
I shoved a fistful of bills at the driver, jumped out of the cab, and
ran inside.

The first assault was the stink. Feces. Smeared over the hallway and up
the staircase. Janet, pale and hunched, sat on the couch beside a
uniformed cop. He was shyly holding a salad bowl. More smells; she'd
been vomiting.

"Janet!" I moved to her side. A detective seated across from her quickly
got up, as if to protect her.

"It's okay, I'm her husband." Janet took my hand, weakly squeezed, then
grabbed the salad bowl and retched again.

I put my arm around her and could feel her trembling.

Through chattering teeth she whispered, "Sorry." Her shaking subsided to
shivers. She handed the bowl to me. The uniformed cop looked relieved.

"Mrs. Sharp called me at work," Janet said. Mrs. Sharp was the
neighborhood busybody.

"Said you were all right but Muffy was bad. I signed out and came home
to this." Her helpless expression as she looked around rendered the
destruction even more vicious. This part of the house had been attacked.
I didn't know yet if anything had been taken, but the room I was sitting
in had been slashed, torn apart, and then smeared with excrement. The
wallpaper along the staircase leading upstairs was shredded and the
chandelier in the entranceway was ripped out of the ceiling and left
dangling from its wires. Broken lightbulbs and pieces of glass crunched
underfoot. The stereo I had listened to the night before lay bent and
cracked open in the fireplace. It must have been thrown against the
bricks.

"It's worse on the second floor." Janet spoke quietly into clenched
hands. "The bastards really destroyed the baby's room." She started
trembling again. I had my arm around her shoulders. I pulled her to lean
against me, but she resisted and stayed rigid.

"I want to know what the hell is going on!" she said, taking back the
salad bowl.

The uniformed cop got up and went into the kitchen.

The plumbing was intact; I heard him washing his hands.

The detective leaned toward us. "So do we," he said, and then ignored me
as he picked up the questioning I had interrupted.

"So, when you arrived, you found the back door locked, and from the
outside there was no evidence of forced entry?" Shit. In the lane. I
remembered a voice behind me, indistinct, a presumed neighbor. "/'// go
make sure the locked." I had never even looked to see who it was; I'd
been focused on Muff.

"Oh, God," I muttered.

The detective sighed. Janet gave me her "you again" glance and tried to
finish her statement. I think talking kept the heaves away.

But I interrupted anyway. "I know how they got in," I confessed.

The detective got a little more interested.

Janet said, "This better be good," and handed the bowl back to me, still
keeping a close eye on it, and swallowing a lot.

"No, I mean it," I went on. "It must've been the person who offered to
lock the house." She looked up, startled. "What?"

"Who did you tell to lock up the house?" The detective was suddenly half
off his chair.

"I don't know." Janet had pulled away again and was holding her hand
over her mouth. I think I heard her mutter something about "turkey," but
I was explaining to an increasingly incredulous cop that after almost
being run down and trying to save our dog, I wasn't exactly keeping tabs
on voices in the crowd.

"You didn't report a deliberate hit-and-run to the police?"

"I didn't have dme to report it." Janet was holding her head.

The detective opened a pad. He looked like he was going to write me up
for stupidity. "Who's 'they'?"

"The people who tried to kill me."

"Kill you!" This was in stereo. Janet and the detective seemed to move
closer to each other to ward off my obvious lunacy.

"You said he'd had an accident." He was talking to Janet now; I wasn't
even in the room for him. I cringed at how many times I'd relegated a
patient to nonexistence in the same way. On the other hand, Janet took
ignoring me as a designated right by marriage.

"That's what the neighbors told me," she answered him. "An accident.
Nobody said anything about anybody trying to kill him." Finally the
detective turned back to me. "I think you'd better go back to the
beginning, sir." Janet had grabbed the bowl, like I couldn't be trusted
with it anymore, and was studying it indecisively.

More cops were coming in the door. Some were carrying suitcases that I
presumed contained kits to test for fingerprints and other traces that
might lead to finding out who did this. A uniformed woman carried a
camera.

Another man had a small vacuum. An open case on the floor in front of me
contained neat stacks of both paper and plastic bags, a box of
disposable gloves, and a jumble of ties and tags.

Janet's indecision was over. She started vomiting again.

Now the detective seemed undecided. He wanted a statement, but Janet's
retching kept getting his attention.

I took another look around at the remnants of wallpaper hanging in
tatters. Our photos and prints of paintings had been hurled onto the
floor, then trampled, leaving shards of glass everywhere. This was more
than a violation of our property. It was a display of insanity.

I swung back to the detective. "Officer, of course I'll make a
statement, but I need to have Detective Bufort of homicide here. He's
probably at St. Paul's." It took a bit to convince the cops, but one of
them finally made the call.

"We got a doctor here who says someone tried to kill him and that you'd
want to hear about it. His name's Garnet." There was a moment's silence.
He read out my address.

Then a puzzled look came over his face. Without a word he hung up. He
said incredulously, to no one in particular, "Bufort's coming right
over." All the cops now looked at me with new respect. I guess in their
circles, anyone who could grab Bufort's attention rated.

Janet was another story. "What the hell have you gotten us into? You
haven't said a word about having cozy new friends in homicide. You told
me the investigation into Kingsly's murder hadn't involved you much." I
sensed a little sarcasm in how she said "homicide." I'm that kind of
sensitive guy.

I started to reassure her. "I've hardly seen you in three days. Besides,
you never want me to talk medicine--"

"Medicine!" she shrieked. "Someone trying to kill you is not medicine!"
The entire force poking around the house had gone still. Our detective
mumbled something about waiting for Bufort out front in case he couldn't
read the street number.

Janet looked hurt more than angry, near tears again. I grabbed her,
tried to hold her, but she pulled away and said, "We had time together
last night. You could have told me."

"Look, I'm sorry. I'm sick this has happened, and God knows I'd die to
protect you from harm, but I didn't really know for certain the trouble
I was in till now." She gave me a skeptical glare. I reached for her
again.

She let me hold her, but kept the bowl in her hands.

Regaining her calm, she asked, "What else is going on at St. Paul's?"

"The police think the killer may be a doctor in emergency," I answered,
feeling a bit sheepish.

She stiffened and then gave a long, incredulous sigh.

"Why in the world wouldn't you tell me that? she demanded. Then,
sounding weary, almost sad, she repeated, "We had the whole evening."
The answer was stupid. Embarrassing. Yet I coughed it up.

"I didn't want to ruin the mood." What a miserable excuse. I felt her
staring over my shoulder. I went on. "It was so special to be alone and
close last night, I didn't want to spoil it. And I didn't have any proof
really that this nasty business would ever have anything to do with us."
She pulled back, looked me in the eye to make sure I was as morose as I
sounded, and gave a nervous giggle through her tears. At last she put
down the bowl and leaned forward to hug me hard. She pressed her hand to
the back of my neck and with her lips to my ear whispered, "You're an
idiot. A romantic jerk. But I love you." "I'm so sorry!" I said again,
adding, "I haven't a clue what I'm supposed to have done to get us in
this mess." "Are you okay?" she asked softly.

"I'm fine."

"And Muff?"

"In surgery. The car eviscerated her, but it was only the abdominal wall
that got cut. Not much bleeding, and I couldn't see any big intestinal
perforations, at least not on gross examination. Otherwise she seemed
intact.

They'll call." Janet knew as well as I did they'd have to check the
entire length of her bowel for any tiny tears or punctures in the
intestinal wall and that any leak, however small, could be deadly.
"Let's look around and see what's gone," she said.

Ever practical; move on. Don't dwell on what's out of our hands. It's a
doctor's hold on keeping the nightmares away. It was Janet's way of
waiting out already inevitable endings.

The rest of the house was a replay of what I'd seen in the front, but
the tour still hit me in the guts. Overhead lights had been smashed,
some small fixtures ripped out; the upholstery was slashed, small tables
and chairs tipped over. Anything made of glass had been dashed on the
floor. Again there were great sweeping cuts across the surface of most
of the walls.

But upstairs the baby's room was the worst.

Janet had started to prepare it a few weeks ago, working at it little by
little whenever she had time. She knew better than anyone what could go
wrong even at four months, but the work pleased her, and starting early,
she had said, would give her time to do most of it herself.

So far she had painted a changing table and crib I'd assembled from a
kit, and then had made a set of covers with matching curtains and wall
hangings. It was these they had ripped up, defecated on, and then used
to smear the walls in the rest of the house. The crib and changing table
were broken.

I was seething. A tenderly prepared nest of love and perfect safety had
been savaged.

I wanted these animals. That they could come even this near our unborn
son unleashed in me a whole new aspect of fatherhood: I could and would
kill anyone who threatened him.

Somehow it was even more disturbing that nothing seemed to have been
stolen. It would take a while before Janet could do a detailed check of
her jewelry or we could sort the clutter enough to verify we hadn't lost
small valuables, but so far the destruction appeared senseless. Then I
reached my office on the third floor and got a surprise. File drawers
were open and papers were scattered all over, but there was no wanton
slashing or destruction. The place looked as though it had been searched
carefully, thoroughly. Not finding what he wanted, had the intruder gone
berserk in the rooms below?

As we returned downstairs, Janet was coldly silent, h own version of
withdrawn fury. She paused by the we outside the baby's room, fingering
the slash marks.

One of the cops noticed and joined her. "Funny, el We saw they were
peculiar. Too clean a cut for a knif More like a razor blade. But to be
wielded with th force, and in those big, sweeping arcs, it would have be
one of those old straight razors. You know, with handle." Janet took a
step back and viewed the handiwork as it were hanging in the Museum of
Modern Art.

She quietly offered her own critique. "Or a scalpel."

Chapter 10.

Bufort arrived resentful as hell. He obviously considered this latest
interruption a continuation of my personal campaign to sabotage his
investigation.

Seated, silent, legs crossed, he listened to my tale and occasionally
made notes in his pad. Once again I felt as if I were being given all
the status of a suspect obstructing his speedy version of justice by
perpetrating a hoax.

As I laid out the details of the lone figure on the golf green with the
Dobermans, the whispered warning by an anonymous caller, and the
footprints at our cabin door, Janet was becoming livid all over again.

Admittedly, hearing myself describe the extent of everything else I
hadn't told her was making me feel pretty sheepish--a

"How could you be such an ass?" type of sheepish--if not outright
deceitful.

Janet's silence screamed I'd damned well gone way too far into this
business, and I'd done it behind her back.

"It would appear. Dr. Garnet," Bufort said coldly, "that you've
attracted the interest and now the rage of a very dangerous person."
Janet was a little less subtle. "You idiot! You've been dabbling like
some damn amateur detective and brought God knows what down on us." I
winced. Bufort smiled at my discomfort. Then he even tried coming to my
rescue.

"Now, Mrs. Gamet--" he began.

Janet bristled. "My name. Detective, is Dr. Graceton," she said icily.

Bufort flinched.

My turn to smile.

Bufort sighed. "I was going to say, I doubt your husband even knows what
he did to make such a nuisance of himself that he'd get killed for it."
Some rescue. His tone echoed Janet's verdict perfectly.

A bumbling fool. Man doesn't know what he's doing. "In fact"--he looked
at me--"I suggest you write a complete account of all your movements,
everything you've said and done in the last four days." He leaned back,
enjoyed my attempted protest, then quickly cut me off. "Everything,
Doctor. Every step, every encounter, and--this is particularly
important--log every word you have uttered and to whom."

"You've got to be kidding! Come on. That would take hours, even days." I
turned to Janet, who was no help at all. She was busy suppressing a
giggle.

"Ah, c'mon. You can't be serious. I've got a department in meltdown, and
a practice, and I don't see enough of either as it is." No use. Janet
was even nodding in agreement. I knew what they both liked best--that
I'd be safely out of the way.

I felt I was being sent to my room to write lines--like I should scuff
my foot, say "Gee whiz, you guys aren't fair," then surrender to the
inevitable and stomp off.

Except I didn't have a room. We didn't even have a house at the moment.

Bufort saw me waver and moved in with the clincher.

"Listen, you're in danger. Someone wants you dead, and your home and
loved ones are obviously of no consequence to this killer. Look around
you, for God's sake!

The mind behind this is frenzied, out of control. Your only job now is
to help us. Until we catch whoever it is, you and your family have no
life, no haven for business as usual. Accept that. Accept that and we've
got a chance of keeping you safe." Bastard. He leaned back, smug but
right. Then Janet and I got fingerprinted.

They had finally gone. Except Bufort. He hung back in the remnants of
our kitchen while Janet and I were in the living room figuring out what
to do. He had said he wanted to know our plans before he left.

I reached over and took her hand. She squeezed back gently. The anger
was gone, and now she just looked as scared as I felt.

"What do you want to do?" I asked quietly.

"I want to get this mess fixed, fast." I smiled at her. She had resumed
her role as a doctor, fixing the physical, but both of us knew it would
take a long time to heal from the other damage done.

"I'll call Doug Perkins," I said, and was relieved to see Janet smile at
last. Doug was our contractor, an artist with wood, and he could
mobilize a small army in less than twenty-four hours. His men were good,
fast, and weren't afraid to pick up a hammer or wrench to ward off goons
of any kind. Doug himself was young, congenitally bald, and tough as a
bull. Besides this, the man had taste.

"You want me to tell him to meet you at any particular time?" I asked.

"He knows what I like." Janet shook her head. "No need for me to see
him. Just tell Doug to get this place back the way it was. Give him
carte blanche. The hell with our insurance company."

"And you?"

"I'll live at the hospital and at my parents' house." She called to
Bufort. "Am I right. Detective?" He took her question as a cue and
entered the room.

"Probably." She continued. "Don't get me wrong, either of you; I'm doing
this to protect my baby. If I weren't pregnant, we'd stay together and
fight. Is that clear?" This time Bufort and I both nodded. She was
absolutely clear.

"Now that I'm taken care of. Detective," she paused, "I want to know how
you intend to protect my husband!" Her glare was like a spotlight in his
eyes. He looked accused.

"Uh, well, I hadn't figured--" She abruptly waved him silent. "Whatever
my spouse has gotten himself into, it is your responsibility to protect
him. Is that clear. Detective? You will take all measures to protect my
husband!" Bufort squirmed like an intern, sighed, and said the
inevitable words. "Yes, ma'am." Janet's curt nod of dismissal indicated
he'd given the right answer. She touched Bufort's arm. "Let's take a
last, quick look around. I'll tell you if anything's missing that I
didn't notice before." When they'd disappeared into the hallway, I
called Doug and got him with a cacophony of hammers in the background.
He explained he was on someone's roof high in the mountains south of us.

"A cellular phone doesn't fit your image," I teased.

"With clients like you who want it yesterday, what choice have I got?"
It was reassuring just having him around. He listened to my description
of the damage. After asking some detailed questions, he lowered his
voice. "Earl, are you okay? I mean, it doesn't sound like a routine
break-in." I hesitated before answering. It wasn't that I had any qualms
about telling him. In fact, I intended to warn him.

But it was just that it all sounded so damned strange.

"Doug," I finally said, "the person who did this probably used a scalpel
and probably already killed at least one person at the hospital. Tell
your guys to be careful." He answered with a whistle. Then he showed the
class that had always made me like him. "Earl, if you've no objections,
I'll move a few of my guys in with you until this is over, as a
precaution. You know, mutual interests."

"You don't have to."

"I want to."

"Thanks, Doug."

"Hey, wait until you see my bill. I gotta protect customers like you to
get the kids through college." I told him he could pick up the keys from
Mrs. Sharp.

He said no problem, he was going to give us real locks this time, and
hung up.

Janet and Bufort had finished the tour, and Janet was still sure that
nothing appeared to have been taken.

Bufort urged us not to stay too long, assured us he'd get added police
surveillance right away, then left.

Janet started to compile a list of lamps, furniture, and electrical
appliances that we'd need. Neither of us had time to shop, and since
Doug had done two expansions on our home up north and some previous work
on the city house, he'd come to expect to take on tasks for us that his
other clients would do themselves. I think he secretly took pride in our
complete trust.

I told Janet of Doug's offer of protection, which made her look
relieved. Bufort's cops might be okay, but with Doug's men around we
knew we'd have the safest house in Buffalo.

The phone rang. I thought it would be the vet and braced myself.
Instead, it was Carole. "Are you all right?"

"Yeah. How'd you know?"

"Ambulance telegraph." I should have guessed. At least they'd think it
was an accident.

"Are we going to see you today?" she asked.

I glanced at my watch. Only eleven. Less than four and a half hours
since I'd stepped out the door, blissfully ignorant of what was in
motion.

"Yeah, soon. Anything big on my desk?" She didn't answer. I suddenly
felt a twinge of fear again. "Carole, what's happened?" I snapped. "Tell
me!" She took a breath, then answered, "Your office here was broken into
sometime last night. They smashed the window and came in from the
parking lot, and made a hell of a mess, tossing around our files and
drawers.

Only one thing seems to be missing, though our backup computer disks." I
couldn't talk. My throat had gone dry again. I had to try a couple of
times before I could swallow. Janet, watching my reaction, started to
look alarmed. She must have thought it was bad news about Muffy. "It's
my office," I mouthed at her. Then I found my voice.

"Carole, what was on those disks?"

"That's the good news. Nothing I can't replace. Only the backup of some
minutes and ER lectures that are already on our hard drive. And they
didn't get at that." After repeated thefts, hospital security had
mounted all computer terminals on sliding trays in heavy wall units that
could be closed and locked at the end of the day.

Anyone trying to break in would need a crowbar and a lot of time, and
have to suffer the consequences of making quite a racket.

"Did security see anything?" I asked.

"No. After breaking the glass I guess the thief was in and out pretty
quickly, probably afraid the noise would attract attention."

"Did anyone in the ER hear anything?"

"It's too closed off. I wouldn't expect them to. But it was Dr. Kradic
who discovered the break-in."

"What!"

"Yeah, he was out in the parking lot this morning around six-thirty to
get some fresh air and saw your broken window. That's when he reported
it to security." I was unable to speak again.

"Dr. Garnet?" said Carole, obviously puzzled by my silence. But my mind
was racing to the earlier doubts I'd had about Kradic back in Sophie's
waiting room.

That explained why I couldn't reach him earlier this morning. A lot of
ER doctors, myself included, went out in the parking lot at that time,
especially if we'd been up all night. By then it was too late to go to
bed, and the cool air made it easier to stay awake while waiting for the
new shift to arrive. But Kradic could also have been out there doing the
break-in and then reported it to take suspicion off himself. And not
getting what he was after in the office, did he come after me in the
alley?

"Dr. Garnet? Are you there?" asked Carole again.

I hesitated, not sure how much to tell her. She had to know at least
enough to be careful. "Carole, my office at homein fact all of my home
was ransacked this morning as well. They probably didn't find what they
wanted here either, because nothing seems to be missing, but I want you
to keep our office there locked even if you step out for a minute. They
may try again."

"My God!" she gasped. "Who's doing it?"

"I've no idea, but you also should warn security to be extra careful on
their rounds. Nobody is to get in unless we say so, not even
housekeeping. And I want you to make sure Detective Bufort knows about
the break-in there. He left here a few minutes ago and should be back at
the hospital pretty soon doing those interviews. If he isn't, track him
down."

"Of course," she said quickly, probably puzzled why someone from
homicide had been at my house for a break-in, but she didn't question
it.

"Anything else important?" I asked, trying to control my fears while
forcing my attention onto routine business.

"No, the usual," Carole answered. "Did you forget you asked me to get
the staff together again for tonight at five?" Forget? Hell, it sounded
like someone else's agenda.

"Let's just say it hasn't been in the front of my mind this morning,
Carole. I'll be there. Anything else?"

"Nothing much. Voyzchek wants our copy of last summer's psych coverage.
Can I give it to her?" Funny. Voyzchek was in charge of emergency for
psychiatry, but Gil Femandez drew up their schedule. I knew they didn't
get along, though it would have been easier just to ask him.

"Sure," I agreed, wondering why she'd want a fivemonth-old roster.
"Anything else?"

"Yes, Hurst's called a staff meeting with Bufort for tomorrow morning."
After what I'd been through, it'd be anticlimactic.

"That's it?"

"Want to know the place is a mess?"

"Not really. Tell Susanne I'll be there in an hour." I hung up thinking
of Muff. She had to be out of surgery by now, or dead. While I was on
the phone with Carole, Janet had gone upstairs. I guessed she was
packing some things for the stay at her parents' place in Lackawanna, a
small town nearby. When she finally came back down, I measured her
optimism by the size of the bag. It was a bit too big for my liking.

"You looked upset by your phone call," she commented without asking
outright what was wrong now.

Oh, God, I thought, I don't want to tell her, not after all this. "Just
office crap," I lied, and immediately felt like an adulterer for keeping
stuff from her again.

We were in what was left of our kitchen. She stood by the counter
picking at an edge of raised linoleum and readying herself for the news
as I dialed Sophie's number.

"Hi. It's Dr. Garnet calling about my dog Muff?"

"Oh, yes. Dr. Garnet, Dr. Sophie was trying to reach you. I'll get her."
Silence, absurd Muzak on hold. It was bad. Otherwise, the receptionist
surely would have said Muffy was all right. Then I remembered the surly
treatment from her earlier. Maybe the woman was cruelly perverse. No, I
thought, they reserved the bad news for Sophie to give herself. Just
like it was in my job.

"I'm on hold," I told Janet. She turned to stare out the back window.
She was unknowingly looking at where it had happened.

The phone clicked off hold. "She's alive but gone septic." Sophie got
right to the point. She knew the agony of not knowing. "Low blood
pressure, lousy urine output, and fever. Same picture as with two-legged
sickles, and the same lousy outcome." Eighty percent mortality in
humans. Muff was in bad trouble. "What antibiotics are you using?"

"Usual triple therapy. Amp and Genta, with metronidazole for the chance
of anaerobes. The only good news is when we explored her gut, there were
no gross perforations we could see." Again, left unsaid was the
possibility of a microscopic hole. The lethality of bacteria from feces
was the fear of even modem medicine. Their names raised the specter of
horrific Greek gods. Proteus, Clostridium, Pseudomonas. Vengeful
creatures. If allowed outside the confines of tough intestinal walls,
they would marshal their armies and sweep through the bloodstream to
infest heart, lungs, kidneys, and brain.

The antibiotics Sophie had chosen were correct but, by human standards,
outmoded. They would guarantee the eighty percent mortality.

"Do you want me to get some Triaxone?" This was a new fourth-generation
cephalosporin that killed everything with little side effects except to
the wallet. The residents called it "gorillacillin."

"It would be a good idea--but it'll be on your card.

My patients don't rate that stuff." What Sophie meant was Triaxone had
been tested and found to be safe for humans but was unproven for dogs. A
bizarre reaction was always possible, and she was merely letting me know
the risk was mine.

"I'll send it over." I hung up, then realized I hadn't thanked her.

Janet knew from my end of the conversation what Muff was up against. She
came up, put her arms around me, and kissed me fiercely on the lips. A
flash of longing, completely sudden and out of place, surged up and then
had to be put down in each of us. Being near death always made me want
to make love. We held each other, letting the mutual hunger ebb. Janet
put her mouth close to my ear. "Save that for me, and you take care!"
she whispered.

I called the pharmacist next door to my private office.

"Carlo, I need a favor. My dog got hit by a car. She's alive but septic,
and I want to get Triaxone for her."

"For your dog?"

"Yeah. She's in bad shape."

"Gee, I'm sorry. Listen, the best way is I list it to your office, then
what you do with it is your business. Where do I send it?" I gave him
Sophie's address and the daily dose calculated on Muffy's weight, then
phoned Mrs. Sharp to warn her that Doug's crew would show up soon, and
asked her please to give them the spare key I always left with her.

She'd be miffed not to be kept up-to-date anyway. I figured her life was
sniffing out neighborhood news and secrets, so why ruin her day?

Soon she'd be out prowling the back lane, trying to engineer a chance
meeting with anyone who might have a tidbit of gossip for her. Two steps
behind would follow her thin, stooped husband, the curve of his back and
nose giving him an odd pecking look, like a heron foraging in grass. In
the prewinter light the old couple might be cave dwellers, except
millennia of marital training had finally got the man where he belonged.

After I replaced the phone receiver, I hesitated about the next call I
had to make. Even thinking about it made my throat go dry again.

I needed to confront Kradic. If he was the monster behind this, I wanted
to flush him out now. But I had nothing specific to do it with. I knew
he was mad at me, but he was mad at a lot of people. I didn't even have
an inkling of what might motivate the man. And I certainly had no
evidence that he was the maniac behind the hit and-run attack this
morning. I had to have something if I was going to voice any suspicions
to Bufort.

I decided I'd call Kradic about the break-in and ask him if he had seen
anything. Or I'd ask him to speak with me before our meeting tonight
about practicing with cardiac needles on DOAS. Either way, I'd look for
some giveaway, some shred of the hatred behind the attacks on me. If it
was him, I figured I might at least sense it.

I called the hospital, got his number, and had them connect me to his
home. Busy. I tried again but got the same annoying sound.

I wasn't going to be put off, so I called the city operator.

"This is Dr. Earl Garnet, chief of emergency at St. Paul's. I've been
trying to reach Dr. Albert Kradic, but his line's busy. Could you please
interrupt the conversation and advise him I have to talk to him?"

"Of course," she replied. I gave her Kradic's number and waited. My
hands were getting sweaty as I psyched myself to sound official while
being shrewd as hell.

"I'm sorry, sir, but that phone seems to be off the hook." Shit! He was
probably sleeping. I'd have to psych myself all over again tonight.

I cleaned up, found some fresh clothes, and got ready to go. When I went
to lock up before leaving by the back way, I found a cop car parked in
front of the house.

Already? I marveled at the effect Janet had on people like Bufort. I
went out and walked over to the driver's side, where a very bored cop
was reading a magazine. He barely looked up as I introduced myself. My
protection. I advised him about Doug arriving later.

"How will I know him?" he asked without much interest.

"Big, very big." Thank God.

The only sign that my usual predawn excursion to the hospital was now
occurring at high noon was a lighter shade of gray and a hundred times
more traffic. Buffalo drivers are an ornery lot after three weeks of
rotten weather. Ten minutes of the snarl-up in the streets and I was
giving the finger and lipping off with the rest of them. By the time I
pulled into the sodden parking lot, I felt warmer than I'd been in
weeks. The weary attendant signaled me to the special spot he kept for a
few of us when we were late and otherwise out of luck. It was the
emergency fire lane outside the staff entry to the outpatient
department, where we held all our clinics. Since I was also chairman of
the Safety and Emergency Measures Committee, it was a slick move. Who
was I going to report myself to?

I parked, got out of the car, and opened the trunk to retrieve the
computer printouts and disks I'd been working on at the cabin. Then I
paused. I hadn't put them there for any specific reason. I was in the
habit of lugging a small office around with me, and rather than cart it
inside each time I parked, I just locked my briefcase and any other
stacks of paperwork in the trunk as a matter of routine.

Could the quality assurance data be why I was suddenly a target? Was
that what the night visitor had been after at the cabin? And this
morning in my office and at my home? The thought seemed absurd. Yeah,
most of the physicians were nervous about their visibility in the study,
but that was tempered, I thought, by their curiosity to have their
competence measured. The sniff of competition had been irresistible when
we'd voted on whether we would enter the QA program. It was the implicit
challenge of a rivalry among old friends and colleagues whose job every
day meant putting their skills on the line. The vote had been nearly
unanimous; only one of the secret ballots had been left blank.

But for any of the reservations expressed then to bubble into the insane
fury of the last few hours was beyond understanding. I had to find out
more about Kradic, but also, almost in spite of myself, I felt my
instincts start to probe what some other members of my department might
be capable of as well. Dark possibilities, unthinkable a few days ago,
now appeared frighteningly plausible. Had Jones been snooping through
the study out of the same nervous curiosity that afflicted most of the
department, or was she after something specific?

Did the data hide a secret so terrible, someone who had seen me leaving
with the printouts felt they had to kill me before I stumbled onto it?

Or did these records somehow connect with Kingsly's killing, or possibly
the wino's, and threaten a killer not even in my department? I still
didn't know of any relationship between Kingsly and members of my staff
that could possibly be a motive for one of them killing him; But this
was far less reassuring now, if the attack on me today, as well as the
destruction of my house and the office break-in, had been set off by
something hidden in the ER statistics. That suggested a motive limited
only to the physicians identified by code in that report.

I was still standing at the back of my car with one hand on the open
trunk, and I couldn't help giving a quick look around. The lot was
filled with cars and mist. An old man struggled out of a nearby taxi,
then walked with a cane slowly toward the hospital. I could see other
figures moving farther off in the fog, but no one was near me. I looked
back down at the pile of printouts and computer disks. I had to keep
them safe. If they were the cause of the attempts at theft and the
hit-and-run try, then it made sense that the perpetrator wanted to keep
me from unlocking their meaning. I frowned. The records themselves had
been sent out from the state health department and were accessible to a
lot of authorized people. But what was in those numbers and symbols that
only I was likely to pull out, cross-reference, and look at in such a
way that I fingered a criminal? If these statistics could tell me
something, maybe they could give me what I needed to find my way out of
danger instead of getting me killed.

No one had found them in the car so far. For the time being, that seemed
the safest place to keep them, so I slammed the trunk closed and checked
the lock.

I was just setting my antitheft alarm when I saw Gil Femandez. Coatless,
he was crossing the hundred yards between the psych building and the
main hospital. Now that the daylight was at least equal to the street
lamps, he looked even whiter. His forehead had the sheen usually seen in
fevers or the sweats of withdrawal. Gone was his jaunty scarlet
handkerchief. In addition his suit and his shirt were equally
wrinkled--and he wasn't even wearing a tie. Instead of the flamboyant
cavalier he had so often mimicked, he slouched by, like a condemned man
headed for the gallows.

"Gil, are you all right?" There was no answer. "Gil!" His head jerked
up. The blank gaze I got was far from recognition. I stepped over to
him. If possible, he looked a lot worse up close. The man probably
hadn't been home, certainly hadn't changed or showered since yesterday.

Being caught overnight wasn't unusual for a physician, but by noon the
next day most doctors could at least find time for a shower. Even
Femandez's usually crisp beard needed a trim.

"Gil, are you all right?" He looked at me, tried to smile a greeting,
but instead his eyes brimmed over with tears. He couldn't stop himself;
his chin kept trembling, and the tears continued to flow.

"Sorry," he muttered, turned, and raced to his car before I could grab
him.

"Gil!" I yelled after him, and started to walk quickly over to where he
fumbled with his keys.

He saw me coming, whirled, and shouted, "Back off!" I was so startled, I
froze in midstep.

"You can't help me!" he said in a more normal tone.

Before I could protest, he got the car door open, jumped inside, raced
the motor on starting, and like a replay from the other night, jerkily
sped from the parking lot.

He had seemed afraid then; now I was afraid/or him, despite the familiar
words. Back off! Coincidence?

Maybe. I'd nearly lost my life passing off some recent events as
coincidence. But it was a pretty common expression, and I certainly had
no idea why I'd be a threat to him. And what the hell had driven him to
this state? I didn't know what to do. Doctors who were sick, whether
mentally or physically, had two problems-- whatever afflicted them and
being assholes who refused help.

Femandez, at the very least, needed a friend. But I had no idea whom to
call. Again, with that peculiar formality of colleagues, we had worked
together for years in carefully defended isolation. I presumed he was
married, but didn't know for sure. I certainly didn't know who his
friends were, or even if he had any. He probably had none in the
hospital. Chiefs rarely did.

As I turned back toward the hospital, I had a funny thought. I'd spent
the last twenty-four hours becoming afraid of people. But I wasn't
afraid of Femandez.

In emergency the clerks and nurses all greeted me with smiles and told
me they were delighted I was okay.

Popovitch and Sylvia Green walked over and started feeling my bones.

"Should we shoot him?"

"Nah, who would we blame this mess on then?"

