Extreme Measures

EIGHT MONTHS LATER

It was just after two o'clock in the morning. Outside of Warehouse 18 the East Boston docks groaned eerily beneath a crust of frozen snow.

Inside, wedged in the steel rafters thirty feet above the floor, Sandy North made a delicate adjustment in the focus of his video transmitter and strained to catch the conversation below. But even if he missed part of the exchange, it was no big deal. At this distance, the souped-up Granville pickup he had brought with him to Boston could record a hiccup.

For nearly three months, under the deepest cover, North had been working the docks for the Bureau of Alcohol, 'tobacco, and Firearms.

He was, in essence, on loan to them through an agency that specialized in providing such personnel. And although his agency had no official name, it was known to those in its employ, and those who from time to time required its services, as Plan B.

North had been sent in to pinpoint the source of a steady trickle of weapons from Boston to Belfast, in rthem Ireland. What he had stumbled on instead was drugs-a shipment and sale of heroin that looked to be as big as any he had encountered on his several assignments with the Drug Enforcement Agency.

And to boot, from what he could pull from the conversation below, one of the two men doing the selling was almost certainly a cop.

Frustrated by his lack of progress on the weapons shipments, and with no time to set up trustworthy backup, North had opted to video the drug sale himself..of all the filth, all the shit his work for Plan B required him to wade through, drug dealers were the most repugnant to, him, and the most rewarding to bring down. At least, he reasoned, if he was pulled off his weapons assignment, the months in Boston wouldn't have been a total loss. On the down side, if something went wrong, if by working on his own like this he blew the weapons operation, his boss at Plan B would have his nuts.

But nothing would-go wrong. He had checked the rafters from every angle and had picked a spot that was absolutely hidden from view. He had taken the sort of comprehensive and imaginative precautions that had made himyen among the highly skilled operatives at His agency-something of a legend. Now, all he had to do was keep filming, and wait.

Far below him the deal was essentially complete.

The cop and his partner had taken two suitcases of money and left. The buyer, who had arrived in a van with a chemist and three bodyguards, was supervising the transfer of his purchase from shipping containers to the van. He was small and wiry and nattily dressed, and he issued orders to his men with the crispness of one who was used to power.

One of the Gambone brothers, North ventured, trying to recall what he had once memorized about the powerful New England family.

Possibly Ricky, the youngest. North shifted his weight a fraction to get a better look at the man, and felt something move beneath his thigh.

Instinctively he reached down, but it was too late. A bolt, probably wedged on the beam since the construction of the roof, rolled off the edge and clattered to the cement floor below.

In seconds North was at the intersection of two powerful flashlight beams. Following the shouted orders of one of the men below, he dangled his revolver in two fingers and flipped it down.

Then, cursing himself, he inched across the rafter and down the narrow access ladder.

It was going to be one hell of a long night.

Over God-only-knew how many dicey assignments, North had been taken just twice before tonight One of those times, in Buenos Aires, he had intentionally allowed his own capture in order to free two political prisoners The other time, in Uganda, he had endured two hours of torture before his backup arrived. Now, he silently vowed to keep the physical punishment he had to absorb to a minimum. He would have to be easy, but not too easy; frightened, but not so much that hurting him would become sport.

One of the goons took his camera, and another punched him viciously in the gut. He dropped to his knees, whimpering, They pulled him up by his jacket and threw him into a chair.

Then, as he responded haltingly to their questions, Sandy North began, one by one, to take the measure of the five men who held him.

". — Myself. J-just myself. There's no one else, I've been w-working undercover, looking for weapons… " The chemist-frail, past middle agean be discounted.

"… It was just an accident I… I stumbled on this. I swear I did. I heard two guys talking and thought I'd see if something was up.

There's rewards for this kind of thing, you know…

Gambone, if in fact that's who he is, clearly likes letting others get dirty. He can be separated from his men in any number of ways.

". — Look, seriously. I don't want to get hurt for this, and I don't want to die. I work for Tobacco and Firearms- I don't even know anyone with D.E.A…

Two of the three goons are young and not all that experienced.

One, Mickey, actually crossed too close with his gun drawn. If the moment had been right for a mole, Mickey would have been truly astounded at how quickly he and his automatic could be permanently separated.

". ' ' This here video transmitter's powerful, but not powerful enough to reach a satellite. I've got a receiver hidden out there. That's where the tape is…

The third goon, Donny, is the real problem. A beast. Six four or five … two-fifty… careful… moms uell.

"… Look, I don't care who you are or who you were dealing with. I … I just want to get out of this with my skin. There's got to be some kind of deal we can make… " It took most of half an hour, and several more almost gratuitous punches to his face and belly, but finally North got the promise of a deal in exchange for turning over the receiver and tape. He knew that the only deal he could realistically hope for was a painless death, but he had precious few cards to play, and what he needed most was to trim down the odds against him.

"Okay… okay," he said as Donny wound up for what would have been another backhand across his face. "I'm beat. The receiver's in an empty oil drum.

I'll take you there."

Donny looked over at the natty buyer, who nodded.

"Fuck with us and you're dead," Donny said, jerking North to his feet.

"After you get the tape, bring him back here," the buyer ordered.

He backed away from the cold as Donny opened the warehouse door.

Satisfied, North led the three bodyguards out into the raw morning.

"This better not be shit," Donny said as they passed first one warehouse, then another, cause I'm getting cold and impatient."

They turned onto a broad, cluttered pier.

"The receiver's in there," North said, pointing to an oil drum, one of fifty or so stacked lengthways in a huge pyramid. The thin wire of an antenna, barely visible, protruded from a hole drilled in the top.

"Open it."

The three men moved back a step as North took a wloden mallet from between two of the drums and gingerly tapped off the cover.

"It's packed in an oilskin sack," he said, reaching inside. "It's in a-"

"Stop right there," Donny ordered. "Now, back away. That's it.

You really are stupid if you think I'd let you put your hand on the weapon you have in there.

Mickey, get it out.

With the third man's gun still leveled at him, North stepped away.

Mickey pocketed his own revolver and reached into the drum. Almost instantly there was a loud metallic snap, followed by hideous screaming.

Mickey reeled backward, pawing futilely at the jaws of a huge bear trap embedded to the hilt in his wrist.

The third bodyguard's reaction was only a momentary drift of his revolver, but for North that was enough. He kicked him sharply in the groin, and in virtually the same moment drove the heel of his hand upward into the man's nose. An expulsion of air, the snap of bone, and the man was down, not two feet from where his cohort lay screaming.

Instinctively North spun and dived away from Donny. The maneuver kept the huge man from crushing North's skull with a six-foot length of two-by-four.

The blow caught North on the temple. Dazed, he stumbled to his feet just as Donny swung at him again. The board slammed him squarely in the back, dropping him to one knee. In the next instant, the giant was on him, his powerful hands working their way around North's neck, his thumbs gaining purchase against North's windpipe.

Using leverage and every bit of his remaining strength, North rolled the man over and tried clawing at his face. Donny's grip did not weaken.

North felt a swirling nausea taking hold. He needed air.

Again he rolled. This time his effort sent the two of them toppling over the side of the pier. Donny's death-hold lessened as they fell the twenty feet toward icy Boston Harbor. It broke entirely as, halfway down, they struck a massive support beam jutting out from beneath the pier. The beam hit North just above one ear. A fearsome pain shot through his head, followed by numbing cold as he struck the water.

Then there was only blackness.

"He's a fighter, Norma. Look at the way his lids are fluttering.

His random eye movements are gone too.

Sir, can you hear me? Squeeze my hand if you can hear me…

There, I felt it! He squeezed my hand.

Sir, try and open your eyes."

Through an artillery barrage of pain, the muffled voices of two women worked their way into Sandy North's consciousness.

"… Jean, I'm going to check on some of the other rooms. Just page if you need me."

"Thanks, Norma. You've been a big help… Sir, you're in the hospital. White Memorial Hospital.

My name is Dr. Goddard. I'm on the neurosurgical service.

You've been unconscious, but you're going to be all right. Do you understand that?"

"I. I understand," North heard himself mumble.

Colors spun like a psychedelic light show as he opened his eyes and tried to focus on the concerned face looking down at him. One by one, recollections of the mayhem on the East Boston docks began floating back into place.

"That's better. Much better," the doctor said. Her reassuring smile warmed a long, angular face framed by frizzy black hair. "What happened to you?"

North looked at the IV draining into his arm, and the overhead cardiac monitor.

"You tell me," he managed.

"All we know is that someone found you unconscious. soaked, and freezing on some road in East Boston, and called the Rescue Squad. It looks like you fell and hit your head. Or else somebody hit you. It also looks like you spent some time in the water."

"I don't remember." That's no surprise. Amnesia's common with concussion- And you've got half a dozen bruises that could have caused one. We've done a CT scan of your head that's negative, and a bunch of other X-rays, also negative. Your temp was only eighty-nine. It's up to just about normal now. What's your name?"

"Trainor- Phillip lyainor," North said without a hitch. The lie came easily, because on other assignments he had been Phillip Trainor; on still others, any of half a dozen meticulously documented aliases.

