Charlatans

29

SATURDAY, AUGUST 12, 1:51 P.M.

Noah felt oppressively hot as he stepped out of his Beacon Hill building into the hazy summer sunshine. Typical of Boston in mid-summer, the humidity had climbed along with the temperature. As he walked up the few steps to the corner of Revere and Grove Streets, he could feel perspiration run down his back despite his summer attire of T-shirt, shorts, and flip-flops. Heat radiating up from the brick sidewalk seemed equal to the heat streaming down from the sun above.

At the corner, Noah stopped and turned around suddenly to look behind him. As he expected, there was a man trudging up Revere Street in his direction. He was dressed in a shirt and tie and had a summer-weight jacket slung over his shoulder. In deference to the heat, the shirt was unbuttoned at the neck and the tie loosened. He was African American with closely cropped hair and a trim, athletic build.

Noah believed he had seen this individual before. It had been on Thursday when he’d emerged from his apartment at about the same time with the same destination in mind, Whole Foods on Cambridge Street. Since the cataclysmic meeting in Dr. Hernandez’s office on Tuesday, Noah had been holed up in his tiny apartment, paralyzed by a combination of depression and anxiety, believing his life was in the balance. Beginning on Wednesday, the only thing that had driven him outside was the knowledge that he needed to eat, even though he didn’t feel particularly hungry. Each day he’d made the trip to the prepared-food section of Whole Foods to bring home some selections that would serve for both lunch and dinner. He felt totally incapable of preparing anything, and the idea of going to a restaurant in the presence of happy, normal people didn’t even occur to him. Breakfast, he’d ignored.

On Wednesday, when he came out on his way to Cambridge Street, he soon had the perception he was being followed. Curiously enough, he had the impression it was the same person who he felt had followed him home on two nights, although he couldn’t be certain, since it had been night and he’d never gotten a particularly good look at the man. What made Noah think it could be the same person was the suit, the same thing that had caught his eye on those nights. That and his particularly trim build, similar to the African American’s.

Although Noah initially attributed the idea of being followed to delusional paranoia, he went out of his way on Wednesday to follow a circuitous route. Without fail, the man reappeared after each turn, even to the point of going in a full circle, forcing Noah to recognize he wasn’t suffering a delusion. He was indeed being followed. Yet the man didn’t seem to mind that he stood out like a sore thumb, which made no sense. If someone wanted to follow him, wouldn’t they try to conceal it? But why would anyone want to follow him? The only possible idea that came to mind was the hospital wanted to make certain that Noah stayed away as he’d been told. Noah admitted that he’d been sorely tempted on several occasions to sneak back to check on his in-house patients.

On Thursday, Noah had thought it had been the same man following him who was now coming up Revere Street. On Friday, it had been the Caucasian man. It was as if they were a tag team, sharing the burden by alternating days.

Motivated by an equal amount of curiosity and irritation, Noah made the snap decision not to move. He thought the man would surely stop and pretend to be occupied with examining something as the Caucasian fellow had done on several occasions, but he didn’t. He kept coming, not in a hurried way but certainly without the slightest hesitation. It seemed that Noah’s standing still didn’t faze him in the slightest.

When the man got to Noah and motioned to go around him, Noah reached out and stopped him by lightly grabbing his upper, heavily muscled arm. They regarded each other. Noah estimated he was in his thirties. Up close, he was clean shaven, handsome, and clearly in excellent physical shape. The man didn’t move except for his eyes, which lowered to look at Noah’s hand that was grasping his arm. Noah sensed that the man was tense, like a tightly coiled spring. Noah quickly withdrew his hand.

“Why are you following me?” Noah said. He tried to make his voice sound casual, even though he was suddenly afraid of this individual.

“I’m not following you, man,” the individual said calmly. “I’m just hanging out here in Boston, taking in the sights. Now, if you’ll excuse me, I’ll be on my way.”

Noah stepped aside. With a slight nod, the man continued along Revere Street. Noah watched him until he was about a half-block away, then Noah turned down Grove Street, more confused than ever. He walked quickly, occasionally looking over his shoulder, fully expecting to see the man reappear.