"Pity, I kinda wanted his car." "Back to work, schleps," I said, and
made my way to my office, feeling slightly restored.

It didn't last. Carole had locked the door as I'd requested. I opened it
and found everything as usual except that she wasn't inside. The only
evidence of a break-in was a plywood sheet nailed over the window.

What bothered me, however, were the notes on my desk.

The first was from Bufort. Since he'd dropped me as his number one
suspect, he hadn't wasted any time. Now he was going after the rest of
my department.

"In-depth interviewing of all emergency room doctors will start
tomorrow; we need only a small room near the ER for this purpose; my
clerk will coordinate on scheduling with your secretary." No "if
convenient," or "at a suitable time," just "will start tomorrow."
Terrific! From court orders to being interrogated as possible murder
suspects. What the hell else could be done to disrupt us?

I found my answer in the second note. It was from Jones's reputed bed
partner, James Todd. It was handwritten, hastily scrawled across the
back of a history and physical sheet.

Dear Dr. Garnet, I had a problem with Dr. Kradic this morning when I
asked him to call you. His outburst was really embarrassing because it
was in front of so many other residents and staff. Please call me
immediately when you arrive. I won't be able to sleep now anyway. I
don't know if I can work anymore with Dr. Kradic.

Jim Todd I'd forgotten. The beginning of this day was like a distant
time unconnected to the present. Obviously Todd had given Kradic the
message to call me and been handed his head for his trouble. I wondered
if the unfortunate resident had innocently added that I'd asked about
cardiac needles and practicing on the DOA. He may have been a fool for
getting involved with Jones, but he didn't deserve this. And the last
thing I needed right now was a coverage problem with a resident, even
one sleeping with his supervisor.

I quickly punched in the number Todd had left, cursing Kradic as I hit
each digit.

He answered on the first ring. "Dr. Todd here."

"It's Dr. Garnet. I'm sorry I didn't get back to you earlier, but I just
now got into my office. What happened with Dr. Kradic this morning?"

"It was pretty unpleasant. Dr. Garnet, and it took me by surprise."

"What happened?" I asked again gently. Even over the phone I could hear
the strain as he was speaking half an octave higher than usual. A
resident making a complaint about his staff man was serious business.

"Well, it probably wouldn't have been so bad if Dr. Jones, hadn't made
such a big deal about it" His voice had just gone up the rest of the
octave.

"Dr. Jones?" I said, trying to keep my own voice steady.

"Yeah," he answered, sounding a little less nervous and a whole lot more
angry. "Right at the start of signout rounds she turned to me and said,
"Dr. Garnet wanted me to remind you to give his message to Dr. Kradic
here." Well, we all know those two can't stand each other, however good
they are individually, but it was the way she said it that got Dr.
Kradic's bristles up, even before I told him to call you." He was
practically spitting out his words now. Whatever inexcusable behavior
had been leveled at him by Kradic, Todd seemed more bitter and hurt
talking about how Jones had set him up.

Damn that woman. She had the highest "fight quotient" on staff, but
around Kradic she was at her very worst, always taking shots to put him
on the defensive. It was part of her ongoing war to discredit him, but
this time she'd used a resident to do it. Not even knowing what I'd
called Kradic about, she probably hadn't been able to resist another try
at getting him riled just for the hell of it. Not that Kradic was any
better. They were like two feuding cats. Even if I separated them, they
went looking for each other to fight some more. But for her to drag Todd
into it, especially if she was sleeping with him, was too damn much.

"I'm sorry. Dr. Todd, but I assure you I'll speak to both Kradic and
Jones about their behavior."

"I'm afraid that's not all. Dr. Garnet." What now?

"Go on," I said, getting ready to control my own temper.

"Well, when I told Dr. Kradic to call you, he immediately asked why.
When I mentioned the cardiac needles and the DOA, he went ballistic.
Shouted that you were trying to pin Kingsly's death on him and stalked
out."

"How did he know about the needle in Kingsly's heart?" I interrupted.
Until yesterday, Bufort had successfully suppressed that detail. It
hadn't been part of the general gossip since, as far as I knew, only the
chiefs and a few others had known. I'd told Carole and Mrs. O'Hara, but
I didn't think those two had blabbed.

Todd seemed surprised at my question. "It was in the papers this
morning. You didn't see it?" Shit! The reporters swarming over the
hospital yesterday had obviously gotten someone to tell all. I'd
expected the press would find out all the sordid bits one way or
another, but I'd somehow hoped Bufort and Hurst might succeed in keeping
the lid on things for a while longer. Then I remembered I'd also told
Zak. And who knew who the other chiefs had told?

I answered wearily. "My wife and I don't have time for the morning
papers."

"In any case," he went on, obviously relieved to be spilling out all the
garbage that had happened to him earlier, "Dr. Popovitch was really
upset and ran after Dr. Kradic but couldn't catch him. Dr. Popovitch did
speak rather sharply to Dr. Jones, right in front of all us residents,
and told her to keep her problems with Kradic out of the emergency
department. Strangely enough, I think the whole thing made Dr. Jones
sick to her stomach. I know she likes to bug Dr. Kradic, but I guess
even she felt it had gotten out of hand this time. She started looking
really pale and disappeared for a while. I think she was in the can,
barfing. When she came back, she asked Dr. Popovitch to excuse her so
she could lie down in the doctors' room. It was almost an hour before
she could come back." As he talked about Jones, his voice grew softer,
and deeper. I wondered if he was trying to find an excuse for her
treatment of him, slough it off as a thoughtless mistake"that went too
far and that he might forgive, for the sake of still getting sex. It
suddenly occurred to me that ordering Jones to keep her hands off him
might do him the favor he couldn't do for himself.

Quickly smothering my impulse to protect this not-so- innocent lamb, I
said, "I'll take care of this crap and they won't bother you again.
Sorry, Todd." He stayed quiet a few seconds, then sounding resigned, he
said, "Well, okay."

"Get some sleep," I told him, "and we'll see you tonight. By then I'll
have taken care of Jones and Kradic." After hanging up, I again
considered dumping both of them. Before this morning I had always
weighed their affinity for trouble against their competence and
willingness to do the nights and weekends no one else wanted.

Reluctantly I'd admitted life in the ER would be more miserable without
their skills and flexibility about shifts.

As a result, when I wasn't dreading their fights, I was marveling at
their saves in the ER and thanking them for filling the hard- to
impossible-to-fill holes in the roster. I had a grudging appreciation of
them for the many times they'd kept me from having to work these
last-minute shifts personally, most often at night, on holidays, or
both. And I was certainly aware no one else wanted their regular load of
nights. So, in exchange, I had always forced myself to endure the
additional aggravation of smoothing over their perpetual flare-ups. But
were they still worth it?

I crumpled James Todd's note and shot it angrily at my basket.

Any other week, sorting all this out would have been my worst problem.
This week I was left sitting in my office wondering if Kradic had a
secret so dreadful that after his fight with Jones he'd gone out and
tried to run me over.

"She's going to arrest," our new junior resident yelled.

He was panicky. When I'd come out of my office about an hour before, I'd
started seeing patients in the ER to avoid thinking any more about who
was after me.

Because of the wet, cold blanket of air hovering over Buffalo, we were
overwhelmed with respiratory emergencies, and I was using the occasion
to teach.

The woman on the stretcher was desperately casting her eyes about for
help. Her bronchial tubes had shut down, and her breath was cut off. Her
chest heaved. She was unable even to speak. She clawed at her clothes
and gave panicky whimpers. Her nicotine-stained fingertips with
downwardly curving nails--a sign we called clubbing-- told the reason:
end-stage emphysema. A lifetime of smoking had come down to a few
desperate seconds.

"What do you want to do?" I commanded more than asked, to get the
resident thinking again.

"Ventolin?"

"Good answer--except it's too late for Ventolin now." She's so shut down
she needs an airway."

"Won't she buck the tube if we try before she arrests?"

"Good question, but I want to prevent the arrest and relieve her
distress. We're going to crash her before she crashes on us. Get your
intubation equipment ready." He looked relieved to have a familiar job.
I knew he'd just come to us from an anesthesia rotation.

Susanne, anticipating where we were heading, had filled the pancuronium,
succinylcholine, and ketamine syringes. Our lady was reduced to useless,
flailing movements like a stranded fish. She already had an IV.

As I worked, I talked out what I was doing for the sake of the resident.
"First a defascicutation dose of shortacting curare to prevent muscle
twitching when we paralyze her outright." I shot in the pancuronium.

"SNEVER paralyze someone and not sedate them.

Though unable to breathe or move anything, she's still conscious--the
living dead, so to speak, and terrified.

For this scenario we use ketamine." In it went.

We started to bag her before intubation. I continued to talk. "That
sedates, gives analgesia, and dilates her bronchial tubes." I let it
take effect.

"Now we paralyze," I said, and injected the succinylcholine.

A few twitches, modified by the preceding curare, and she was flaccid,
unable to move a muscle, including her diaphragm. We were committed;
either we succeeded in getting an airway or she was dead.

"All yours. Doctor," I said as I stood back to let him intubate. Given
his recent training, it was unlikely he'd have any trouble. But in the
OR, the resident was used to a calm, well-planned routine for
intubation. Here we had to snatch the same technical precision from a
lot messier setup.

He moved in and positioned her head. I gave three quick puffs with the
bag and mask and then removed it.

He scissored open her mouth with his right hand; with his left he slid
in a laryngoscope. The curved blade with a light in its tip pushed aside
the tongue and illuminated the vocal cords. Through them he'd slide a
tube into her trachea. The nurses went quiet. The resident steadied the
light in position.

"Do you see the cords well?" I asked him to confirm this crucial step,
"Yep." He picked up the endotracheal tube with his right hand and slid
its tip carefully over the tongue held aside by the blade of his scope.
He paused with the tip of the tube aligned at the small opening in the
windpipe, then slipped it through. "Got it!" he announced, and the
nurses began to chatter again.

He hooked up the bag to the tube, squeezed in a few test puffs of air
while listening at the bases of the lung for confirmation. "We've got
air entry!" He sounded surprised at his own success.

"Of course, Doctor, good job." I knew he'd build on this case.
Respiratory emergencies would no longer frighten him.

We added some Ventolin down the tube, started steroids through the IV to
dampen down the underlying inflammation of the lung, then arranged the
transfer to ICU. I let the resident continue bagging her and supervise
the trip upstairs. He'd enjoy presenting his win. The lady looked pink.

Before this week I never would have thought I'd be using shifts in the
ER as a way to relax.

The whole department was present, a first, but then, they'd never been
summoned because of an injunction before. Even Sylvia Green, who was on
duty, came up to the meeting room, but she stayed near the phone, ready
to be called to the ER in an instant. And I'd had Carole make two
special calls: to Kradic, who had finally put his phone back on the
hook, and to Jones. She'd given them my order to be here, and they
were--sullen, withdrawn, and sitting at opposite ends of the table, but
they were present. Jones avoided my eyes; Kradic seemed oblivious of me.
Finally he realized I was staring at him and looked annoyed, but then,
he always looked annoyed to me.

There were a few wisecracks sent my way about the accident. The usual
type of stuff--"Anything for a day off."

"What'd the other car look like?" Obviously no one except the murderous
driver knew that the hit-and-run had been deliberate. All the banter
ended when I mentioned the injunction.

"We'll get to that in a minute. First I need to talk about Kingsly's
murder. For those not up-to-date on the situation when we found him
early Monday morning, he had been stabbed with a cardiac needle. No one
knows why, let alone by whom." I paused a second, then said, "Because of
the way Kingsly died, anyone with the skill or means to perform
intracardiac insertions is under scrutiny. Each one of you will be
questioned, starting tomorrow." Now there was more dismay than offense.

"They gotta be kidding."

"That's nuts."

"Christ!" I waved the noise down. "I know. I share your feelings.

But until they get some clue as to what's going on, be careful. Anything
unusual, take note, and get back to me." The initial shared outbursts
were being replaced by averted eyes.

"Look, I don't mean I want you to spy on your colleagues or anything. I
mean, we all have to remember that after this ends we're still going to
be working together and, I hope, continuing to trust one another." My
attempt at perspective sounded feeble even to me.

I tried the practical example. "Here's what I mean. This past Monday
there was a DOA derelict found in the street and brought here without
any resuscitation attempt tried on him. The post found marks from an
intracardiac needle. Anyone here know of any practice procedures on the
body?" I had asked this looking directly at Kradic. He swallowed and
then quickly glanced down at his lap. The rest of them answered my
question by saying no or shaking their heads. All except Jones. She just
stared at the center of the table.

"Dr. Jones?" I asked to get her attention.

"No, I don't," she said resentfully without even looking at me.

I turned back to Kradic. "And you, Albert?" His head snapped up, and he
seemed surprised, but that could have been because I called him by his
first name, which was rare. "Of course I don't." He scowled, then added
even more resentfully, "Why are you asking us about this anyway?"

"Because, as I said, the DOA had a needle track into the heart we can't
account for. And, since we can't explain it, I have to think the
derelict was also murdered, the same way as Kingsly." Kradic looked
startled. Others at the table expressed their shock.

"Another one?"

"Good Lord!"

"Like Kingsly?"

"What the hell is going on?" But I just kept staring at Kradic. He
looked even angrier now, and leaned forward as he spoke over the noise
of the others. "Are you saying the cops will blame that on us too?" he
demanded, his voice rising.

Everybody in the room went quiet.

"As I warned you, the police will start questioning you tomorrow about
Kingsly's death. I don't know what they're doing about the derelict." He
was red in the face now. "Jesus Christ! What kind of setup is this?" He
began pounding the table with his right forefinger as he spoke. "I don't
know about the rest of you, but I'm getting a lawyer!" He rose partly
out of his seat and used that same finger to point across the table at
me. "And you," he yelled, "are letting the staff of this department be
hung out to dry!" Then he shoved back his chair and stomped out.

His accusation hung in the silent room. Some looked at me, obviously
nervous; others looked anywhere but at me.

My mouth was too dry when I first tried to speak. I had to take a sip of
water and try again. "I don't need to tell you this is a very serious
matter. Perhaps each of you should consider legal counsel before talking
with the police." The silence remained, but now nobody was looking at me
except Popovitch. He gave me a sad little smile and then came to my
defense.

"I'm sorry," he started to say, and got everyone's attention, "but Dr.
Garnet can't change what has happened in the last few days. The police
are looking for a killer, and until they succeed, this department, along
with a few other areas in the hospital, will be under scrutiny. It may
not be fair, and it's certainly not desirable, but it can't be helped."
He looked around at his colleagues, then spoke rather sternly. "It is
absolutely unacceptable to blame the messenger, and I insist, on behalf
of all of us, that we dissociate ourselves from Dr. Kradic's inexcusable
behavior." Most quickly came to my defense, but a few still looked
pretty worried. Jones was scowling at Popovitch now, probably still
smarting from his rather public rebuke of her this morning in front of
the residents. I turned back to Popovitch.

"Thank you, Michael, now let's deal with this courtorder nonsense." I
told them my plan, but I doubted many of them had much confidence in my
ability to pull it off.

And I still had no idea who had tried to kill me.

Coming home that evening was more like entering a boys' camp than being
at the site of a recent attempted murder. Right away I knew Doug's men
were out in force when I saw the number of pickup trucks wedged into my
driveway. The warm scent of pizza greeted me as I stepped into the
kitchen. "Hi, Doc!" and a chorus of other welcomes came from those
filling the room.

Someone opened the fridge, which was now full of beer, and handed me a
can. Seemed like Doug had made my mental well-being the primary
responsibility of his crew.

I recognized some of the guys from the renovation work on the cabin, and
the others cheerily introduced themselves. Doug's best. Many had
families they were abandoning for the evening to baby-sit me, and I was
warmed and flattered.

"Thanks, guys."

"Hey, no problem. Our pleasure. Glad you're okay." Doug led us into the
living room where, clearly, he'd made replacing the large-screen
television a priority and had hooked up our still-functioning VCR. He
punched Play. Casablanca, in all its original black and white, was
starting to unfold its tale of love and glory. It was my favorite movie
of all time. "How'd you know?" They answered with pleased, knowing
grins. Doug must have called Janet.

"C'mon, Doc, sit down. We've got it cued up so he's about to do the"Of
all the gin joints in all the towns in all the world, she had to walk
into mine' bit." And I did sit down. I watched that famous craggy face
and took courage from it. I felt blessed.

It was after midnight when Janet called me from the case room. "How'd
you like it?" she asked.

"Would have been better with you."

"Flatterer."

"You okay?"

"Yeah, you?"

"I'll be better when we get our life back."

"How's Muff?"

"I dropped by the vet's on the way from work. Sedated, fever, but
pressure and urine output are up. I left one of our pillows. She didn't
know I was there, but if she ever does wake up, she'll recognize our
smell."

"I'll go see her in the morning. "Night, love."

",,'Night, Janet. I love you."

Chapter 11.

Hurst started his meeting promptly at seven a.m., and almost everyone
was present. Not surprising. I was relieved to see that Gil Fernandez
had turned up. He was bathed, his beard trimmed, but still he seemed
subdued.

Even his pocket handkerchief was less puffed up than usual.

Sitting beside him was a uniformed policewoman with a stenographer's pad
in front of her. On the opposite side of the long table, but farther
down, a second uniformed police officer, a pad also in front of him, sat
between Bufort and Riley. A dozen legal-size file folders were stacked
near Bufort, and two open briefcases were on the floor near his chair.

I happened to sit by Watts. He leaned over and quipped, "If those are
Kingsly's financial records, it'll be ruled justifiable homicide." Hurst
stood, cleared his throat, and we were off.

"Though this special meeting of the chiefs of staff was requested by
Detective Bufort, I want to remind you we are under police orders not to
discuss the details of Mr. Kingsly's murder. A sordid tragedy such as
this is disruptive enough without the appalling sort of headlines we saw
in yesterday's paper." As he slowly turning his head, his glare spared
not one of his medical colleagues at the table. I suspected he was more
concerned about bad publicity than any negative impact a leak might have
on Bufort's police work. "For those of you interested," he added, "a
memorial service for Mr. Kingsly will be held next Monday at one o'clock
in the hospital chapel." Some of the chiefs made a gesture to note the
announcement.

I was saddened to think of how few of them would actually bother to go.
Hurst sat down with a curt nod at Bufort.

Bufort sat motionless for a few seconds, as if waiting to make sure he
had our undivided attention. The two uniformed police picked up their
pens and got ready to write. Even Riley had taken out a notebook.
"There's a rule of thumb in homicide," he began, "that the most
important evidence is found within the first few hours after a crime.
Then the trail grows cold quickly." He seemed tense, and I was surprised
to see dark shadows under his eyes. Without me as a suspect, I wondered,
did he feel the case was slipping out of his grasp?

"The first days of this investigation seemed to go well," he continued.
"We discovered a probable motive for Kingsly's killing, and were looking
at a few suspects." He looked at me briefly, then continued. "But recent
events, some of which were brought to our attention only two days
ago"--he frowned in the general direction of Watts--"have made it
necessary to widen our investigation. While it's unusual for us to
conduct a session like this, we've been forced to do it to try to make
up for lost time. We hope mat after hearing about some of the evidence
gathered so far, one or more of you may realize you have information or
insights that will help us find Mr. Kingsly's murderer." Damn, if he was
this desperate, he was really back at square one. Then I noticed
something strange. While Bufort talked, neither Riley nor the two
uniformed police were looking at him. Each had his eyes fixed on a
different section of the group at the table.

Bufort stood as he resumed speaking. "One of the avenues we have
explored to find out why Kingsly was killed and by whom is his hospital
records. The other avenues, his personal life, his associations beyond
hospital life, haven't yielded anything so far. Besides, as you probably
know, the manner in which he was killed suggests it was done by someone
in this hospital, someone with a special stall." Hurst was starting to
squirm. I wondered if Bufort had questioned him on his ability to needle
a heart. The policewoman opposite Hurst watched him for a couple of
seconds, then wrote something on her pad.

"In these records," Bufort continued, "we find what I take it all of you
are aware of: The hospital's finances are in a mess. Every department,
it seems, has a debt. It isn't easy for the auditors we've called in to
determine who controls what expenditure. People just forward requests
for equipment, tests, and supplies, and other people fill those requests
from preauthorized labs and medical supply houses. No one at any level
seems to know why existing supply and service contractors were chosen.
The authority to question alternatives, let alone actually implement any
attempt at more cost-effective measures, doesn't seem to be exercised in
any consistent or logical way." He paused. Around him a ring of puzzled
faces echoed my own confusion. It sounded more like a management seminar
than a murder investigation. Riley and his two colleagues watched their
sections of the table but wrote nothing down. And Hurst was really
squirming now.

"The budget of this place is one hundred and twenty million annually.
That's a great deal of money by anyone's standards. And Kingsly and the
director of finance, Thomas Laverty, alone controlled its allocation."
Everyone at the table looked around. Laverty wasn't present. The police
officers watched our faces, and I slowly caught on. Bufort and his
people were checking for reactions again.

"The opportunity for diddling the till here is immense," he continued,
starting a professorial strut behind the chairs occupied by the
policeman and Riley.

"Increasingly Mr. Kingsly was  ...  well, incapacitated.

The clerks up in finance kept sending checks to pay the bills as they
came in. Overdrawn, why not? A lot of hospitals are these days. The bank
relishes racking up interest charges, and loans to the health care
system are a cash cow to the moneylenders, so they don't complain.

End of the year, there's a deficit. The board screams, then approves
borrowing the money to pay the interest and further service the debt.
The bank now has interest on interest but assumes that even if the
hospital is in danger of defaulting, another institution is likely to
buy it out and make good on the loan. So for the time being, who even
thinks of paying back the principal? After a few years the entire mess
becomes such a routine, it gets no more than token scrutiny. The
familiarity gives a false sense that it's all proper, and the diddling
continues." He had us all now. Hurst looked as if his second heart
attack had plugged his pump. His first one, ten years ago, was the
reason he'd given up surgery. His hands rolled into fists; his mouth
made sucking movements. I leaned forward and took his arm. He wrenched
it free. I saw the policewoman write something else on her pad.

"We don't have many details yet," continued Bufort, "and we haven't
finished looking at all your departmental salary pools, but we have a
pretty good example of wrongdoing. The first oddity was a receipt for
etchings and prints from a place called Renaissance Art Gallery.

More than two hundred thousand dollars' worth, labeled as institutional
art, that no one knows about. We have no idea where they ended up. There
wasn't a trace of the stuff in Kingsly's home." He paused, surveyed his
incredulous audience, and seemed to particularly savor his next
revelation. "There is a single account in all the hospital's bank
records and cost centers that routinely holds money. We noticed it
because, in contrast, all the other cost centers are continually in
deficit. This center, with no designated function, is numbered 0067."
The absurdity exposed. An account rendered peculiar in our madhouse by
the simple deviance of actually having some money in it.

He no longer needed a dramatic pause to get our attention.

In fact, he seemed taken aback as, one by one, we reacted to the
enormity of what he'd told us. We'd endured shortages year after year.
Suggesting we had an embezzler in our midst was a flashpoint. Every
person at the table seemed to be getting angry. By now some were
standing, leaning in on him. Others remained seated, staring at him,
their expressions changing from disbelief into disgust and their hands
curling into fists. Riley and his two cops occasionally made a note.
Names? Reactions?

A lack of reaction?

It was Sean who found his voice first. "Do you mean that creep was
siphoning off hospital funds?" he asked, barely controlling the rage in
his voice.

Bufort clearly hadn't expected this level of fury and still seemed
astonished by what he'd unleashed. "We don't know much yet," he said
cautiously, "but I'm asking anyone who does to come forward. We're
especially interested at the moment to hear from anyone with any
information on cost center 0067." I got my own brain functioning again.
"How much do you figure went through this center?" I asked.

"More than a million a year," Bufort said carefully, as if each word
were nitro.

I swung on Hurst. "That's the cost of closing fifty beds. Were you aware
of this?" He had a lock on the table's edge that turned his knuckles as
white as his face. "Of course not!" I didn't believe him.

"Is this why you were so hell-bent on attacking the deficit and ordering
such excessive bed cuts? Were you planning to use the extra savings to
cover some embezzled shortfall of Kingsly's?" At my accusation his lips
trembled so violently that I was sure he'd have attacked me if we'd been
alone.

"Well, get this. Hurst," I said before he calmed down enough to speak.
"Patients in emergency aren't going to play victim to cover Kingsly's
dead ass, incompetent, crooked, or both. Your court order's dead in the
water as of now." I hadn't planned to use that fact this morning. I
pulled a rolled fax of legal-size text from my lab coat pocket. It was
confirmation that our malpractice insurance group in Albany would assign
a legal team to quash Hurst's court order. But I unscrolled to an even
more pertinent section.

Against the sounds of Hurst's sputters and the counterprotests of
Carrington and Watts telling him to "stuff it," I started reading aloud.
""Specifically forbidden is any action on the part of the county,
hospital, or any individual representing the hospital who attempts to
coerce a physician to work in conditions unsafe for patients or
contributing to patients being subjected to substandard care. Our
company deems the long waiting times for emergency patients to get beds
as unduly dangerous to their well-being and, as such, a breach in the
standards of acceptable hospital practices. Adherence to such standards
is the basic tenet under which we grant malpractice policies, and any
failure to adhere to them automatically renders our contracts null and
void. The probability of costly lawsuits is too great, and we refuse to
underwrite in such a high-risk situation."

" Everyone was looking at me now with very confused expressions on their
faces. Even the cops.

Sean asked, "What's that mean?"

"It means if a hospital doesn't have the integrity to shut down
emergency services that can't supply timely care, then the insurance
company can withdraw malpractice coverage. Without coverage, it's
against our own hospital bylaws for a physician to work."

"Wow!"

"Finally!"

"Great!" Lost in this chorus. Hurst went an even paler shade of his
usual white. "It'll never stand!" he snarled at me.

"Then try this," I said, and handed him another document.

All the side conversations stopped. Every pair of eyes gazed at Hurst as
he skimmed my latest offering.

Probably, I thought, he was going to say we should meet privately later
and discuss the matter, try to bury the ruling without the other
department heads finding out. I blew that option off the table.

Not letting my eyes off Hurst, I raised my voice.

"Gentlemen, what I've shown Dr. Hurst is a letter of intent from our
protective agency to defend free of charge any physician subjected to
legal action for his or her part in shutting down an unsafe ER. They
figure it's cheaper to prevent the inevitable litigation than to pay for
it later. And whatever our own financial woes might be, Dr. Hurst and
his bean counters aren't likely to go into a court of law to argue their
right to force doctors into unsafe practices just to balance their
books." Now I looked at my colleagues. Four days ago they had been cool,
outright hostile to any action on our part against the bed closures. A
few had probably welcomed the injunction.

Arnold Pinter hesitatingly tried to rekindle their opposition.

"Uh, Earl, surely this is completely inappropriate at this meeting,
don't you think? I suggest you forget this ridiculous idea of shutting
down emergency. Why, the--"

"Shut up, Arnold!" Scan Carrington shouted. "And I'll be raising this
same principle of standards with the department of surgery." The other
chiefs came to Carrington's and my support.

"Right."

"Agreed."

"Bravo!" A few even gave me a slap of congratulations on the back. Their
smiles lightened the mood, but only for some.

Femandez was staring into space. He gave no sign of following what was
going on around him. Instead, as white as Hurst, he got to his feet and
made for the door. I was startled to see his hand shake as he reached
for the handle. I don't think anyone else in the room noticed him leave.
Except the policewoman. I saw her watching his departure and making a
note on her pad.

I turned back to the table.

Saswald was desperately oiling his sensors to gauge the political swing
unfolding too fast for his usual self serving calculations.

I enjoyed putting him on the spot. "Where are you now, Sas?" He started
weaving the air with his hands. "Well, I ... of course, I must raise any
such serious matters for careful study within my anesthesia department,
and I'll make a motion--"

"Forget it, Sas." Gotcha! I knew I was being petty, but it felt good.

In my mind I fancied a perversion of one of those righteous bumper
stickers: I don't brake for politicians, EVEN IF THEY PRETEND TO BE
PHYSICIANS. LET"EM BE smears on the road. Then I remembered that I'd
nearly been dispatched to that status myself and sobered up. I turned
from the still-blustering Saswald and faced Hurst.

"Forty-eight hours. Hurst, or we shut down. Open the goddamn beds!" He
glared at me but said nothing. I glared right back at him. I was pretty
certain now that he'd gone as far as crippling the hospital to cover up
a scandal over Kingsly.

Was he also capable of killing for it? I still didn't know, but clearly
we were now on a different footing about the beds.

Arnold sank morosely into his chair.

Riley broke my second of triumph with a quiet cough, then deferred to
Bufort and thus duly returned us to the business at hand. We all sat
back down and stopped muttering to one another. Riley and the two
uniformed police resumed watch on their respective sections of the
table. I don't think anyone else noticed we were being observed so
systematically.

"We are questioning the director of finance." That explained Laverty's
absence.

"We are not sure yet of the extent of his involvement.

Nor do we know how these events led to your former executive director's
murder. But we're very sure there is a connection." I saw the
policewoman look at Hurst and make yet another note. I wondered if
because of my outburst he'd be questioned now about covering up the
embezzlement.

Bufort made his next disclosure very quietly. "Two days ago, as I
mentioned, we had to completely change our thinking and the scope of our
investigation. That's when we learned from Dr. Watts that there may have
been a second murder with a cardiac needle." While everyone else at the
table gasped in surprise, Watts grimaced at this belated acknowledgment
of the inconvenient find and leaned back with his arms folded.

Bufort gave him a wary look, then said, "A derelict DOA in your
emergency had evidence of an unexplained intracardiac needle stab. We
are looking into other explanations, but given how Mr. Kingsly died, we
have to keep the possibility of a connection open, though what the
connection could be, we've no idea." More silence--until he added what I
wished he'd left out. "Yesterday morning both Dr. Garnet's house and his
office here in the hospital were broken into, and he was the target of a
hit-and-run attempt." It was my turn to stare at the center of the
table. I heard horrified exclamations of shock from all around me. "Oh
my God!"

"How awful!"

"Good Lord!" Beside me, I sensed Watts tense up.

"The attack," Bufort explained, "was vicious, and barely failed. Again
we haven't the slightest idea how the attempt might be tied in with
Kingsly's killing. Not even Dr. Garnet has a clue as to what has made
him so vulnerable." Arnold and Saswald nodded readily--probably in
agreement to the judgment that I was "clueless."

"For the moment," continued Bufort, "we must assume these extraordinary
events are linked somehow. Please contact me if you think of anything
that might help us. In the meantime, I would like all of you to be
careful." As the meeting broke up, I got some more patronizing looks
from Arnold and Saswald. They made me feel I could have avoided my own
misfortune had I just paid attention. They were obviously not going to
make the same mistakes I'd made--whatever the hell those mistakes were.
What pompous asses.

Sean stood up and gave my shoulder a hearty squeeze as he went by me on
his way to me door. A few of the others mumbled words of sympathy while
they pushed away from the table, but I got the distinct impression the
danger I was in made them feel uncomfortable. I felt a flash of
impatience and almost blurted out that it wasn't catching, but I had to
admit they had a point. I probably wasn't the healthiest guy to be
around right now.

Out of the corner of my eye I saw Watts frowning at me. When he caught
me looking, he quickly turned away. Of all of them, his was the opinion
I most cared about, but if something was troubling him, he didn't let I
me in on it.

Chapter 12.

It was the type of day when the afternoon light starts fading at one
o'clock. Fog and low clouds slid over the city like rolls of steel wool.
Even photo sensors on the street lamps had declared most of the sun's
effort invalid and left a ragtag pattern of some off, some on, and some
flickering feebly in limbo--vital signs of a dying neighborhood on a
monitor, part of a city weakening and shutting down.