This time he had chosen to be Sandy North. It would, he decided, be the last time. North seemed to get into more scrapes than the rest.

Subtly, he began to test his extremities. Each muscle, when called on, seemed to respond. Apparently Sandy North had dodged another bullet.

"Almost nine A.M."

"which day?"

"Tuesday the twenty-fifth of February."

"Good. I've got to leave."

The physician Patted his hand. "I'm afraid that isn't possible, Mr.

Trainer.

"Why not?"

"Well, for one thing you've already been admitted," she said cheerfully.

"You might as well use up one day, at least. Let us keep an eye on you." Then Squeeze my hand if you understand that… "What time is it?" he asked. page sounded, summoning her to another room.

"Look, Mr. Trainer. I've got a man with a fractured neck I have to check on. Do me a favor and just stay put. I'll have someone come in and talk to you."

The moment she had left the room, North grabbed the siderails of the bed and pulled himself up. just as quickly, he sank back, mortar fire barraging his temples. Seconds later he was lying again.

"Back from the dead. My God, what a recovery."

The woman behind the words, a nurse in her early fifties, entered the room and raised the back of the litter. She was a trim, officious-looking woman with carefully styled silver hair and eyes that spoke of hard times. North thanked her and leaned back against the support. The mortars were beginning to let up.

"My name is Norma Cullinet," the woman said.

I'm the nursing supervisor for this shift."

"Trainer. Phil Trainer."

"AH, welcome back, Mr. Trainer. For a while we thought we might lose you.",I'm grateful to all of you."

You had no wallet when you arrived. Were you assaulted? Robbed?"

"I really don't know. It sounds like I might have been. Now, if you'll pardon my abruptness, I have to leave.

"So Dr. Goddard tells me. She doesn't think that's such a good idea."

"I understand. I'll be happy to sign out against medical advice."

The nurse turned off the — monitor and removed the electrodes from his chest.

"As a head injury victim, you could be kept here against your will. but neither Dr. Goddard nor I think that's appropriate. I'll tell you what. Let me get some information for our records, and then I'll pull that IV, clean off your scrapes, and you're out of here."

"Deal," North said.

"Fine." Norma Cullinet picked up a clipboard.

"Name and date of birth?"

One by one North answered the nurse's questions with whatever lie he felt she would accept most readily. "Occupation?"

"Import/export."

"Health insurance?"

"Blue Cross. I'll phone the number in as soon as I get home."

"Next of kin?"

"None."

"No one? Brothers? Sisters? Cousins?"

"None that matter."

"Aunts? Uncles? Business associates? Anyone we can call?"

"Mrs. Cullinet- please. You asked; I answered.

Now how about keeping your part of the bargain.

There are some things I must get out of here and do. Very important things to… my business. Believe me, I'll be fine."

"Sorry," the nurse said, heading for the door. … Two minutes. Just give me two minutes and I'll have you out of here. I've got to get you some clothes, anyhow. Yours are soaked." In two minutes, as promised, Norma Cullinet was back. She gently cleansed the scrapes on his forehead and back, then gave him a set of disposable surgical scrubs.

"Tetanus okay?" she asked as she helped him off the bed.

"Up to date. Mrs. Cullinet, thanks. You've been wonderful."

"It's cold out there."

"I'll call a cab. My apartment's not far from here."

"So you said…

"Well, thanks again,"

"Yes. We'll, see you around."

"Pardon?"

"Nothing. Nothing. Just take care of yourself."

The nurse smiled briefly, turned and left.

North's high-cut shoes, warming by a heat register, were almost dry. He glanced around and then pulled up the inner soles and extracted three hundred-dollar bills and a twenty from beneath each shoe.

His parka was sodden, but wearable. He slipped it on and then carefully made his way out of the emergency ward through a back entrance. If, as he suspected, a Boston police officer was one of the dealers, no place was safe. He had hidden the video receiver as securely as time would allow, but there was always the chance someone would stumble on it.

It was likely that two of Gambone's men had survived. By now the docks would be crawling with men looking for him or his body. Still, he had to find a way back. The weapons mission-months of planning and work-was blown to hell regardless. He would have to answer for that But without the tape the sacrifice of his time and usefulness was absolutely futile.

He took a cab to the Salvation Army and bought a set of well-worn work clothes, gloves, an oil-stained overcoat, and a woolen cap. Next he stopped at a package store for a bottle of cheap wine. In a nearby alley he sprinkled some on his coat and placed the bottle conspicuously in his pocket. Some carefully smeared grit, a change in posture to that of a beaten man, and he was ready. The transformation, which he checked in the mirror of a gas-station restroom, was striking. He hadn't shaved in two days as it was, and the hollow fatigue around his eyes was genuine.

He hoped no one would take much notice of a derelict wandering about the East Boston docks. At least not until he had his hands on that video.

Unwilling to return to his room, he checked into a seedy hotel to await the night. As he lay down on the musty mattress, he finally began to appreciate the heavy toll the events on the dock had taken on him.

His headache was constant, but manageable. His legs were leaden, although that feeling, too, he could cope with. what disturbed him most, and was beginning to frighten him was a bandlike tightness constricting his chest. He endured several fits of coughing, then sank off into a fitful sleep.

NOrth awoke and fell back to sleep twice before he was finally able to leave the hotel and take a cab to a spot near the docks. The tightness in his chest was constant now, and every breath was an effort. He moved toward the lot where the receiver was hidden, and then he froze. There were men everywhere-two that he saw inside the fence, another across the road, not far from the receiver, and one more just cruising in a car with its headlights off. Biting almost through his lower lip to keep from coughing, North backed away and headed toward East Boston center.

He would have to wait for things to cool down; a day, maybe more.

Just over a block away, he stopped and leaned against a lamppost, winded. It was crazy, he thought, During a recent screening at Plan B, he had held his breath for more than two minutes. Now he couldn't seem to get enough air. He forced himself to move on, but again had to stop.

This time, without warning, he began to cough. And for several minutes, he could do nothing else.

"You all right, buddy?"

North, who was doubled over, looked up. A derelict, dressed in clothes similar to his own, was looking at him with concern.

"I… I'm fine, thanks. A cold. That's all."

"Could I have a hit of that?"

"Huh? Oh, sure. Here."

North handed over his bottle. The man took a long swig, wiped his mouth with the back of his hand, and headed off.

Slowly, North made his way down the street. By the time he reached the downtown area he was doubled over again, coughing mercilessly.

White Memorial, this is MedEvac helicopter. Nurse Specialist Burns speaking.

We are enroute to your facility from Interstate Four-five with a Priority One motor vehicle accident victim. Male, age forty-four.

Driver and only occupant.

Multiple injuries. Definite left fractured femur. Definite right fractured forearm. No definite head or neck injuries. Hypotensive at seventy by Doppler, with no E.K.G is sinus tach actate IVs times two are running wide open.

MAST trousers are in place. Repeat, this is Priority One traffic.

Our E.T.A at your helipad is twelve minutes…

Priority One-immediately life-threatening illness or injury. The words, as always, sent a surge of energy through the White Memorial Hospital emergency room.

Priority One another chance to validate WMH's reputation as the finest trauma center in Boston, in the state, and according to many, in the world.

Before the radio report was complete, the E.R. team was in action.

Arms folded, Eric Najarian stood alone to one side of the gleaming receiving area, savoring the immense pride and confidence of the technicians, nurses, and residents as they prepared for battle that February morning.

The image of the emergency room as a feudal castle under siege had first arisen in Eric's mind during his second year of residency, and had grown in complexity and color over the two years that followed.

The technicians-E.K.G, respiratory, and laboratory-had become the support troops and intelligence agents, gathering information and transporting arms and other gear to the militia, the nurses. The interns and junior residents were the officers-the lieutenants and captains.

And above them all, watching more than doing-waiting for the moment when the encounter with death hung on a single major decision, on one brilliant tactic-stood the lord of the castle, the trauma team leader.

Over the years of his apprenticeship at White Memorial, Eric had driven himself to the limit with thoughts of the day when he would hold that position.

Now, six months into his tenure as one of the two chief residents on the emergency service, he drove himself even harder.

He had grown up in Watertown, not ten miles from the hospital, and was the first in his family even to attend college, let alone graduate school. He had started way at the back of the pack, but after eight years of schooling, every one of them as a full scholarship student, and five more years of the most grueling residency, he was finally beginning to make his mark. And Reed Marshall, the other chief resident, notwithstanding, there were those who now regarded Eric as perhaps the best that White Memorial had ever trained-the best in a hospital that had spawned 150 years of the finest physicians anywhere.

Tern Dillard, the charge nurse on the shift, finished issuing a set of orders to her staff and then spotted Eric.

"We're set for him in Four," she said, crossing to him "I told you we'd get one today," he responded, smiling. "I want the crowd in there kept to a minimum, Tern, okay? Have Dierking get in a CVP line and handle the peritoneal lavage. I don't want the other two yet, and I don't want to have to worry. June Feldman can meet the chopper and do the intubation if necessary. What did they say the guy's pressure was?"

"Seventy."

"Hmmm Eric stroked the mustache he had grown and shaved off half a dozen times in the past three years.