It had been a difficult three days for Noah. Being isolated in his depressing apartment and having nothing to do was torture. Accustomed to working fifteen hours a day seven days a week and always behind, the change was intolerable. He couldn’t remember when he’d been so idle, unable to stop obsessing about what was happening to him. And, disturbingly enough, he’d learned Wednesday afternoon that there were many more days of boredom to be endured. It had been then that he’d gotten a call from Dr. Edward Cantor’s office, and, as a further humiliation, it hadn’t been the surgical residency program director himself. It had been his secretary, informing Noah in a disinterested monotone that an ad hoc meeting of the Surgical Residency Advisory Board to decide his fate was scheduled for 4:00 P.M. on Wednesday, August 23. She also gave Noah the name and phone number of an attorney that the hospital had retained for him, in accordance with existing labor laws.

The idea that Noah would need an attorney, which hadn’t even occurred to him, didn’t help his terror about the upcoming meeting. For him, having lawyers involved made the whole situation much more threatening and serious. He’d been hoping the problem might resolve itself when people realized he didn’t manufacture data but rather just conservatively estimated the results to make a deadline and replaced them as soon as the real data was available.

The other issue that weighed heavily on Noah’s mind was learning how long he would have to suffer the uncertainty of his fate. Initially, when he left Dr. Hernandez’s office, he’d assumed the meeting would have been scheduled within a day or two at most. He had not expected two weeks! For him it was an added torment to drag it out.

Reaching busy Cambridge Street, Noah glanced behind him. He didn’t see his follower, but he sensed that the man would reappear just as his partner managed. Noah still could not imagine why the hospital was keeping him under surveillance but accepted he just had to live with it despite its absurdity.

Once Noah was in the supermarket, he went directly to the prepared-foods section. Since he didn’t feel the slightest bit hungry, it took him quite a while to pick out a few items from the vast array available. At least it was cool in the store. After he paid for his purchases, he started back up Beacon Hill. He looked for the African American but didn’t see him. Since he no longer thought of it as any kind of threat, he was beginning not to care.

Noah’s legs felt heavy as he trudged up Grove Street, which seemed to have become steeper than he remembered. He was dreading returning to his sparse, lonely apartment. Late Wednesday afternoon, Noah had finally swallowed his pride and had tried again to get in touch with Ava in hopes of eliciting some sympathy. He’d expected to hear from her as soon as the word of his suspension spread through the operating room, which he assumed would have been almost instantaneous following the meeting with Dr. Hernandez Tuesday afternoon. He’d fully expected she’d call or at least text between her cases, considering the seriousness of the situation. When it hadn’t happened by 4:00 P.M. Wednesday, he’d first tried to call her landline, thinking she’d be at home. When she hadn’t answered, he’d tried her mobile. When that was unsuccessful, he’d texted and waited for a full half-hour. Ultimately, he tried both email and Facebook messaging. Nothing had worked.

All day Thursday and all day Friday, he had hoped to hear from her, and when he hadn’t he’d become progressively more depressed. It seemed totally out of character. She would have known immediately the depths of his despair since she had firsthand knowledge of his total commitment to surgery, which was as strong as her commitment to anesthesia. Considering their physical intimacy, how could she not feel an irresistible urge to get in touch with him, just to be sure he was all right? Noah knew that if the tables were reversed, he’d be the very first to make sure she was okay, even if he were irritated with her over some other issue.

By Friday night he’d reached his emotional nadir. Could she still be that upset and angry over his violation of her trust? Apparently so, even though it didn’t seem possible to Noah, especially after his sincere apology, and once again his yearning to hear from her morphed into anger at her apparent lack of empathy. Such a mind-set had led to another even more disturbing possibility. He’d recalled several weeks earlier in responding to Ava’s questions about his Ph.D. by admitting that he had fudged it a little. Since she’d been the only person in recent years to whom he’d mentioned his thesis, could she possibly have anything to do with the issue being raised by the surgery department?