The daylight filtering through the mist was little more than a dim glow,
the kind that emanates from a TV set left on after sign-off. The houses,
modest boxes set back from the street, were blurred. The few cars that
were out hissed their approach before I could see them emerge and then
vanished quietly in the white haze. Each time I heard the sounds I
stiffened and hugged the inner sidewalk, then relaxed and tried to shake
the previous morning's attack.

But that wasn't why I was out walking, at least not entirely. A bit of
it was frustration at trying to dodge a faceless menace. But the real
reason was a deeper niggling that had kept interfering with my attempts
to work.

I'd tried several routines throughout the morning to distract myself. In
the end I felt like an actor, restlessly putting on one costume after
another and none of them being right for the part.

I'd checked emerge. It was a mess. Did they need help? No, they needed
beds. I called Janet. She was busy in the OR. At least she was safe, if
operating on AIDS patients was safe. Her partner had just had his hand
sliced by a resident's slip with a scalpel while in the open abdomen of
an HIV-positive woman. The risk depended on the amount of the patient's
blood that had contaminated his wound, but even if it was minimal, and
even if his tests in three months and six months were negative, there
would be lingering doubts for years each time he made love to his wife.

My feet made crunching sounds on the remains of a broken beer bottle. I
sidestepped the jagged end piece and thought of our wallpaper. I scuffed
the smaller glass bits off my wet soles and trudged on, but I couldn't
shake off my black thoughts.

I'd called the vet. No change. This was the gray time, hope soiled with
dread. On many occasions I'd cast that same sentence over human life.

I'd tried working on the quality assurance study in my office. When
Carole had placed all the material on the disks now in the trunk of my
car, she had done the work on the hard disk of the computer she locked
away each night. With her help--I was hopeless wading through her
computer files myself--I had been able to work on the numbers in the
office, but the data was frustrating in its monotony. Any answer it held
slid beyond my grasp.

There were highs and lows, wins and losses, but mostly draws, and all
within the norm. I could find nothing to kill for. At least, nothing I
could see. But the image of a baby's room slashed and coated with feces
suggested madness, not logic.

I'd managed to make the record of my actions and conversations over the
last few days for Bufort. The net result was, as he had so eloquently
put it, I hadn't a clue who I'd threatened or why anyone thought it
necessary for me to die.

I felt a little satisfaction though. By taping the report instead of
laboriously writing it out, I'd foiled Janet and Bufort's plan to keep
me busy for days. When I'd finished, I had asked Carole to type it up
and send it to Bufort.

Then I'd ended up pacing the office, driving her insane. She suggested I
go bother Mrs. O'Hara, but no patients were booked that day. Still, I'd
shuffled over through the parking lot and found Mrs. 0 filing lab
reports. After having me check a few abnormals and arrange follow-up
tests or repeat examinations, she wasn't putting up with me either.

So here I was, walking in the fog, trying to get past the debris of what
I knew and tease out what was bothering me. Cushioned by the mist and
braced by cold, I kept thinking I had missed something. I reran the
morning meeting, and the fuzziness slid into a single focused image:
Femandez. But this time it wasn't his fear and agitation that struck me.
I'd just discovered what I'd overlooked. In fact, it was something that
was missing from the events at the meeting that was incongruous. I'd
missed it because it was a negative find--not there when it should have
been. As I told my residents over and over, unless you go after negative
signs, you'll miss them every time. I had to talk to Femandez. It didn't
make sense, but what wasn't there that should have been was all I had.

I wheeled around and headed back toward the hospital through the fog. It
was growing darker now, and the hospital's lights loomed up over me like
an onrushing ship.

I left my raincoat in the doctors' coatroom, dripping alongside other
bedraggled wet wear. The place smelled like the inside of a running
shoe. Plaster fell out in chunks, pushed by fuzzy green and blue mold
that bulged from inside the walls. Maybe Hurst's cost cuts could lead to
a new source of income--growing our own penicillin.

Hurrying down the hallway toward psychiatry, I had little idea of how to
confront Femandez other than surprise him into leveling with me. But as
I got closer to his office, I remembered him screaming at me in the
parking lot the day before and began to rethink the likelihood of
startling the truth out of him.

My second thoughts brought me to a stop in front of the coffee shop.
After the gloom outside, it looked like a sanctuary of warm light and
delicious aromas. Hot soup and a bagel with lox suddenly seemed far more
important than ambushing a frazzled shrink.

I slipped into line and caught the attention of the woman behind the
counter. She mouthed over the other waiting heads, "The usual?" I nodded
thanks, stayed in line to prepay the order, and tried to think of a
better way to question Femandez.

At the cash register, my musings were interrupted by Bessie. Eighty-one
now, and a regular volunteer for the auxiliary, she had been head nurse
in emergency when I first came on staff. Trained and seasoned in World
War n, she was at ease in a crisis and ever ready for a drink or a poker
game after the work. "That'll be sixfifty, Doc. When are you and that
other doc of yours going to finally learn how to make kids?" Janet was
her doctor. She'd taken an ovarian cancer out of Bessie two years ago,
and Bessie had been back on her stool three weeks later.

"Hey, lady," I said, "shows you haven't kept your appointment with Janet
We finally figured it out Must've missed the lecture. Looked it up in
one of her books. Our first will be here in April." Her smile and
surprise were genuine. "I'm so glad for you." She gave my hand a squeeze
after handing back my change. "And my best to Janet. Tell her I'll be
in."

"You'd better, Bessie. Skip one appointment and see what you miss?"
Another smile and she was on to the next in line.

I headed for a free table and passed a foursome of retired surgeons.
They gathered each afternoon to relive old battles and rehash cases long
since dust. Twenty years ago they were my teachers and in their prime.

When I took over as chief eight years ago, one of them, Jack Graham, was
still working emergency, hopelessly unable to keep up with the
increasing pace and standards.

He'd become outright dangerous. My first task was to tell him it was
time to leave. It was like telling him he had cancer, but for him it was
even worse: He was sentenced to go on living without his work.

I greeted them all by their formal names, since I remained an intern in
their eyes. Three of them nodded, but all I got back from Jack Graham
was an accusing silence.

I passed the very stool at the coffee counter where, as an intern those
same twenty years ago, I'd received a hurried cup of coffee and a
five-minute orientation from the chief resident. He had raced back to
the OR and I walked into emergency for my first shift under Bessie's
ample wing. Now I was at the halfway point of my own journey toward the
day when one of my current residents would probably tell me the ride was
over, that it was time to go home. Would I blame the younger doctor, or
only the bitter irony?

"Jack still hold you responsible for his old age?" It was Watts, sitting
alone at a table, apparently amused at what he'd seen.

"Hey, for time itself." I noticed his half-empty cup of coffee and an
open sailing magazine by his elbow and invited myself to sit. "How's
your dream machine coming?"

"Going to be ready when the spring ice goes out, and I'll be out of here
with it." I paused with a spoonful of soup halfway to my mouth.

"That's bad news." I meant it. I didn't relish surviving the rampant
rise of hospital bureaucrats without his deflating wit and clinical
savoir-faire to keep some vestige of sanity. I also knew his term had
two more years.

"Why?"

"I've had it. My Christmas card this year will include my resignation.
They'll have till spring to find my successor." There was a heaviness
about him that didn't surprise me. He'd vigorously carried the load of
being the hospital's conscience for thirty years. As keeper of the final
diagnosis, he had wielded his knife with a passion to improve care and
learn from the verdicts: correct or incorrect, right or wrong,
unavoidable or avoidable death. There was no appeal, and no one escaped
his theater of judgment. Watts had been our gatekeeper.

All of this had changed forever when his wife died. He still did the
job, but his passion and his quiet joy in excellence were mostly gone.

"Some investments I made came through," Watts added. "I'm expecting some
more final dividends soon. I don't need the next two years. Enough's
enough." There was a bleakness now to his plan in contrast to the same
dream he had expressed to me at a happier time three years ago. He
stared at the photo on the open page, a sailboat ad, with a robust
gray-haired man and woman at the wheel of a yacht on open seas.

My bagel tasted dry. "What was bothering you at the end of today's
meeting, Robert?" His double-take startled me. "What do you mean?" he
asked.

"Your look. At the end ofbufort's soliloquy." He shrugged as if he
didn't know what I was talking about.

"C'mon, Robert, I've seen that look before. Your nose was definitely out
of joint--and that's something, considering what your nose puts up with.
So what was it?" He sat completely still, like a card player weighing
his hand, trying to decide whether to play or fold. Finally, he said,
"It shook me that an attempt had been made against you." I waited for
more.

"Hey, that's it! I swear! It's one thing to do what I do to strangers.
It's another when a pal threatens to become one of my patients!" He
sounded sincere, but I didn't believe him. I also knew pushing him
wouldn't help. Over the years I'd seen how stubborn he could be once he
decided something.

"What about the derelict?" I asked instead.

He seemed relieved to change the subject. "Funny, that. The tox screen
was nonsignificant apart from his maintenance level of alcohol, but it
was alcohol, not some cocktail better suited for cars." He meant no
antifreeze or methanol.

"I don't have the trace-element levels yet. We send them out to another
lab. The rest was negative, pretty much."

"Pretty much?"

"Yeah. He had hay fever, but some rookie, probably in a street clinic,
thought it was a cold."

"You might diagnose chronic allergies from tissue samples on a post," I
answered, "but find out the thoughts of people he met too?" I knew it
was my expected role to play incredulous. I was going to be taught
something.

"Traces of terfenadine and a touch of erythromycin." He leaned back with
a smug smile.

I saw what he meant. Terfenadine was a hay fever medication, but
alcoholics living on the streets usually spend what little cash they
scrounge on booze. The John Doe must have gotten a clinic sample.
Erythromycin was a form of penicillin especially for people with a
penicillin allergy. It took a prescription, and only a rookie would have
given antibiotics for hay fever or been browbeaten by a patient into
prescribing them for the symptoms of a viral infection that hay fever
might mimic. Worse, a precautionary had been issued against giving the
two together. Fatal arrhythmias had occurred with little more than
therapeutic doses.

"Do you think it's a drug-induced dysrhythmia?"

"No. But you're right to think of it. These things rarely leave
footprints. His anatomy and conduction pathways were normal, and the
rest of the drug screen was negative.

However, you're forgetting another little feature in this guy's heart
that was a lot more obvious cause of death." He made a stabbing motion
with his finger over the left side of his chest. "The slides of tissue
samples along the needle track show extensive intracellular bleeding and
none of the degenerative changes I'd expect to see if the needle went in
postmortem." In his own inimitable fashion Watts had made a clinical
description of the stark way the DOA had died.

The needle had gone into the beating, healthy heart of a very live man
and then killed him, fast. The mechanical effect of the tip or something
injected had stopped his heart cold. Either way, it was murder. The
needle definitely hadn't gone in after he was dead. He had been killed
just like Kingsly.

"Did you tell Bufort?"

"After our last encounter? Fuck him. I'm submitting my written report as
required." He surprised me; revealing nasty news to people bent on
keeping their illusions was Watts's specialty. Besides, this morning
Bufort had seemed pretty resigned about what Watts was going to find.

"Do you mind if I do?" I asked. Bufort needed to know as soon as
possible.

He hesitated, then replied quietly, "Be my guest. By the way," he added,
"I've called a few of our sister hospitals to see if anyone found
cardiac needle tracks on any other DOAS, and I suggested that they keep
their eyes open."

"M? God! And did they?"

"They haven't had the chance. It seems the run has dried up for now." He
gathered his magazine, stood up, and said, "Well, back to work." I
watched him carry his tray to the rack by the door. He found a slot for
it there, then smiled and gave me a parting wave. Always a teacher, he
should have been restored from enlightening me. Instead, he looked
worried.

Femandez wasn't in his office. His secretary, dressed like Elvira,
thought he'd gone home but wasn't sure and obviously didn't care.

My tactical plan exhausted, I decided to head home myself for an early
dinner and movies with Doug's boys.

I rescued my coat, which wasn't any drier, except now it smelled bad and
hung on me like a wrinkled foreskin.

I peeked into emergency on my way out. I immediately wished I hadn't.

Sylvia Green's eyes were brimming with tears. The nurses went quiet at
my entrance. Everyone focused on the floor. It was embarrassing. I
waited. No one spoke.

Sylvia started to look more mad than tearful, and for that I was
grateful. But it was clear that I had to be the one to break the
silence.

"Okay, everyone, what the hell is going on?" The nurses looked at one
another, but still no one said anything.

I turned to Sylvia. "Syl, are you all right?" She looked at me and
decided on angry. "No, I'm not all right!" she answered, her eyes
flashing. Wrenching a chart off the wall, she strode down the hallway to
her next patient.

The silence only got worse after she left.

"Look, I need to know what happened." Lisa Gray, sheepish, offered,
"It's the killings."

"What do you mean?" She glanced at her friends for support. They
continued to keep the floor under observation. Nevertheless, she went
on. "Those two detectives, they got us all in a room and started asking
a lot of questions." Everybody got more intent on studying the floor,
and I got angry. "What the hell's going on here?" Silence.

"Lisa!" It was a plea.

"Okay. But promise you won't be mad."

"Lisa!" More like an order this time.

"Okay, okay! Like I said, they asked a bunch of routine questions. You
know, how we work, how the shifts are arranged." She shrugged. "They
asked about the doctors.

At first it was innocent, how you guys work your shifts, who works when
...  that kind of stuff. Then they wanted to know who was really good
with procedures, lines, that kind of thing."

"That kind of thing' include intracardiac injections?"

"Yes, but we didn't know they'd use any--"

"And you gave Sylvia's name."

"Well, you know how good she is," Lisa said defensively.

"We're proud of her."

"Any other names you were proud of?"

"A few."

"Oh, Jesus, who?" She hesitated.

"Lisa!"

"Popovitch, Kradic, Jones, and"--she took a breath-- "and you." Now I
knew what had been bothering Susanne.

"It's okay about me. They're not interested anymore, but do the others
know of the high honor you've accorded them?"

"No, just Sylvia."

"Why?"

"I* guess she's the only one they questioned." "Questioned! Here? While
she was on duty?" I knew the interviews would be scheduled at the
convenience of the police, but I'd naively assumed they'd start with off
duty doctors and conduct the sessions in private, not ambush a doctor
trying to run the ER at the same time.

"No, not here. They took her to their interview room before her shift
started. She told us what they asked about when she got back. That's the
worst part--they asked about her mother's death." I couldn't have heard
right. "Her mother's death?" She nodded, and the incredulity of the
other nurses matched my own.

A year ago her mother had been admitted over Christmas with severe flu
and aggravated heart disease. She'd come in with acute respiratory
distress, cardiac failure, and chest pain. She was eighty-seven, and we
prepared for the worst. To our surprise, she recovered and went home in
a couple of weeks. Two days after that, she collapsed at home in acute
pulmonary edema and arrested in the ambulance on the way back to the ER.
When she got here, it was too late.

It wasn't that anyone had been negligent on discharge, but more could
have been done. An echocardiogram to better assess the function of the
heart and the use of an ACE inhibitor to reduce the load on the heart
were options available but not taken.

The echo had a waiting list from budget cutbacks. The additional
medication simply hadn't been thought about at the time. neither
omission was cause for a lawsuit, Sylvia had been bitter. I'd held her
hand while we sat together in the nursing station. She'd told me how her
family had been prepared for her mother's death but gained hope again
when she'd recovered, been discharged, and seemed to have beaten the
odds.

At that moment Kingsly had gone stumbling by. Sylvia had looked at his
lurching backside and started to sob. "That's the son of a bitch who cut
the very echo time that might have made a difference. Maybe I could have
had her a while longer. Just a little while." I'd been unable to say
anything then. Now I was furious that this moment would be used against
her. And how did they know?

I spun out of the room and went down to the examining cubicle, where I
found Sylvia dutifully preparing to repair a gaping facial cut on a
young girl.

I waited until she finished replacing a dressing pad, then excused
myself to the patient and led Sylvia out to the hall.

"Syl, I'm furious. Those cops were way out of line!"

"Damn right they were." I put my arm around her shoulder and gave her a
hug.

"Listen, for what it's worth, I'll scream bloody murder to stop those
jerks from harassing you and any of us around here." She looked a little
mollified. "Us?"

"Yep, they've been on my case since Monday. At least they were until
someone tried to run me over yesterday."

"Oh my God! I thought it was an accident. Who was it?"

"I've no idea." A slow, sardonic smile transformed the horrified
expression on her face. "If that's what it takes to get clear, I'll
settle for staying on the list."

"I need to ask you something. When your mom died, who else did you
mention Kingsly cutting the echo time to?" Her mouth became a hard, thin
line before she spoke.

"Hurst!" she snarled.

I-only half heard the PA as I walked out of the building. A code 44 was
being called for nine west.

Nothing unusual, a code 44 means a psychiatric disturbance and brings a
gang of orderlies to restore peace, one way or another. I hear it
announced a dozen times a day and never really pay attention.

It was 5:10, and the parking lot was already dark. In the distance, low
rolls of thunder mixed with the drone of commuters heading home. The
resultant grumbling noise made this daily evacuation seem more desolate
than usual. The air was something to be chewed before breathing.

Lightning danced up the hospital walls, then left them invisible again
in the black, but not before I glimpsed a lone bowed figure, like a
cathedral gargoyle, on the roof of the west wing--the wing that had only
eight floors.

Nine west was the roof.

The next flash caught a huddle of white figures creeping up behind the
figure in the dark suit. In the dying illumination I saw the man step
forward as calmly as if entering an elevator. The return to black
enveloped his drop, but not even thunder could mask the wet, soft thud
of his impact on the pavement ahead of me.

Fluttering down after him in the soft descent of a wounded cardinal was
a wisp of scarlet. A flicker of lightning caught its brilliance until it
landed and disappeared in the spreading ooze of mud and blood.

Chapter 13.

The chief of psychiatry leaping off the roof of his own hospital was the
lead story in all Buffalo's TV, radio, and newsprint media. Even the
trashy tabloid Police News out of New York City, which usually focused
exclusively on their own body count, led off page three with a wire
photo of poor Gil's remains--only the feet poking from under a sheet, of
course.

"Psychiatrist Jumps!"

"Suicide!"

"Killed!" The stories underneath contained a spatter of quotes.

"He'd seemed distracted lately."

"He'd stopped caring about how he dressed."

"He hadn't looked well recently." Now everyone was saying they'd known
something, but no one had done anything. In medical circles we called it
the retroscope, perfect hindsight.

I couldn't read the stories. I kept imagining that moment when his brain
was still cognizant of onrushing cement and inevitable death was
milliseconds away. Was there time for a final no?

Immediately the media recounted the details of Kingsly's murder they'd
been reporting for nearly four days. Most of them hinted at the
possibility of a connection between the two deaths and left the question
tantalizingly up in the air. There was no mention of embezzlement so
far, but it would be a while before our story even got off the front
page or was relegated to the end of a newscast.

We buried Dr. Gil Femandez that Sunday, and with him, Bufort buried his
murder investigation.

The cemetery was a large green oasis around which the rest of the city
sprawled. Covered with trees and slopes of mowed grass, it would have
been the perfect place for families to have picnics--except there were a
few centuries' worth of tombstones. Rich and poor, black, brown, and
white, people whose ancestors had come from far continents; all lay at
peace together. It was the inverse of the American ideal--men and women
equal in death, not quite having managed it in life.

The questions I'd not had the chance to ask Femandez thudded into my
thoughts with each ritual toss of earth on the closed casket.

Was the money in the unexplained account that Bufort found actually the
surplus that Femandez had bragged about so often? Was that what Femandez
meant when he'd boasted that psychiatry paid its own way?

Was it dirty money, Gil? Otherwise, you would have stood up and proudly
claimed responsibility for it and pulled Bufort back from a false lead.
That's what I finally realized was missing from our last meeting
together.

I also remembered Voyzchek requesting the emergency psych roster for
last July. I'd thought it peculiar that she would ask us, because
Femandez drew up the psych on-call schedule. But had she noticed
something, Gil, and wanted to check it out behind your back? Obviously
Bufort had, and when he announced he was looking closely at the salary
pools, you knew you were going to get caught. For fraud.

A man of God started some words. Some more dirt hit the coffin.

I thought I knew how it was done. It had to be with fee for-service
patients, and their care had to be government funded. Psychiatrists in a
teaching center can bill both for patients they see themselves and
patients the residents see in their name under their supposed
supervision. So even legitimate billings to Medicate or Medicaid might
not seem familiar to a psychiatrist looking at computer records six
weeks later. They'd just put an unremembered session down to an
uneventful supervision signed off to them by a resident. This happened a
dozen times a week per psychiatrist. When billing records showed
increased claims, no one would remember enough about the exact amount of
their supervision activity to suspect an error.

Supervision was sometimes done too much at a distance anyway, but
residents liked the apparent autonomy. They got to play real doctor and
erroneously rated staff who kept out of their way as "good teachers."
And it suited the staff. If their billing statements showed they did a
lot of this "teaching," in a university center it was the currency of
tenure.

The secretaries for the salary pool would prepare and submit bills in
the name of supervising psychiatrists, having power of signature in
billing claims for the entire staff. So, Gil, you could add hours of
claims for sessions never done, hours per day per week per psychiatrist.

With a staff of twelve, at a rate of one hundred an hour, and two to
three bogus supervised hours a day per doctor per year, an extra million
would be easy.

A last handful of earth arched into the grave. A wisp of dust hung in
the air, then vanished. The mourners had finished. The man of God
hadn't. His words drifted in and out of my thoughts.

It could be done only in a salary pool, Gil, and only in a psych pool at
that. Your docs would bring into the pool an annual income reflecting
both their work with patients and money generated by supervised
sessions. Out of this total, two-thirds would be paid back to the
physicians as salary. The balance would be used to cover operating
expenses. Even so, your docs would end up innocently taking home a
little extra--and who questions a raise, or a year-end statement that
shows increased productivity?

"Look what I'm worth," each would think, or "/ knew I was working
harder." The documented increase would be readily taken as a
well-deserved pat on the back.

We were now in a moment of silence. A lone plane droned overhead.

Nor would Medicaid or Medicate officials handing out these funds call
psych patients and ask for a detailed account of their treatments and
the hourly breakdown.

The bureaucrats got away with checking with Mr. Jones if indeed Dr. X
had seen him on such-and-such a date for pneumonia, thus verifying the
billing. But no way would the public tolerate bureaucrats delving into
psychiatric matters, even at the excuse of avoiding fraud, such was
still the stigma of mental illness. So they acted only on
patient-generated complaints, and those would mostly be for some claim
of abuse, usually sexual.

So, Gil, you could bill a little extra here, a little extra there, and
as long as your staff didn't diddle the patients, you'd be safe.

But you got careless. I know now why Voyzchek wanted July's roster.
Because she was on vacation then, had switched with someone at the last
minute, had let us know, and found a substitute. But she probably hadn't
changed your master list. As long as the roster's covered, none of us
really keeps track of who's away. So you did your usual creative
billing, including her name. She might not know how many hours she
supervised, but she'd catch supervision billed to her while she was on
the beach in Acapulco.

How did it start, Gil? The dashing champion of care daring to steal from
the bureaucrats and deliver it to the healers? More funds for research?
Special patient programs and equipment? I'd like to think so; at least
I'm pretty sure it started that way.

If it had ended there, you wouldn't have chosen to die.

No, you would have been a hero--in trouble, but a hero.

You would have been a masked protector of the mentally ill undoing the
evil bureaucrat kings and rendering better means of care to the sick.
No, if it had ended there, you would have stuck around, played Zorro
against the technocrats and basked in the glory of the docket, a pulpit
for your cause.

But it obviously hadn't ended there.

The clouds begrudgingly shifted enough to let a needle of sunlight
through to our little graveside band and then snapped it back.

Hunched in pain, an older version of Femandez cried silently. His hands
were weathered. He had the leathery look of a man who had worked
outdoors most of his life, probably to give his son the education that,
dll Gil Fernandez, I'd been told, no one in the family ever had.

Beside him, her face invisible under veils, erect and silent, sat
Femandez's wife. She was surprisingly young and slim-figured. I winced
at the chilling mix of grief and rage that came out of her stillness. I
didn't know if Fernandez's mother was sedated somewhere, unable to bear
this, or long dead. I hadn't read the obit.

But the pity I felt for Femandez's father and wife was a fraction of
what I felt seeing the horror and agony in the hollow face of his young
son. I estimated his age at ten or eleven. He stood at the side of the
grave, a brittle sentinel, looking as if he were on the verge of
speaking, of calling his dad back. I felt no one in that sad huddle
loved or needed Femandez more. Certainly no one had been more betrayed
than that poor boy. He would always wonder why his dad had chosen to
desert him so finally.

From the grave, Femandez's suicide gave an answer the boy would dodge
all his life. "My love was enough for you. Your love was not enough for
me." I left that graveyard hating Femandez.

It was Sunday morning and the traffic was sparse. The hospital was a
twenty-minute walk, but anger would get me there in ten. I wanted the
time alone.

During the service Hurst had quietly gone from chief to chief asking us
to meet briefly in his office afterward and hear his strategy to get the
hospital back to normal, starting tomorrow. It looked like he was giving
condolences, but he was really counting on our respect for the family to
prevent us from making a scene and telling him to get lost.

As I walked, I returned to my one-sided conversation with Femandez. was
probably Kingsly's strategy all along. He snagged you to play Zorro, and
then he got you dirty.

Were the prints and etchings offered you as a tribute to your noble work
and the service you were doing the hospital?

He'd say, "You, more than anyone, both deserve and can appreciate a
collection of fine art. Savor it.

You 'we earned it." But here, my dear psychiatrist, your ego bought a
bill of goods, allowed your fantasy as superhero to excuse and explain
going on the take.

And Kingsly had you; he owned your soul. Probably less and less of the
pilfered money went to extra care, while more and more went to him. You
must have hated him and feared that one night in a haze of booze he'd do
something that would expose the scheme and your part in it. Is that why,
at every meeting, every encounter, on record, you ran your boast that
psychiatry gave back funds to the hospital? To warn him that he was also
under your control and force him to at least make some show of funds
back into research and patient care?

But your position was the more precarious. He had what he wanted, a cash
cow. You had lost what you thought justified larceny. The money going to
research and treatment programs became a barely maintained trickle. Now
most of what you stole went to a pathetic alcoholic who 'a trapped you
with your stupid ego and a moment of greed, You probably didn't need a
lot of time to figure your options when Bufort's investigation seemed
poised to expose you. Hell, you'd been living with imminent exposure for
years. I don't think it was being a thief or a fool that you couldn't
live with. Even jail, if you got that far, I think you'd have taken.

No, I think what killed you was the automatic loss of your license to
practice medicine ever again, the consequence of a criminal conviction.
That, and the even more immediate loss of your reputation. The adoration
of grateful patients would change to shock and outrage.

Your articles would be relegated to trash cans the world over. They
would never be refuted scientifically; no one would bother. It would
just be that Gil Femandez, worldfamous psychopharmacologist, would now
become "That fraud, convicted, in jail, on parole." And academic
psychiatry would move on to its next hero.

I stopped at a streetlight and admitted I'd never know for sure how
Pemandez had slipped and crossed the line that doomed him. But cross it
he had.

The light changed. So'd my thoughts. I kept seeing the grief-stricken
face of Femandez's son and his hand reaching out and dangling empty at
the grave's edge.

My own hands were fists in my raincoat pockets by the time I reached the
hospital drive. I scowled my way through the stone arches and automatic
doors. A security guard was too busy eating a doughnut to challenge my
ID.

In the lobby, a gaunt old man was pushing his IV pole through the racks
of get-well cards by the gift shop. The wheels made muted squeaks. My
own steps cut through the echoing hush that settles over a hospital on
weekends.

It's a brief respite, a truce between the weekday hustle of white coats
and shuffle of patients scurrying to endless probings and tests. Both
sides need the pause before going back at each other Monday morning.

While I was waiting for the elevator, the old man's IV pole stopped its
whimpering. He reached for a card and then studied it carefully. The
racks were full of treacly verses; maybe he'd found one he hadn't seen
before. The noisy arrival of the elevator rang through the lobby, and
the old man looked up. His face and eyes were yellow.

He watched me as I stepped in and in turn watched him through the
closing doors. He looked terminal. He probably envied me for having a
place to go.

My mood got no better walking the deserted corridors to Hurst's office.
I couldn't help seeing Femandez, stepping to oblivion, and that old man
downstairs, clinging to his remaining moments when just a guy taking the
elevator was an event.

As much as I was raging against Femandez for betraying his son, and as
readily as I could find him capable of fraud and a lethal mix of greed,
shame, and pride, I couldn't go the rest of the way and label him a
murderer. When a patient's condition was a mystery, when the residents
were trying too hard to force an easy diagnosis onto symptoms and signs
that didn't fit, I had an instinctive sense, developed over the years,
that told me not to trust their conclusions. And now, with the same
intangible intensity, I knew that Femandez was not the killer.

This was Hurst's meeting, but when I entered, it was a victorious Bufort
I saw strutting around the room.

"--obviously this case is closed," he trumpeted.

"Since there won't be a trial, the hospital will be--"

"You're out of line!" I blurted out.

Everyone looked at me in surprise.

"We just buried Femandez," I said hotly. "I watched his family at the
graveside. I don't want to watch you dance a jig on his grave, Bufort."

"Dr. Garnet!" Hurst was horrified. The others glanced nervously at one
another.

"And what are you doing here anyway?" I demanded.

"We were told this was a meeting to agree on the best way to get St.
Paul's back to normal." I was still standing, and Sean reached over to
put his hand on my arm, trying to get me to sit down beside him.

"Detective Bufort is here at my request," answered Hurst. "The first
step to help everyone move on from this tragedy is to explain what
happened." Bufort pompously held up his arm to me as if I were oncoming
traffic. "Why, Dr. Garnet, you of all people should be grateful it's
over. Femandez tried to kill you and gravely injured your dog. Now, I
understand how upset you are, but go home. It's over. You and your
family are safe."

"Why did he try to kill me? It makes no sense!" A Gallic shrug. "Perhaps
Kingsly had secretly started to blackmail him while overtly being his
partner in crime. He might have sent Femandez anonymous letters,
demanding money orders for cash, tunneled through a series of post
office boxes. Who knows? I've seen that method used many times before.
In any case, Femandez couldn't be sure it was Kingsly, but he'd
certainly suspect him. He already had cause to feel it was too risky to
let him go on, what with him drinking more and more.

The chance of Kingsly babbling was just too great, so he killed him.
Then you made some crack to Femandez in the parking lot about finally
checking the books." He stopped, stepped over to his briefcase, and
lifted out a sheaf of papers. "I read that in your own report," he
continued, holding the document up for the others in the room to see.
"Suddenly Femandez thinks he made a mistake.

Thinks that you were the blackmailer all along, and that you'd probably
heard Kingsly burble out the truth one drunken night. But now, in
Femandez's mind, you also could expose him for murder. You had to die,
and fast." I felt stunned. Bufort had taken the dictated report of my
movements and conversations he'd insisted I write and was using it to
dismiss my doubts. He'd even made sure he had it with him today. Given
that I had little more than my instinct to go on, I was pretty easy to
dismiss.

He rushed on, waving my own statement at me, the better to demolish my
protests.

"Already terrified, he feared his worst nightmare had come true. On
impulse, he followed you out of town. He probably couldn't believe his
luck, that you'd let yourself be so isolated, so vulnerable. If he were
thinking right, he'd have realized that had you been the blackmailer and
were willing to take on a murderer, you wouldn't have been so foolish.
But he was probably in a panic. That chance comment about an audit
confirmed you were dangerous and set him off." He stopped, obviously
enjoying the theatrical hush, and then delivered the denouement. "The
first time at your cabin, the dog chased him off. The second attempt was
better planned. You survived only by chance." He turned his back to me
and added my report to a stack of files on Hurst's desk. He appeared
done.

"Why a cardiac needle?" I asked quietly, slipping into a seat beside
Sean.