He had no particular desire to have one, but there were times when he felt his authority was compromised by his looking years younger than his age, which on that day was a month shy of thirty-one.

"What are you thinking about?" Tern Dillard asked.

"Your eyes," he said absently.

"I wish."

It would be a surprise, she was thinking, if Eric Najarian ever thought about much of anything except medicine. During her nearly ten years as an E.R. nurse, she had seen all manner of residents come and go-flakes and philosophers; insecure jerks who needed to verbally abuse nurses; brilliant thinkers who came unglued at crunch time; soft-spoken young women to whom she would not hesitate to entrust her life. But this man was one of a kind. When he wasn't working killer shifts in the E.R he was in the library or the lab. If the E.R. was backed up at the end of his shift, he would pitch in and play intern for as many hours as it took to catch up.

As a physician, Reed Marshall was good, very good; but he seldom stepped down from the pedestal of his position-seldom got "dirty." Eric was a barroom brawler. And although Tern knew nurses who had dated Eric, and even slept with him, she knew of none who had been able to compete with medicine as the love in his life.

"why's he in shock?" Eric muttered, asking the question primarily of himself. "A spleen? A river?"

"Aortic tear?" tern ventured.

"Maybe…" His voice drifted off. "It's in his chest," he said suddenly.

"How could you know that?"

"I don't know it. I just feel it. God, I'd love to know what the steering wheel of that car looked like…

"The steering wheel?"

"Listen, I want you to do me a favor. Call Dave Subarsky's lab, extension four-eight-one-one, and see if you can get hold of him.

Ask him to come down here right away, and tell him… Better still, just get him on the phone. I'll talk to him."

He raced off toward the radio. As Tern picked up the phone, she heard him raise the MedEvac helicopter and ask about the accident-particularly about seat belts and the condition of the steering wheel.

She knew from five years of watching him work, that with a Priority One just minutes away from arrival, Eric Najarian was operating in a zone few trauma specialists ever reached.

Within seconds of the MedEvac chopper's touchdown on the roof of the Richter Building, the battle was underway. June Feldman, the junior resident, began her evaluation on the way to the elevator and had her report ready for Eric by the time she and the rescue team exploded through the emergency room doors.

The prize at stake was the life of a man named Russell Cowley, the president of one of the region's larger high-tech firms. Eric's pulse had speeded up a notch at that news, This man's rescue and subsequent resurrection would be the stuff of front-page headlines.

According to the MedEvac crew, Cowley had been speeding north on the interstate, seat belt in place, when the right front tire of his Mercedes 450SL had blown. The car had careened through a snowbank and then the guardrail, sailed nearly fifty yards over an embankment, and then crashed into the base of a tree. The jaws of life had been needed to extricate him from the wreck. The steering wheel, bent almost in half, had pinned him to his seat.

"Cowley… Russell Cowley," one of the residents had mused as they were awaiting the chopper. "I could swear he's a trustee of this place.

In fact, I'm sure of it." Eric had taken in the information without reaction, but the look in his eyes grew even more intense.

With Craig Norrell's abrupt dismissal and subsequent disappearance, the position of associate director of emergency services had suddenly come open. And everyone from the secretaries on up knew that only he and Reed Marshall were in the running for the job.

Now, with the search committee struggling for justification to choose one or the other of them, a trustee had been dropped in his lap.

You don't know it, Mr. Russell Cowley, he was thinking, but there is no way that you're going to die from this. Absolutely none.

The Corporate executive howled in pain as he was transferred to the hospital gurney. Crystals of windshield glass sparkled in his hair.

His face, beneath the smeared blood from several lacerations, was violet. He flailed his good arm and screamed again as a nurse inadvertently jostled his left leg. Gradually he drifted off, moaning softly, The orthopedic resident set about stabilizing the obvious fractures. Eric did a rapid exam and then stepped back. He had found nothing that argued against his notion that the impact of the steering wheel had bruised the man's heart, causing pericardial tamponade.

Blood was collecting between the cardiac muscle and the pericardial membrane that surrounded it. The mounting pressure of that hemorrhage was compromising the filling and pumping power of the heart, and causing progressive shock.

If that was in fact the case, then a pericardiocentesisrainage of the constricting blood-was in order. The standard procedure involved the insertion of an E.K.G-guided needle through the upper abdomen, just past the liver, then through the diaphragm, and finally through the pericardium-a tricky, potentially dangerous maneuver.

Eric had other plans. He glanced toward the 'doorway, wondering what was taking Dave Subarsky so damn long.

"Films first, films first," he said, forcing calm into his voice.

"I need a good lateral of his neck right away.

Have them shoot a chest and pelvis as well. June, I don't think he needs a tube yet, but he might. He looks like hell. What's his pressure?"

June Feldman tried to find out with a cuff and Doppler electronic stethoscope, then shook her head.

"As soon as bloods are off to the lab, get an arterial line in him.

Then a catheter," Eric ordered.

Feldman set to work cannulating the man's radial artery, while a second resident numbed a spot near his navel and thrust a tube into the abdominal cavity.

A flush of saline through the tube showed no evidence of internal bleeding.

Eric nodded. The test had ruled out a ruptured spleen or liver, and had made an aortic tear less likely.

The possibility of pericardial tamponade as the cause of Russell Cowley's shock had just increased severalfold.

Tern Dillard rushed into the room.

"How's he doing?" she asked breathlessly.

"No better, no worse," Eric said. "He's tamponading."

"You sure?"

"Not yet, but almost. And if it's true, hold on to your hat.

'You're going to get to see something no one has ever seen-not even me.

That is, providing goddam Subarsky gets down here in time."

"Well, I hope whatever it is happens quickly," Tern said, "because we just got a call on the Batphone.

Boston Rescue is on the way in with another Priority One-a man found in an alley in the North End. No pulse, no respiration. They're doing CPR."

"A drift diver?" Eric asked, his concentration still focused on the residents and technicians.

The term referred to the derelicts pulled from snowdrifts throughout the Boston winter. Most of the time they were well beyond salvation.

"I think so," Terrf said. "The rescue people refuse to incriminate themselves over the radio, but they did say there was a nearly empty bottle of Thunderbird in the man's coat pocket."

"Is he warm?"

"I have my doubts. Rescue made it sound like they were only working on him because their protocol demands: it."

"E.K.G?"

"Essentially straight-line, with an occasional agonal beat."

"Pupils?"

"Dilated and fixed."

"Lord. Tern, isn't there someone else around to work on him?

This is big stuff going on here. This guy's the president of a company, a trustee of this hospital, and he's got treatable injuries.

I don't want him shortchanged while I go through the motions with a wino who probably died hours ago."

Tern's eyes narrowed.

"You're the only senior person around," she said coolly. "If you need help, Dr. Kaiser is next door doing walk-ins." "tell him to take charge of the diver. If this guy needs his pericardium drained, I'm going to do it.

"En'c, come on," she said. "Gary Kaiser's been here a year and a half, and he gets flustered taking care of strep throats. I think his father must have endowed a building or something. There's no other explanation for his getting an internship here."

"well, just tell him it's time to be a goddam doctor.

That's what he came here to be. Anyhow, it sounds like this diver's going to be just another D.O.A. Tern, for chrissakes, don't make that face. Okay, look, I'll be over to help him as soon as- Wait, there's Subarsky.

If things go the way I hope, we may be done before the diver arrives."

Dave Subarsky lumbered into the room, hauling a cart laden with complex machinery. Subarsky had a PhD. in biochemistry from M.I.T but at six foot two or three, with a full beard and massive gut, he looked more like a professional wrestler. He and Eric had grown up just a few doors from each other in Watertown. And although they had entered grammar school the same year, by the time Eric graduated from high school, Subarsky was in his third year of college. It was an unexpected perk of Eric's residency appointment to find his old friend doing independent research in one of White Memorial's labs.

"Ye, David," Eric called out. "You have the right dye? Great.

Run into your boss at all? No? Perfect.

Okay, then, set up right there. We're going to go for it.

June, is that arterial line in yet?"

"Right now," she answered. "One more second and… Voila!"

A low, rapid wave-tracing appeared on the oscilloscope beneath Russell Cowley's E.K.G pattern. Next to it were the numbers 50 and 0.

Systolic and diastolic pressures. Cowley himself had lost consciousness, but his respiration remained steady and reasonably effective. The violet in his face, however, had deepened.

"Call the O.R. and have them mobilize the cardiac surgical team," Eric said. "If this doesn't work, we'll try a needle. But they'd best be ready to open this man's chest." "Okay, David, this is it. Everybody listen up. This is Dave Subarsky. He's a biologist from M.I.T and this is a new kind of laser he's helped develop.

We're going to use it to open a window in this man's pericardium and drain the blood out from around his heart and into his chest cavity, where it will simply get absorbed."

"Is it dangerous?" one of the nurses asked.

"Not in David's hands. It was developed for vascula work, but I got the idea to adapt it for pericardiocentesis- I have total confidence in our ability to do this. We-Dave and I-have been doing animal work with it for months, mostly at three or four in the morning-"

Dave Subarsky, adjusting the dials on the machine, smiled behind his beard.