One thing that Noah was certain about was Dr. Mason’s role in the affair. His self-satisfied smile alone during the fateful meeting in the chief’s office had made that clear. Noah was certain it had been Dr. Mason who had gotten the bound copy of his Ph.D. thesis from MIT, apparently studied it as evidenced by the Post-it notes, found the discrepancy between the submitted hardcopies and the online version, and had sounded the alarm. Could Ava have been so low as to communicate to Dr. Mason to look for discrepancies in the thesis?

When this thought had occurred to Noah Friday night, he had dismissed it out of hand as he’d done other suspicions. Noah was absolutely confident that Ava detested Dr. Mason, so the idea that she would help him was ludicrous. Yet how did Dr. Mason know about the issue? Noah had no idea.

Arriving at the corner of Grove Street and Revere, Noah was about to turn right when he glanced over his shoulder down the hill. He started. Almost a block away was the African American. He was coming in Noah’s direction once again with his jacket still slung casually over his shoulder.

“Taking in the sights, my ass,” Noah said under his breath, his anger at Ava finding a convenient target even though he’d resigned himself to being under surveillance. He hurried down Revere Street to his front door and quickly entered. A moment later he was in his apartment and rushed to the front window. He was certain the man would appear, and when he did, Noah planned on opening his window and loudly embarrassing the man. Noah even briefly thought about calling 911 to complain about being harassed.

After ten minutes of watching, Noah gave up. He carried the bag of prepared food into the kitchen and pushed it into his refrigerator without opening it. Now he was less hungry than when he was at the store despite not having eaten since the previous night. It was a little after 3:00 in the afternoon.

Returning to the living room, Noah again looked out the window. There were a few pedestrians going in both directions as there had been before, but no athletic-appearing African American with white shirt and tie carrying a suit jacket over his shoulder. Just like on Wednesday, Thursday, and Friday, the person he thought had been following him just disappeared, making him question his sanity.

Sitting down on his couch and gazing at his blank walls, Noah felt adrift and intensely lonely. It was as if the weight of the world was pressing down on him. He needed some human warmth, and unfortunately, Ava was not coming through. The only person who came to mind was Leslie Brooks. He looked at his watch again as if he’d forgotten he’d just checked it. It was almost 4:00. He wondered if Leslie would be available. For the entire two-years-plus that they had been apart, it had always been Leslie who called, and it had always been on Saturday afternoon. Maybe she might be available. After all, it was Saturday afternoon.

In his depressed state, Noah found decision making difficult. Should he call, and if he should, should he use FaceTime or not? As a doctor he was always decisive, but in the social arena, he was not, especially now, under these extraordinary circumstances. After going back and forth several times, he heaved himself to his feet and went into the bathroom to get a look at himself in the medicine-cabinet mirror. He didn’t like what he saw. He hadn’t shaved since Tuesday, hadn’t slept well, and accordingly looked like death warmed over. No, he wouldn’t use FaceTime if he called. He didn’t want to scare Leslie, even though he craved sympathy.

After flip-flopping on whether to call or not, he impulsively clicked her number. He felt great relief when she picked up on the third ring. Noah had been counting.

“Will wonders never cease?” Leslie said. She was a little out of breath. “This is the first time you’ve called me since I don’t remember when. What’s up?”

“Can you talk, or is this an inconvenient time?”

“I’m on the street, walking back to my apartment,” Leslie said. “I’ll be home in five minutes. Can I call you back?”

“I suppose,” Noah said. Now that he had her on the line, he didn’t want to lose her.

“You don’t sound good. Is something wrong?”

“Call me back,” Noah said. “But don’t use FaceTime. I don’t want to scare you.” He disconnected without waiting for a response.

As Noah impatiently waited, he found himself imagining how her apartment looked. Undoubtedly, it was the opposite of his, with all sorts of decorative, feminine stuff, including colorful curtains and soft rugs. When he lived with it, he’d never appreciated it. Now he missed it.

True to her word, she called back. It was more like ten minutes than five, but Noah was happy to hear her voice.

“Okay,” Leslie said in a serious tone. “What’s wrong? Have you broken up with your new girlfriend?”

“Worse,” Noah said. “I was suspended from my residency position. In a week and a half I have to go before the Surgical Residency Advisory Board to see if it is going to be permanent. One of the ironies is that I sit on the board, so I need to recuse myself.”