Bufort whirled around. "Why not?" he snapped. "It nearly worked." He
glared at me. "It was pure luck you found the needle. It was his bad
luck it broke off. Probably his original plan was to insert and
withdraw, but Kingsly struggled, or convulsed as he died, and it
snapped, just as you and Dr. Watts originally surmised."

"And what about the wino?" His cheeks flushed. "Winos die. Doctor! You
know this as well as I do, and no one makes a thing of it. And I suspect
you never have before either."

"Because they don't die of cardiac needle stabs."

"Winos die with everything under the sun inside them.

From drain cleaner to gasoline." Mistake, Bufort, I thought. Now you're
on my turf.

"This guy's tox screen was clean." He backed up. The expression on his
face told me he wasn't about to get suckered into a slugfest with me on
medicine.

"Quite right. Doctor, but didn't he have some medicines in him that we
hear on TV not to take together because they stop the heart?" Good move,
Bufort. Reduce it to civilian medicine. If I clobber you here, I'll seem
an arrogant prick.

I answered quietly. "The post showed that the needle killed him. The
rest may have helped, but that needle went into a live man and stopped
his heart."

"Fine, Doctor, then Femandez killed that homeless man. Wherever he
killed Kingsly, the derelict was hiding for the night. Too late,
Femandez realized he had a witness and got him as well. Later he moved
the body out to an alley, and it was picked up as a DOA. Again it was
you. Dr. Garnet, who told me homeless people sometimes sneak into the
hospital to get out of the cold." I sat there, speechless.

I glanced at the others. They were looking at their watches, shuffling
their feet, shifting restlessly in their chairs. Someone murmured, "Come
on, let's go. It's over." I heard similar mutterings behind me. Hurst
nodded in agreement, almost encouraging the protests. If he'd organized
this little show just to kill any arguments against Bufort's "solution"
of the murders, he'd succeeded.

The increasing unwillingness of everyone in the room to put up with any
more of my questions proved that.

Bufort quietly gave me the coup de grace. "Haven't bag ladies and
derelicts been found on cold nights hiding in stairwells and in the
basement to keep warm?" I didn't answer, but he wasn't about to let me
stay silent. "Haven't they. Dr. Garnet?"

"Yes," I conceded.

With operatic show, Bufort finished putting his papers away. "I want to
thank you for your cooperation in this difficult time. Without your
help, I--we wouldn't have been successful." I nearly pointed out that in
our profession, a man's brains all over the parking lot is not a
success. I looked over to Watts, but he gave a me a dismissive wave.

There'd be no mention here of checking other dead street people for
signs of intracardiac stab wounds. The others in the room began pushing
their chairs back from the table. They all wanted out of there. So did
I. As the meeting broke, I saw Riley standing in the doorway, his jaw
muscles working overtime. When I got near, the side of his face relaxed
and he seemed about to say something to me. Instead, he glanced at
Bufort, stepped aside, and let me leave the room. I was halfway down the
hall when Hurst's call from behind made me wince. "Dr. Garnet, could I
see you a minute?" He hurried along the corridor, pulling on his coat as
he came up to me. I knew he often used the walk to the lobby after a
meeting for a conversation he didn't want to be official or recorded in
a set of minutes. "I've canceled elective activities tomorrow as part of
the memorial to poor Kingsly," he began to say, falling into stride
beside me. "That means you can have surgical beds for emergency until
Tuesday, providing, of course, your staff withdraws their threat to
withhold service." I'd expected this. It meant Hurst's hospital lawyers
hadn't found a way to prevent us from shutting down emergency--yet. This
was to buy time until they could.

"Of course." He stopped walking. My ready agreement must have caught him
off guard. Until I turned to him and added, "For the duration of the
day's memorial to poor Kingsly." Had he been anatomically equipped with
venom and fangs, I'd have been looking for shots. As it was, I left him
standing there, narrowing his eyes and making do with his lizard
imitation while I continued down the hall.

When I reached the next corner, I looked back and saw him still watching
me.

I'd bought a day of respite for emergency, but I wondered what I'd
bought for myself.

I took the stairs down to the main entrance on the ground floor, but
even on a Sunday, I couldn't leave the hospital without walking over and
checking the ER. On my way, I wondered about Hurst and Bufort's curious
need for quick closure on the murders. I guessed each had different
reasons--Bufort because he had no one but Femandez to blame the murders
on; Hurst because he wanted the scandal over with  ...  or because he
was the killer.

When I stuck my head in the door, I saw Jones down the hall and
overheard her quietly reassuring a very relieved-looking older woman
that her son would be okay. The young man on the stretcher beside them
was about thirty and didn't appear too bad, but he was hooked up to a
portable monitor, IVS, and an oxygen tank for the transfer to the ICU.
The nurses were putting away the crash cart.

"What's up?" I asked the charge nurse, who was standing at the nurses'
station.

"Another one of Jones's miracles," she said appreciatively.

"He's a dialysis patient who came in with florid pulmonary edema. I
don't know how she did it, but she keptjiim alive until the renal guys
got here and dialyzed him." She was obviously impressed, and so was I.
Not many in the department were both good and aggressive enough to pull
it off. I watched Jones give a final reassuring pat to the man's mother,
a few more supportive words to the patient himself, and then start back
toward where the charge nurse and I were standing. The contented smile
she was wearing faded a bit on seeing me, and I started feeling my usual
ambivalence toward her.

"Beautiful work, Valerie," I said quickly. "Congratulations!"

Despite the praise, she seemed genuinely, but not pleasantly, surprised
to see me here on my day off.

"I just dropped in after a meeting," I explained without waiting for the
question. I wanted to make sure she didn't think I was checking on her.

She hesitated, then started to smile again. "Thanks" was her only reply.
She moved over to the work counter and started writing up her chart.

"She's a wonderful doctor." It was the man's mother passing us as she
followed her son's stretcher to the ICU.

"Yes, she is," I replied, finding it hard to reconcile the decisive
clinician I'd just witnessed with the departmental brat she could
sometimes be. Yet the only medical criticism I could make against her
was that like most prima donnas, she was less enthusiastic about the
smaller cases and left them more to the residents. I sometimes worried
what subtle but serious problems might get overlooked this way, but in
her case, so far, nothing of consequence had happened. Ironically,
during the entire eight years she had worked at St. Paul's, not once had
I ever gotten a complaint about her behavior from a patient or a
patient's family. No one else, not even I, had that clean a record. I
guess, with them, she was in control, and therefore secure.

"Everything else okay?" I asked the back of her head while she continued
to write. I really didn't want an answer.

I didn't get one.

I reminded myself I hadn't called her in about Todd yet, but
today--after Femandez's funeral and while she was on duty--definitely
wasn't the time. I promised myself once more I'd do it tomorrow.

I left the hospital and located my car in the parking lot.

Under the windshield wiper I found a card. Written on the back was

"Please meet me at the Horseshoe Bar in thirty minutes." It was not
signed, but on the front was the logo of the Buffalo police, and printed
on the bottom, "Detective G. Riley." The Horseshoe was near the
hospital, but it was a place I'd rarely visited. Ten years before we'd
get a stabbing victim from that bar nearly every weekend, usually drug
related. It was a student hangout for the university, but it wasn't a
watering hole for philosophy and suds like I'd known in the sixties.
Kids went there to score hard drugs.

I'd learned my toxicology on pretty teenagers with a
thousand-dollar-a-week habit from this place. I'd asked one of those
girl-women how she managed it. I'd just resuscitated her from a deluge
of pills, cocaine, and booze. She'd been brought in naked and
unconscious.

Her body was young, breasts and hips maturing at odds with her
still-present baby fat. After I intubated her and lavaged out her
stomach, she was a bedraggled, coughing mess of vomit and the charcoal
used to neutralize whatever she'd downed. Yet her face held the pudgy
features of the little girl she'd once been.

"How do you pay for it?" The hard eyes that flashed back were older than
I'd ever want to be.

"Guess!" she dared.

A year later I'd pronounced her dead on arrival. By then she'd become so
wasted I didn't even recognize her until I saw my note from a year
earlier in her chart. The stillness of her parents when I told them in
our grieving room chills me still. There was not a move of either the
father or mother toward each other, nor any show of feeling. The father,
my age, had coldly signed for the body and left. The mother, dark like
her daughter but with a face set hard long ago, walked out stiffly a few
minutes later.

Now the drug wars had spread throughout the neighborhood. The stabbings
and ODS came from everywhere.

The Horseshoe, its job done, had gentrified itself. The owner had put in
a few plants, added some mirrors, and updated the green walls to a dark
tone seen in a lot of home digests this year. It hid the blood and
fitted the nineties, but it didn't do it for me.

As I entered, the stench of cigarette smoke mingled with the odor of
stale beer. Four guys in raincoats at a booth looked me over as my eyes
adjusted to the pink neon that lit the place. They looked like police,
or soldiers for one of the gangs. Gloomy veterans from one side or the
other toasting old battles and what-ifs. Riley was alone at the bar.

"This place still active?" I asked as I joined him.

"Only for old cops and crooks. Kind of a club. Hasbeens telling lies and
drinking booze to dull the memory.

What'll you have. Doc?" Hell. It had not been a good day. I needed
something strong. "A Black Russian would be most welcome." Riley looked
relieved and approving. I guessed he felt more relaxed with a guy who
took a real drink.

He caught the bartender's eye, a bodybuilder in a black T-shirt wearing
a ponytail. He ordered doubles and downed the remnants of the amber
rocket fuel he'd nursed waiting for me.

The drinks arrived. We both stirred, sipped appreciatively, and settled
back to face each other.

I started. "What's up?" He took another sip. My first was still burning
its way down my belly, reminding me I hadn't had lunch.

Finally he began. "To start, I'd like to keep this meeting confidential
and unofficial."

"Why?" I already knew, but I wanted him to say it, still unofficially,
of course.

He took a sip, raised his eyebrows, and went on.

"Because my boss is a brilliant prima donna prick, and if he knew I was
doing an end run round his legendary judgment, he'd put me back on the
street directing traffic." I smiled at his candor and toasted it with
another sip.

More burning. I remembered I hadn't even had breakfast.

"I can't ignore the questions you raised earlier," Riley said. "Your
uneasiness with pinning the murders on Dr. Femandez leaves me uneasy."
He paused, sipped, and continued. "Have you got anything hard you can
give me to back up your doubts?" The glass was cold in my hand. The
ghosts of all those pathetic kids who had poisoned themselves here were
making me colder.

"No," I admitted.

"Why are you so sure he didn't kill Kingsly and the wino, just like
Bufort claims? He had the motive. You know we found the artwork hidden
in the attic of Fernandez's cottage. His wife told us it had been
hanging in their home until a few months before, when he suddenly
cleared it out and claimed to have sold it"

"Because murder, for him, doesn't make sense. Fraud, arrogance, and
greed, yes. Then shame and a loss of face, that I buy too." I stopped
and looked around the deserted bar, then back at Riley. "And there was
the search of my office at home. Femandez didn't need anything from me.
Hell, what he had to fear was in Kingsly and Laverty's files.

You guys found them." That was it. The biggest incongruity of all. I
leaned toward Riley. "If Femandez killed Kingsly for fear of exposure,
why didn't he search the files then and there and destroy what
ultimately nailed him? The chaos of financial records in this place is
legendary; nothing would have been missed. Why didn't he search when he
was alone in Kingsly's office, middle of the night, after supposedly
killing him and moving the body there?"

"Maybe he did and couldn't find them."

"How hard was it for you guys?"

"What do you mean?"

"For you to find the anonymous account and the art receipts. How long?"

"Well, not too long. Remember, we didn't know what we were after, and
everything was such a mess anyway, but it took a few days." I sat
stirring my drink. Femandez would have known what he was looking for.
But he also would have known the confusion of records might make it hard
for even him to dig out the incriminating material. No, he couldn't
count on even a hurried hour alone at night producing what he had to
destroy to be safe. And what about Thomas Laverty? Surely as director of
finance he was in on the embezzling as well? Wouldn't he have to be
silenced?

Riley prodded gently, "I'd like you to let me in on your thoughts." I
smiled. Exactly what I always said to residents struggling to find the
"right answer." I wanted to hear their process as well as their
conclusion.

"Okay," I agreed. "Femandez didn't kill Kingsly, at least not hurriedly
without a better chance of it kicking up what Femandez really needed,
Kingsly's evidence.

Femandez would have had to destroy those records and therefore needed
time to find them. And to be consistent, if he was going to murder
Kingsly to cover up their scheme, he probably would have needed Laverty
dead as well, but there isn't a hint of that kind of logic here. From
Femandez's point of view, stabbing Kingsly with a cardiac needle and
dumping him nude in his own office just doesn't make sense; it wouldn't
achieve the result Fernandez would be after. Why not just make Kingsly
disappear or, better still, search the office first, over several nights
maybe, until he found the evidence, and then make him disappear?"

"Maybe he was doing that," answered Riley. "Kingsly staggers in, nude
from a prowl, catches Femandez in the midst of the search, and Femandez
grabs the nearest weapon at hand and stabs him."

"Come on, a psychiatrist doesn't carry cardiac needles around. Hell,
nobody does. They're kept on a crash cart for arrests and in surgery."
Then I smiled. "Besides, Detective, you're forgetting, there was no
blood in his office. He was killed elsewhere." Riley gave me a grin.
"Just checking. Doc. You amateur sleuths have gotta be kept on your
toes." He began waving his empty glass around to catch the bartender's
eye. I was looking around the lounge again. They once sat here, all
those ODS. "Empty chairs at empty tables." It was a phrase from the
musical Les Miserables.

Except these dead students had poisoned themselves.

Then I had it. "Poison!" My outburst startled Riley. "Poison?" He was
perplexed.

He gave a guilty glance at his still-unfilled tumbler and quickly
replaced it on the bar.

"Yeah, Kingsly wasn't poisoned." He frowned at me. "So? We know that."

"Precisely." I paused, then leaned forward, enjoying this. It's amazing
what a few sips of a Black Russian with no breakfast can do. I lowered
my voice. Cheap melodrama, but hey, I don't get out much. "If Femandez
had murdered Kingsly, he would've poisoned him." Now the detective was
looking interested.

"Elaborate for me."

"Femandez was a psychopharmacologist."

"Huh?"

"Sorry. That means he has special expertise in psychiatric drugs. More,
he was a renowned researcher and was studying a number of new,
unreleased drugs. He investigated their effects, therapeutic and toxic,
as well as their properties when mixed with other medications or, better
yet, with each other."

"Better yet?"

"Better yet to murder with." My Black Russian no longer burned. Or maybe
my stomach was numb. Riley didn't even notice the bartender slip a
refill in beside his elbow.

"Look, some of his studies found drugs too toxic to be released. I'm
sure he found mixtures of drugs that were particularly lethal. Approved
tricyclics used to treat depression can cause cardiac arrest when taken
in excess.

Who knows what other toxic effects he discovered in experimental drugs
never released for public use? And while these formulas would be
available to him for research, they would never be part of a pathology
tox screen. A drinker like Kingsly would be a perfect target.

But first Femandez would find the evidence he wanted, then he'd coax
Kingsly to take his favorite but final beverage.

Heart attack, and who needs needles?" Riley leaned back. He rolled his
glass back and forth between his hands as if he were trying to make
fire. I knew he was also rolling my scenario around in his head.

I downed my drink, waiting for his verdict.

Finally he stopped rotating the glass, and I figured the movement in his
head had stopped too. "You must be very careful. Doc." He spoke
quietly--too quietly. He then went on to say what even I, Black Russian
and all, was just figuring out.

"If you are right, and I'm afraid what you say makes more sense than the
conclusions of the genius / work for, out there is a killer who thinks
Femandez's suicide has closed the case. Right now this killer feels
safe, which means for now, you're safe. However, the instant you voice
these doubts, all that changes. This killer will feel threatened again,
and you, sir, will be a target again."

Chapter 14.

It was only 1:30 when I left the Horseshoe. The afternoon light had
dimmed to premature dusk. I hadn't seen the sun in weeks and knew how
the dinosaurs must've felt at the end. Maybe we were having an eclipse.
Hell, was there even still a sun out there behind all those clouds?

Riley had done the bureaucratic shuffle as far as I was concerned. He'd
made it clear he'd enjoy taking on his boss, but it was also clear that
I'd have to provide him with more than hunches to get him to do it.

As I got back to the hospital grounds the rain began falling again. It
was cold, and the drops were like sludge on my glasses.

I paused by my car and realized I had nothing to do for the rest of the
day. I wanted to see Janet, but she was on call at her hospital. I
unlocked the driver-side door, slipped the key in the ignition to
activate my car phone, and dialed the case room. They informed me Dr.
Graceton was busy in the OR. I called the vet and learned Muffy was
sedated, afebrile, but still fragile. So, I couldn't even drive over and
give comfort to my dog.

I sat staring out the windshield stained with rain.

Without the women in my life, I was at loose ends. The parking lot was
foggy, and I couldn't see past the few cars parked nearby.

But out there, somewhere, was a killer. Was I safe for now? Maybe. Maybe
not. Probably not. Not until I figured out why I'd ever become a target.
Fact was, I still didn't even know how to "be careful," as everyone
advised.

Again I thought of the ER stats. If I was a threat because of some
information hidden in the those studies, then I wasn't safe at all.

It wasn't only because I loved an excuse to go to the cabin that I did
my computer work there. I was so electronically stupid that Carole
wouldn't let me use our office computer unless she was physically
present. I'd once crashed a complete hard disk attempting to find
something on my own. Since then she wouldn't even trust me with the pass
code. She routinely duplicated all departmental information with a
separate set of disks formatted specifically to work on my clunker at
the cabin. I knew how to work the routine programs for the terminals at
the nursing station. In fact, any innovations there were tried on me, on
the principle that if I could do it, anyone could. But getting into the
hospital network without Carole to guide me, code or no code, was beyond
my trying. Yet I didn't want to call her in to help. This wasn't going
to be the conventional analysis of QA data she'd helped me with two days
ago. Now I was going to use those numbers to go after a killer. She'd
have to work along with me and know what I was doing, and until I
figured out what was going on, I wasn't about to endanger her or anyone
else.

To be alone in the woods on this shrouded weekend was not a soothing
thought, but I needed my own computer again. If I was going to unravel
anything today in private, it would be in front of that forgiving relic
in my beloved cabin. I pocketed my keys, got out of my car, and headed
toward my office. The QA material was still in my trunk, but I needed
some other disks for an idea I was getting.

I stopped by the coatroom to check my mailbox.

Behind the coat racks was a wall of open mail slots, each with a
doctor's name over it. For once I could see easily into mine. Usually
the slot above, which was Jones's, was so stuffed, the overflow flopped
in front of mine.

Today' hers was empty. Mine held a notice for a hospital bake sale.

Emergency was bustling, but the nurses were smiling.

A steady stream of orderlies and nurses were pushing gumeys along the
corridor to the elevators that would empty those patients into real beds
upstairs. Hurst's beds, finally. The vacated hallways and stretcher
stalls had the debris from a week of crowded living. It looked like the
morning after a wild party. A small group of cleaning people waited to
move in.

"Congratulations, Chief!" It was Sylvia, in for the evening shift, but
three hours early.

The nurses echoed their relief at the reprieve. I didn't tell them it
was only for a day.

"Where's Jones?" I asked. She should still be on.

"She got a phone call, some personal business. She asked if I could come
in early. Baby was asleep. Daddy was sitting around; no sense both of us
watching the angel. Besides, someone has to put her through college."
Graceful as usual. I knew she'd love to have spent a few extra hours
just watching their new daughter. Like most older parents, she and her
husband treasured the additional joy of affirming and reaffirming that
"Yes, it's finally, really true." I wondered if Jones's lonely life left
her incapable of realizing what she cost others.

The call came minutes after I'd entered my office. "Dr. Garnet, you're
wanted two-three in the morgue." I needed a second to get it. "This is a
joke, right?" "No, sir. Call came a few seconds ago. Said you were in
your office and wanted you called, to come down two-three."

"Who?"

"They didn't say."

"Why?" "Just said it was urgent." A 2-3 call would get me running,
normally, no questions asked. But this was weird. A macabre joke in
hospitals is about mistakenly sending a live one to the morgue.

Had one of Watts's tenants suddenly sat up?

"Sir, are you going?"

"Yes, operator, but have security meet me there right away." I grabbed
my stethoscope and was out the door and halfway through emergency before
I saw a nurse.

"Sandy, grab the resus cart and meet me in the morgue!" She was taken
aback. Obviously she also presumed this was a bad joke.

"I mean it!" I snapped, and headed for the door. I grabbed a ventilator
mask and intubation gear hanging there for resuscitations off the
premises.

The stairwell was empty for my run to the basement.

The echoes of my own steps followed me down. I had a bad feeling about
this. The only way someone could have known I was in my office at that
minute on a Sunday afternoon was by watching.

The thin line of overhead bulbs led off into the distance toward Watts's
lab. No one else should be here on a weekend, but I listened and peered
down that string of light pools inviting me farther in. I had thoughts
of a spider and a fly. I took a breath, remembered with relief that a
security guard and a nurse were on their way, and picked up my pace.

The anteroom was just a pocket off the hallway right in front of the lab
doors. Two stretchers were parked on either side of the narrow passage.
There were no bulbs suspended above this area, but there was enough
light from the hallway behind to show me that one of the stretchers was
occupied. To me, the shrouded figure was more suggestive of death than
an uncovered corpse woul9 have been. Obviously Watts planned a weekend
dissection. I edged my way around the body and approached the lab
entrance. To my right was the heavy wooden door of the walk-in freezer,
where bodies waiting to be picked up are kept. It was ajar.
Instinctively, I clicked it shut. My mother had always taught me to
close the refrigerator. Ahead were the double swinging doors to the
dissection room. Light seeped under the sill.

I knocked, feeling foolish, especially for still keeping an eye on the
sheeted figure behind me.

"Hello? Anyone there? Robert?" There was no reply, but coming from
inside the lab I could hear a fast, steady beeping that was familiar,
yet out of place.

I opened the door and stepped into the bright interior.

Watts was spread-eagled on his own autopsy table, naked from the waist
up, white, not breathing, and wired to a portable monitor. He had a
large bruise on the side of his head, but it was his sightless stare,
the wet mark at his crotch, and the stench of fresh excrement that told
me he was clinically dead. The jagged run of ragged peaks across the
monitor screen meant ventricular fibrillation. I could still bring him
back.

At the far end of the counter that surrounded the room a tap was open
full, and water was sloshing over the edge of the sink, spilling onto
the floor. Damn, but the place would be flooded soon. What the hell was
going on? I didn't have time for that question--or anything else, if I
was going to save Robert.

Quickly, but still moving carefully so as not to slip on the wet floor,
I stepped to the monitor and grabbed the paddles. They were already
greased, and the machine was charged to 360 joules, ready to fire. None
of this made sense. But my training took over. Though hardly necessary,
I checked his neck pulse and verified its absence. I placed me paddles
at the appropriate landmarks on the chest and got ready to attempt to
recapture a normal heart ihythm with a jolt of direct current. These
moves in preparation for discharge were automatic. I leaned over Watts
to assure a good electrical contact, but inside I was recoiling. What
monster had set this up, made Watts a specimen, like a drill dummy, and
then readied everything to lead me through his resuscitation like a
training exercise?

Positioned, not even having to think about it, I moved my thumbs over
the red discharge buttons. Even though I was alone, I automatically
glanced around the table. We give our residents holy hell if they miss
taking a look around and calling "stand back" to prevent a member of the
team who may still be touching the patient from getting shocked. This
omission can result in having two cardiac arrests to deal with. In spite
of myself, to no one I muttered, "Stand back." The harsh dissecting
light glinted off the steel surface of the autopsy table and the wet
floor as I completed my look around. Maybe that glint was what broke my
unthinking rush through the steps.

"Shit!" I shouted, slapping the paddles back in their holders as if they
were snakes.

I had to insulate him--and myself--from the water and steel. An
uninsulated shock would hit me and stop my own heart.

Far off down the hall I heard the distinctive crashing noise our
elevator makes to announce its arrival. Then came the excited chatter of
the security guard and Sandy running down the long tunnel pushing a
squeaky resuscitation cart.

To buy time, I positioned Watts's head, sealed his lips with my own, and
gave him two quick breaths. Then I moved my hands to his midchest and
gave fifteen brisk compressions. At one moment I felt the dry snap of
his ribs, but if he lived, I knew he'd forgive me. It took three cycles
of this before Sandy and a puffing, fat security guard pulled the cart
inside the room.

"Sandy, call a ninety-nine. You, sir, we've got to insulate him, and
us." I was speaking between puffs. Watts's chest rose each time I blew
into his lungs. "Grab that backboard!" The guard moved to the cart. On
it was a folded sixfoot board for lifting people with back injuries.
Sandy made the call, then came to Watts's side. She started pumping his
chest. That left me free to assemble the bag and mask, slip in a curved
airway to keep his tongue from blocking his throat, and start
ventilating him. The guard wrestled the board to the table. Sandy
pumped. I bagged. The rigors of giving compressions loosened a few
buttons on Sandy's blouse. She wasn't wearing a brassiere. The guard
slipped on the floor trying for a better angle.

"Okay, here's what we'll do." I got his attention away from Sandy. "On
three, we'll stop, roll him toward us, and you'll slip the board under
him." We got the count right, but rolling Watts on the narrow table
nearly dropped him over the edge. The guard dinged the overhead light
and then nearly hit me trying to get the board into position while
watching the developments of Sandy's blouse. With our feet sliding in
the water and all three of us pushing Watts onto the board, we landed on
his stomach, but at least the board was between Watts and the metal
table.

"Right, Sandy, keep pumping." I kept bagging. The guard kept ogling.

"You!" I snapped. "Quit that crap." He went red.

Sandy rolled a stare of contempt his way but kept quiet and continued
pumping.

"We have to insulate our feet!" I ordered. "We're still too wet to shock
him. Turn off the water, then go out to the hallway and grab a mattress
from a stretcher. Hurry!" I was watching the monitor. The ragged
activity persisted, but it was weaker. We were running out of time.

The guard went without protest. He didn't seem to mind that he'd be
alone with a corpse out there.

Sandy was getting flushed and breathing hard.

"You want to switch?" I asked her.

"No! Just keep that bozo away from me."

"You're just too sexy when you save a life."

"Creep. Watch it or I'll tell Janet." The banter. Whistling past the
reaper.

While pumping, she took a look around the room.

"What's the story here?" I kept bagging. "I don't know. I found him like
this."

"Like this!" The surprise interrupted her rhythm.

The guard stumbled in the door with the mattress and plopped it at our
feet.

We stepped up on it. I took a final glance at the monitor; the tracing
was a mere nicker. I reached for the paddles, placed them, and glanced
around. "All clear!" Sandy stopped pumping and stood back, still on the
mattress.

I pressed the red buttons.

The charge arched Watts's back. He smacked back down on the board like a
slab of sirloin hitting a butcher block. But I was watching the monitor.
The zigzags flattened into a wandering straight line, nothing else.
"Come on. Watts, come on!" Still a flat line. The steady whine of the
machine mocked our effort.

"Shit! Keep pumping." Sandy resumed chest compressions.

"Grab that high stool over there," I told the guard.

He dragged it over. "Up you go. Sandy. You'll have more downward force
on your push." I squeezed four full puffs of air into Watts, then
dropped the bag and foraged in the cart for an ET tube and a working
laryngoscope. I found the size I wanted, nicked the blade of the scope
open to activate the light, and stepped to Watts's head.

"Hold it, please!" I ordered.

Sandy stopped pressing down on his chest. The guard held his breath. I
scissored Watts's mouth open with the fingers of my right hand, inserted
the blade with my left, and slid it back to the base of his tongue.
There were the cords, clear, no vomit. I threaded them with the tube.
The monitor was barely quivering now, almost flat. "Okay, pump." Sandy
moved to compress, and I'd just hooked up the bag to give more air, when
we heard the first beep, and a healthy complex leaped to the screen.
"Hold on," I said quietly. This would be it. A few salvos and then death
was sometimes all we got. Another beep, another complex, then more line,
then another beep. "Any pulse with that?" Sandy touched his neck. A beep
came and went; she shook her head and started pumping again.

"He needs help." I grabbed three ampules of Adrenalin, drew them into a
syringe, and emptied it down the ET tube. Then I bagged that little
cocktail home. There was another beep, then a line again. I heard loud
clanking at the door. Our 99 summons was beginning to produce help. The
respiratory technician struggled in with oxygen tanks, saw Watts, and
silently hooked up his cylinders. In seconds he took over the
ventilation, bagging pure oxygen into the lungs instead of air. "What
happened?"

"I don't know." Beep, then another, then a few staggered beats, then,
like a car in winter, they started and kept coming in a steady, regular
stream.

"Yes!"

"A pulse."

"Great."

"We got him!" Sandy dived into the cart to start an IV. "Put some Xylo
through that, will you. Sandy? Seventy bolus and two a minute drip?" A
resident touched my arm. "Earl, did you inflate the cuff?" I hadn't.
"Sorry, is it leaking?" He answered by injecting a syringe full of air
through a catheter running down the outside of the tube in Watts's
trachea. This would inflate a small balloon around the tube and block
any oxygen from escaping instead of going on down to the lungs.

Two more residents charged in.

"Pull some bloods and a gas, you two," I said.

I moved to take Watts's pressure. Not bad. Hundred over sixty, and
getting stronger.

Ever-increasing numbers of residents, nurses, and students swarmed over
the now-alive Watts, securing lines, slipping in catheters, hooking up
monitors, and cleaning up spilled blood and other bodily fluids. He even
began to look a little pink, but he needed a respirator. Whether or not
he still had a brain was the real question.

Stewart Deloram from the ICU arrived. I gave him the story of the
resuscitation, added I'd just found him, and left out the peculiar
details. He slipped the strap of the portable defibrillator over his
shoulder, and I stood back as the whole chattering, caring collection
clanked and bumped their way out the door. I followed them into the
hallway and watched the stretcher shrouded in a web of IVS and winking
monitors recede through the dark like a departing train. They reached
the end of the corridor and turned into the elevator.

Alone, I stood in the antechamber. Dripping noises were coming from the
dissecting room behind me. I felt a coolness at my side and turned to
find the freezer door open again, this time wide enough that I could see
the interior.

All the racks were empty. I was about to close it when I noticed a bunch
of half-melted boot prints outlined in the frost on the floor just
inside. I leaned against one of the stretchers. It held a stained,
rumpled sheet. It took a few seconds before I remembered that twenty
minutes earlier, on my way into the morgue, the stretcher had held a
corpse.

A quick call to the nursing supervisor, Mrs. Quint, confirmed my growing
fear. No one had died in the last twenty-four hours. No autopsies were
scheduled for the weekend.

"So far," she added, probably thinking of Watts. "By the way, good
work." She paused, then asked, "Is it true what Sandy told me, about you
finding him, hooked up and all?" I didn't know what to say. Tales of
missing corpses and hidden killers were not going to assuage Hurst's
attempts to keep me categorized as the resident nut.

I minimalized. "I don't know who called me, but whoever found him and
hooked him up probably was goofing off and shouldn't have been down
there. Maybe a smoker." I waited to read the silence on how this was
going over. It was a pretty skeptical silence. I tried putting her on
the defensive. "Maybe a nurse," I added softly.

I heard her breath hiss in. "Now, really. Dr. Garnet, you've no call to
implicate my girls and boys." Some of her "girls" were
forty-eight-year-old women, her "boys" about the same age, and too many
of them still snuck off to smoke since cigarettes had been totally
banned. At least we were arguing about who was goofing off and I wasn't
having to explain killers and corpses.