As soon as it received F.D.A approval for general use, the combination X-ray and coaxial, flash-lamp, pumped-dye lasers would, Eric hoped, become known as the Subarsky/Najarian laser.

First, though, the technique had to work.

"I want you all to know," Eric went on, "that this procedure is virtually noninvasive-far safer and more accurate than the needle approach you're all familiar with. In that lower machine, there, we are using a dye specific for the protein in the pericardium. 'This upper component is an X-ray laser beam that will carry the dye laser beam through the intervening structures, right to the pericardium."

"What should we expect to see?" the same nurse asked.

"well, for starters, a drop in his CVP, and something a little more effective than a systolic pressure of fifty," Eric replied, barely masking his growing irritation with the woman. "Now, if you'd all just move back." "a-I," Tern Dillard hurried into the room.

"Eric, the other Priority One is in Six. Gary Kaiser's working on him."

"What's his temp?"

"Ninety-six two."

"E.K.G?"

"Straight-line with a rare agonal beat." god."

"Tell Kaiser to pronounce the guy if that's all he's-" "Yes, but-"

"Is the cardiac team on standby for this man?"

"Eric, we just lost his pressure," June Feldman said. "Do you want me to start CPR?" the wave formation on the oscinoscope was a straight line. The systolic and diastolic readouts both showed zero. The heart rate began to slow.

Cowley's respiration grew shallow.

"Damn," Eric whispered. "Okay, everyone, this is it. Tern, you'll just have to tell Kaiser to do his best.

Then call the cardiac people and get them down here.

We may have to open his chest right here. Also, get some blood.

They should have him typed by now. Tell them to forget the cross-match on two units and get them over. June, keep a finger on his carotid.

Ready, David?"

"Ready.

"Go for it."

Dave Subarsky hit one switch, then another. A faint blue beam shot from the upper laser, followed almost instantly by a red one from the lower.

The beams intersected at a spot just above Russen Cowley's lowest left rib, and disappeared into his chest.

For five seconds, ten, there was nothing.

Eric shifted nervously and moved forward with the cardiac needle.

"More power?" he asked.

"I don't think so, Doc," Subarsky replied.

"Jesus. Okay, I'm going in," Eric said. "Someone page the cardiac people. Stat."

"Wait!" June Feldman was staring down at her fingertips. "Wait… Yes, I've got a pulse. I've got a pulse." At virtually the same instant, the central venous pressure level began to drop. The arterial pressure monitor kicked in at 70 over 30. Seconds later' it read 90.

Subarsky, cool as snow, nodded as if the wholeaffair were routine, but two of the nurses began to applaud.

"I've never seen anything like that in my life," one of them exclaimed.

"Never."

"Neither have I," Eric muttered, softly enough for no one to hear.

Russell Cowley's coloring improved almost as dramatically as had his blood pressure and CVP. His breathing grew strong and steady. And within two minutes, his eyes fluttered open.

NO One spoke- Eric studied the faces around him.

Their expressions were a wonderful mix of awe and jubilation, It was the prolonged silence of a concert audience who had just experienced the music of a master.

And Eric relished every bit of it.

Through the open doorway, he saw Tern Dillard approaching.

No, not yet, dammit, his thoughts hollered. This is my moment.

Not yet.

':Everything okay?" Tern asked.

'Look for yourself."

He motioned toward Cowley.

"Nice going. Eric, the cardiac people are on their way down.

You've really got to come in and help Kaiser."

"Lord. Any change in the diver?"

"No."

"So what's to help?"

"Eric, please."

"Okay, okay. June, have the cardiac service admit this guy to them with ortho as consult. I'll be back in a few minutes." He glanced over at Tern. "Maybe sooner.

Gary Kaiser annoyed Eric more than any resident he had ever known.

He was immature, indecisive, and nervous as hell in all but the most routine situations.

It was no surprise to see him running a full Code 99 on a derelict who looked as if he had been dead for hours.

"Gary, what gives?" Eric asked.

The scene was subdued, in sharp contrast to the action and energy surrounding Russell Cowley. A nurse was doing CPR while a respiratory therapist was ventilating the man through an endotracheal tube.

Nursing supervisor Norma Cullinet was assisting another nurse in keeping notes on the code and administering meds.

Kaiser, a rosy-cheeked enlargement of the Pillsbury Doughboy, glanced down at the E.K.G machine.

"Nothing," he said.

"Nothing? Do you think this is the result of a coronary.

"I… I imagine so." The E.K.G pattern showed a straight line with an ineffectual electrical pulse every ten or fifteen seconds. It was the sort of complex that often persisted for hours after a patient was clinically dead.

"Who is this man?"

Reflexively, Eric motioned the nurse to stop her CPR while he checked the man's groin and neck for pulses. There were none. He motioned her to start up again.

"A John Doe," Kaiser said. "We've been working on him for almost fifteen minutes."

"Why?"

"Why?" Kaiser shifted nervously. "Well, he had those beats on his E.K.G."

"Those beats mean nothing more than a dead heart."

"And… and his temp was only ninety-six. I…

I thought we should try to warm him up a bit before calling off the code."

As usual, Kaiser was performing mindless, cookbook medicine. it was a maxim in most hypothermic situations to warm the patient before calling off a resuscitation. But ninety-six was hardly hypothermia, and this man was clearly beyond help.

"So," Eric said, "what do you want to do?"

He checked the man's pupils, which were wide and lifeless.

"Do? no, I.- I was sort of hoping you'd take over here so I could get back to the walk-ins."

"Kaiser, what branch of medicine are you going into?"

"Well, I… I've just been accepted in dermatology residency for next year."

"Excellent. I think that's a perfect spot for you. you are excused."

"What?"

"I said, leave. Go back to your walk-ins. I'll take over here."

"You sure it's okay?"

"It's more than okay, Gary. It's an order."

His moon face flushed with crimson, Gary Kaiser backed from the room.

"Dermatology," Eric muttered as he turned his attention to the derelict.

"Thank God for dermatology." The man, unshaven and unkempt, smelled of the alleys. He was dressed in soiled long johns, a frayed checked hunting Jacket, and tattered pants, all of which had been — cut away during his attempted resuscitation. He had a scar on his abdomen-possibly from an old exploratory. There was a tattoo on one hip and a bruise and healing abrasion on his forehead. Eric flashed on the corporation president lying two rooms away, and wondered what the cardiac team was saying about the remarkable save.

"Eric, do you want me to keep pumping?" the nurse asked.

"Huh? Oh, keep at it for a few moments more while I get oriented.

Thanks. You're doing a great job.

Did Kaiser give him anything?" Eric asked the second nurse.

"The usual. Epinephrine, atropine. There's an Isuprel drip running now."

"Right by the ol' cookbook."

"Pardon?"

"Nothing. Norma, do we know who this man is?"

"John Doe. That's all we have."

"well, for my money this is an exercise in futility.

Any objections if I call it off, and we all go about trying to save the living? Good."

Eric studied the end-stage cardiac activity for a few more moments. With the most vigorous efforts, and a great deal of luck, they might be able to reestablish some sort of more effective heartbeat. But with no blood pressure and fixed, dilated pupils, what then?

The time for battle had passed, probably well before the rescue squad had even arrived. He sighed and then reached up and flipped off the monitor.

"That's it," he said. "Thank you all. Norma, i want to get back in with that other Priority One. Can you take over and call the medical examiner about this guy?"

"No problem," the supervisor said.

"Also see what you can do about finding a next of kin. I'll talk to whoever it is, if you want."

Eric turned and hurried from the room without waiting for a reply.

He wanted to be with his save for as long as possible before the cardiac team took the man away.

Norma Culfinet assisted one of the nurses in removing the derelict's IV and endotracheal tube.

Then she wheeled the sheet-covered body out of the room.

You needn't worry about a next of kin, Dr. Najarian, she was thinking. You see, I know for a fact that there isn't any.

Entering the crosswind leg of its landing sequence, the Delta 727 banked sharply, giving Laura Enders an expansive view of Washington, D.C. She had been there once as a ten-year-old, on the only trip she and Scott had ever taken with their parents, and had returned to their Missouri farm determined to become someone of importance.

Now, she pressed her forehead against the Plexiglas window and tried to remember exactly what it was she had wanted to be.

Her flight from Little Cayman Island via Grand Cayman and Miami had been uneventful, but the few days preceding it-the phone calls, the trips to the bank on the main island, the search for someone to replace her at work-had ranged from hectic to frantic. For nearly three years she had been the scuba diving instructor and guide at the Charles Ray Club, the only resort on the tiny Caribbean paradise. It was an experience that had transformed her. But now-at least until she found Scott-it was over.

When she had first arrived at the club as a guest, she was pale, hollow-eyed, emotionally drained, and physically flabby. It took just ten days of vacation there for her to decide not to return for her fifth year of teaching special education at Montgomery High School.

Now, at thirty, she was in the best shape of her life-tanned and solid.

Her psyche, too, had responded to the peaceful magic of the Caribbean.

And in part at Scott's urging, she had sent off a couple of inquiry letters to graduate schools in the States.