“Good God!” Leslie exclaimed. “How? Why? This has to be a misunderstanding.”

Noah told her the whole story. It felt good for him to voice it all, especially to someone who knew him and whose opinion he trusted. Leslie was well aware of Dr. Mason, as she had been around during the Dr. Meg Green fiasco and the resulting fallout. Noah included that Ava, whose name he now used, had not so much as texted him since the event, which she surely would have learned about. He admitted she was justifiably angry with him and described why. As a final point, he mentioned that Ava had been the only person in years to whom he had mentioned anything about his Ph.D. thesis.

“First let me say how very sorry I am this has happened,” Leslie said when Noah fell silent. “Knowing you, I can understand how devastated you are. I’m sure it will be reversed at the advisory meeting. Clearly, from what you have told me, no one has put more of themselves into being a surgical resident than you.”

“I wish I could be so sure,” Noah said, his voice breaking.

“With your record and your level of commitment, it is an inexcusable reason to dismiss you. I’m sure of it. It has to be reversed. I think their motivation is merely to play along with Dr. Mason and make a statement about ethics.”

“I hope you’re right,” Noah said. “It’s possible it was done to humor Dr. Mason. Dr. Hernandez did specifically tell me a week ago that Dr. Mason had to be reckoned with. Well, we’ll have to see. Regardless, I appreciate your sympathy and thoughts.”

“Now for the rest of my response, which I assume you want because you made the effort to call, how honest do you want me to be? I know on our last conversation you weren’t too happy with what I had to say.”

“I need you to be honest,” Noah admitted. “I might not like it, but I need to hear it.”

“I think there is a very good chance that Miss Ava was the source of raising this thesis issue, especially after you telling me how angry she was catching you snooping in her computer.”

“But I apologized profusely,” Noah argued. “It doesn’t seem reasonable she’d do such a thing, even as it smacked of betrayal to her. The punishment doesn’t match the crime, and she hates Dr. Mason, and I believe she truly cares for me. And she knows how much surgery means to me because I think she cares about anesthesia to the same degree.”

“Again, you are asking for my opinion, and I am giving it,” Leslie said gently. “If you listen to this story that you are telling me about this woman, there seems to be a disconnect. You even questioned yourself if she was being manipulative, and she has used this silence routine before. In my mind, I don’t think there is any question. But more to the point, have you asked yourself why she should be so damn sensitive about her computer? I mean, you said you apologized.”

“Good point,” Noah admitted. “I have asked myself that question. I think it has to do with her lobbying for the nutritional-supplement industry, which supports her lifestyle. When she caught me at her computer, I was reading a letter she was in the process of writing to her boss. It was serious stuff advocating dirty tricks associated with the law that keeps the FDA from interfering with the industry. We’re talking about billions of dollars.

“And there is another reason for her to be sensitive about her computer. Incredibly enough, her major social activity is social media. It is a significant part of her identity.”

“You are joking,” Leslie said.

“I’m not,” Noah insisted. “She’s on all forms of social media every day, from Facebook to Twitter to Snapchat to dating sites. She even has a fan page with over a hundred thousand followers.” What he purposefully avoided saying was that she used sockpuppets, except for LinkedIn.

“Noah!” Leslie exclaimed. “What you’re describing is a media-crazed preteen girl inhabiting a grown woman’s body. Are you sure this is a healthy relationship for you?”

“There are extenuating reasons for her interest in social media,” Noah said. He didn’t want to hear where Leslie was going, since it mirrored too closely his own reservations about Ava that he’d been trying to ignore. “She is reluctant to socialize with hospital colleagues, somewhat like myself. And her lobbying job takes her away most weekends, so social media fills a void. She lives in Boston but doesn’t seem to know anyone in particular.”

“I don’t know,” Leslie said with resignation. “I wish I could be more positive about this woman, since you obviously care for her. But I think you should be careful.”

“She also has a history of having been emotionally injured,” Noah said. “She was abandoned by a new husband who was a surgical resident from Serbia who needed a green card. I’ve never been married, but I think I can relate to that.”