I let her run on, then picked my spot and made my pitch. "Look, relax.
What I'm saying is, it was probably one of your 'girls' who saved Dr.
Watts's life, and she can't come forward about it." The silence
returned. It held a "maybe." I pushed. "Whatever she or he was doing
down here, that person's a hero." More silence. She knew I'd just
inferred her "girls" and "boys" sometimes did other secret deeds in
hidden places besides illicit smoking. Sometimes the cigarette was
included, after. Long ago, as a resident, I'd had my own induction to
these liaisons, and, a half century ago, so probably had Mrs. Quint.

"Amazing" was her only comment, and then she hung up.

I'd made the call from the wall phone in Watts's lab.

As I replaced the receiver, it dawned on me I might have smudged
fingerprints left on it by the person who had called locating. But now I
wanted out. With the dark corridor outside the door, the weight of the
hospital over my head, and my second near-miss, I began to get the
creeps.

An unknown killer was still hunting me, already setting up the next
attack. Was it Hurst? But what did he care about ER stats? Had it been
Kradic? He'd know how to set up Watts, but he had no connection with
Kingsly.

Yet he would have a connection with the ER data. For that matter, could
it be someone else in the ER? I began to wonder if maybe, just maybe,
Kingsly's death and the ER stats were completely unrelated. I had to get
away-- had to run. My breathing was openmouthed, and I kept trying to
find some saliva for my dry tongue, but fear wouldn't have it. We
learned as students in physiology how the adrenaline response mustered a
fight-or-flight syndrome. I was all flight.

But I made myself do one last thing: I went to the edge of the locker
and kneeled to see the boot marks better. At first they seemed
indistinct and blurred together, but me wanner air through the open door
increased the icy condensation over the prints and made them clearer. I
could see two definite sizes.

Then I started out. The nearer I got to the stairwell leading up to
light and air, the faster I moved. I heard nothing in the dark behind
me, but I straight-armed the door leading to the steps and went up three
at a time.

Adrenaline, we were also told, gives us a sense of impending doom. I was
getting a good dose. That, and a full-blown panic attack.

I blew out of the stairs and halfway across the hospital front lobby
before I pulled up to a trot. The same lone man, tethered to his IV, and
the gift shop lady, equally elderly, gawked together at my noisy
entrance. I could see her thinking "escaped psych patient," but before
she could reach for a phone, I waved my stethoscope at her.

"It's okay, I'm a doctor," I said, and made for the ER.

"Emergency," I called after me, and felt like an idiot.

I managed to reach my office without the nurses getting a good look at
what must have been a white and sweaty face. Had they, I would have
found myself ded to a monitor and enroute to the CMU. Instead, I pulled
an old paper bag out of our recycling box and started breathing into it.
I don't know how long it had been there, but it still held a faint odor
of onions and something fishy. Nevertheless, rebreathing my own carbon
dioxide began to slow my heartbeat and alleviate the numb tingling in my
fingers. I've treated hundreds of patients with panic attacks, but now I
know why they all think they're going to die.

My own chest finally lightened up by thirty pounds, and my breathing
slowed. Okay, I thought, I'm okay.

Then the fish smell and my own stress got me, and I barfed into the bag.

"The horny-nurse story will make more sense to Bufort than a killer
still running around." It was Riley over the phone. After cleaning up my
mess, I had decided, for the record, to report what happened. In case I
could ever prove any of this, I wouldn't be nailed for withholding
evidence.

I'd figured the shrouded body back at the morgue was alive and well as I
slipped by it heading in to find Watts.

The open freezer might have held a couple more buddies, all ready to
finish me off if I didn't zap myself first. I'd inadvertently shut them
in on my way past. They were wearing boots, probably rubber, to protect
themselves from the water if they had to "help me" fibrillate myself.

Their shrouded buddy was likely letting them out to come in after me
when the noisy elevator door announced Sandy's arrival and scared them
off.

Riley interrupted these musings. "Or more to the point, he'll like it a
lot better than admitting he was wrong."

"I know," I replied curtly. "Just memo this, will you?

So if anything comes of it, I'm officially on record as having reported
it." Riley didn't answer right away. Perhaps he sensed how fed up I was
with his reluctance to defy his boss, or maybe he was thinking over the
politics of my request.

"You got it, Doc," he said finally, but I suspected he'd probably
forward the message to Bufort through channels, knowing full well it'd
be lost there for weeks. "And, Doc--" I waited.

He finally asked, "Why did they want Watts?"

"He was bait to get me" was my immediate reply, but I remembered
something more. It was so speculative that I was hesitant to tell Riley.

He sensed my holding back. "Okay, Doc, let's have it." I felt reluctant,
but added, "Watts had started phoning around to the other ERS to see if
any of them had noticed unexplained cardiac needle tracks on their
DOAS." After a few seconds of silence, he asked, "What did he find?"

"He didn't find out anything. The run has apparently dried up."

"Still, Doc, it's a hell of a thought."

"Are you willing to follow it up?" I demanded.

I could almost hear the lid snap shut on his own moment of speculation.
"Like you said," he replied coldly, "Watts didn't find out anything." I
was about to hang up in disgust.

"Okay," he added after a few seconds, "obviously I was wrong. Someone is
still coming at you." No kidding, I thought bitterly. He was my best bet
on the police force, but I wondered if someone else would have to die
before he'd risk insubordination and stand up to Bufort.

"I'll alert a patrol car in your neighborhood," he continued, his voice
no longer cold, "and ask them to make extra passes by your house. But be
careful, and call me tomorrow. Maybe we can work out something else."
Swallowing my anger, I thanked him, and hung up without further comment.

I sat at my desk, doodling on a pad of paper, and thought some more
about Watts's questions and our own dead vagrant. On impulse I made a
quick calculation and wished I hadn't. If the other hospitals had been
getting DOAS at the same rate as St. Paul's, one or two a month, there
had been one helluva lot of them delivered to Buffalo-area ERS over the
last year. Watts's hunch couldn't be right, not with the kind of numbers
that could be involved. Yet I remembered his grave mood when he first
raised the possibility in the coffee shop. He was earnest, almost grim,
and clearly convinced it needed to be checked out. Over the years I'd
found it unwise to dismiss any idea he put forward without looking at it
pretty carefully first. His track record was too good. But if some of
those corpses, now long buried, did have undetected cardiac needle marks
in them--and those marks would be easy to miss in a routine autopsy--I
hadn't any idea how that remotely related to Kingsly, or to me.

As Riley said, it was a hell of a thought, but pure speculation. Without
evidence, even I had to admit I'd be a lunatic to suggest opening a few
of their graves.

I shivered and called Janet's hospital again.

"Dr. Graceton is doing another C section. Can I give her a message?"
Janet had kept to her plan to work that weekend. She believed my
suspicions that Femandez wasn't the killer, and had agreed to continue
to take precautions.

"Just tell her I called, and that everything's fine." Yeah, sure. "Tell
her I'll call back later." I gave the vet yet another call. This time I
got one of Sophie's assistants.

"Good news, Doctor. The fever's gone. Muffy's lapping up a little liquid
and starting to put out urine." Thank God for "gorillacillin."

"Great. Do you want me to see her?"

"No, she's alert enough now to get overexcited.

Wouldn't do her a bit of good, so just leave her with us, Doc."
Chastised, I thanked her and hung up. I gathered the computer disks I'd
originally come for, and left. My loved ones were safe for the moment,
and I was starting to get a little more sense of fight than flight. By
the time I reached my car, I even had a plan.

Over a beer, Doug listened to what I was going to do.

He'd sat motionless in a quiet corner of our kitchen while I told him
everything. Elsewhere in the house the comforting banter of his men
mixed with the racket of hammers and saws. They were working throughout
the weekend to get us back in our home as quickly as possible.

The late afternoon light gave a sheen to the top of Doug's bald head.
Explaining my plan had sounded strange and impossible, but his absolute
stillness reassured me he was taking me seriously, very seriously
indeed.

"I don't want any of your guys to endanger themselves, Doug. I have to
have your promise on that." I couldn't see his eyes. They were in
shadow, but I saw his slow nod.

"I want them there only to call in the cops, to get help when it's
obviously time." I handed him Riley's card, the one I'd found under my
wiper summoning me to our meeting.

Doug took it but played with it and looked off into the increasing dark
of evening. He knew violence. He'd told me of the times when, as a
private contractor, he'd had to protect his building sites with shotguns
from union goons. The thugs still roamed the labor movement, but now
they wore suits and used laptop computers.

"Time's the problem." His sudden speaking took me by surprise. For a
moment I was afraid he was going to tell me he didn't have time for this
nonsense.

"You're too alone," he continued, "and too far from help, even with a
good response. It'll be too long before the cops will get to you. We
need something closer." He was with me.

Stiffened by this reinforcement, I began to think a little more
offensively. "Give me that card a second." I reached for the phone. This
time, with the help of information, I talked to another police station,
near where we were going to play. They understood, and would be
available to help. Easy. Cooperation assured. Of course the county cops
had no idea I wasn't really Detective G. Riley of the Buffalo police
force.

Doug went upstairs to select the men he'd need for his part of our plan.
I went downstairs and collected my waterproof hiking boots and changed
into long underwear and heavy socks. I put my dress slacks and socks
over the outdoor stuff so no watcher could guess my destination.

I replaced my sport jacket with a heavy ski sweater and hid this with my
regular topcoat and white scarf. The bush would ruin the coat, but it
would be warm enough. I dumped out my doctor's bag, actually more a
small suitcase, and hid my boots in there. I added my computer disks and
made sure I had all the keys and money I'd need. Finally I squeezed into
a pair of black oxfords. To all appearances I looked city bound. Doug
and I met quickly back in the kitchen, checked our watches, and he
started getting the men he was taking with him ready to leave.

I wasn't hungry, but I made myself heat up some soup.

It was going to be a strenuous night. The cold itself would take its
toll. The soup was tasteless but hot. I downed it like coffee and was
out the door.

My first task was to lay a false trail. It was completely dark now, and
the air was fresh with frost. I walked a block south to the corner of a
main thoroughfare, where I grabbed the first cab I flagged. Buffalo
still partied Sunday night to buffer facing the gloom of Monday, but it
was early. I asked for the downtown train station, then watched as we
entered the east end and passed by blocks of buildings long gone out of
business and boarded up with plywood. A few stores remained lit up but
were nearly empty of goods and not far from the inevitable slide to
bankruptcy and more plywood.

The station, little more than a redbrick house, was a cruel testament to
the abandonment of the train travel that was once so prevalent in this
city. But it was where a lot of taxis could be found. I paid the fare
without comment, hopped out with my briefcase, and walked up to the lead
cab in the line. It was strewn in back with old mud-stained papers. I'd
just passed cleaner versions using more recent editions, but to avoid a
fight with the driver, I ignored them and jumped into his more livedin
offering. Besides, the bus terminal was only four blocks away.

The driver must have figured he had a real tourist who didn't know the
city, because I got another tour of plywood tombstones, in silence,
before he finally deposited me back where I could have walked in three
minutes flat.

My tip evoked a slightly raised eyebrow. I didn't ask for a receipt.

I ducked into the bus station. It was an overlit, echoing cavern
designed for hordes coming and going. No one was leaving or arriving
that night. Expectant vendors eyed me hopefully as I clacked across the
tile floor. I felt their disappointment when I headed straight over to
the Ellicott Street exit. Back outside I turned right, walked two blocks
north to Clinton, and turned west. This brought me to the side door of a
large hotel that squatted beside Lafayette Square. It had once been
grand but now seemed faded among the refashioned buildings that
surrounded it. A perfect place to hide out, I wanted my pursuers to
think.

I slipped into the lobby. The interior was dusty and the carpet worn.
Bored bellhops didn't even look up. They'd come to take vacant rooms for
granted.

I walked by the front desk without a glance and pushed my way out the
revolving front door that jammed only a few times. The security guard
eyed me suspiciously from where he was sprawled on a feeble-looking
wooden chair reading the Police News.

Back on the street, it took me three minutes to reach Main, where the
tram cars ran. Here I would make sure no one followed.

Since the events in the morgue, it seemed pretty evident I was being
stalked by more than one person.

I really didn't care what they made of all my skulking about. I wanted
them to see me running and perhaps assume I was trying to hide in the
city. Or think I was trying to leave town but presume I'd head where a
train or bus could take me. Their confusion would buy me time to get set
up, yet I had to do more than confuse them. I had to really lose them,
and here was my key move to accomplish that, if they were still out
there, tracking.

I dropped ten quarters into the fare box, got a roundtrip ticket, and
then stood by the tracks for a northbound tram. As I waited, I looked up
at the city hall building, a huge layered obelisk that bulked thirty
stories over downtown Buffalo. The windows were narrow, pointed at the
top, and set in deep vertical grooves running up the height of the
walls. In the mist they resembled scales on loose folds of skin. The
final hundred feet of the tower was eight-sided in shape, and the peak
was a series of ever-smaller octagons stacked on top of one another to
form a ridged hump. Decorative patterns of yellow and red had once been
stained into the sand-colored stone, and the entire structure was touted
as a monument to Art Deco. To me it always looked rather shabby and
rusted, like the sides were about to slough off. Ironically, it was
these upper floors that housed Zak, his staff, and the command center
from where they dispatched ambulances in response to 911 calls. But
instead of overlooking the city as a beacon of help, the place brooded
in the fog. I shivered and glanced back down the darkened street behind
me. I was still alone, yet I welcomed the distant bells of the
approaching tram.

Once on board, I relaxed slightly. It was a three-car train less than
half full, and for the next few stops we poked along the aboveground
tracks through the theater district. I found the light and laughter as
people got on and off briefly comforting. All too soon we went
underground, where the tram picked up speed and I got ready. I let the
first station go by and got off at Summer-Best. On this platform there
were nearly as many people as I'd seen on the tram. At first I thought
waiting for the subway had become a night out in itself. On closer look,
the bags carried by these withered, dirty women told me I was in their
home.

I stood at the platform's end near the stairs. Across from me was its
mirror image for southbound travelers.

More people were gathering on both sides of the station, but the place
was full of the hush that marks a crowd of strangers. I watched every
newcomer on my side of the tracks but saw no likely candidate. Not
surprising, since I'd no idea who they were anyway.

Another northbound train arrived first. I let it go by. A few people got
off and went upstairs. Most of the people on the platform entered the
train, were shut in and whisked away. The taillights and sound of the
last car faded up the tunnel, leaving me alone with the bag ladies and
their suspicious stares. This uneasy silence lasted until in the
distance I heard the approach of a southbound train. I bolted for the
stairs, ran over the crosswalk above the track, and descended on the
other side just as the doors slid open for business. A quick glance
behind assured me none of the bag ladies had followed. There was no one
else. I felt an odd little spurt of elation. I had lost them.

Still wary, I jumped off the train after only one stop, ran up the
stairs, found a cab, and gave him the mother lode of fares, at least in
this city on this night.

Any initial sense of advantage began to fade as the city dropped behind
us. The deserted highway led my cab south through me farmland toward the
mountains. Some of the bungalows that had seemed so bleak midweek looked
cozier. Through the lit windows of kitchens and sitting rooms, I caught
glimpses of happy children bobbing around gray-haired elders. It
reminded me of Sunday nights long ago on my father's farm--family and
neighbors gathered to share and lessen the worries.

My cab made a sorry comparison. The floor was littered with more wet,
shredded newspaper. The driver looked concerned about what he'd gotten
into and kept glancing nervously back at me, chewing his lip.

The plan Doug and I hatched at my kitchen table had seemed simple,
plausible. Now, in the dark, and with increasingly cold feet, I had the
feeling that same scheme was rapidly becoming pathetic.

"Could you turn up the heat back here?" I asked.

Without answering, the cabdriver grudgingly turned some dials on the
dash and sent a blast of hot air directly into my face. It just made it
hard to breathe and my feet seem colder.

"Thanks." He missed the sarcasm. He'd gotten over his first enthusiasm
at the hundred I'd handed him in Buffalo.

Out here on the highway, alone, it was little wonder he was visibly
afraid. Someone in the city had recently taken to hunting cabbies. It
had been a front-page headline recently that three had been killed in
the last month.

I knew how he felt.

Waves of sludge from southbound traffic arched over the median and
thudded onto the hood of the cab.

In the glow of theory, I'd thought coming north would be unexpected,
that I'd be safe for a while, and Doug would have time to prepare for
his part in what lay ahead.

But I kept looking out the rear window and didn't feel safe at all.

A heavy ridge of slush caught the cab's front wheels, and we lunged back
and forth until my reluctant driver regained control. I heard some
muttering, but he didn't dare turn his eyes from the road to give me an
accompanying glare. His grip on the wheel was so tight, his knuckles
were nearly white enough to glow in the dark.

My thoughts were no less erratic than the movement of the cab. The
attacks had to have come from someone near me. They seemed based on an
intimate knowledge of my life and where I was at work. Tracking me to
the cabin, the move on me in the alley, the search of my house, the call
to the morgue within minutes of my arriving at my office, unscheduled,
on a Sunday; it all suggested they knew my movements. Whoever they were,
they obviously could keep track of me from close by and remain
unobserved. They also appeared capable of taking instant action. The
person--or, now, I assumed, people--who wanted me dead must have been
right in the thick of the attempts to kill me. It would probably be a
hands-on killing, not an anonymous hit ordered through a chain of
command. At least I'd know my killer when the time came, I thought
bitterly.

But the elaborate setup with Watts betrayed even more. One of these
killers knew modem resuscitation routines and techniques, knew how I'd
react, and counted on my shocking myself into oblivion. Electrocuting
myself. My pulse raced.

Evidently my death had to appear accidental now.

They had to know Bufort was about to blame Femandez for the murder of
Kingsly and the derelict. Otherwise, why all the trouble and risk of
staging the show at the morgue to make it seem like a bizarre yet deadly
mishap, not another murder? I could just hear Bufort and Hurst
explaining it. Tragic!" they'd say. "Obviously Dr. Watts had a cardiac
arrest while working in his lab at the sink.

He must have hit his head as he fell. Dr. Garnet, in his rush to
defibrillate him, forgot to turn off the water and insulate himself.
Terrible loss." There'd be a lot of unanswered questions, but for sure
Bufort and Hurst wouldn't ask them.

Only someone at our meeting earlier that day could have known for
certain that Bufort was holding Fernandez responsible for the murders.
Was it Hurst? But if he had murdered Kingsly, would he now risk trying
to kill me simply because I hadn't accepted Femandez as the killer? And
while he might know how to use a cardiac needle, was he up enough on
cardiac resuscitation to have pulled off such a cunning plan?

All this begged the real question: Why did whoever it was think I still
had to die? Why didn't they lie low and let Bufort's closed mind do the
rest? Somehow I was still a threat to them and could possibly, even
probably, stumble across what had really happened. I looked at my
briefcase on the seat beside me.

My plan in heading to the cabin this way was twofold-- lose them long
enough to find the secret of the ER stats and, after, use myself as bait
to lure them into a trap.

More slush splatted across the windshield, then slid down like dirty egg
whites. The wipers smeared this mess into a greasy film. Apparently our
budget for the trip didn't include windshield fluid. The driver just
hunched farther down to peer through a bare spot. Like Quasimodo with a
day job.

My questions raised even more gruesome possibilities.

Was there a connection between the citywide increase in DOAS and the
murders at St. Paul's? Did my ER data hold evidence of an even blacker
secret rotting in God only knew how many paupers' graves? No! That was
just too fantastic, too paranoid. But as my cab brought me nearer and
nearer to where I'd intended him to drop me in the night, a little
paranoia didn't seem inappropriate.

I brought myself back to the odds. Doug's precautions in case the
attackers were able to watch the cabin presumed they'd have to do it
from a distance. Otherwise the people who shared our road might spot
them or their vehicle hidden in the woods. We'd also presumed they
wouldn't break in and wait in the cabin, since again they might be
spotted by a neighbor.

In this cold, they'd have to have a shelter, a vehicle they'd turn on
now and then for heat. Or a tent with some kind of heater, or fire.

At least that's how it played back in my kitchen. Now, nearing my
drop-off, the inside of my mouth blow-dried with the blast of the heater
and my cold feet becoming unpleasantly metaphorical, the chances of our
plan working out seemed to depend on a lot of assumptions being correct.
If they weren't, I'd probably end up dead.

We rose out of the farmlands and onto the dark, twisting road mat
started the climb into the mountains.

The course of the black pavement ran back and forth like a metronome
timing my thoughts. Occasionally the entire road disappeared into sheets
of blowing white snow.

My jovial chauffeur slowed and muttered, "Shit!" For a moment I feared
he was going to dump me right there.

"It's only another twenty minutes!" I implored, hoping for a shred of
empathy. He didn't bother with an answer but kept going.

I began preparations and tried to shut out any more gloomy thoughts. I
pulled my winter hiking boots out of the briefcase and switched them
with my oxfords and toe rubbers. My feet warmed, and I quickly felt
better. I stuffed my shoes back into the briefcase. Snapping it shut
pretty well wrapped up getting ready, and I again began to think maybe
my plan was a little thin. I sank back into nineteen more minutes of
such morbid thinking.

For a change I looked out the rear window--as if I hadn't a hundred
times already. Whatever vehicles had accompanied us from Buffalo had
long turned off to saner and safer destinations. No lights followed for
any distance. Local traffic getting on the road and then getting off
again was all there seemed to be. At one point a flashing red light
caught my attention. The vehicle came up fast, its siren soon audible.
We'd just passed the Holi Mont ski area, which was where the police I'd
called earlier were located, and for a minute I wondered if Doug's boys
had already sounded the alarm and called the cops prematurely. But in
minutes the yellow truck body of an ambulance was clearly visible. It
swirled the snow sweeping by on our left and went speeding on into the
night. Only once did it slow, at the curve ahead, the brake lights
illuminating the yellow rear box and doors. It skidded a bit, warning my
own driver to slow. By the time we rounded the corner, only the flashing
red could be seen disappearing over the next hill. Good luck, I thought
grimly. Whoever needed help out here so far from ER miracles could use
good luck.

We were about fifteen minutes from my chosen spot, and I was feeling
downright stupid. Any cleverness in my idea to hole up in the cabin and
crack the secret of the ER now seemed pathetically obvious. Still, once
they-- whoever they were--figured I was there, they'd assume just that:
incredibly stupid. That was the bait. Hopefully, they'd then come on in,
arrogant and careless, not suspecting it was really a trap for them.

I didn't feel a lot better, but maybe our plan had a chance of working.
Yet springing the trap--having the cops catch them red-handed trying to
kill me--was going to be tricky. The final village came into view.

Five minutes to drop-off.

A distant lit steeple, even some early Christmas lights, glowed in the
fresh snow. A luminous Nativity scene was the centerpiece of a deserted
parking lot, the glare of green, red, and blue bulbs muted by swirling
flakes. The rest of the village sparkled up the hillside in a spray of
tiny amber lights. It was like a vision from childhood, full of magic
and promise.

If my night's work went awry, I thought, I might never share the world
with my son.

The feeling hit me like a jolt. It was new. Till now, fear, worry,
doubt, and anger had driven me through the last few days. But about to
come face-to-face with whoever was trying to destroy me, I felt a cold
rage.

I sat motionless in the dark cab. I'd never felt a similar emotion. I'd
wanted safety for Janet and me, for our home, and for our child-to-be.
But even in our wrecked house while standing by the baby's crib and
feeling ready to kill anyone who might hurt our child, I'd been ready to
let the cops stop them. This was different. I was shaking, but not from
any chill now. I felt a strength and focus I'd thought were unique to
the insane or soldiers going into battle.

I'd blundered into a killing game. To get out, I was setting a trap. But
it remained a killing game. On the brink of my own son's birth, I felt a
savagery that had always revolted and disgusted me when it exploded out
of others. I'd spent a lifetime putting back together the human pieces
mat resulted from those eruptions.

Maybe it was as simple as self-preservation, an instinctive preparation
as old as the cave, the getting ready to do battle with the beast that
slouched toward it. Nobody was going to kill my chance to see my son and
rob him of a father.

If they came under my hand tonight, I'd be capable of killing them
myself.

We were passing the last of the village. Brash red bulbs lit the local
coffee shop. They shone harsh against its year-round color of canary
yellow. Neither snowflakes nor a full blizzard could soften the effect.
They usually left the bulbs up all summer, unlit. Janet and I had ended
many a warm weekend here, ordering hot dogs and ice cream to hold off
the evening and the melancholy of returning to the city.

Four minutes more. I leaned forward. "Only a few miles to go. I'll tell
you where. And slow down, now!" The cabbie gave me an uneasy look, as if
this were where I was going to jump him. I chattered on, to make sure he
got it right and hopefully to reassure him. "Drop down to twenty. Up
ahead is a hollow in the road. When I say stop, exactly at the bottom,
stop dead. The second I'm out, go on, but drive slow. Leave your light
off and keep going south, about ten miles. Then you can turn around and
get back to Buffalo." His silence eloquently said he still didn't like
it. I began to fear my whole plan was going to fall apart here.

"Look, I need you to do this. There's nothing illegal involved, but if
you don't let me off this way, some very bad and big men might spot me."
This rattled him even more. We were only three minutes away, and I
realized too late he might suddenly refuse to stop in the middle of
nowhere, where he could be jumped by "bad big guys." I improvised some
more, trying to undo the effect of my last effort.

"My wife's brothers are watching the entrance to my place up here. I ran
around on her, but they come from a family that cuts your nuts off for
that. I just gotta get in without them seeing me and talk to my
wife--you know, get her to forgive me and call off her brothers. Then
it'll be okay. Please, you gotta do this for me." I had his attention.
His jaw stopped the grinding movement that had gone on since we left
Buffalo.

We were only two minutes away. I went on with my wheedling.

"So I'm not a nice guy, but do you want to be party to me getting my
balls cut off?" I sensed him flinch somewhere down in the region of his
crotch. He must have known the kind of relatives I meant.

"Okay," he grunted, "but it will cost you another fifty." Human
kindness. I crossed his palm with two twenties and a ten.

We crested the final hill. Here the road dipped down about a mile before
our turnoff. Anyone watching from near that entrance could still see the
glow of the lights but would lose sight of the actual car as it went
into the hollow. I'd be able to jump out of the taxi without anyone
spotting me. All an observer would see was the cab as it came up out of
the hollow and headed south. They'd assume it was driving slowly because
of the storm.

I got ready. "Just along there, at the bottom of the hill.

Remember, stop dead! The second I'm out, go on, but at the same slow
speed." He said nothing. I could only hope.

We rolled to the spot.

"Now!" I opened the door, and lugging my briefcase after me, I hit the
pavement with my boots even before he stopped.

"Now go," I said softly, closing the door. The cab crept forward and
continued up the hill. In the glow of his dash, I could see him
immediately hunch forward to go on the radio mike--probably to tell his
buddies about the kook he'd just dumped in the wilderness. Then his
taillights disappeared over the crest and he was gone.

That he would keep his word and continue south to complete my cover I
could only hope.

It was so still, I could hear the snow fall. It made a gentle, steady
hiss. Big flakes descended slowly and stuck to my cheeks and eyebrows.
The cool was welcome after the blast of the cab heater.

There wasn't any light, but it wasn't dark either. A luminous glow
reflected from the white surface and made it possible to see quite well.

I took a few steps through the ditch and up the shallow bank that ran
along the highway. The snow was fluffy stuff that barely reached my
knees and fell away easily when I walked through it. For the moment, I
wouldn't have any trouble.

I climbed over a broken fence, then stopped and looked back. My tracks
were visible if you were looking, but the fresh snow would soon cover
them. Once in the woods, my trail wouldn't be seen from the road.

Ahead lay a mile-and-a-half trek, all uphill, to reach the cliffs behind
the cabin.

Going in this way should take care of any watchers.

Make them sweat where I was and make my hiding out seem real. But was it
clandestine enough to bring them in, unsuspecting?

Before heading into the woods, I looked across the highway. I could
hardly make out the black shape of the cliff top opposite, bulky against
the sky and trailing off in each direction until, like the road, it
became lost in swirling snow. That's where Doug's boys were to wait,
watch, and spring the trap.

He was moving a pickup and a vanload of his men over from their village,
Colden, east of us, but they were coming on a back road. A mile from
here, they would turn onto a logging cut, known only to locals, that
would bring them up the back side of the cliffs facing me. There they
would be overlooking the highway from Buffalo I'd just arrived on, and
the entrance to our property. Any watchers already hidden by the
roadside couldn't drive up to the cabin without being seen. All
newcomers would be spotted.

"I sure hope you're there," I muttered, and turned to enter the woods.

Chapter 15.

My first mistake was gloves. My socks and hidden longjohns had been
clever, but I hadn't thought to bring warm gloves. My stylish black
calfskin pair were a soggy wad in minutes. The underside of the large
evergreens rising away from the highway was far darker than the
roadside. I was stumbling along the uneven ground, one arm forward for
balance, the other dragging my briefcase, and I was pitching frontward
on a regular basis.

This methodical plunging of my arms into the snow soon filled my short
gloves and froze my wrists. With each fall I also clobbered the back of
my legs with my briefcase.

Unseen twigs attacked my glasses and repeatedly tossed them into the
snow. Finding them didn't help. A frozen coating of ice impossible to
see through had glued itself to the lenses. I pocketed them.

The next time I fell, I simply lay there. The highway was mockingly
nearby. My flailing about had given me sweaty thermal underwear, frozen
hands, enough facial scratches to mimic a cat fight, but little
distance. So much for clever. Time for practical.

I needed to free my hands and warm them. The double socks were redundant
and making my feet swim in their own sweat. I carefully unlaced my
boots, got them off without too much snow falling inside, and peeled off
the outer layer of wool. Chucking my useless gloves, I pulled these
smelly, thumbless mitts over my hands and coat sleeves to halfway up my
arm. I managed to get rebooted with only a few chunks of ice puddling
under my toes.

Then, fumbling with my improvised mitts, I opened my case and quickly
transferred my computer disks to an inner pocket of my coat. I separated
the sheaf of printouts into smaller rolls and stuffed them into various
pockets, down my trouser legs like hockey pads, and inside my shirt and
waistband flat against my stomach. Bending over to tuck my trouser tops
into my boots made the papers at my waist dig into my chest, but it'd
do. Then I chucked the briefcase. Optimistically, I tried to note where
I was beside the highway so I could find it later.

But it didn't seem so important now.

I turned again to the mountain, this time with both hands free.

I made slightly better progress, yet it was slow going. I could grab
overhanging branches to steady myself with both hands now. But since
these were the lower stubble of ancient fir trees, half of them broke
off, resulting in an unwelcome slide backward. Even when I got enough
traction to step forward, my boots would often slip out from under me,
and I'd again drop to my knees.

The cabin lay four hundred vertical feet higher than the highway, but
the mountainside itself rose and then descended into gullies, then rose
again. Going down was even more treacherous than climbing up. The snow
hid pockets of rocks and fallen tree branches ready to snag and snap an
unsuspecting ankle. I had to inch down these slopes, testing with one
foot forward. I couldn't avoid repeated wild descents on my backside
that slammed me into the next lower tree trunk. Usually my legs
cushioned the blow, but some smaller saplings managed to reach more
sensitive parts.

As the night wore on and I was out of sight and sound of the highway, I
began to wonder about keeping my bearings. I had hiked the area many
times, but usually in summer and always in daylight. I was heading
generally up, but even in the dim light I could see my trail of
footsteps had meandered to avoid more forbidding sections of rock and
cliffs.

By now the snow was falling heavily, and not even stars were available
to give me some sense of direction.

All my thoughts were focused on finding footholds. In some places where
the snow was over my knees, the effort of walking nearly doubled. My
breathing was hard and loud enough to be heard, but I didn't care. My
pursuers would not be stupid enough to be out in this.

Then with a giggle of fatigue, I thought, "Great, I've outstupided
them." More giggles, and a particularly slippery outcrop of rock
launched me down the next gully and plopped my behind in an unfrozen
spring-fed stream.

"Shit!" My yell was involuntary. Even after realizing the noise I'd
made, again I didn't think it mattered. Besides, my immediate concern
was the ice water percolating through my trousers, the printouts, and
down my legs.