But now, all her plans were on hold. After years of neatly weekly postcards and at least once-a-month calls from her brother, more than six weeks had passed without a word from him. She had waited to act, perhaps longer than she should have; she reasoned that his globe-hopping job, setting up communications networks for a company in Virginia, could well have sent him to some inaccessible place. But now that April 3 had come and gone, and Delta had assured her that Scott had not canceled his longstanding reservation for the Caribbean on that April date, there was no way she could remain passive.

Her isolation on Little Cayman had been selfimposed. But a byproduct of that exile, of her commitment to learning who Laura Enders was before allowing herself to choose another career or to fall in love again, was that Scott was all she had.

He was twenty-two and she fourteen, when a kid, high on pills and beer, had jumped a median strip and snuffed out the lives of their parents.

Until that day, she and her brother had never formed any real bond or friendship. Nevertheless, Scott had refused the offer of distant cousins to have her move to Kansas City and had instead taken a hardship discharge from the Special Forces and returned home. The next eight years of his LIFE, including Laura's four years at the university, had been focused on her.

An accident… a prolonged vacation in some out of-the way spot… a romance… a screw-up in the mails… For perhaps the hundredth time Laura ticked through possible explanations for Scott's failure to contact her. None of them eased her foreboding.

It had been more than five months since his last vacation on Little Cayman, and it was on the final afternoon of that visit that they had made arrangements for his April 3 return. Then they had taken the club's small skiff and motored around Southwest Point to dive the sheer coral wall at Bloody Bay. The images from that day were still as clear in Laura's mind as the water in which they dived. It was a double-tank, decompression dive to 120 feet. The day was sparkling and warm, the visibility 200 feet or more. A pair of enormous eagle rays had glided by, near enough to be stroked. Soon after, a dozen or more curious dolphins knifed past and then returned again and again, tumbling and spinning through the crystal sea. It was as close to a perfect dive as Laura ever expected to have.

The next morning Scott had flown back home to D.C. And soon after, his usual weekly postcards began arriving-this time from Boston. … Ladies and gentlemen, the captain has turned on the fasten seat belt sign in preparation for our landing at Dulles International Airport. Please be sure that all carry-on baggage is securely stowed beneath your seat or in an overhead compartment, that your tray tables are locked, and that your seatbacks are in their full upright position…

The businessman who had spent the first half hour of the flight trying to impress Laura with his attainments smiled over at her from the aisle seat and winked. Laura managed a thin smile and nod in return. During three years of working at a resort, she had been forced to hone her skills" at being open and friendly to men without encouraging them in the least. But this day she was far too worried to be cordial.

Despite their frequent contact, she realized now that Scott had shared surprisingly little of his life with her. He knew movies and music, played chess well enough to beat her without paying much attention, and read voraciously in a number of areas. He occasionally spoke of royalty he had dealt with in various countries, but had a self-effacing way about him that warned against being impressed by anything he said or did. He was a whiz with computers or so he had said.

And except for a brief stab at marriage, he had apparently lived a life as solitary as her own.

He had a post office box in D.C. and a phone number that invariably was picked up by an answering service. Laura would not even have known the name of the company he worked for-Communistics International, someplace in Virginia-had he not mentioned it once in passing.

As the 727 glided over the runway, Laura felt a knot of apprehension tighten in her gut. There was so little for her to go on.

Almost certainly she was overreacting. Scott had probably left Boston weeks before, and was now on the Riviera, sipping cappuccino with a beautiful model. Maybe she should just take the return flight to Cayman and wait things out for another month or so. Make some more calls.

But in truth Laura knew there would be no turning back, and no calls. As it was, she had had to beg the operator to search harder for the number of a company called Communigistics, in Virginia, before the woman finally came up with one in the town of Laurel. Laura's call was routed to the person in charge of personnel, who was far less helpful, denying that anyone named Enders had ever worked there. In fact, when Laura pressed matters the woman had actually become rude, and finally as much as hung up on her.

Laura had tried a second time, and a third, but her attempts to be connected with someone other than the personnel director were stonewalled. Now, she decided, Communigistics International would find her someone else to talk with, or deal with an all-night sitin at their offices.

The cab ride to Laurel cost sixty dollars, ten of which was spent trying to find Communigistics. After stopping twice'for directions, the cabbie at last turned into an industrial park, drove past several nondescript gray marble buildings, and pulled to a stop before one that was indistinguishable from the others except for the number 300 on a small sign in front. Then he offered to wait.

"I may be a while," Laura said.

"I got a meter."

"Okay," she said. "Here's twenty. If that gets used up, it's okay for you to take off."

A week's budget just for cabfare. Laura could see that some of her perspectives were about to undergo a change. The world beyond Little Cayman clearly viewed money differently than she did.

Even though the woman in the Communigistics personnel office had denied that Scott worked there, Laura felt certain of what he had told her. It seemed strange now, entering Scott's world without his knowing-it was like looking through his closet. She crossed the sterile foyer to the directory of offices.

Communigistics was on the fourth floor. She tried to imagine her brother dressed in a suit and tie, carrying a briefcase through the brass-rimmed doors and across to the bank of elevators. The image did not fit with the easygoing, independent man who dived with her on Little Cayman, and who cared so much about natural beauty and the nature of things. It was easier to imagine Scott as a professor someplace, or perhaps a foreign correspondent.

Communigistics International occupied the entire floor. A trim receptionist was typing behind a huge, solid-front desk with the name of the company emblazoned in gold across it.

"I'm looking for my brother," Laura began. "I don't know what department he works in, but his name'sEnders. Scott Enders."

The woman checked her directory.

"I'm sorry," she said, "but I don't have anyone listed here by that name."

"And you don't know him?"

"No, I'm afraid I don't."

Laura fished in her purse and brought out a photograph. It was a picture the club manager had taken of Laura and her brother, dressed in wet suits, getting ready to dive the wall at Bloody Bay.

"This is Scott," she said. "It's about five months old." The woman shrugged and smiled politely.

"How long have you worked here?" Laura asked.

"A year. Longer now."

"And you've never seen this man?"

"I'M sorry."

"This is crazy. -I know he works here. He… he's on the road a lot.

Perhaps She was interrupted by the phone. The receptionist answered it, transferred the call, and then turned back to her.

"Can I help you with anything else?"

"Yes. Can I please see your personnel director? I think her name is Bullock."

"that's right. Anne Bullock. She's gone for the day.

"well, who's here?"

"Pardon?

The woman glanced pointedly at the work in her typewriter.

"Look," Laura said, wrestling to maintain her composure, "I want to see whoever is in charge here."

"I'm sorry, that's not-"

"Please. I've come a long way. I'm trying to be polite about all of this, but I will not leave until I've spoken to someone who might know about my brother.

"What seems to be the problem, Alicia?"

Startled, both women turned.

A man, tall and balding, perhaps in his early fifties, stood ten feet away.

"I'm looking for my brother," Laura said quickly.

"His name's Scott Enders, and he works here.

Only-"

"I tried telling her that no one by that name-"

"Please," Laura cut in. "Please let me finish. This is my brother."

She handed over the photograph. "It was taken about six months ago at the club where I work."

"And where's that?" the man said, studying the photo.

"Little Cayman Island in the Caribbean. I'm a diving instructor at a resort there."

"I've always wanted to dive. You must love it."

"I do. Now, about my brother."

"Why don't you come on down to my office, Miss..

"Enders. Same name as my brother. Laura Enders.

"Well, I'm Nell Harten," the man said. "I'm vice president here."

He extended his hand, which was large and warm. "Alicia, this woman's brother did work for us once, but I believe he left before you arrived.

However," he added, looking pointedly at Laura, "he called himself Scott Shollander then, not Scott Enders. Now, if you'd like to come down to my office, I'll be happy to tell you what I know of him."

On the way to his office, Neil Harten stopped at the locked personnel office and retrieved the file on the man he had known as Scott Shollander. He poured Laura a cup of coffee, then settled in behind his desk.

His office was fairly large, but not opulent. Certificates from a number of chambers of commerce, service organizations, and business bureaus were spotted on the walls, along with framed advertisements for various Communigistics programs and equipment.

Harten, who had a weariness about his eyes and deeply etched furrows across his high brow, answered Laura's queries with practiced patience.

Yes, he was certain that Scott Sholiander and Scott Enders were the same person. No, he had no idea why Scott would have changed his name. No, Scott hadn't been fired-he was very good at his job. He had simply walked in one day and quit. And no, he had no idea where Scott had gone or for whom he was working.

Laura reached into her purse and handed over a stack of postcards.

"Here," she said. "These are the cards I've received from Scott for the past two and a half years.

There are nearly seventy of them from all over the world. He missed a week once in a while, but he's never missed two that I can remember.

Now, all of a sudden, I haven't heard from him since February.

Harten flipped through the cards. Most of them contained just a line or two.

"'Wish you were here'… 'Hope you're okay'…

'Casablanca is more mysterious now than it ever was in Bogey's day."

Your brother isn't the newsiest writer, is he?"

"There's nothing in any of them about changing jobs."

Harten shrugged. "I don't know what to say. Scott was a very private person, but I guess you know that.

I can give you the address we have for him in D.C and I can ask around.