There was a pause in the conversation, with the issue of abandonment hanging in the air.

“Is there anything you can do to prepare for the Advisory Board hearing?” Leslie said to change the subject.

“The hospital has assigned me a lawyer,” Noah said. “I haven’t called him yet. I’ll do that on Monday. I suppose it will be interesting to get his take. But it scares me the hospital thought I needed a lawyer. It certainly suggests they are taking this seriously. They even have me under surveillance.”

“What do you mean?”

“Every time I go out there’s a guy in a suit following me. There’s two of them and they trade off.”

“Are you sure they’re following you?”

“I’m pretty sure,” Noah said.

“You think it is the hospital?”

“I do. Who else would it be? The only problem is that I think it might have started before my suspension.”

“That doesn’t make any sense.”

“Tell me something I don’t know.”

“But why would they be watching you?”

“Your guess is as good as mine,” Noah said. “I guess they want to keep tabs on me to make sure I don’t sneak back into the hospital. It’s true that I considered doing it. I can’t imagine what my patients are thinking. I don’t know what they have been told. Maybe there are some serious legal issues I don’t understand.”

“I’m so sorry all this is happening to you,” Leslie said. “You don’t deserve it. I still think it will work itself out, at least in respect to the hospital. I’m afraid your girlfriend might be another story.”

“I appreciate your listening to me,” Noah said.

“Call me whenever,” Leslie said. “And good luck. I hope everything turns out okay. I really do.”

After appropriate goodbyes, Noah disconnected the call. For a moment, he sat staring at the blank wall. His calling Leslie had been a toss-up emotionally. He appreciated her sympathy and support, but she’d aggravated his concern for Ava’s possible involvement in his suspension.

Thinking about his thesis got him up from the couch. He went into the surprisingly large walk-in closet where he kept several heavy cardboard storage boxes. He rummaged through them until he found the large portfolio with an elastic closure containing all the material relating to his thesis — all his notes and copies of the various drafts. He brought it out into the living room and began to go through it to refresh his memory. He hadn’t opened the file for more than ten years.

30

MONDAY, AUGUST 14, 3:34 P.M.

The lawyer that the hospital had retained for Noah was not the warm-and-fuzzy person Noah had hoped for. His name was John Cavendish, a thin, young man with gaunt features and lank blond hair who Noah guessed was in his late twenties. He was not particularly personable. Although he was a member of a large law firm housed on the fiftieth floor in an elegant high-rise building on State Street, he had only junior status. His office was an interior one without a window and was as small as Noah’s living room.

Noah’s appointment had been for 3:00, but as eager as he was, he’d arrived around 2:30 and had been kept waiting for forty-five minutes. John had come out to the waiting room when he was ready to see Noah and had stiffly introduced himself. The lawyer was now going through Noah’s Ph.D. file page by page, his expression neutral.

Taking a deep breath, Noah settled back into his chair. It was the first time he’d ventured out of his apartment since going to Whole Foods Saturday afternoon. He was still depressed and anxious, hoping the visit to the lawyer might buoy his mood. So far it didn’t seem promising.

The weather was as hot as it had been on Saturday, and Noah felt it more acutely, because he was now dressed in his only jacket and tie. As he had expected, he’d been followed, this time by the Caucasian, who was significantly more subtle in his surveillance technique than his African American colleague.

“Thank you for bringing in this material,” John said as he slid the papers back into their folder. “Unfortunately, there doesn’t seem to be anything of particular value in the present circumstance.

“Let me ask you again, just to be sure. It is my understanding that you stated in front of witnesses that the bound volume of your thesis contained falsified information. Is that correct?”

“It is,” Noah said. He then went over the entire problem for the second time to make sure the lawyer knew all the details. Watching the man’s expression as he talked made Noah feel he was trying to go up a down escalator.

“I can appreciate what you are saying,” John said when Noah finished, “but you did admit to falsifying data. It would have been far better if you hadn’t done that.

“Just so I am not blindsided, have there been any other similar ethical lapses in your academic career that if revealed would influence this current problem?”

“Only one,” Noah admitted. “Once while I was a freshman at Columbia University, I bought a paper off the Internet and handed it in as my own work.”