"Damn!" I was on my feet instantly, but my clothing was soaked enough
for the water to continue on into my boots. I started to wade out of the
pool, giving a pretty good imitation of someone who's peed in his pants.

It would have been funny except for the cold. From the waist down I was
soaked, and cooling fast. The papers were probably ruined.

I squeezed what water I could from my pant legs but managed only to wet
my hands in their improvised coverings.

Before I fell, I'd been warm with all my exertions, hot even. Now I was
shaking with cold. I had to start moving again and get to the cabin
fast.

But any hope I had that I'd reached the downhill run to our lake
finished with a sharp upturn in the slope ahead that was even steeper
than before. The snow was falling thickly. My only choice was to
continue uphill. The rolltine two steps up, slide back ten, was
happening more often now. I was unable see if I was even making some
forward progress. I had a panicky image of becoming a frozen Sisyphus
condemned to struggle up, fall back, and get nowhere. My pant legs had
become hardened into corrugated iron tubes. Burning seared any remaining
skin that wasn't numb.

I was lying at the bottom of one of these many descents, listening to my
own breathing, when I heard the plodding behind me.

I spun around and pressed my back into the hill. In the white and black
below, there was a definite steady thudding, coming right up at me.
Suddenly I wasn't cold anymore.

I squinted, but I couldn't see anything. The heavy, uneven thudding
moved nearer. How could they have found me? How were they coming so
steadily, and what made their steps so heavy? I could feel the vibration
as well as hear them. Nausea and fear rose hot to the back of my throat
Then I saw a wall of black behind the white, a wall that moved. I made
useless scurrying movements backward and tried to fight away an evident
hallucination. Hell, I wasn't that cold or gone yet. But I was looking
at a moving black wall plodding at me that suddenly stopped.

Then it moved at me and stopped again. Next, from above the wall I saw a
great head topped with antlers the size of a small tree. Nostrils and
large, forlorn eyes glided down to my face, took a sniff, then receded
as the great beast turned away and began steadily plodding up the hill,
past me to my left.

The moose was soon gone from sight and sound, leaving me with only the
thud of my own heart.

They'd been around for years, but never came close.

They felt safe here, a small refuge from hunting, but mostly they
wandered quietly and alone. On rare occasions we would see one in a
sheltered spot on the lake, where they came to take water. Mostly they
wandered by night.

This moose seemed to be on his routine prowl. His large hoofprints
looked like they might be good footholds in the snow. I wondered if he
was heading to the'drinking cove. If so, crazy as it seemed, my only
chance at surviving might be to follow him. The cold was going to do me
in if I nailed around much longer.

It was a risk--I had no sure idea where he was headed--but I decided to
take it. Getting to my feet provoked a sickening wave of numbness and
fire from the waist down. This solitary creature had better be on the
shortest route to our shared cove, I thought, or it wouldn't matter for
long where he led me.

Though only a little off my path, his trail rose steadily and was free
of the hidden boulders and pockets that had made my chosen route so
hazardous. It also provided the foot- and handholds I'd hoped it would,
and climbing was infinitely easier. Ahead only the occasional snap of a
twig confirmed his presence. For all his two-ton size and antlers rising
six feet above my head, he glided through the forest like a spirit. My
huffing and coughing must have been an unseemly din to him.

In minutes we crested the ridge. A blast of wind in my face confirmed we
were over. His prints kept their measured pace, but trusting his
affinity to find known pathways even in snow, I started the descent with
new confidence. Picking up speed, reaching from one tree to the next for
support, I pirouetted down the mountain in a mad slalom of "allemande
left, allemande right" from trunk to trunk. So invigorating was this
senseless speed into thick snow, I began giggling again at the absurdity
of my situation. Hunted by killers, saved by a moose.

I crashed right into the forming ice at the lake's edge.

A few seconds of teetering on my toes like a drunk kept me from diving
outright into the open black water.

Regaining my balance and my bearings, I knew the cabin was minutes away
on my left. The creature I'd staked my life on was nowhere to be seen.
His prints led to a few yards from the water's edge, then wandered off
north, to nowhere. He hadn't come to drink.

In the light of day it would seem that plain blind chance had caused our
paths to cross. But here, jubilant at my reprieve, readied for war, I
felt I'd been blessed and delivered to safety through that solemn beast.

The snow blurred his empty path. I turned in the opposite direction and
trudged toward the cabin.

In a few minutes I was going by the boathouse where the trees reached
the edge of the lawn. I stopped in the shadows of a large pine and
peered through the storm at the darkened, familiar refuge.

This lakeside path was farthest from the front entrance.

Anybody already there wouldn't expect me to arrive from this direction.
The downside was, I couldn't see the front entrance and if any snow had
been disturbed.

No telltale tracks or depressions covered by new snow ran around this
end of the cabin, but the structure was about a hundred and thirty feet
long. I stared at the large black picture windows overlooking the lake.
If anyone was inside, they would see me before I saw them.

I hung there, listening, watching. There was nothing but the snow.

I was getting ready to hurry to the end wall when the gravel-covered
area in which we parked and the entranceway at the far end burst into
light.

"No!" I breathed, and froze, still in the cover of the pine's shadow.
Expecting catastrophe, I waited. A light breeze caught the boughs above
me. They made a soft hushing sound as they swayed in response.

No shouts, no running boots, nothing. After thirty seconds, the light
went off.

The wind. It had swayed the trees and fired the movement sensors that
automatically went on when we arrived at night. It always happened in a
wind. I had learned to ignore it. But this night it made me jumpy.

Any jerks in the house wouldn't know it was just the wind. They'd be
watching now, but they'd be looking down the road, where they'd think
I'd be coming from.

Time to move.

My pause in the shadows had left me stiff. I groaned out loud as I
lugged myself awkwardly over the snowcovered lawn to crouch under the
gable end of the cabin.

I peered around the corner but saw nothing in the murk ahead.

I began creeping along the front wall, staying low to keep under its
many windows. I was a quarter of the way up when another gust of wind
whirled down the cliffs behind me and once again tripped the lights.
This time everything around me, myself included, was bathed in beams of
light in which the falling snow danced madly.

Pretty, but deadly, if it was still important I remain hidden.

But again, there were no shouts, no hands from anywhere to grab me.
Nothing.

Ahead the snow in the parking area and the path to the front was level
and undisturbed. While the light stayed on, I stood up and walked the
remaining sixty feet to the door. The glass was intact. The lock was on.
There were no signs of it being forced. No tracks led around to the
windows on the opposite end of the cabin that I'd been unable to see a
few minutes before. All I saw were soothing gusts of snow swirling
against the log walls.

No one was here. For the moment, I'd gotten ahead of them.

Once inside, the warmth compared to the outdoors and the wood smell of
pine logs provided its usual solace and comfort. I felt heady, defiant.
I could win this thing.

Doug's boys had binoculars. At the first sign of a hidden exhaust plume,
smoke, or an unidentified vehicle entering the property, they'd be using
the cellular phone to warn me and then summon the police from nearby
Holi Mont to "assist Detective Riley immediately." Then I would have to
make a choice. If I preferred, I could play it safe and clear out into
the woods. The killers, once on the property, were trapped. Doug's boys
would move their truck down and block the road and then hide out until
the cops came. If the killers got dred of looking for me or sensed the
trick and tried to get out, they'd be stopped by the roadblock. Then
they'd either waste their time trying to get their vehicle around it or
take off on foot, in winter, in the mountains. Easy prey, either way,
for the cops when they arrived. I'd finally know who my attackers were,
except this way all I might be able to charge them with would be
trespassing.

I hadn't told Doug my other choice. He never would have agreed to it.
I'd head out to the woods as the killers came in, but only to have more
room to maneuver.

Instead of hiding, I would show myself and provoke an attack. Until I
found the secret of the ER data that they so feared, I had no proof. I
had to let the police catch them actually trying to kill me.

In the vestibule, I dropped my frozen clothes and grabbed the phone.

I dialed the number of Doug's cellular; he flipped on instantly.

"Earl?" he asked, obviously waiting and worried.

"Yeah. I'm okay. The snow made it slow. I'm in now, and all's quiet
here." I glanced at my watch. 10:30. Three and a half hours since I
began my run. The trek in had taken over an hour.

But Doug had other news. "Earl, get ready to move.

We've got company here." I stopped undressing. "Already! Damn!" So much
for outmaneuvering them. "How? What have you got?"

"Look, it just may be watchers, like we anticipated.

Here on spec, without a clue that you're already in. But I want you
ready."

""What are they doing?"

"Watching. But get this. These guys have a pretty distinctive choice of
transportation."

"What do you mean?"

"One of them's in an ambulance."

"Shit." It had passed me on the road. Then I remembered the box van that
had been behind me when I drove south five nights ago. I'd seen its
brake lights in my rearview mirror after I'd taken the turnoff to the
cabin. It could have been an ambulance too. It was making sense fast. So
fast, I was holding my breath and going cold in my guts.

I exhaled into the receiver.

"Earl?" My mind was racing ahead. What was implausible before was
becoming a hideous possibility. If Watts's hunch was right and the rise
in derelict DOAS was from some maniac knocking off drunks with cardiac
needles, an ambulance with the help of equally ghoulish attendants was
the perfect cover. The calls would lead them to possible prey. Once they
had a victim inside, they could do whatever manipulations they wanted.
Screams wouldn't be heard over the siren. And if they were, what the
hell. It was an ambulance with yet another maimed and screeching patient
enroute to an emergency room.

And then they'd spread the corpses around the city. I shuddered. It
might be the how of the DOA epidemic, but not the why. And not the
connection to Kingsly. Nor to me.

"Are you there?" Doug asked again quietly.

"Yeah. But if I'm right, Doug"--I faltered, still stunned at the
probable scale of systematic killings--"Jesus!"

"Earl, tell me later. Now, just get ready to run!" But I stayed on the
phone. "Doug, this afternoon I estimated the number of DOAS in the city
this year. It's maybe what's behind all this, and they may all have been
killed like Kingsly and the derelict at St. Paul's. It took over a year
for the medical examiner to notice. Hell, it took me that long to
realize that one DOA every few months had crept up to over one or two a
month. If the other hospitals in and around the city have the same,
we're looking at a mind-boggling number of murders."

"Lord!" he exclaimed. "Are you sure?"

"No, I'm not sure, not at all. But like it or not, I just figured out a
way so many people could have been murdered." And slipped in unnoticed
under our overworked, preoccupied noses, I thought. Whoever was doing
this had cynically relied on our fatigue and usual indifference-- born
of overwork--to a dead vagabond. Again it had to mean that at least one
of the killers knew emergency and knew emergency physicians but this
time had played us like a program to hide corpses.

My distracted silences were obviously making Doug edgy. "Earl, figure it
out later. Get ready to move!

They're here. Let's call the cops!"

"No! We have to wait till they come in," I insisted, "just like we
planned, or I'm back to square one." I heard him sigh heavily, but he
didn't refuse to hold off our call for help. Thank God I hadn't told him
I intended to be more of a decoy than we discussed. Then another thought
fell into place, like a tumbler to a lock.

"Wait a minute, what do you mean 'one of them'?

There's more than the ambulance?"

"That's right. About ten minutes ago, another car arrived, slowly, from
the north, just like you in the cab. It went on south. A few minutes
later we see it coming back on the northbound, lights out, and it pulls
in behind the ambulance."

"What are they doing?"

"Like I said, sitting there."

"How many?"

"Can't tell for sure. No one's gotten out."

"Did the ambulance try to arrive on the q.t.?"

"Nope. It drove up, lights flashing from the north, did a U-turn at the
intersection near your entrance, and parked with the lights doused."

"Did my cabbie go out of sight way farther south like I asked?"

"Yep. As ordered."

"And their car went farther south before turning around, like the cab,
and afterward snuck back?"

"Right." The car had taken the same precautions I had; the ambulance
hadn't.

"Do you figure they don't know you're up there yet, watching them
watch?" I didn't like the pause Doug took before answering. Finally, the
best he seemed able to muster was a quiet "Probably."

"Probably! Hell, not exactly a battle cry of confidence." No answer.

"Doug, what's bothering you?" A wave of static came and went before he
answered.

"You mean besides the fact I'm looking at a nest of vipers who kill on
almost a daily basis? Well, it's that I think there's not enough of
them."

"What!"

"Your escapade at the morgue involved at least three people. We know
there's at least two down there, but I think that's all."

"How? I thought they didn't get out of their vehicles."

"They didn't. But one of my guys saw a cigarette tip glowing in the
driver's seat of the ambulance, and the same thing just now in the car.
Nothing in the passenger seats, and the glow just staring at your
entrance each time; no turning toward a passenger to talk."

"Maybe they don't talk."

"Maybe, but the way the tips are bouncing up and down, the two drivers
are talking to each other, or someone, on the ambulance radio or car
phone. Seems funny such chatty types wouldn't say a word to someone
beside them." He was reaching. I was beginning to feel guilty for
involving him at all. It was turning out a lot worse than we had guessed
back in my kitchen. "How can you see all this?"

"One of my guys has night binoculars."

"Where'd he get those?"

"Souvenir from"Nam. Amie and Norm are vets." I wasn't surprised. Over
the years I'd enjoyed the quiet closeness of these two large men. Even
in a crew of characters like Doug's team, their easy humor and
unflappability were a pleasure to be around.

"I'm impressed."

"Yeah, except they don't work so good."

"Which, Amie and Norm or the binoculars?" Doug chuckled. "Both. The vets
are fat forty-five-year-old warriors." I heard mock protests from
somewhere in Doug's cab. The morale was still good at his end. "And as
for the binoculars, well, let's say they worked better in "Nam, where it
didn't snow." How many killers there were had always bothered me.

"So we're missing a viper. Maybe it's still in Buffalo, looking. Maybe
we've confused them as planned."

"We might get a better count on how many are here soon; the snow's
letting up. Meantime, stay ready." He hung up without waiting for my
answer.

My pants and half-removed longjohns were twisted into partially thawed
ropes that lay in a cold puddle at my feet. I stepped out of them and
then extracted what was left of the computer printouts I'd stuffed
around my legs from the soggy mess on the floor. They were unusable, at
least for now, but might be legible if they were dried. I placed them on
a marble table over an electric heater. I gathered up the rest of the
clothing and carried it to the washing machine, where I dumped it.

Next I salvaged the disks from my inner coat pocket.

Thankfully, they were fine. Most of what I needed to start with was on
them. I'd need the printouts only if my first ideas didn't work out.

I peeled off my sweater and T-shirt, more soaked with sweat than snow,
and found that the printouts wrapped around my waist were just as wet as
the others. I added them to the table and put the remaining clothes into
the washer.

Naked and shivering, I quickly headed to the master bedroom at the far
end of the main floor, where I'd find something dry to put on.

This room was the windowed end of the cabin overlooking the lake where,
fifteen minutes ago, I'd been peering in from the outside, unable to see
anything. As I found my clothes and dressed in the familiar darkness, I
could see outside relatively easily. The snowfall was letting up, and
the lake was becoming visible to the end.

The dark trail of my tracks where I had run from the deep shadows at the
edge of the woods to the outside of this bedroom wall was obvious. But I
wasn't going to worry about that at the moment. It shouldn't matter
anyway.

Warm and dry, I grabbed the disks and headed back to the other end of
the house and the small room over the kitchen that held my computer. I
turned the screen on, and the gray glow bathed the keyboard enough to
work without turning on the room light. It didn't make sense, but I felt
better keeping in the dark.

The sprawl of numbers and abbreviated diagnostic categories spilled down
the screen and gave me a sense of security. I was back in my own realm
of expertise.

Here, amid the maze of a functioning emergency department, if one of the
killers had left aberrant signs, I had a good chance of ferreting them
out.

I entered the DOA category into the most frequent diagnosis menu so I'd
be able to subject it to the same profile breakdown I'd already done for
the major emergency case categories. DOAS would hardly ever command such
attention, apart from a footnote as to their proportion of our overall
mortalities. The killers probably counted on that too. The posts on
those derelicts would be done cursorily by frazzled pathologists
wondering what bureaucratic idiot was wasting their valuable time.

All pretty safe for our murderers, until Kingsly.

The screen flickered and retrieved the diagnostic categories I was
waiting for. I punched in the keys to call up a coded cross-reference
with individual physicians for the frequency of DOAS. The screen hummed
and clicked again to follow this unusual command.

I was looking for a fiend with the knowledge of someone close to the ER.
Hurst gave me the creeps, but he wasn't part of emergency or linked to
the data in front of me. Besides, he simply didn't have the ER mentality
that I'd sensed driving the work of the killer, especially the way Watts
had been set up--an ER drill with a live victim.

I sure had my suspicions about Kradic, and I had to control my dislike
of Jones long enough not to exaggerate what I thought she might be
capable of doing, but I also thought again about other doctors and
nurses I'd worked with for years. With a few exceptions, I realized I
knew nothing of their private dreams, desires, hatreds, or burning
causes. All I ever saw was their outward professional conduct. Did the
repeated rudeness of a triage nurse mean stress and insecurity, I
wondered, or a pathologic cruelty? Was the distance I'd seen some
doctors take from pain and fear a blundering defensiveness or a
carefully concealed sadism?

I winced, remembering an old school of so-called thought where respected
emergency physicians would roughly perform a not-so-necessary gastric
lavage on an overdose patient to "teach her a lesson." Thankfully those
days were over, but was one of them a fiend, hungry for a reason to
inflict pain?

Surely, though, killing, repeatedly and almost clinically, went beyond
any of the scenes I had witnessed.

I stopped myself, a little aghast, not because I had failed to guess who
might be the monster among us but because for too many I couldn't say
for sure who or what they were outside our peculiar cell of work. The
medical field had hidden murderers before. So-called doctors and nurses
had performed atrocities in Dachau and gone home to play with their
children. One such "healer" had dedicated his life to humanitarian
clinics in the third world before being tracked down after the war. In
the past year an esteemed physician in Oregon had slashed and strangled
six prostitutes over a ten-month period, then moved over to Europe and
was caught after a series of similar killings there. The DOA profile by
individual physician popped onto the screen and pulled me back to my
hunt for a current creep.

Nothing.

Fifteen physicians, identified by code numbers across the bottom of the
page, me included, made up the ER roster. A black bar rising above each
number indicated the number of DOA cases. No one stood out. Most had one
or two, a few had three or four, and a single physician apparently had
none. I shouldn't have been disappointed, but I'd thought maybe I was
smarter and more clever than whomever I was after and that a bar graph
would point to the killer. Obviously not.

I hadn't broken open the number code yet, so I had no idea who was who.
I'd do it later. At least I could eliminate suspicious thoughts about
the doctors with low numbers.

Perhaps I'd have to look at the two or three with the higher bars. As
Doug had reminded me, this was a nest of vipers, and we had at least
three snakes to trap.

I pressed the copy button, and as my noisy printer started drawing up
the apparently innocuous graph, I laid in the program to compare the
incidence of DOAS by shift. The noise of the type head stopped, and
while waiting for the new table to pop on the screen, I ripped out the
first graph and dropped it unthinking on the floor.

The grid for a week of work appeared, broken into three eight-hour
shifts--days, evenings, and nights-- starting at seven a.m. By these
hours doctors and nurses the world over live their lives.

A superimposed grid then made an hour-by-hour subgrid, and a spatter of
dots finally appeared spread out over the screen. Each spot was a
corpse. The groupings told us the times and days we were most busy with
the already-dead over the space of a year.

Visually I couldn't read much into it; the picture looked like a space
map with over thirty stars, a few more than I'd estimated. I then
punched in the analysis program that would plot any significant time and
day groupings.

This took a little longer. Carole had given me the program in a
simplified version for my lowly skills and PC.

The same exercise went much faster at her desk, with her machine, and,
more important, with her hands tapping in the commands.

Waiting out the hums and clicks, I stared at the first graph as it had
fallen upside down at my feet. I had been foolish thinking a simple
flick of a computer switch would give me a singular accusing bar graph
rising up over a killer's name.

Viewed from upside down, a black bar graph changed.

The white background became the bar. The white bars measured the
negative finds. And seen this way, one number had a massive white bar
under it compared to all the others. The negative find, no DOAS, was
made significant.

The code to identify this doctor was on another disk. I didn't want to
stop the program already plotting DOA times midrun, so I waited, growing
steadily excited that the absence of bodies might be the slip-up I was
looking for.

The screen sprang out an ordered collation of times and days. There was
no preference of days, but twenty-five of thirty-one DOAS had arrived in
the morning hours. Most of those arrivals were between eight and ten.

This was a huge bias, but it could mean nothing more than that the
derelicts who had died or been killed overnight got found in the morning
and were sent in then.

Our doctors worked shorter blocks of time than the nurses and overlapped
their shifts. This strategy lessened the stress and fatigue inherent in
ER work. I requested that the schedule of individual doctors over the
last year be correlated with the exact time slots in which there'd been
DOAS, and that the result be represented by a bar graph again. As I
expected, no single physician worked these slots more than any other,
but this time I was ready for the negative find. Long white bars rose
over several numbers, distinct from the black columns over all the rest.

The numbers with white bars hardly ever worked mornings. They included
the same code number that had no DOAS.

Again, by itself, there was nothing sinister about this.

Some doctors simply preferred afternoons and evenings and didn't work
mornings because of competing schedules and commitments outside the
hospital. That had been my own preference before I became chief.

I played some more with the schedule data and asked for a list of the
M.D.s preferring evenings and afternoons.

As I expected, this consisted of about half the department. This group
included the number I'd started to track.

Then I played a hunch. I shifted back to the DOA time and day graph and
combined it with the year's schedule.

I asked for a correlation between the DOAS and whoever worked the
preceding shift.

This was a very unusual request, and the computer had to whir and click
much longer than before. As I waited, a cold draft stirred at the back
of my neck. I absently added this room to the list of ones that Doug was
to caulk against leaks. It was an early winter routine that mercifully
lessened each year as the logs in the newer parts of the cabin finished
settling. The older sections, permanently cozy, gave me faith the
process would end someday.

As I sat there in the dark, listening to the machine while the gray
light on its screen nickered, I felt chilled despite the warm clothes
I'd put on. I'd get a sweater as soon as the program finished.

Just then the screen snapped into yet another horizontal spread of
vertical bars.

Except this time I had my markers, two in fact, one white and one black.
The black bar rose like an obelisk above all the rest, but not over the
number I now knew by heart. Above that number was a white column.

It was like looking at a positive and a negative. The physician I'd been
tracking virtually never did a shift prior to the arrival of a DOA. The
doctor represented by the black bar was on duty before most of them were
brought in.

I spooled back over the graphs I'd constructed and tracked this new
number through their grids. I began to see what it might mean.

Before changing disks and activating the program to the identity code, I
wanted printed backup of what I already had. Years of being computer
stupid included some bitter "save-it-while-you-got-it" lessons. I also
no longer completely trusted my ten-year-old clunker; it sometimes
jumbled text and then showed a little bomb sign that meant I was out of
luck. Before risking yet another disaster with the drawn-out routine of
switching disks to make duplicates, I started running off paper copies
of all the graphs. The printer sounded like a sawmill, laboriously
grinding out each line I'd just concocted.

While waiting, my fingers tap-danced the passing seconds on the blue
surface of the disk containing the names.

One minute; one sheet finished. Five more graphs, and five minutes to
go. What a dinosaur, I thought, and decided to go back downstairs to get
a sweater.

As I walked through the kitchen and started toward the other end of the
house, I could hear the stutter and whine of the printer overhead. It
got quieter while I made my way through the cozy sets of chairs,
couches, and small tables in the darkened living room, our chatting
areas and reading nooks in happier times.

Soon the noise became a dull whir in the distance behind me, stirring my
thoughts. I figured I understood why one physician was never around and
another was nearly always present prior to the arrival of a DOA at St.
Paul's. And if I was right, that same telltale pattern would hold for
most of the other DOAS recorded around Buffalo--if I lived through the
night and ever got a chance to check that data.

I walked down the hallway that led to the master bedroom.

It was even darker here, and I had to feel along the walls. I still
didn't want to turn on a light.

So many DOAS; so many statistics--yet some numbers had a vague
familiarity. More chairs and nooks. I felt my way by them in the dark.

What other riddle involving numbers had I looked at recently? Stats
related to the emergency study? Probably, and possibly of no
significance.

I entered our large bedroom. After the darkness in the rest of the
house, I found the blue glow of moonlight coming through the big corner
windows more than enough to see by. Outside, the snow-covered lawns and
surrounding thick forest were now equally visible. Doug had been right;
the storm had stopped.

I found the sweater I'd remembered stashing in a bureau drawer and put
on the pullover. The lake, still open, stretched out darker than the
night, black glass set in a shore of white. I could even see under the
pines at the edge of the lawn, where an hour ago I'd huddled in the
shadows and watched for signs of someone inside.

It was probably a good thing they weren't, I thought.

From the dark in the room I would have been spotted easily as I ran to
the cabin.

The cut of my tracks stood out like a laceration in the moonlit snow,
deep with shadow. It looked darker than before, like a line of dried
blood. Not much snow had fallen since I got in. But as I watched, I let
my memory wander, struggling to recall what relationship these pieces of
data had one to another.

Possibly. For some reason the word drifted into the back of my mind. The
word probably floated in as well.

Why did possibly and probably connect with the elusive numbers I was
trying to recall? Three hundred? The number seemed to come out of
nowhere. Three hundred what? My memory refused to divulge the source of
that figure. I was ready to dismiss the silly little words as one of
those trivial loops the mind can fixate on. But the loop continued to
play, and the word study joined the others.

They all swirled around like an annoying anagram that defied solution
until, just as abruptly, the words settled and changed for me.
Probability. Possibility. The chance of error of a study. The source of
a p value.

I knew whose name I was going to find under the white bar on the code
disk.

The phone rang like a scream in my ear.

I yelped without realizing it and spun around. Quickly I picked up the
receiver of the phone beside the bed. I didn't even have a chance to say
hello.

"Earl, get out!" Doug shouted. "Get out now! A second set of tracks
followed you in. Get out now!"

"Second tracks?"

"Don't talk! Just get out. They've pulled an end run.

The car that came up after the ambulance must have pulled the same
maneuver the cab did with you and dropped at least one of them off at
the same spot. We didn't see it at first because of the storm. They're
coming for you through the woods."

"Doug, I think it's just a moose!" There are qualities to a silence in
which you know, with absolute certainty, that people have decided you're
insane. This was one of those moments.

Finally, Doug asked, "Earl, is this a code? You're in trouble, right,
and talking gibberish is meant to tip me off?"

"No, Doug, I met a moose. It followed my tracks. Hell, it led me out of
the storm to the lake. It's just a moose."

"I don't believe it."

"Christ, did you call in the cavalry yet?" His stony silence started a
rising dread he'd blown our cover, but finally, reluctantly, he said,
"No, I wanted you out first." More silence, then, "But I don't like
this."

"How'd you just see the tracks?"

"The night binoculars are great once the snow stops." I knew now the
computer was going to give me a name, a suspicious pattern on a
schedule, but no proof. I could accuse, and arouse suspicions, but not
necessarily convict. I still had to get Doug to wait. "Well, relax. It's
nothing," I said to him. "Let's watch a bit longer." There was more
doubting silence on his end. "Hold it a sec," he said.

I heard him carry on a hurried conversation with one of his guys in the
truck. I could hear a snatch of Amie's twanging. "No fuckin' way that's
a moose track. Moose leave prints; that's a steady human track. And it's
too fresh. Dr. Garnet's tracks are already half covered, barely visible.
These couldn't be more than an hour old. Get the idiot out of there."
Amie had hunted both men and animals. He was edgy.

As I listened, I found my mouth going dry. I involuntarily pressed my
back to the wall. I peered across the dim room and out the window to the
dark trees where my path left the forest.

Upstairs the clatter of the printer abruptly stopped. A shutter thumped
the wall in another part of the house.

The logs creaked in the wind, and a puff of snow flew against the panes
of glass across the room from me. The printer sputtered to life again in
the distance. It must be almost finished.

Doug came back on and diplomatically translated.

"Uh, we got a serious difference of opinion here. Look, I want you out
of there till we sort it out. Have you got that dinky little portable
phone that works near the house?" I'd bought it for work in the garden.
Doug had borrowed it during projects here in the old days before he got
the cellular.

"Yeah, I got it. What are the two watchers up to?"

"Nothing. Just sitting there."

"If someone else is on the way in, how'd they know I was here?"

"I don't know! Look, just get out of there. Go up and hide in the cliffs
behind the cabin. We'll watch these turkeys here. If they move or anyone
shows up where you are, we call the cavalry. Phone me when you're
outside, to check that your cheap walkie-talkie talks." In a flash I saw
what we'd forgotten. "My tracks!

They'll see my new tracks heading out again and follow them right to
where I'm hiding." Even though I'd decided to be a decoy, I thought I'd
have control of when I'd allow them to see me. Then I could have timed
it to happen just before the cops arrived. The Holi Mont police were
about ten minutes away, and we'd told them to come in without sirens
when they got our call. But now, instead of dodging the killers for a
few minutes, hopefully long enough for them to incriminate themselves, I
might be at their mercy a lot longer, no matter how quickly the police
got there.

Doug's silence confirmed he hadn't thought of this either, even with his
safer version of our plan. We were improvising now, and our scheme,
either way, was coming apart.

"Earl," he said urgently, "it's gotta be that you head up the cliffs and
watch for them from there or I call the cops now and scare them off." He
let this sink in, then added, "It's your call." I was getting scared,
but leaving these killers free frightened me more. If the secret of the
bar graph was what I thought it was, my "accidental death" was not only
to keep me from trying to expose a mass murderer, it was to allow the
killings to continue. "All right," I agreed, "I'll hide in the cliffs,
but we wait and watch. I'll call you when I'm outside."

"Remember, take off through the woods back toward the highway as soon as
we call the cops. They'll probably check out the cabin first before they
start tracking you again. If the cops get here fast, we might even trap
them while they're still in the house." But he sounded pretty tense
about our prospects.

"Okay," I answered, "but did anyone ever call you cheeky and bossy?"

"Wait till you see my bill." He hung up.

The click that ended the call stuttered and became a dial tone. The
drone was unpleasant, like a fly in my ear.

I'd wanted to tell him what I'd found on the computer and whose name I
expected to reveal with the identity code in case anything happened to
me. I decided I'd call him back as soon as I was safely outside.

I glanced back at my outside track through the windows.

How did they get on my trail, get a car up here, and replicate my slow
drop-off?

I visualized rolling out of the cab; the hollow was completely invisible
to the rest of the road. Hell, I saw the dimming taillights of the
departing cab go out of sight over the rise between the watching
ambulance and me.

They couldn't have seen me.

As I stood in the darkness looking out, I replayed the image of the
departing cab. In my mind I saw the shadow of the driver hunched over
the dashboard, then taillights.

Suddenly I had it: The dash. The radio. The ambulance must have been
monitoring the cabbie when he'd radioed in. He probably mentioned
dropping off some lunatic in the woods. The ambulance driver would have
realized it was me. And now they were coming in the same way.

I moved away from the window and turned toward the hallway. The portable
phone was at the other end of the house on a charger in the guest
bedroom. I'd grab it and call Doug once I was outside. Time for the
cavalry. I was halfway through the dark passage before I remembered what
I'd find: a phone unplugged.

I always unplugged the damn charger when we were away. It got too hot
while charging, and I was worried it would short and bum.

I'd use the phone at the entrance and then get out to the cliffs.

I had reached the long hallway that passed from the living room to the
kitchen. The vestibule and entranceway were about halfway down the
corridor that stretched ahead of me, I heard another burst of noise from
the printer upstairs.

Then a gust of cold air caught my face.

I went still. The door was open! Or was it another draft? I'd stopped
breathing. More cold air blew against my skin. My thoughts raced ahead.
The tracks outside hadn't been darker, they were deeper. They'd already
gone by. My tracker was in the house!