But beyond that?" He held up his hands. "Where are you staying?"

"Staying? Nowhere. I… I just flew in and took a cab here."

"I'll be happy to call you another cab and make reservations somewhere."

Laura wandered over to the window. Four stories below, she saw her cabbie reading a paper behind the wheel.

"That's okay. My ride's still here," she said. "But I will take that address."

"Fine, Here it is. Win you be heading back to the Caribbean from D.C.?"

"I'm not going back until I find Scott."

"Well, then, I hope you do."

I will," Laura said. "I'll stop by this address right now.

"And then?"

"And then Boston, I guess. The last few postcards came from there."

Harten sighed and tapped his fingertips together for a time.

"Here," he said. "This is my home phone. I have business connections all over the country. Feel free to call me if there's anything you feel I can do to help."

"I appreciate that. It's very kind of you. Mr. Harten, I'm going to find him."

Neil Harten studied her face.

"I believe you will," he said.

Laura took the elevator back to the lobby and paused by the directory.

Nothing made sense. Nothing at all.

Why would Scott have used a false name? Why didn't he mention leaving Communistics?

She thought about the years following the death of their parents-Scott's emotional and financial sup port during her schooling, the cards and calls, the holidays spent together, the nonjudgmental acceptance of her decisions. Through those years her brother had never asked a thing of her. Now he needed her. She felt that with near certainty. He was in some sort of difficulty, and he needed her. She stepped out into the graying afternoon.

"Take me to the city, please. This address," she told the cabbie, handing over the note Harten had printed for her.

"You got it," he said.

They drove out of the industrial park and onto the highway.

Moments later, a dark sedan swung around the corner and followed.

By the time his bedside alarm sounded to wake him at 5:45 A.m. Eric Najarian had already completed twenty minutes of intense calisthenics and was skimming through a medical journal as he wolfed down two glasses of orange juice and a bagel. It was rare that he ever slept past five, and he would have reset the clock to an earlier hour had he ever thought to do so. But invariably his thoughts were otherwise occupied-usually with — medicine.

On this April morning, absorbing a significant percentage of those thoughts was the selectior. of the new associate director of the White Memorial Hospital emergency service. The position carried with it an associate professorship at the medical school, and it continued to be, at least according to rumor, a twoman contest between Reed Marshall and himself.

Now, after months of interviews and speculation, the three-person search committee was scheduled to meet at four o'clock to announce its decision. If Eric was chosen, he would become the youngest faculty member to be tenured in the history of white Memorial. In over a century and a half, the youngest. For years he had worked toward rewards and acclaim that such an honor would bring. Finally, before this day was over, he would know.

Engrossed in an article extolling the value of placing portable defibrillators in airplanes and on golf courses, he stumbled over cartons of books as he picked his way down the cluttered hallway to his bedroom. The unpacked boxes, sparse furnishings, and unhung pictures gave the impression that he had moved into the Beacon Hill apartment just that week.

In reality it had been well over a year. Initially, his friends had teased him about ignoring the place. With time, they had become more concerned. Eric, however, simply didn't care.

He turned off the alarm and opened Verdi's cage.

The macaw hopped out onto the bed, then swaggered over to him for a dog biscuit, which it devoured with the voraciousness of a German shepherd.

The bird had been a fixture in Eric's life for nearly three years-since the day it was delivered by the uniformed chauffeur of a man whose son Eric had saved from a potentially fatal gunshot wound.

It arrived with no note or instructions-no name, no age, no sex-and spent its first month in Eric's company glaring at him.

Eric initially named the bird Hippocrates after the father of medicine.

But that was before it began singing opera. From what Eric could tell, it could do snatches of a dozen or more arias-all Italian.

There was no way it could be induced to sing on cue; nor, once it started, was there any nonviolent way to stop it. But sing it did, sometimes for as long as ten minutes at a stretch. And although Eric had never held any great interest in opera, he had listened to enough of it now to tell that Verdi was not very good.

Eric waited until the macaw had headed down the hall before shoving the box of biscuits back under a sweater in his closet. Then he checked-his calendar and confirmed that Marshall would be covering the E. R. that day. Eric had decided to pass the hours until the search committee meeting working in the lab with Dave Subarsky. The prospect was bittersweet. From all indications, Subarsky would be closing shop soon.

Over the few months since he and Eric had successfully introduced their pericardial laser, the biochemist's lab, like many others at the hospital, had fallen on hard times. Two government grants he had been counting on-grants that would have been automatic in the past-had been refused. A reordering of priorities coupled with a decrease in available funds was the, explanation the N.I.H and National Science Foundation people kept giving. But everyone in science knew what they really meant.

Finding a cure for AIDS had become politicized, both within the scientific community and without.

Pressure on the federal government had been passed on to the bin government research installations, which, in Turn, had responded with a demand for more authority to direct investigations, and of course for more funding. The reductions in university-centered programs such as Subarsky's had gone from cuts to hatchet jobs. A whole community of scientists were suddenly "outsiders," and for them the situation was desperate.

The professor with whom Dave originally worked had given up basic research altogether and returned to full-time clinical practice.

Subarsky had begun searching for jobs in industry. But even using the laser as bait, he had been unable to attract any decent offers.

Today, unless some miracle had intervened over the few days since they had last spoken, Eric knew that he and his friend would begin dismantling and packing their work. Their laser project was, for both of them, a sideline- They had proven its applicability in one rather unusual medical situation. Unfortunately, "sideline" and "unusual medical situation" were not what the current Washington funding sources wanted to hear.

In a month or two, Dave Subarsky, perhaps the brightest man Eric had ever known, would be unemployed.

Eric sat on the edge of his bed and flipped through the classified ads in the back of the New England Journal of Medicine. There were a dozen or so from various hospitals for emergency physicians, but none for genius biochemists. If the committee chose Marshall, Eric would have no problem finding a job somewhere-probably a damn good one, too.

Such options were a luxury Dave Subarsky did not have. Yet not once had Eric seen even a small crack in the man's quietly positive outlook.

Why, he wondered, couldn't he get his own situation into perspective?

Why, for weeks, had there been a persistent knot of anxiety in his chest?

The answer to both questions, Eric knew, was the same. He would admit it to no one, and could barely admit it to himself, but he wanted this position more than he had ever wanted anything in his life: more than acceptance to college or medical school, more than the appointment to white Memorial, more than the chief residency. To his parents and much of the Armenian community in Watertown, his accomplishments and degree already made him something of a hero. But to the university people-the Ivy Leaguers who dominated most of the departments and residency slots-he was still a state school grad, good at what he did but lacking the scope, the sophistication, to make it big in their academic world.

He wandered to the window. The narrow street, three stories below, was deserted. To the north, over the tops of buildings, Cambridge was bathed in the sterile gray light of dawn. Thinking about what this day held in store was at once exciting and frightening.

Of all the cities in the world, Boston was still the one most looked to in medicine. And at the epicenter of the Boston medical community was White Memorial.

Is it wrong to want to be acknowledged as the best of the best?

Armenians had always been special, had always risen to the top, to positions of influence in their societies. The Turks had known and feared that uniqueness, and over a million Arnenians had been massacred on the altar of that fear. Now, seventy years later, the descendants of those victims were again being persecuted, this time by the Soviets.

Is it wrong to dream?

The phone had rung three rings before the sound intruded on Eric's thoughts. He glanced at the clock radio. Six-fifteen. The call could only be trouble. His father had retired from his maintenance job after his second heart attack. His younger brother George, a dropout from high school, had already served two brief jail terms.

"Hello?"

"Please listen, and listen carefully, Dr. Najarian." The voice, probably a man's, was monotonal and distorted. A vibration machine, Eric thought-4he sort held against the neck by a patient whose larynx had been removed. On one level, he felt certain the call was a prank.

On another, much more primal level, he found the bizarre, emotionless tone chilling.

"Who is this?"

"we are Caduceus, your brothers and sisters in medicine. We care about the things you care about.

We care about you."

"Dammit, who are you?" The chill grew more intense. This was no prank.

"In the days soon to come, we may call on you for help."

"What kind of help?"

"Do as we ask, and the rewards will be great-for you and for the patients you care for so well."

"Rewards? Would you please-"

"Our work is of the utmost importance, and we need you. We can also help you. There is a position in your emergency service. That position can be yours."

For the first time since the phone had rung, Eric felt some lessening of his tension.

"You're full of shit," he said. "The committee has already made its choice. They're announcing it this afternoon."

"When we contact you," the voice went on, as if he had not spoken, "you may be asked to administer a certain treatment to a patient in a manner that is unfamiliar to you. Trust us, do as we ask, speak of this conversation to no one, and you will have what you wish."

"That's nonsense. I told you, the committee has already made its-" The dial tone cut him short.

The Proctor Building, a thirty-year-old, ten-story monument to the monolithic architecture of the late fifties, held most of the research labs at White memorial. The biochemistry unit filled the eighth and ninth floors.

At one time, laboratory space especially at WMH had been at a premium.

Now, Eric noted as he wandered off the elevator and down the dimly lit corridor, several of the labs were deserted.