“Was there any fallout at all at the time?”

“No,” Noah said.

“Does anyone know of this incident?” John asked.

“No,” Noah said. “I don’t believe I’ve ever mentioned it to anyone other than you.”

“Good,” John said. “If the question of other ethical lapses comes up during the Advisory Board meeting, I don’t want you to answer. I will answer for you. Understand?”

“I suppose,” Noah said. The meeting with the lawyer was not helping his anxiety.

“All right,” John said, standing up behind his desk. “I will do my best. Thank you for coming in. If you think of anything else germane, please let me know. Otherwise, I will see you on the twenty-third of August.”

A few minutes later Noah walked out into the August heat onto State Street. He felt so depressed he didn’t even bother to look for his tail until Court Street. He wasn’t sure what prompted him to look back over his shoulder, but he was surprised not to see the Caucasian, so he stopped to look more carefully. When he still didn’t see him, he felt somehow let down, like his life was in such dire straits that even his mysterious followers were abandoning him.

Thinking the man was being more subtle than usual, Noah continued at a slower pace to the northeastern end of the Boston Common. The route required a number of uniquely Boston twists and turns, due to the city having been designed more for horseback than cars. On each corner, Noah checked behind him, expecting to see his follower, but he was nowhere to be seen.

Suddenly feeling relieved rather than abandoned, Noah wondered what he should do to take advantage. Since he had no idea why he was being followed, it wasn’t a totally rational thought. Nonetheless, the idea of visiting Louisburg Square occurred to him, maybe even ringing Ava’s doorbell. What could he lose? Since his conversation with Leslie Saturday afternoon, his confusion about Ava had weighed on him. Although he had thought about trying to contact her again, he hadn’t. The idea of confronting her seemed appropriate, although there was the question if she would even talk to him. He decided it was worth the risk.

Arriving outside her house, Noah climbed the half-dozen stairs of her stoop and entered her foyer. Since he knew she had a camera at her front door as part of her security system, he purposefully stood to the side to avoid being seen. He rang the bell. Staying perfectly still, he could hear a phone ring in the distance. When she didn’t respond, he tried again. This time he heard her voice from a hidden speaker asking who was there.

“FedEx,” Noah said in a falsetto, making him cringe at the absurdity of it all.

“Just leave it,” Ava’s voice said.

“I need a signature,” Noah said in the same falsetto. He was embarrassed for himself and suppressed a nervous chuckle about the antics he was capable.

A moment later the door swung open. Ava was back to her yoga pants and tank top, presumably in anticipation of her afternoon workout. Within a fraction of a second her expression morphed from ennui to irritation when she caught sight of Noah. She started to close the door, but Noah inserted his foot like an old-fashioned door-to-door salesman.

“I need to talk to you,” he said.

“I’m still angry with you,” Ava said. She pushed the door against him, but not with much resolve.

“That’s obvious. I want to know if you’re aware that I have been suspended from the hospital.”

“Of course I know,” Ava said. “Everybody in the hospital knows, and no one can figure it out. You are a popular person. I give you that.”

“Can I come in for a moment?”

Ava reluctantly opened the door, leaving it ajar. It was apparent she expected it was to be a short visit. Both cats appeared and sniffed Noah’s leg.

Noah and Ava eyed each other. Finally, Noah spoke: “Knowing my commitment to surgery, I thought I would hear from you. I could have used some sympathy. I’m devastated, and I’m having trouble coping.”

“As I said, I’m still really, really mad at you.”

“But I apologized sincerely about violating your trust. I’m so sorry, Ava. I admitted my mistake of going on your computer. I thought you could forgive me and be supportive, considering how close we’ve become. If the tables were turned, I guarantee I’d be on your side.”

“I’m not so sure about that,” Ava said.

“Why not? Why would I lie to you?”

“You betrayed me. Not only did you go into my computer because you had misgivings about my anesthesia training, you went to my boss, Dr. Kumar, questioning my competence in regard to the three deaths. And you did it behind my back. You know how I know? He told me. He has that much confidence in me. How dare you?”