I was too still. I had to buy seconds to get out, which meant I had to
keep moving. I couldn't let on I knew the killer was already inside.

As I made each step, I thought I'd be jumped.

I crept up to the entrance of the vestibule and peeked around the door
frame.

Empty. The outer door was closed, but a cool, steady breeze came at me
from where the pane of glass beside the lock used to be. I slipped into
the vestibule but kept watching the dark corridor by backing to the
door. With my left hand I made a grab for my boots; my right fumbled
blindly behind me for the handle. The floor was wet with melted snow. I
stepped on the missing pane of glass and crunched it. The suction cup
that had removed it was still in place. If I cut my foot, I didn't feel
it.

Above me the whine of the printer stopped. The silence was as still as
my breath.

I felt the thudding up the dark end of the hallway before I actually
heard the running. I was more startled by a steady rising beep, familiar
as a heartbeat, but grotesquely out of context here.

I got the door partly open behind me as a figure in a black ski suit,
gloves, and mask neared the vestibule. The beeping increased its
crescendo. The intruder was holding out two paddles, like lethal suction
pods. They were connected by coils of wire to a small monitor slung on a
shoulder strap. The beeping had reached a steady scream. The paddles
were fully charged and ready to deliver. A single jolt and my heart
would be a fibrillating sack, useless as a bag of squirming worms.

Before I could get out, the partly open door behind me was slammed hard
into my back. It sent me flying facedown on the slate tiles at the boots
of my attacker with the paddles.

The air flew out of my lungs with an involuntary roar.

One of the boots came down on my head, and pain exploded over my skull
and down my back while my throat burned with surges of vomit. A heavy
knee dropped on the back of my legs. My sweater and shirt were ripped up
my back to the bottom of my neck. The one with the bootsi could feel the
heavy corrugated ridges on my scalpplopped the paddles, cold with
lubricant, on the back and side of my chest behind my heart.

I was going to die. I started to flail and squirm, but pretty weakly,
given I couldn't get my breath. I clutched feebly at the boot on my
head. I thought of Janet, of my unborn son, and finally gurgled in
enough air to sob, "Please!" All I got was a gruff "Stand clear!" The
knees went off my legs and the boot lifted off my head, but the full
weight of the hooded creature bore down on the paddles, crushing my
chest into the tiles. I still couldn't breathe in. I weakly raised my
head and spat out vomit. I started kicking jerkily with my legs but
touched nothing. Drooling and sputtering more vomit, I strained my head
up a few inches higher. Above me, my attacker stretched in a grotesque
push-up, arms straight and pinning my chest to the floor with full body
weight on the paddles. Legs akimbo and out of reach.

Behind the oval mouth hole in the ski mask, I could see a red leer.

A little flick from within the black eye slits invited me to turn my
head farther around, to watch the paddle handles and the gloved hands.
The screaming tone kept shrieking in readiness. Knowing I could see, the
blackgloved thumbs moved with sadistic slowness to finger, to caress the
red buttons.

Then a familiar voice, a voice I knew, the voice I expected, hissed, "So
long. Doc." The thumbs hit the buttons before I could curse the name.

Chapter 16.

The juice kicked through my chest. The whack of its force hit me like a
train. White light shot up over my eyes and head. My ears recorded a
loud whump, like kerosene rags igniting. Then they sealed off, filled
with a hollow ringing.

An unsynchronized shock can restart a stalled heart, but it will stop a
healthy heart cold. Mine was no longer beating. It had been reduced to a
quivering, disorganized mass of muscle. But I wasn't out. Not yet. That
would, could, take thirty seconds. That was the point. I had enough time
to know I was dead.

Shocked still, my heart no longer pumped blood. Air hunger mounted in my
chest, then drove me to make useless gasping movements--my turn to
endure, like a stranded fish, the longest seconds at the end of a life.

I didn't like it. I felt no peaceful ascending and looking down at my
remains. This hurt. I remembered the eyes of men and women I'd seen die
over the years, awake and knowing as they shut down. I'd pampered my
horror with the platitudes "It was quick; they didn't suffer." This
wasn't quick; the suffocation was slow, sure, and the tips of dying
nerve ends hurt like hell. I strained for a gulp of air but got only
futile twitchings from muscles that no longer worked.

I wanted the end, I wanted out of the agony. Please, I begged, let the
blackness come. End it!

But that fight for air is the most powerful drive in the human body.
Life begins and ends with it, and it's as ancient as the first primitive
gasp that hauled life out of the swamp. It wouldn't let me go. There
were no childhood memories, no rerun of my life; only that squeezing
urge to breathe.

Vaguely, in spite of the pain, I realized that thirty seconds must have
passed. Why wasn't I dead?

I must have been rolled onto my back, because I started to sense someone
pushing, not unpleasantly, on the front of my chest. Next, bursting into
my lungs, I felt a rush of air explode the vise of asphyxia. Again,
again, and again. It was like sex, like coming, release.

More pushing, more volleys of relief.

The whiteout in my eyes began to clear. Shadows speckled with light
moved above me. The ringing dimmed a notch; voices vibrated through the
din.

More pushing, more relief. I could feel a mask applied to my face.

These creeps were resuscitating me. They were bagging air into my lungs,
compressing my heart.

The voices organized to speech. I still saw only shadows dancing above
me.

One of the shadows barked, "All clear!" The other form withdrew. The
precious puffs of air stopped, the vise in my chest clamped back down.

They were stopping. I wanted seconds more. Don't stop.

Not yet!

I sank back into the airless pit. I still could see the remaining shadow
lean over me. I felt more pressure on my chest.

Another ignition of white light exploded up my eyeballs, arched through
me, and flopped me back on the floor.

My world stayed white, but the vise on my chest was lifting. This time I
could even feel the press of the reapplied mask on my face and a
delicious flow of air bagged into me. My ears were back to ringing. I
couldn't move, couldn't twitch a muscle, but I knew my heart had been
restarted. Hey, when you've been down to the last ticks of the second
hand, you take what you can get, although even in my recently fried
state, I figured I wasn't exactly in the care of a concerned team of
health professionals.

I tried taking inventory. Breathing on my own was slowly coming back,
the mask assisting my still-feeble efforts. Talking was impossible. My
tongue felt the size of a salami. I could only gurgle pathetically. My
sense of smell was all too functional; I was lying in a pool of my own
urine and feces. Everything hurt, nothing moved. Anoxia, acidosis, and
postresuscitation myalgia were the medical terms. In reality, it was the
wall of screaming muscle pain marathoners hit when their bodies run out
of oxygen. I was powerless, effectively paralyzed. Their specimen. They
had turned resuscitation into an instrument of torture. Any move by them
could plummet me back to a slow and lingering horror, death.

The flashing lights subsided. The hooded shadows became silent ski
masks. Behind the odd "0" eyes and mouth shapes, I looked for some shred
of pity, doubt, or change of heart. Instead, the eyes above me revealed
a cold indifference. In the one bagging me, the lips were thin,
grimaced, neutral. The other, hunched over in front, leered at my
increasing fear. The mouth was hideously familiar. I knew she would
speak, would no longer take the trouble to hide. She would leisurely
savor a running commentary on my death, or deaths even, repeated over
and over, as long as the cruelty pleasured her.

"Go check his computer. See how far he's got!" Jones's voice was cool,
matter-of-fact, the voice of a practiced clinician, familiar with the
process. The other figure left without a word.

"So, who'd you tell. Doc? Or did you figure it out yet?

Before you go, we have to know." Her leer returned at her own accidental
rhyme. My attempt to reply was still a gurgle.

"Fuckin' Kingsly. Came up on me in the path lab that night. I think the
slob went there to hump the corpses when-he couldn't find a stray woman
to paw. He caught me with one of my subjects. Even stewed, he knew I was
being a bad girl. He started loping off down the hall, hollering.

I had to run after the dumb fuck. I grabbed my cardiac needle and caught
up with him easy enough, but he was thrashing around like a cornered
pig." I heard more gurgling. It was my breathing. I tried to turn my
head to get rid of the drool and vomit, but I couldn't move.

"Oh, airway trouble. Doc. You were always the stickler about teaching
the importance of managing an airway." With a vicious twist, she
wrenched my head to the side. A sour goo ran out the corner of my mouth,
and I stopped choking. But every part of me felt encased; I couldn't
seem to move at all. Even my eyes had trouble turning back toward my
tormentor's voice. I gave up trying to see her. If she was talking, she
wanted me able to hear. That's all I was reduced to--listening and
gulping air, grasping a few more seconds.

Her voice dropped the clipped neutrality. "Did I do that good. Doc!" she
exclaimed. I could feel her breath on my ear. "You hear me. Doc!" she
shrieked, and snapped my head back around, grabbed my chin, and pinched
hard, putting her face right up to mine. Her eyes, dead before, now
seethed with fury, a ferocity I'd diagnosed and felled with Haldol many
times. This was one sick cookie.

She switched back and donned her cool indifference like a gown. She
studied me, her specimen, and continued her dissertation.

"So I had to settle him down. Doc, get him positioned, you know what I
mean. So you know what I did? Hey, you're going to love this one. I
ripped open my shirt and showed him my titties!" At this revelation, she
snapped her head upright and waited, real delight on what I could see of
her face, as though she expected a laugh from me. When none came, she
shrugged and went on with her tale.

"Dumb fuck went for them, like a bull to a red flag, sucking and
slobbering all over the place. I had to get my back up against the wall
to support his weight. As he entertained himself, I got his shirt
unbuttoned, slid in the needle tip, and did an underhand into the
heart." The recollected moment brought another smile. "Funny, he was so
into my little titties, he didn't realize at first he was dead. Kept
sucking away." The smile faded, the voice hardened. "Then he dropped;
broke the needle.

Sprayed blood everywhere and peed all over me as he went down." She
seemed transfixed as she continued. "Stripped off his shirt and pants,
cleaned up the blood, got him into a wheelchair, and bagged his clothes.
I covered him with a sheet and had to switch into OR greens myself, in
case a stray guard saw us, but they didn't usually go to administration
at night. I got him up the freight elevator to his office without being
seen." She'd started out by taunting me but now was staring off into
space as I'd seen her do so often at staff meetings.

It was as though she'd repeated what happened many times before,
compelled to reiterate her downfall, like a liturgy for her own undoing.
"I dumped him on the carpet," she continued, not even looking at me,
"wiped off his chest again with alcohol swabs, and cranked up the heat
to dry him off. By that time the blood had clotted and the puncture site
was just a tiny scab. With what everybody knew about him, they'd still
think he'd tried to have sex somewhere, stumbled back to his office in
his underwear, got cold and turned up the heat, and then died from a
heart attack. I slipped back to the morgue, cleaned off the wheelchair,
called in my ambulance, and whipped the derelict I was working on, the
bloody clothes, even the sheet, out the back door." She stopped, seemed
to see me again, and added, "Did you know you can move a body in a body
bag in and out the back door of a hospital morgue at almost any time
during the night and nobody questions it? Everybody assumes it's a
pickup for a funeral home." She looked proud, but seconds later the smug
expression faded and her face took on a hardness again. "Who would've
thought a stupid civilian would pump a corpse?

Hell, no doctor would have. Even with the heat, Kingsly would have been
stiffening up after five hours." Her eyes were filling with rage. "And
you," she snarled, grabbing my hair and leaning toward me, "you homed in
on the call, noticed the blood, and found the needle. Then you just kept
pushing. Watts's little pointer. When you called to ask Kradic about
needle stabs and the DOA, I knew you were getting close to what was
really happening and you had to die too. Even without Watts, it'd be
only a matter of time before your damn ER data gave you my name. The
rest, as they say, is history, and so are you, you pompous,
self-righteous prick." She slammed my head back on the tile floor.

I had at least started swallowing again, but the stench of her breath
and the pain in my skull promised new vomit to choke on. I tried to pull
my face away, but instead she gripped my chin again with her fingers.
"How about you. Professor?" she whispered. "Do you want to suck my
tittles while you go?" She suddenly brought her head so close to mine, I
could see only her eyes. "Don't worry, I won't tell your precious
Janet." My fury snapped through me like a jolt of current. If I could
have moved, I would have torn into her like an animal, with teeth,
hands, fingernails--anything.

Just as abruptly, she moved back, and I was being eyed as a specimen
once more. She returned to the defibrillator monitor on the floor beside
us. Quickly she set the machine at ready and picked up the electrical
paddles.

She began slathering lubricating gel onto their surfaces.

Over her shoulder she bellowed to her partner, still upstairs,
supposedly with my computer records. "Did you find anything yet?" The
reply was muffled but satisfied her, something about "in a minute,"
which was probably how long I had.

I tested if I could move anything. I got a finger to twitch.

She kept circling one paddle on the other, languidly spreading the
lubricant as if absently stirring a bowl of batter. I noticed she'd
taken off her gloves.

"You know," she said softly, "if mag sulfate had been the magic bullet
to resuscitate arrests the early studies had hinted at, my trials would
have discovered the standards for the most effective dose and
administrative protocol long before the rest of the world. Other
researchers in the study were tied to the tedium of double-blind
randomization and limited by having to wait for natural arrests to
occur." She kept circling one paddle on the other and staring off into
space. I tried to move my hands.

"And the delays, they always had the delay before they got to the
subject. I had them fresh; time didn't obscure my results. Sometimes I
could run up to ten treatment protocols on a single specimen before they
were gone for good." More silence, more circling. A faraway look glazed
over her eyes. I knew her fever. It was like Femandez's, but on a much
greater scale. Jones was after the adulation of sensational health
research. The same forum of recognition and respect that so enthralled
Femandez, but multiplied tenfold. At this level there was the
possibility of big bucks. The drug-company cash available for backing a
winning record was phenomenal. Discovering a drug protocol that
dramatically increased survival after heart attacks and cardiac arrests
would be heralded everywhere and set its founder up with research funds
for life. Jones had been after a breakthrough in resuscitation, a kind
of Lazarus protocol, a new and better way to raise the dead that would
catapult her to the head of the field.

I could hear her bitterness; "It wasn't there. Mag sulfate, the cheap
heart saver, didn't work much better than the usual treatments." Then
she stopped circling the paddles and looked down at me. "But Doc, I
couldn't let all that risk, all that work go to waste. No, I grabbed one
corner of resus protocol and made it mine forever." She leaned forward.

"Did you figure it out yet. Professor?" It was a command, an order to
see and acknowledge her genius. And I had figured it out. Torsade de
pointes.

An obscure, rare dysrhythmia, never frequent enough to give the
opportunity for much definitive study, had started turning up
unexpectedly as one of the dysrhythmias in patients on allergy
medication, like terfenadine, in combination with antibiotics, like
erythromycin.

Those were the drugs found in our DOA. When the health warnings first
came out, Jones had seized on the knowledge to salvage something from
her failing murderous quest for recognition. Alcoholics had been
injected, probably intracardiac, to produce torsade de pointes and give
Jones enough cases to get the best protocol with magnesium sulfate. Then
she buried her data in the Buffalo cardiac arrest study.

But the p value for her results, the probability of certainty over
chance in scientific studies, was far too good for the small number of
cases the Buffalo area should have had. That's what twigged when she ran
her study by me--her possibility of a result due to chance was below a
probability of one in ten thousand times. She must have had nearly three
hundred cases to have such certainty.

Of course, she'd never spelled out her study size. She never had to. She
was sentenced to having her name confined to a minor find, just a
footnote added to a larger investigation. A mention, a p value, nothing
more. There were no detailed numbers or data. She couldn't afford closer
scrutiny. But the rarity of naturally occurring torsade de pointes
wouldn't invite much interest. Her study would be a little oddity in the
literature of cardiac arrests.

To end with so little; to have hungered after so much. To have caused so
much evil.

I had to stop her.

She placed one of the paddles on my chest and languidly spread the gel,
absently, almost tenderly, like greasing up a lover. Her eyes were far
away again, as if locked on her failure.

I could still feel the cold slush from melted snow under my palms. I
could move my hands enough now to press them against the wet dies.

She stopped stroking my chest. The paddle had smeared itself dry.
Sticking to my skin, it tugged her focus back on me. She troweled on
some more gel, but roughly this time. "What the hell's keeping you!" she
screeched over her shoulder.

There was another distant murmur. I heard the floorboards above creak,
followed by the heavy thud of returning steps.

The other figure loomed behind her.

"Anything?" She was curt, clinical now.

The figure stepped around in front, shook a masked head. My sight was
clearer. I could see white stubble lining the silent mouth. Older; male.

"Good for you. Doc. No entry to the identity code logged. Got here just
in time." She turned to the dials.

"You hadn't gotten my name yet." The click of the sync switch going off
sounded like a cocked pistol.

"So now a little heart attack. All that paranoia, running around, and
sneaking in through the snow. Too much stress. Popped your mind; blew
your heart." She. spun the charge to full. "Nobody likes their easy
answers messed up. Not the cops, and definitely not Hurst. They're gopna
love this." She plopped the paddles on my chest. I tried to strain away.
My fingers flexed, my arms budged a little, but I was still unable to
move the rest of my body. The beeping steadily rose toward ready.

"Grieving widow, unborn infant already fatherless." Any reserve I had
went into a gurgled roar.

It surprised her, then tweaked her interest. I felt her lean on the
paddles. She put her thumbs over the buttons and wiggled them.

"So, a little response. I thought this was going to be boring. That
you'd be classy to the end with this stiffupper-lip bit." She brought
her mouth down and exhaled.

"Want to beg?" I started moving my head, tried to spit in her face, but
managed only to drool.

"Oh, so fierce," she mocked. "Good. Hate me! I'm taking away your
miserable high-class fucking life." My legs shuffled uselessly, but my
hands were opening and closing, squeezing the slush between my fingers.

"Ah, that's good," she crooned. "I like them writhing." She was
breathing hard enough now that I believed her.

She pressed just one thumb down on the red button. I braced. She kept
the left thumb up, twitched it. I tried not to close my eyes but kept
staring at it. I was going to get only a fraction of a second to do
this, and it would have to be the right fraction.

"Yes, yes," she teased, caressing the button now.

"Fuck this shit!" hissed the figure behind me.

The voice. I knew that voice.

Jones reacted as if she'd been slapped. She glared up at him, forgetting
me for the moment but still leaving the paddles in place. "Don't you
ever speak to me like that," she said. "Do you hear me! Don't ever
interfere with what I do!" I saw the large shape turn and heard the
latch behind me snap open. Cold air ran over my head while his footsteps
crunched as he walked away over the snow. He didn't bother to close the
door.

Jones squatted, hunched over her machine, her shoulders drooping. After
a few seconds the piercing tone of the monitor seemed to revive her. She
gave it a final look, then turned abruptly back to me. I got ready. I
was going to die, but I had a chance to take her with me.

She pressed the paddles hard down onto my chest. I gasped one final
breath and grabbed for her hands.

Her thumbs dropped. I exhaled a scream. The white explosion roared back
through my brain. I felt the current lock my wet hands to hers and curl
our fingers into spasms, clamping us to the paddles. Through the pain, I
heard her shriek--an explosion of sound blown out of her lungs as the
direct current convulsed her diaphragm. I'd gotten her!

Then my hearing sealed off, and the searing grip of electricity snapped
through my back, arms, and legs. It shot my muscles into a fixed
seizure. My back jerked into an arch, my arms jammed into my chest, my
grip on her increased.

For that fraction of a second we were arched away from each other, yet
fused in the extended agony of a violent convulsion. When the discharge
ended, we both flopped back down--released, and dying.

I could feel her twitching on top of me, fighting for air, the same as I
had done. She must be aware, gasping in pain and terror, as I'd been,
and as so many others had done under her cruel watch. I felt no
forgiveness, no pity as we hurtled toward death together. I wanted her
to fight it, to feel the horror of knowing she was already dead, to
strain for air that would never come. To endure the long seconds at the
end of her life knowing I'd sent her to hell.

I went easier this time. Already weak, and with no one pounding my chest
or shoving air into my lungs, I fell back to black.

The rush into silence was unseemly. I tried not to struggle, to just let
go. A vision of Janet came, then vanished.

Even the rage and anger faded. My last thought was that I'd stopped
Jones. I felt an acceleration, but it was more a dispersal in all
directions than any real movement-- spreading out--like a drop of water
going back into the ocean. Death as a diluent.

Suddenly there was a flash, followed by another. They were more
whiteouts of the black than anything I could actually see. This wasn't
part of the ride. The hurtle slowed, reversed. The sound of surf began
rushing in and out of my skull. I was going back. That bitch wasn't
dead! I thought, suddenly terrified again. She was bringing me back! The
surf got louder. A tunnel burrowed into my throat. I was rising fast,
welling back to life with the surge of vomit that flew out past the tube
now snug in my airway. Seconds later I became very worldly and simply
fainted.

The sounds of surf were back; steady, running in, running out. It was
the sound of my own breathing, noisily pushing up and down the tube in
my windpipe that felt like a garden hose. I seemed buried alive, so
heavy was each limb, every finger immobile. What flicker of brain
activity I had left was enough to fear more games. It became essential
to open my eyes. What was she going to do? Why was I still alive? Why
was she? The rushing sound of my own breathing blended with a tinny
rumble.

A voice? Was someone speaking to me?

I felt hands on me. I got ready. I still couldn't lift my lids. Had the
bitch stitched them closed? I could barely manage a good flinch.

But the hands were gentle. The breathing got less loud, and the rumble
organized itself into a man's voice.

He kept saying two words, but they were garbled. He repeated them, and
finally I could hear what he was saying.

"I'm sorry." All at once the hands, and the voice, were gone.

Everything hurt, even my eyelids. I finally opened them, but it didn't
matter. The hallway was dark, and I wasn't past seeing just blurred
shadows anyway.

My breathing kept me company. Any gagging I felt didn't amount to much.
I was too feeble to vomit.

I heard a sound, rising and falling like my breathing.

Except it was higher, annoying, getting louder. A siren. It seemed to be
right in my ear before someone mercifully shut it off. I heard doors
slamming, boots crunching on snow. Then I felt a shot of cold air over
my head as the door flew open and my new visitors arrived.

I sensed more than saw one of them kneel by my side.

"Are you all right?" he demanded.

Sure, I'm lying there in my own pee and crap, had been dead twice, and
now I didn't have the strength of a polio victim, but sure, I'd reassure
my rescuer. My brain said "nod." What my head did, I don't know, but it
must have budged.

The man, who was still blurry and unrecognizable to me, leaned back as
if relaxing. "Wait till you get my bill." I couldn't see yet. My vision
remained a blur of speckled lights. Any effort to speak left me gagging
on the tube in my throat. I could hear their voices, but they sounded
pretty far off and faded in and out like a poorly tuned radio. In the
background I recognized the steady hum of a vehicle moving fast.

I was still barely able to move, but I had to get that cursed tube out
of my throat. It was making me cough and retch continually now. I tried
to move my arm and feebly brought my hand up to the part of the tube
sticking out of my mouth. I got my fingers around it and pulled.

Whoever had intubated me hadn't inflated the cuff to keep the tube
secure. It slid out easily, and while the extraction had left me
coughing and spitting, I immediately felt better.

Someone supported me when I tried to turn on my side and clear my mouth.
I heard Doug's voice say, "Easy, Earl."

"What happened to Jones?" I managed to croak after I caught my breath.

Doug didn't answer at first. "Was that the woman we found beside you?"
he asked after a few seconds.

"Yeah," I answered. I'd forgotten he didn't know her name.

He waited, then told me, "She's dead. Earl." At first I didn't feel
anything in particular. Not relief, not triumph, not even a sense it was
over. It worked, I thought almost neutrally. My grab at her hands had
worked. I seemed to accept this outcome the same way, as a physician,
I'd have accepted the successful outcome of an attempted therapeutic
act. Then a horrible feeling of emptiness came through me--a hollow,
sick feeling-- absolute, final, irrevocable. I felt dead inside.

Chapter 17.

I could finally see. Amie was driving the commandeered ambulance with
full lights and siren. I was trying to stay in the bouncing stretcher. I
found my voice enough to ask Doug a few more questions on the ride into
Buffalo.

"What brought you in?"

"You didn't call."

"You sound like a mother," I quipped, trying to hide how shaky I was,
inside and out.

Arnie whooped with glee as yet another column of traffic pulled over to
let him pass.

When I hadn't phoned in, Doug told me, he radioed the cops. Then he and
his boys drove down to the highway and with their trucks cut off Jones's
two thugs waiting in the ambulance and car before they even could start
their engines. The sight of him and his men jumping from their vehicles,
armed with crowbars, ball-peen hammers, and a few hunting rifles did the
trick. The two came out, hands up. Doug trussed them in bandages, threw
them in the back of the ambulance, and roared in to find me.

"When we arrived, no one else was there except you and that woman.
Scared me shitless, seeing the two of you stretched out like that," Doug
continued. He paused, having trouble finding the words to recall the
scene.

"With that monitor thing wired to you and a tube down your throat, I
thought we were too late." I was still confused, but I started to get
it. "You mean you didn't shock me back?"

"Me? No way. You were already beeping away with a pattern on the
screen--the pointy pattern, like you see on the TV shows when it'll be
okay. Still, we didn't want to take any chances with you by waiting for
the cops to arrive. That's why Amie and I have you in this ambulance.

We left Norm and my other men back there guarding the bad guys." The man
with the familiar voice must have somehow slipped back and resuscitated
me. I was still wondering why when I went unconscious again.

The next dme I woke up Janet was holding me.

"You turkey!" she yelled as she burst into tears. She was still giving
me a hug when I slipped away again.

The next few days were a series of comas. In between I slept a lot. They
hooked me up to every piece of equipment they had in the ICU. Then they
went out and rented some they didn't have just to make sure. When they
finished, I looked like a pinball arcade paying off in free games. But
they needn't have bothered. My best monitor was Janet. She was there
each time I woke up, watching every blip, every digital printout.

"Hold my hand?"

"Sure."

"Rub my head?"

"Don't press your luck, turkey!" There were no windows in the ICU. The
mornings were marked by how many times the powdered egg stuff came by. I
could tell it was night when all the needling and testing stopped.

I could tell I was doing better when I awoke and the chair where Janet
kept her vigil was empty.

By crossing my eyes I could see the tube running out my nose. The
needled catheters inserted under my right collarbone and into both arms
were easier to spot.

Another permanent arterial line was stuck in my wrist with a spigot on
the end for immediate access to my blood. I felt like a keg of draft on
tap.

But the ultimate humiliation was the tube running off the end of a
condom I now peed through. For some strange reason, they called this
contraption a Texas catheter.

Stewart Deloram, the chief of intensive care, seemed to enjoy having me
under his total control. He strutted to the end of my bed and boomed,
"How are you today, Chief?" It wasn't a question. It was a gloat. A
look-at-youthereandme-here kind of gloat.

"Deloram, you're a sick, sadistic son of a bitch in a control frenzy!"

"Ooh, nurse, has Dr. Garnet shown signs of delusional paranoia, an ICU
psychosis?"

"You're the only psychotic on these premises. Hell, I don't need half
this crap."

"Is that a professional opinion, Chief, or does all this crankiness mean
you're really getting better?"

"Apart from being pretty sleepy, I can't tell there's anything wrong
with me."

"Frankly, neither can we."

"Why not back off all this mother-hen stuff?" I waved my arms and the
attendant tubes at him. The attached bottles of varied green and yellow
secretions rattled noisily. The bells and whistles on all the machines
lit up.

Five nurses ran over to our cubicle.

Deloram waved them off. "He's just being expressive again. It's all
right. Everyone back to work." He turned to me. "You keep crying wolf
like that, Doc, no one will believe it if you really need us."

"How do you know I need you at all?" He pouted, then did something
really scary. He got serious. "We don't know. Nobody's done studies on
stopping and jump-starting a normal heart before."

"You find any damage?"

"None we can measure."

"Do you think it'll affect my life expectancy?"

"Like I said, no studies. There've been a couple of series on dogs who
had tickers locked and restarted with a shot of juice. They did okay,
but by that I mean you can expect to be burying bones in the backyard to
a ripe old age of twelve in doggie years." This time his humor felt a
little thin. The look on my face must have betrayed a wee touch of the
cold, crawly feeling I was getting inside. He put a hand on my shoulder
and became very gentle.

"Look, Earl, what you were put through is as weird as I've ever seen,
and probably ever will. Those creeps seem to have kept you pretty well
aerated while they had their sick jollies. In that regard, they were at
least technically competent, but monsters with expertise are somehow
even scarier." For a moment I didn't see Deloram. I saw a pair of older
eyes, eyes of a man who kept saying he was sorry.

"Any word on the fourth guy yet?"

"Apparently the cops got him. They picked him up coming out of the woods
about two miles south of you.

So you don't have to worry about any of them. It's over." I still had a
dead feeling inside. In some ways I knew it would never be over.

"By the way," Deloram continued, "some big detective's taken a special
interest in you. He's been here regularly for the last two days to see
if you were ready to talk to him yet, but I told him you weren't going
anywhere and needed the rest. I suggested he run your name for unpaid
parking tickets while waiting." Riley. "Let me speak to him next time."

"Sure."

"Where's Janet?"

"Asleep." I must have looked lonesome because he said, "Hey, give your
guardian angel and us a break. She's been like a one-woman accreditation
visit since you got here. It took her twenty-four hours just to trust us
enough with your precious skin before she agreed to a little nap
herself.

She's in the residents' room, wondered if we'd changed the sheets since
she rotated through here ten years ago. Let her rest."

"So this is day two?"

"More or less."

"How much longer?"

"Now, that, my son, is a closely guarded medical secret."

"Dammit, Stewart, quit kidding around. When do I get out of here?" He
slid off the side of the bed where he'd been sitting, strode to the
cubicle curtains, struck an operatic pose, and answered, "Soon, my son,
soon, or never." Then, with a maniacal grin, he left.

Outside from the nurses' station I heard his deliberately overloud
instructions. "Oh, Nurse Mandy, I think it's time to change Dr. Garnet's
Texas catheter, please." There were giggles, and Nurse Mandy, who
regularly modeled swimsuits in the ad section of the Buffalo Gazette,
jiggled into the curtained area to do her duty. Then he must have hit
the alarm-set switch at his desk because every bell and buzzer at my
bedside went off again.

"You're a sick person, Deloram! Sick!" I yelled against a rising wall of
laughter from beyond my curtains.

Nurse Mandy never missed a beat, so to speak.

I figured the stay at Deloram's little kingdom would end when he got
bored with me or I could stay awake for more than an hour. The first
occurred pretty quickly. I didn't see him much after our chat. The
second feat proved more difficult.

A few awakenings later I found Janet back in her chair.

She looked tired, but she smiled my way and softly said, "Hello."

"Hi. yourself." I enjoyed just watching her for a few quiet minutes.

She looked pleased that I was awake and reached for my hand. It felt
wonderful.

"I was afraid you'd still want to brain me," I whispered.

"That would presume some brains in the first place." Her voice was a
little less soft.

"You do still want to brain me."

"I'm letting them fatten you up here first."

"How's Muffy?"

"Better than you. She's out of intensive care." I was left to stew in an
uneasy silence for a while.

Then Janet added, "She's going to be all right. Probably will be home
next week."

"And how is home coming along?" It wasn't exactly a roaring
conversation, but I figured sputtering talk was better than icy silence.

What I got back, however, was ice and talk. "Let's just say," she began
rather coolly, "that Doug's wife was as thrilled as I was with the great
bozo escapade. Now that she's let him back out of her sight, the work is
going quite nicely." A pause. Then a hint of melting, "Especially the
baby's room." More thought. "It's really quite lovely."

"You look like you could use some of the sleep I'm getting."

"It's the two men I run around with. One keeps me up all night with
worry, the other kicks me awake when I sleep."