It was nearly nine-thirty. Following the bizarre phone call earlier that morning, he had gone for a prolonged walk along the Charles, over the Massachusetts Avenue Bridge, and then back by the Museum of Science.

Part of him still clung to the hope that the eerie call was part of some elaborate spoof. But he knew otherwise.

Caduceus. The staff and twin serpents symbolizing medicine. He had looked up the word, hoping that some aspect of its definition might give him insight.

All he had learned was that in mythology, the staff was borne by Hermes, the wing-footed messenger of the gods, patron of travelers and rogues, conductor of the dead to Hades, known for his invention and cunning- How it had come to signify the healing arts, he had not yet learned.

Throughout the walk, just over four miles, he had played and replayed the brief conversation in his mind. it, simply made no sense. Administer a treatment in a manner unfamiliar … What sort of treatment? To what end? How could Caduceus promise him the E.R. appointment when that decision had already been made?

He had entered the hospital through a side entrance and stopped by the speech pathology lab. The speech therapist, a bright, enthusiastic woman, was pleased to demonstrate for him the voice device, known as an artificial electrolarynx. Pressed tightly against a "sweet spot" beneath the jaw, it transmitted impulses from the-mouth and worked whether its user had a functioning larynx or not. The voice it produced when Eric tried it was virtually indistinguishable from that made by the therapist. On a whim he had asked her if anyone at the hospital had borrowed such a device or shown a special interest in it.

Her response had been a predictable negative.

His size-thirteen sneakers propped on his desk, Dave Subarsky was sipping coffee as he pecked with one finger at his computer keyboard.

"Greetings, Doctor," Eric said. "I've been sent here by the Nobel Prize Committee to check on what you're up to."

"I've been expecting you," Subarsky said, hitting the return key.

"Convey my thanks to your committee, and tell them that I and my trusty IBM are on the verge of proving, beyond a shadow of a doubt, that someone with no income, eighteen hundred dollars in monthly expenses, and three thousand dollars in the bank, cannot stay out of the poorhouse for more than two months."

"That bad, huh?"

"It's starting to look that way."

"Something will Turn up."

"Maybe. But it ain't gonna be a grant from the Sackett Foundation."

"You heard?"

"Uh-huh. This morning. The cupboard is bare. I tried telling them that a mind was a terrible thing to waste, but they didn't buy it.

They said my work was too theoretical."

"They're nuts. That stuff you've been doing with.progressive DNA mutation has tremendous clinical potential.

"Maybe," Dave said, his voice drifting off. "Maybe SO.

"You'll find a way."

Subarsky flipped off his computer.

"That I will, my friend," he said. "So, today's the big day, yes?"

Eric shrugged.

"I think so."

"I thought the committee was meeting this afternoon."

"As far as I know, they are, but… David, there's something I want to tell you about, but it's got to stay between us."

"No problem."

Eric hesitated, then recounted the eerie call.

"Does any of that mean anything to you?" he asked.

"Aside from suggesting that there's someone running around White Memorial with a screw loose?"

"David, I tell you, the guy who called may be crazy, but he-or she; I really couldn't tell-sounded like he knew exactly what he was doing. Any thoughts at all?"

Subarsky drummed his fingers on his ample gut.

"Only one. That stunt we pulled with the laser hardly went unnoticed."

"Tell me about it. Joe Silver was thinking about reporting us to the Human Experimentation Committee."

"Why didn't he?"

"Well, for one thing, we saved the guy's life,"

"Minor detail."

"And for another, I convinced my esteemed boss that the only danger of the procedure was that it might not work, and that my hand was poised with a cardiac needle, ready to drive it home, if that was the case. He made it clear, though, that if we ever felt the urge to try out our toy again, we had better have an okay from the committee and a release from the patient."

"As if that dude was capable of signing a release."

"What's the point you're driving at?" Eric asked.

"The point is that the whole goddam hospital knows what we did.

This Caduceus may see you as someone who might be willing to bend the rules a bit in the interest of getting some stuff done around here; something that hasn't been approved by the H.E.

Committee. Isn't that what it sounded like?"

"Sort of. But that damn electrolarynx sure gave the whole thing a sinister cast."

"Regardless, we should know whether or not the guy is for real in a few hours."

"What do you mean?"

"Well," he said, "if Marshall gets that job in the E.R I think you can safely say that Caduceus is a bag of shit."

"What if I get it?"

Subarsky lowered his skateboard-sized feet to the floor," In that case, my friend," he said, "I guess you won't really know."

The administrative wing of White Memorial, located on the ground floor of the Drexel Building, was designed to impress. Crystal chandeliers overhung Oriental carpeting, and cracked, ornately framed oil portraits lined the walls.

Guarding the entry to the corridor, a busty, broad shouldered receptionist coolly appraised Eric from behind a Louis XIV desk.

"I'm Dr. Najarian," he said. "I'm here for a committee meeting."

After spending several hours with Subarsky, he had returned to his apartment and changed-first into the dark suit he had last worn at his med school graduation, and which he ultimately decided was woefully outdated; next into brown slacks and a tweed sport coat that turned out to have a two-inch tear along one shoulder seam; and finally into gray trousers and his navy-blue blazer. It was fortunate, he acknowledged, that he wasn't any more nervous about the meeting, because the search for the right attire had spanned his entire wardrobe. still, the receptionist seemed to approve of the result.

"Dr. Teagarden's committee?" she asked, smiling and pushing her shoulders back just a bit.

"That's right."

"Well, they're just getting started. She asked me to have you candidates wait down there in the sitting room."

"um… exactly how many of us candidates are there?"

"Oh, just two. Dr. Marshall's already there."

"What?"

"He's been here for half an hour."

"Bad."

"Pardon?"

"Nothing. Listen, thanks. Thanks a lot."

"No problem. If you need anything, my name's Susan."

Eric thanked her again and headed down the corridor.

"Anything at all," he heard her say.

"So," Eric said as he entered the plush sitting area, "you're the other candidate the receptionist was talking about. what a surprise."

"Just a second," Marshall said, engrossed in a book, which Eric managed to see was something by John Updike. "I just want to finish this page.

Updike's some talent, don't you think?"

"I haven't read him." In fact, Eric reflected somewhat wistfully, he hadn't read anything outside of medicine in longer than he could remember.

"Well, then," Marshall said with genuine enthusiasm, "you've got a real treat in store."

With his tortoiseshell glasses and aquiline features, Reed Marshall resembled Clark Kent, and in fact was called that in some quarters of the E.R.

Eric settled into a high-backed oxblood leather chair and watched as Marshall finished. The two of them had known each other since internship, and had shared many of the victories and much of the heartache that went with becoming a physician. 'two years older than Eric, Reed had a wife, a son, a circle of successful friends, and virtually universal respect around the hospital.

Initially, Eric had been put off by Marshall's patrician roots and Harvard education, and by an aloofness that Eric interpreted as snobbishness. But one night, as they sat sipping coffee after working side by side on the casualties of a multivehicle catastrophe, Reed confessed that he was envious of Eric's coolness under fire.

"That's crazy," Eric had replied. "You're the iceman Everyone in the E.

R. knows it."

"What I am," Reed said, with deadly seriousness, "is scared to death of freezing up or of doing the wrong thing, and even more terrified of having anyone know how I'm feeling. In fact, I can't believe I'm telling you this."

"Hey, don't worry. Nothing you say win ever leave this room.

You're just exhausted right now, that's all.

Believe me. I'm frightened at crunch time too. How could anyone who's human not be?"

"I didn't say frightened; I said terrified. I want to laugh when someone says I'm as good at this as you are."

"Listen, Reed," Eric had said, "this isn't a contest.

We didn't select ourselves for this residency-all those professors did.

Our job is just to do our best. And believe me, your best is damn good."

Beginning with that night, a mutual respect, almost a tacit friendship had grown between them.

And over the years that followed, not once had either of them mentioned the exchange again. As far as Eric knew, Reed had come to grips with his dragons. Eric believed that in terms of knowledge, dedication, and rapid response to life-threatening emergencies, he held a definite edge on Marshall. But there were other intangibles-Marshall's dry wit, poise, and eclectic intellect-that made any choice between the two of them difficult.

"Any idea why they sent for the two of us at once?" Eric asked after Reed had set his book aside.

"Nope. All I've heard is that they've made their decision.

Knowing ol' Grendel Teagarden, we'll probably learn that some hard-nosed woman from Stanford has been recruited for the position, and you and I are gonna be out of work."

Teagarden, the tyrannical chief of surgery, was as renowned for her outspoken feminism and undisguised partiality toward female physicians as she was for her skill in the O.R. Her volatile capriciousness had made or broken any number of careers.

"Are you sure you want this job?" Eric asked.

Marshall grinned.

"I'm sure Carolyn wants me to want it. You're not married, so you don't know that that's quite enough."

He laughed somewhat wistfully. "oh, I want it, too, Eric," he said finally. "It'd be foolish to say I don't, although even I can't say how much. Put another way, my ulcer may be rooting for you, but my ego is pulling for me. Still, I see the whole question as moot because I have no doubt I didn't get it."

"Nonsense."

"This from the man who not only is a legend at his work, but who just happens to have saved a trustee's life."

"He never even sent me a thank-you note."

"Jesus. Well, that's no surprise, given the holier than-thou philosophy of this place. Speaking of which, before we get called in there, I want to thank you for doing your best not to make a big deal out of all this."

It was Eric's Turn to smile, "You mean not openly," he said.

"Of course. The whole damn committee has been doing its best to set us at each other's throats, privately and in public."

"The famous WMH pyramid."

"Exactly. Room for one and only one at the top.

Survival of the nastiest. We both deserve a pat for not taking their bait. I know how much you want the position, and the real truth is, if it didn't mean so much to Carolyn to stay around here, I might have actually considered pulling out of the running.":'You don't have to say that."

"It's true… Well, at least, it might be true."

"I wonder what in the hell they're doing in there," Eric said.

"Two-on-one with Grendel?"

"God, what a prospect! If so, my money's on Teagarden. Say, listen, does the name Caduceus mean anything to you?":'Aside from the obvious?" 'Aside from the obvious."

Reed Marshall shrugged and shook his head. "No bells," he said.

"Why?"

"Nothing. Maybe later we can-"

The door to the conference room opened and Dr. Joe Silver stepped out.

A ferretlike man in his late forties, Silver stood no more than five foot five in the two-inch lifts that, rumor had it, he wore even to bed.

He had been the chief of emergency services for five or six years, and ran his office in an autocratic manner that would have made Napoleon proud. He was knowledgeable enough, but he had no sense of people's needs or how to deal with them straightforwardly. And over their years of association with the man, neither Eric nor Reed Marshall had been able to develop anything approaching a warm relationship with him.

"Gentlemen," Silver said, "we apologize for keeping you waiting.

If you'll both come in please…

Both? Eric wondered why the committee would do something so insensitive. Surely, after three months, and interview upon interview, it would have been more appropriate to speak with the losing candidate alone. He thought back to the eerie call. The caper, whoever he or she-was, seemed so confident of being able to affect the selection process. Was Joe Silver Caduceus? It was so like the man to play control games with people.

The committee was seated at a massive hardwood table, with Sara Teagarden at the head. She was a large, androgynous woman with close-cropped auburn hair and gold-rimmed granny glasses. That day she was dressed in a royal-blue suit with a large pearland-diamond broach on the lapel. It was an outfit that somehow made her appear even more intimidating than usual. As she welcomed them Eric tried unsuccessfully to match the cadence of her voice with that of the caller.

Joining the heads of surgery and emergency medicine on the search committee was Dr. Haven Darden, the chief of medicine. The highly publicized demise of Craig Worrell, the former associate director of emergency services, had bathed White Memorial in an intensely unfavorable light, and the high-powered makeup of the search committee underscored the hospital's determination to put the whole- matter to rest. Silver, Teagarden, Darden-Eric had not faced a panel such as this one since his internship application days. He wondered if the triumvirate was about to take the WMH pyramid philosophy to the limit by engaging the two of them in a medical quiz-down.

As if reading Eric's mind, Haven Darden said, "Now don't get worried, you two. We're not about to start firing clinical problems at you."

Of the three committee members, Darden, a tropical medicine specialist, was the one Eric felt was least in his corner. Like Reed Marshall, he had come straight up through the Harvard system. Unlike Marshall, though, he had risen from abject poverty. His life, from his illegitimate birth in a ghetto in Port-auprince, Haiti, through his escape to the United States and his subsequent adoption by a wealthy black physician, had been chronicled in various Harvard publications.

There was a rumor that somewhere not far down the line, Darden was slated to become the first black dean in the history of the university.

His detractors, and there were a number, pointed to his inability to make any major research contributions to his field.

But his reputation for clinical brilliance kept all but the most vociferous enemies at bay, and residents often jockeyed their schedules to be on the wards when Darden visited.

Darden's English was clipped and precise, with just the hint of an accent. And unless he could change his speech radically, Eric decided, there was no way he could have been the caller. He struggled to force thoughts of Caduceus from his mind and to concentrate on the business at hand. In a minute or two the committee's decision would be known, and the whole bizarre affair would most likely be exposed as a hoax.

"Gentlemen," Sara Teagarden began, "we don't wish to drag this business out any more than you do.

However, I am sure you know that we are trying to recoup some pretty heavy losses in the public's confidence in our hospital, and in particular in our emergency service. I would like Dr. Silver to explain how and why we have arrived at our decision. But first, I would like to be certain that both of you are still interested in becoming his associate. Dr. Marshall?"

"I'm still in."

"And Dr. Najarian?"

"Yes "Very well. Dr. Silver, will you please explain our current position."

Eric gripped the edge of his chair as Joe Silver straightened his notes and adjusted his reading glasses.

"Reed, Eric," he began, "I first want to congratulate each of you for the impression you've made on this committee, and also to thank you on behalf of President Tertensen, the trustees, and all of White Memorial for the marvelous years of service you've rendered here. As you know, the previous associate E.R. director brought us more ill will and bad ink than any hundred other doctors who have ever worked here combined…

Despite the tension of the moment, Eric and Reed exchanged amused glances. Craig Worrell had gone to the well of his perversion once too often, and had been videotaped soliciting sex from a young woman emergency-room patient in exchange for a hefty narcotics Prescription.

He was arrested soon after in his BMW in the hospital garage as he urged the undercover policewoman to hurry up and get on with her Part of the deal so that he could return to duty. The entire Boston press and TV corps seemed to have been present for the bust. A month later, while free on bail, Worrell vanished. Since then there had been rumored sightings of the man, but nothing more.

Silver continued, "We three are understandably, I think you'll agree, reluctant to make a final choice if there is the slightest uncertainty.

We know that you expected a decision today, and we appreciate that this may seem cruel, but we have voted to, ah, put off making our selection for perhaps another two or three weeks. If this decision puts either of you in a position where you need to withdraw your application, please tell us at this time."

Silver's pronouncement hit Eric like an uppercut.

No decision-the one option he hadn't considered. But the committee had made a definite choice. At least, that was what Silver himself had intimated not two days before. What in the hell is going on?

Eric stared at his chief and then, one at a time, at the others on the committee. Their faces seemed plastic, unreal.

Eric'? Excuse me, Eric?"

"Huh? Oh, sorry."

Silver looked at him oddly.

"Eric, Reed here has indicated that he is willing to put matters on hold for two or three more weeks.

We're waiting to hear whether or not you can do the same." Eric battled to bring his thoughts together.

"Of course," he heard himself say. "It's fine with me to wait."

The plastic faces grinned approvingly.

"Excellent," Sara Teagarden said. "Dr. Darden, have you any comments?"

The internist looked first at Reed, and then at Eric.

"I would only beg you gentlemen's forgiveness and understanding in this matter. If it were possible, I believe we would choose to keep both of you. However, things being as they are, and with the trustees and press watching our every move, there are a few more avenues we wish to explore, a few more inquiries to make. If either of you has problems or questions, I am sure any of us would be happy to meet with you."

Without further comment, Sara Teagarden hoisted herself to her feet, shook hands with the candidates, and adjourned the meeting.

"You okay, Eric?" Marshall asked after the others had left. "You look green."

This is bullshit. Absolute, insane bullshit, Eric wanted to holler.

Instead he just shrugged.

"Sure, I'm fine," he said. "I… I had just prepared myself for a decision today one way or the other."

"Me too. I ran into Teagarden just yesterday, and she made it sound as if it was all over. I even had the feeling from things she said that you had gotten the job. I didn't want to say so out there, but it's the truth.

Well, listen, I'm due back at the E.R so I'll see you later.

It's only another couple of weeks." He punched Eric lightly on the arm.

"You keep your nose clean now, ya hear?"

"You too," Eric said. "You never know when big brother-or big, big sister-may be watching."

Eric stood motionless as Marshall hurried off. The two of them had never spent any real time together outside of the hospital. Now, as their time at WMH was nearing an end, he wished they had.

Susan, the receptionist, was watching Eric as he approached.

"How'd it go?" she asked.

"It didn't. Nothing happened."

"Well, committees are like that. I've taken minutes at some meetings, and you wouldn't believe how little a group of M.D.'s can get done."

"You said it. Well, see you in a couple of weeks."

"Wait, " she said. "I have something for you."

She handed him a plain envelope. DR. ERic NAJARIAN was printed on it in a meticulous hand. Eric's knee-jerk reaction was that the envelope was a note from her, but he quickly realized from her expression that it was not.

"A candy striper dropped this off for you a little while ago," Susan said. 'She was real cute, but a little too young for you, I think."

Eric was too distracted to pick up the.woman's cue. He fingered the envelope for a moment.

"Thanks," he mumbled, and headed off.

"I'm here all day," Susan said.

Eric turned into the main corridor of the hospital, and then leaned against a wall and tore the envelope open. The note inside was printed in the same hand as was his name.

WEAR THIS, AND WE WILL KNOW, was all it said.

Wedged in one corner of the envelope was something metallic.

His fingers stiff and cold, Eric pulled out the object and held it so that no,passerby could see. it was a stickpin bearing a black oval stone, possibly obsidian. Inlaid in the stone was a finely tooled gold caduceus.