"I'm sorry, Janet. It was a pretty boneheaded idea." She rolled her eyes
and said, "Oh, great! You decide on your own to play Hardy Boys with our
contractor, without so much as a word to me, and then bring the Wicked
Witch of the Night down on us, and you think a big doleful"I'm sorry' is
going to cut it!" As Janet's voice rose, the rest of the ICU suddenly
got very, very quiet.

"C'mon, Janet, this is embarrassing me."

"Ahh, scare me half to death, then poor you gets embarrassed." She was
up off her chair now, obviously enjoying my discomfort. "You can just
lie there in silence and contemplate your sins," she proclaimed rather
loudly, then walked over to my array of monitors. She gave me a big wink
and started shutting off the alarm switches one by one. "No! Not another
word." She started undoing her ponytail. "Just let me read in peace" was
her final, very public instruction.

Then she leaned over me and let her hair shower down around our faces.
For the next half hour, not a bong could be heard. At least not in my
cubicle.

My next awakening was not so pleasant. Bufort sat huddled in the chair
like a hulking toad. Riley prowled restlessly back and forth in front of
the curtains.

I wasn't sure what time it was except that another serving of the dried
egg stuff lay congealing on my bed tray. Must be day three.

Bufort didn't even wait until I was fully awake. "Dr. Garnet, do you
know the penalty for impersonating a police officer?"

"Why, Bufort? Is someone threatening to charge you with it?"

"What!"

"I wouldn't worry. It'll never stick. At least not for impersonating a
competent one!" A few of my bongs had started going off. Janet must have
reattached them. Bufort's eyes bulged, he was so enraged. Riley had gone
perfectly still.

"That's right, you pompous prick, your silly, conceited posturing left
me at the mercy of a serial killer, a maniac.

If I hadn't done what I did, I'd be dead by now, and you'd be clucking
your tongue and pronouncing it an unfortunate end by stress."

"That's absolutely--"

"It's absolutely true, and you know it! You bother me one more time and
I'll give enough depositions to bust you to traffic tickets!" A few
nurses swished by the curtains and busied themselves with the alarms my
rocketing pulse and blood pressure had triggered. A very stem Nurse
Mandy said, "Gentlemen, you are out of here." Forcefully, she levered
Bufort out of the chair by the elbow and showed him the door. Riley
winked at me as he trailed after his boss.

The rest of the afternoon crept by. Popovitch and Sylvia Green dropped
in to wish me a speedy return to work. Sometime later a rather morose
Hurst hung around the end of my cubicle for a few seconds, mumbled about
reopening the hundred beds, then left. I guess he figured it was
politically unwise to continue our battle while I was so helpless.

I had a couple more sleeps and then was gently shaken awake. It was
Riley. "Hi, Doc," he said quietly. "Dr. Deloram said you wanted to speak
to me?" He'd pulled a chair up near my bed and kept looking nervously
over at the curtain. I guessed he'd snuck back in and was afraid of
being found again by Nurse Mandy.

"Yeah," I answered sleepily.

But before I could say anything else, Riley interjected, "I wasn't part
of what that idiot boss of mine pulled today, but I couldn't prevent
it." Then he gave me a big grin. "You really got him!" I smiled back at
the compliment. Then I got down to what I wanted to ask him. "I've got a
lot of questions about how it all happened. And with Jones dead, are you
going to be able to make a case against her thugs? The thought of them
getting out scares me. And who was the guy that came back to resuscitate
me? After all the killings that Jones had involved him in, why'd he
bother?" Slept out, I was eager now to talk.

Riley leaned back in the chair. "First of all," he began, "the guy who
saved you is going to testify against the other two goons who worked
with Jones in exchange for a lighter sentence. You won't have to worry
about them.

Apparently they used to beat up on strikebreakers for the truckers'
union before they got to be ambulance drivers.

That's where Jones found them. Since they know we have a witness, their
lawyer advised them to cooperate, and they're talking now as well,
though we haven't made them any promises. They claim they never actually
killed anyone, but are admitting to working with Jones for more than
three years, snagging derelicts off the street for her 'research," and
then scattering their bodies around town after she was done with them."
Three years. That was longer than I'd figured.

"They also did her other dirty work," Riley added, "like trying to run
you down, helping her trash your house, and setting up Watts. We found
the Dobermans in a cage behind the house where one of them lived. They
said it was for the money she paid them, but I got a creepy feeling they
liked watching people suffer and would've done it for free. One of them
also told me she really liked getting it on with them, together." He
related her sordid story with the neutral cynicism I'd expect from a
cop. But I couldn't suppress a shudder on hearing what she'd kept hidden
all these years.

"A few of the vagrant DOAS' bodies are being exhumed," he continued, "to
get evidence of needle marks in the heart. By the way, why was she so
afraid of your ER data?" I sat up. "The data covered only twelve months
of her activity, but it contained enough information to expose her, if
you knew enough to ask the right questions. It showed that DOAS came in
only on the mornings when she was off duty the night before, or, to put
it crudely, only when she wasn't stuck in the ER and was free to go out
and kill. I'm pretty sure the same pattern will show up for the times
the other DOAS turned up all over the city. At first I made the mistake
of looking for the shift with a lot of DOAS, but then I realized that
didn't make sense because they weren't being killed in the ER. What
pointed to her was the lack of DOAS when she was on duty. Show that same
pattern for all those derelicts murdered with a cardiac needle and Jones
would stand out from every other ER doc in Buffalo. I don't know if she
always used Watts's lab to kill them, or if she sometimes ran her codes
right in the back of the ambulance. If so, it might also have been
possible to link the deaths to the nights she was on the road with the
cardiac study." Riley reached for his notebook. "Can I get copies of the
data that shows this?"

"Sure. See my secretary." Then I remembered Jones's words back at the
cabin.

"All that risk, all that work. I couldn't let it go to waste."

"Oh my God!" I exclaimed, suddenly realizing the obvious. "The torsade
de pointes killings were only part of it. There must have been earlier
murders as she tried to get a breakthrough treating V. tach. and V.
fib." Riley looked puzzled, and I took a moment explaining the
terminology. When I finished, he stayed silent, then reached into his
briefcase and handed me a folder. "Does this mean what I think it does?"
he asked. "We found it in her apartment." I opened the file and
recognized Jones's familiar handwriting.

It was an outline of the research she'd intended to pursue in phase two
of the cardiac study, but it was never intended for presentation to any
ethics committee.

"My God!" I said again as I handed it back to him.

"She intended to go on killing, didn't she," he replied.

"I think she'd already started," I answered.

"What!"

"Her idea in there," I said, nodding to the file, "was to see if
magnesium sulphate would be a breakthrough in the prevention of deadly
heart rhythms as opposed to their treatment. She proposed loading up her
derelicts with magnesium sulphate and then challenging them with her
erythromycin/terfenadine cocktail or unsynchronized electric shock, like
she'd tried on me, to see if they'd be more resistant to developing
abnormal rhythms."

"I thought those medicines usually produced torsade de whatever, and it
was too rare to make her famous."

"Torsade de pointes is still a variant of V. tach., and preventing it
might have given her a useful lead on how to prevent ordinary V. tach.
and V. fib. I'd already figured she was onto something new, using her
old techniques, because the DOAS had kept coming. And even though she'd
finished her paper on torsade de pointes, Watts had found terfenadine
and erythromycin on the last John Doe." I paused, thinking of all the
poor souls who had died in such fear, then tapped the grisly document
still in Riley's hand. "She'd obviously begun her own phase two."

"Christ!" whistled Riley as he returned the file to his briefcase. I
thought he was going to close it, but he hesitated before snapping the
clasps shut and took out a small cassette instead. I noticed his jaw was
bulging as he looked at it. "Doc, you also asked about the fourth man,
the one who saved you. I wasn't going to put you through this yet, but
if you're well enough, I'd like you to listen to part of his
interrogation."

"Sure, but why wouldn't I be well enough to hear it?"

"Because it's going to take you back through all that happened to you,
but from their point of view. And there are some nasty insinuations
about you, at first."

"What do you mean?"

"Let me start by telling you about the guy who saved you. His name's
Vito Manley, though that wouldn't mean anything to you. What's important
is he's different from the other two. He worked for the same company as
them, but he'd been transferred to dispatch at 911 about four years ago
as part of some program to improve standards when MAS took over. A few
months later, Jones appeared on the scene and started riding the
ambulances for the research project. He noticed she preferred his old
company and later realized it was because the types there suited her
purposes."

"How'd he get involved?"

"Listen for yourself. The full session was formally videotaped, but I
recorded the parts I wanted you to hear on a cassette." He pressed the
Play button. Even with the hollow sound of a recording taken in a room,
I recognized the familiar voice of the man who had saved my life and who
had kept saying, "I'm sorry."

"She'd slipped me a few thousand to direct any calls to pick up street
derelicts to her and not make a record of it.

Hell, I thought it was a Medicate scam--that she was copping their cards
and running up a bunch of bogus claims payable to her. It seemed safe
enough, at least for me. It wasn't until last year, when someone started
blackmailing her, that she told me what was really going on.

Then she threatened to pull me down with her unless I helped her find
out who it was." His words kept coming in a rush, as if he felt
compelled to talk.

Riley leaned over and stopped the machine. "Did you know anything about
a blackmailer?" he asked.

"No!" I exclaimed, astonished.

"The next part is going to be hard for you to hear," he warned,
restarting the tape.

After a few seconds of room noise, the man spoke. "At least, at first it
was to find out who was blackmailing her.

After the Kingsly fiasco, whoever it was hit her for a last big payment,
probably figuring she'd soon get caught and the cash flow would end. The
way Garnet had kept the pressure on, discovering the needle in Kingsly
and exposing the derelict's murder, she actually figured for a while
that it might be him. That made her nuts. She thought he was lording it
over her that he was a medical bigshot while he was bleeding her dry.
But she didn't want to kill him outright until she was sure. That first
night she had her goons use the dogs on him, it was a warning, like, to
back off." The man coughed, then said, "The next night she had the two
of them follow Garnet to his country place--at that time she only wanted
them to steal the analysis of the ER statistics. You see, she was also
afraid Garnet was preparing a record of dates based on the data that
would show her connection to the DOAS. She figured it would have been
good strategy on his part, had he been the blackmailer, to have it as a
kind of insurance policy against being killed if he was ever found
out--to be opened if he died. Something like that. If she found a
document like that she'd know for sure he was the blackmailer and could
kill him. But his dog chased the guys off before they could get what
they came for. She tried again herself and broke into his hospital
office early one morning. She didn't find anything. But when he had that
resident ask about using cardiac needles on derelicts in front of her,
she was sure it was him, and that he was still playing with her to get
more cash out of her. So she phoned her goons and arranged his
hit-and-run accident on the spur of the moment. I think it was as much
revenge as a need to get rid of him. When it didn't work, she got away
from the hospital long enough to join the men in searching his house
while we were on the way to the vet's with his dog. Boy, did she go
berserk when she couldn't find his analysis." Riley stopped the tape
again. "Does any of that make sense. Doc? Or was this guy blowing smoke
to try to get a better deal?" My mouth was so dry, I could barely
swallow. "She thought I was blackmailing her?" I finally managed to
croak.

"Apparently, at first."

"What do you mean, 'at first."

"There's more. But what about his account of what happened? Does it jibe
with how you remember things?" The swirl of events he described ran
through my mind like fragments of a movie--familiar, yet seen from the
other side. "I guess so," I said haltingly. And then a detail popped
into place. "He said he drove me to the animal hospital. That's where I
remember him from. He was the older attendant! Good God, does that mean
he was the one who tried to run me down?" As an answer, Riley continued
the tape.

This time I heard the detective's voice echo my own question.

"Was it you who hit Garnet and the dog?"

"Oh, no! That was those two goons others. I was only told to be in the
area. Like I said, it was a last-minute call just twenty minutes before.
She said that she was gonna take care of the blackmailer. I had to be
careful because my partner had nothing to do with it."

"Were you supposed to finish him off?"

"No!"

"Level with me! What were you supposed to do with him?"

"If he was okay, just shaken up like, I was to make sure we took him to
the hospital for a checkup. To get him away from the house so she could
search it."

"And if he wasn't okay?" I heard some shuffling noises and another
scrape from a chair leg.

"If he wasn't already dead, but near killed, I was to tip him over, an
accident like. Drop his neck, leave his airway blocked, stuff like that.
You know, our usual screwups." There were a few more seconds of
shuffling sounds.

"Hey, I didn't do it, did I?"

"Because he wasn't near dead, and it would have been too obvious."

"No! I couldn't do that." There was another pause, then he added very
quietly, "At least I found that out." Riley pushed Stop and waited.

I felt angry. "He probably saved my life only to get a better deal with
you guys, once he saw Jones was dead."

"Maybe. Either way, he's going to do time. But I don't think he had the
taste for killing the way the others had." "You said there was more  ...
about the blackmailer?"

"That's the next bit," he answered. The tape came on in the middle of
his next question.

"--Garnet the blackmailer?"

"No! That Sunday evening she calls me and says she's taken care of the
real blackmailer and that it hadn't been him after all. But she told me
Garnet was still a threat because he wasn't buying that Kingsly and the
derelict had been killed by that crazy psychiatrist who dove off the
roof. She knew he hadn't figured out it was her yet or he would have
already gone to the cops and had them arrest her. If we moved fast, she
said, we could stop him before it was too late and make it look like a
heart attack.

That we'd all be safe forever." Riley snapped off the machine and moved
to put it back in his briefcase. "Do you know who might have been
blackmailing Jones?"

"No. Did he, Vito, what's his name?"

"Manley. No, he said she never told him. The other two men had no idea
either."

"Did you really think it was me?" Riley looked embarrassed. "He brought
it up. I had to ask the question. No offense. I only wanted you to hear
in case you'd felt there was a blackmailer involved somewhere and hadn't
been sure enough about the idea to mention it. But if you've no idea,
you know what I think? Here this guy's talking ten pounds of fog, trying
to get us hooked on chasing some crazy story about a blackmailer so he
can get a better deal. No, I think it's a crock. There were four creeps.
One's dead, and we got the rest. For once I agree with my boss. This
case is closed." That evening I got to sit in a chair for half an hour.

Carole came up and would have put me to work had Nurse Mandy not shooed
her off. But before she left, Carole sat on the edge of my bed, hunched
forward, and started rubbing her palms together. I waited. Still looking
at her hands, she said, "The police returned the articles they found in
Jones's locker that they didn't think were important." She reached into
her sweater pocket and handed me a small envelope. "I thought you should
have this." I opened the flap and shook out the contents while Carole
continued to look down at her hands. It was an old newspaper clipping, a
photo taken a few years ago of Janet and me in formal dress at the
annual hospital ball.

We wore polite smiles. We usually had the best fun of these evenings
while getting ready, with Janet doubled over laughing as I struggled
into my tuxedo. This kind of social circuit definitely wasn't our style.

Clipped to the picture was an unused ticket. My first response was so
what, but by the way Caiole's palms were rubbing together, I figured
there was more. ''What does it mean?" I asked, truly puzzled.

Carole stopped rubbing her hands, then looked up at me with a kind of
smile you bestow on a child who's too naive to get it. She started
talking very softly, careful of her words. "With a woman like that, I
wouldn't use the word love, not at all. But she was interested in you. I
could tell by a lot of little things, the sort of things only a woman
might notice: the way she would watch you when you weren't aware; all
those green outfits she wore--in the early years I think they were
mainly for your benefit.

But you never caught on." "Why didn't you warn me?" I asked, incredulous
at what I'd just heard.

She laughed, leaned back, and said, "Hey, I'm your secretary, not your
mother. Besides, you didn't need warning. You weren't going to do
anything about it.

Everyone knew that."

"What do you mean 'everyone' ?"

"Well, not everyone. Just some of the more observant women in the
department who could see what was going on." Jesus Christ! I thought. My
old nemesis. Denial.

Maybe that was why I'd become so aware of her sexuality recently, since
it was safely directed at others. I'd spent years denying her overtures
to me.

I needed no reminder of the demonic rage Jones had exhibited while
straddling me back at the cabin. Good.

Hate me! I'm taking away your miserable high-class fucking life. I'd
hear that shriek in my dreams the rest of my days.

I looked back down at the unused ticket and the old picture of Janet and
me in our evening clothes.

"You see," said Carole, leaning forward, "I think what Jones really
coveted was this." And she tapped the photo of Janet and me, decked out
in the full regalia of a highclass fucking life.

A few hours later I had the strangest visitor of all.

Kradic.

He stood at the curtain, fingering it, before giving a little cough.
"Hi, Dr. Garnet," he said hesitantly.

"Dr. Kradic," I acknowledged, genuinely surprised.

"Can I talk with you for a moment?" He was so uncertain, almost shy,
that I was actually curious what was up. I was also relieved he'd no
idea how much I had suspected him.

"Sure, have a seat." I was back in bed; he took Janet's chair.

"How are you doing?" he asked, uneasy and obviously bad at small talk.
He wanted to get on to what he came for.

I answered, "Okay," and waited.

He coughed again, took a breath, and then started.

"With Jones gone, I wondered if you'd give me her nights." I gave a
laugh in spite of myself.

Kradic didn't even look offended but pressed on with his case. "Look, I
know it's indelicate and that you don't particularly like me, but I can
do the job. You know patients are safe on my shift. Who else are you
going to get to replace her?" He had me there. Carole and the others had
all assured me they were muddling through, but without Jones, the
schedule would be a holy mess, and with Christmas coming up, it'd be
worse yet. Nobody would admit it, but even increased doses of Kradic
would be acceptable if he did more nights, worked holidays, and kept the
rest of us, me included, from having to double up on these difficult
shifts.

But I wasn't prepared to pay any price for his help. I stared back at
him, still not answering, and calculated my terms. "Since we are being
frank. Dr. Kradic, let me say that the entire department, including
myself, is fed up with your rudeness and your complete lack of
professional behavior with your peers. I'll give you the shifts on
trial, for the holidays. Then the rest of the staff, nurses and clerks
included, will decide if they want you around anymore." He looked taken
aback but said nothing.

I continued. "I am offering you this last chance only because you are an
excellent physician. I would trust you with the care of myself or any
member of my family, but your skill doesn't give you a license to
disrupt the department.

If anything, it gives you an obligation to help, not clobber, other
physicians less gifted than yourself." The compliment surprised him. His
face flushed. He swallowed hard and started blinking a lot.

I watched him as he regained his composure.

"Thank you," he said simply, but he was looking down at his hands so I
wouldn't see his face.

"Al, I want to know why you've started to come late.

Punctuality is part of the deal." My question broke his reserve. I
watched his whole body tense, his hands tighten into fists. "Because my
wife divorced me and is suing for custody of my two little boys." He was
spitting out his words. "I took some extra shifts at other hospitals to
help pay my lawyers." He looked straight at me, and his voice softened.
"The additional nights will give me the income I'll need, and I'll be
free in the days to take care of them." He took a deep breath,
swallowed, and very quietly added, "I can't lose my boys, Dr. Garnet, I
can't. They're all I have." Then, embarrassed, he got up and left. When
I fell asleep again, I was worrying about the schedule. Things were
returning to normal.

The morning I was discharged, I walked out of the ICU and went directly
down to the ER to work a shift.

My doctors had been livid, but Janet had understood.

"Go to it," she'd whispered in my ear, giving me a hug on my last night
as a patient.

Susanne unceremoniously stuck a chart in my hand.

"Welcome back. There's a guy with multiple trauma in Resus A. The
residents are losing him, and I mean losing!" We started for the room,
and she told me the rest while we walked. "He's a jumper. The medics
said he must have fallen forty feet. He was still conscious when they
found him, but he screamed when they tried to move his legs." I glanced
at the ambulance sheet and learned he'd jumped from Oratory Steps, a
shrine that some faith healers had erected on top of a fifty-foot
staircase in an escarpment overlooking the Niagara River. A lot of
cripples crawl up there to try to walk again. Apparently this guy had
reversed the procedure.

When I stepped to the side of his stretcher, he was already half dead.
The surgical residents had been fiddling with him an hour and fifteen
minutes without calling their staff.

"What's his pressure!" I asked, snapping on gloves.

"Sixty over zip," hissed one of the nurses up by the guy's head. "Like I
been telling these two!" She glared at a pair of baby-faced kids in
greens. New rotators. Lord help us.

"Shit, he's in shock!" I roared at them. "What the hell's he still doing
here? He should have been in surgery an hour ago." I spoke quickly to
Lisa, who was nearest the door. "Call a code blue." Then I turned to my
new residents. "Gentlemen. This is unstable multiple trauma.

It needs a trauma team. No one, not even you two, can save this man's
life diddling over him alone. Now get me two more lines, big ones!"
Thirty minutes later I stepped out to the parking lot. It was a clear
morning. The small amount of snow covering the ground crunched under my
shoes. My ears tingled. I could see my breath when I exhaled. All over
the city, vertical white plumes were rising into the blue sky as Buffalo
started its day.

Half an hour on the job and already I had staff problems, inexperienced
residents to worry about. And I'd barely arrived in time to save a
patient's life.

Slowly I blew out another cloud of frost, and smiled. I was back.

Four Months Later It was a Tuesday afternoon at the end of March. The
remnants of winter were at last reduced to a few crusty ridges of silt
and ice and a gritty covering of sand left on the roads. Even the sun,
for a few minutes at two in the afternoon, seemed to remember what it
was there for. I couldn't take my coat off, but I could open it, and the
back of my neck felt warm if I stood out of the wind.

I was driving north out of Buffalo. On my left the Niagara River surged
toward its rendezvous with the falls. It had broken free of winter's
bondage weeks ago, though the currents here never really surrendered in
the first place.

The waterfront back in the city was still snarled with ice.

I'd put off this trip, but his secretary had told me he was setting sail
that weekend. His house was sold. His phone was disconnected. When the
ice went out he'd moved onto his boat. Now it was stocked and seaworthy,
and I was out of time.

Power lines ran overhead; telephone poles ticked by on my right. An old
freight train rumbled the other way.

Everybody was going somewhere.

The light danced across the water, giving it a sparkle and the illusion
of being clean. A sign said it was twenty more miles to the village of
Youngstown, where he kept his boat.

This morning Janet had actually put bedding on the new crib. Three weeks
to go, but staring down at that little flannel sheet and quilt had made
the arrival imminent for me.

The ER was in better shape too. There were no more bed closures without
my approval, and I'd been made chairman of the new financial ways and
means committee.

We didn't have much means, but we'd shut down Arnold's "pet farms," and
at least I was able to protect emergency from more idiocy.

Kradic was still a pain in the ass, but he'd started teaching seminars
for the staff. So far everyone was willing to let him stay.

The parking for Watts's yacht club was on a small bluff above a series
of rickety steps leading down to the boat basins. To my right I could
see the open waters of Lake Ontario. The smell of seaweed and dead fish
got fresher as I descended. A bunch of boats leaned crookedly on dry
land cradles.

Most of the slots on the water were still empty. His was the only
sailboat. No one else was there. They were all probably working at the
jobs they needed to try to pay for this stuff.

The wharf was a series of floating docks. My steps on the wooden slats
and the creaking of the adjoining hinges announced my arrival. He'd been
coiling and stowing ropes on the front deck, and he spun around at the
noise.

I hadn't called ahead. He was clearly surprised. And puzzled.

"Earl, what a pleasure," he said with a big smile.

I forced one in return. "I came to say goodbye, Robert."

"Well, come on board and let's do it right," he said with some real
enthusiasm and a trace of relief.

He helped me across the gap between his bobbing boat and the dock and
onto the thirty feet of rich, glistening deck he planned to make his
world. I couldn't help my own twinge of excitement at the allure of it
all.

"Very nice," I said, and meant it.

"Sit down, sit down," he replied, relaxing, and waving me toward an
expensive-looking set of black canvas and teak deck chairs.

Sitting in them warranted another even more enthusiastic "Very nice!"

"How about a drink?"

"Sure."

"What do you like?" He strode to an on-deck bar.

"A Black Russian would be great."

"What's a Black Russian?" I told him. He made it.

I settled back and looked at him over the rim of my glass.

He looked casual enough, what with his mackinaw over a white turtleneck
sweater. And he looked a hell of a lot better than when I'd last seen
him in his lab. He'd been discharged before me, and hadn't come to
visit. But now his eyes had the hardness they'd always assumed when he
was standing over a particularly problematic case, scalpel raised and
ready to start.

I lifted my glass, took a sip of the liquid, and savored the icy warmth.
I'd come to like Black Russians. It was time to begin.

"I'm here to say I know." He remained still, just staring at me.

"Jones was your investment." He was dead still.

"The police dismissed a statement from one of Jones's accomplices who
claimed someone was blackmailing her, but I couldn't. His story made too
much sense and explained too well the events of that week. It even began
to answer the questions I had about you." I set my glass on the table,
keeping my eyes on him.

"You probably noticed the increase in DOAS before anyone else. You got
curious. You got thorough. Anyway, long before Kingsly's murder, you had
discovered what Jones was up to." Nothing moved. Not in his face. Not
even in his eyes.

"I can only guess why you then did what you did. I mean, besides for the
money." I hesitated. About this I wasn't sure. "I figured it was your
wife's death. It must have left you devastated. Not only with grief but
with anger. Anger at the very profession you had dedicated your life
to." Here he blinked. He looked a little startled.

"For all your attention to detail, a lifetime of teaching us to be
better doctors, no one had caught your wife in time. When she died, you
had to have felt betrayed that your profession had let her down." His
upper body tensed.

I went on. "But even this wasn't enough to make you turn against what
you'd served your whole life. There had to be another reason you hadn't
put a stop to Jones and why you chose to let her continue the killing
and to blackmail her. It had to be a specific hatred to drive you to
that." I paused, then told him, "Before I came out here, I went down to
the medical records archives and pulled your wife's chart." He started
breathing through his mouth. His lips thinned, and he bared his clenched
teeth. That familiar face suddenly looked ugly and sullen as he glared
at me.

I waited, felt the calm would hold, and went on. "I found the notes from
her last admission before she died, when the cancer was diagnosed. They
were straightforward, tragically so, but appropriate and in order. Then
I leafed back through her dossier and came to the records of her visits
to emergency. There, I found she'd presented to our department a full
six months prior to the discovery of her cancer with a complaint of
abdominal pain. The clinical notes were written by a resident. Quite
complete, they described your wife having a month long history of cramps
and reduced bowel movements. The exam was unremarkable, and she was told
it was constipation.

The staff signature validating that 'diagnosis' was Dr. Valerie Jones."
He still didn't move.

"If the proper follow-up had been done then, the cancer in your wife's
colon might have been caught in time to save her. Or if she hadn't had
those false reassurances from Jones, maybe she would have mentioned her
problem to you. For whatever reason, she obviously remained silent until
it was too late. You chose to let Jones go on killing vagrants for more
than a year so you could torment her with blackmail and punish her for
your wife's death  ...  punish her over and over." No denials.

"After Kingsly's murder was discovered, you really tightened your hold
on her. Feeding me the pathology evidence on the cardiac needles, first
for Kingsly, and later for the DOA, you cocked and pointed me like a
pistol. That's why you delayed 'finding' the needle track in the
derelict and reporting it to the police. The better to keep her
terrified of being discovered and force her to give you a big final
payment by first threatening to expose, then making good on your threat.
Trouble was, she thought I was the blackmailer. You must have made your
last demand the day after Kingsly's murder. Maybe you anonymously
slipped her a copy of my note to you.

Remember? "Pigmented lesion vs. small scab at left xiphoid-stemal
junction. Check it out'? I knew something had driven Jones to think she
had to try to warn me off with the dogs later that same night. She
didn't see the ER statistics in my office until Tuesday morning." The
stare continued. I took another sip of the Black Russian. He hadn't
touched his drink.

"When she was trying to kill me, she said something about me being your
little pointer. I wasn't paying much attention, considering the
circumstances, but I thought it was just a general slur, part of her
fury. You probably hadn't counted on pushing her to actually try to
knock me off. That day at the meeting, when Bufort announced the
attempted hit-and-run, you were truly shocked, more than the rest of
them. I'm sure it gave you pause. Hell, later in the cafeteria, I think
you actually considered putting a stop to it, but in the end you let
your play ride.

Let me be the decoy while you turned up the heat." I took another
swallow. More warmth. He turned his glass by its stem.

"Oh, and I figured out how you did it. Prior to Kingsly, you probably
just mailed your threats and demands to her apartment. But after
Kingsly, to save time, I bet you used that mailbox of hers, the one she
hardly ever emptied.

You could have delivered your anonymous notes through the hospital
in-house mail or even slipped them in there yourself. By the dme she got
it, she wouldn't know what day it had arrived, let alone who'd been
around to do it.

That's why she started to keep her slot clean. I ought to know. Her
uncollected mail always used to fall over into mine." His gaze had slid
off me now and was somewhere out over the water. The sunlight was
starting to thin. Now I needed the warmth of my drink.

"Did you use the technique Bufort described as common to blackmailers?
Have her send money orders to different post office boxes, pickups she
couldn't trace?

At first I thought it was simple convenience that she used you as bait
for me. But I think you'd screwed up. That Sunday you probably didn't
wait for the in-house mail to put another of your threats in her box. My
tirade at the meeting that Femandez wasn't the killer must have
convinced you I was on the verge of nailing her, so you wanted that last
payoff fast, before I found her name and exposed her to the police. I'll
bet your note even told her that I'd challenged Bufort and wanted the
case kept open, then made it look like the tactic of a blackmailer
increasing the pressure on her. But she'd begun keeping an eye on her
box and must have seen you slip the note in." He didn't answer. It
didn't matter.

"I don't suppose you ever got that final payment." I paused and waited
until he finally looked back and faced me. The hardness was gone. His
eyes were dead.

The sight of him hunched over in his chair suddenly disgusted me. I
slammed my empty glass on the table between us. "You'd kept her too busy
trying to kill me!" He flinched at my fury.

I leaned across the table at him. His mouth opened. He made swallowing
movements.

"Don't worry," I said through clenched teeth, inches from his face. "I'm
not going to the cops. I'm going to do something a lot worse. I'm going
to leave you to yourself, with what you've become, and let you go crazy
with it. You will, you know. All that instinct for nasty truths turned
in on yourself, in this floating jail of yours." He suddenly looked a
little puzzled. Maybe I was wrong, perhaps he would let himself off the
hook. I really didn't care. "Even if you don't drive yourself mad, I'm
not going to tell the cops because there's no good in it to drag your
dirt into the open. Not for me, not for the hospital, not for anyone.
And personally it doesn't really matter to me what happens to you. I'm a
physician, not some avenging angel or Lady Justice herself. I've got my
life back. That's all I ever wanted." At this point I was standing over
him. I nodded toward my glass. "Am I going to need an antidote for
that?" He was still gaping at the chair where I'd been, but he managed
to shake his head. I believed him, and left.

I didn't look back until I was up in the parking lot and getting into my
car. He hadn't moved. His drink, still untouched, sat on the table
beside his motionless arm. He seemed to be fixated on my empty chair.

I felt cold. I once thought he was a friend. Maybe once he was.

The sun, low now, cast him in the glow it saved until the end of the
day. It highlighted the ropes and rigging that coiled about his yacht,
like snakes ensnaring it. In widening circles around the white hull
bobbed the wreckage and silt of the end of winter. The debris at the end
of a life.

Arched across the stern was the name of his boat. It was once intended
to celebrate his cleverness, his success.

Now, like a verdict, it hung there.

THE PATH OF LOGIC THE BUFFALO GAZETTE, APRIL 25, 1997 DEATHS.

Dr. Robert Watts, lost at sea during a squall in the waters of
Chesapeake Bay. Physician, teacher, and former chief of pathology at St.
Paul's Hospital. Age sixty-three. Survived by his daughter and two sons.

THE BUFFALO GAZETTE, APRIL 29, 1997 BIRTHS.

Brendan Garnet, seven pounds, six ounces, was born this morning to Dr.
Janet Graceton and Dr. Earl Garnet.

All are doing well.