Noah felt his mouth go dry as he realized she was partially right. He had betrayed her in both circumstances. “I felt it was my ethical responsibility as the super chief resident to voice my concerns to the proper person. You weren’t willing to talk to me about them. I’m not an anesthesiologist. In retrospect, it was a mistake to go to your chief. I should have gone to mine and let him talk to Dr. Kumar. I’m sorry for that, too.”

“It seems that your ethics function selectively,” Ava snapped. “The rumor is that you were suspended from the hospital for falsifying data on a thesis that helped get you into medical school.”

“How did you know that?”

“Dr. Mason told Janet Spaulding, which is a sure way to get it all around the OR.”

Noah knew there was no way Dr. Mason would have told the whole story. He worried how such rumors might affect the people on the Advisory Board.

“Dr. Kumar advised me to break off our relationship,” Ava said. “He strongly suggested I avoid fraternizing with you.”

For almost a full minute Noah and Ava stared at each other. Both were overwrought. Noah broke the silence: “So is this the end of our little romance?”

“I don’t know,” Ava said. “I’m trying to digest it all.”

“If it is the end of our relationship,” Noah said irritably, “there is one thing that I’d like to know. Were you the one who raised the Ph.D. thesis with Dr. Mason and got the damn thing from MIT?”

Ava threw her head back and laughed derisively. “Hell, no. I can’t stand the blowhard. There’s no way I would want to help him. Why would you even think such a thing?”

“Because you were the only person I’ve talked with about my thesis for years. And you are certainly the only person I’ve said anything to about ‘fudging.’ Dr. Mason wouldn’t have come up with the idea on his own.”

“It wasn’t me,” Ava snapped. “Maybe it was your old girlfriend who you ignored. Maybe she wanted to get back at you.”

“It wasn’t Leslie,” Noah snapped back.

“Then I don’t know who the hell it was,” Ava said. “Now I want to work out. So if you don’t mind, I’d like you to leave.”

His emotions in turmoil, Noah walked out of Ava’s house. When he’d entered, he’d felt perplexed, depressed, and anxious. Now he felt perplexed, depressed, and angry. Despite Ava’s protestations to the contrary, she had to be the one who brought the stupid thesis issue to Dr. Mason’s attention. Yet her suggestion about Leslie ate at him even though he was sure she could not be involved. She’d never acted angry when she left. If anyone had been angry, it had been Noah, but even he had been angry at himself not Leslie.

He pulled out his mobile phone as he headed up Revere Street toward his building and called her. He had no idea if she’d answer, but at least it was after 5:00, so he was reasonably confident he wouldn’t be disturbing her at work.

“What’s up?” Leslie responded after only two rings. “Are you okay?”

Noah assured her he was okay and explained that the reason for his call was just to ask her if, by any chance, she had ever said anything to anybody about his Ph.D. thesis, particularly recently.

“Absolutely not,” Leslie said. “To tell you the honest truth, I completely forgot the whole story about your thesis until you brought it up on Saturday. I’d never given it any significance that you’d had to estimate some figures to get it in on time since you made the effort to replace them with the real ones when they were available. Besides, I’d never say anything to anybody about your thesis. I don’t even remember the name.”

“Okay, good,” Noah said. “I just wanted to be sure.”

“I’ve been thinking about your situation ever since we hung up on Saturday,” Leslie said. “Are you interested in what I’ve been thinking?”

“I guess,” Noah said.

“The more I think about it, the more certain I am that your erstwhile friend Ava has to be responsible for raising the thesis issue.”

“I thought the same thing, since you and she were the only two people I’d ever confided in about it. Five minutes ago, I asked her point blank whether she’d done it, and she denied it.”

“So she finally contacted you?” Leslie said.

“No, I went to her house and rang the bell.” He was too embarrassed to mention the FedEx ruse.

“Was she at least friendly?”

“No. She said she was still angry at me.”

“Did you believe her denial?”

“To some degree,” Noah said. “She didn’t hesitate in the slightest. She even mocked me for suggesting such a thing.”

“Well, I certainly didn’t do it,” Leslie said. “And if she was the only other person who knew about this thesis issue, it would have had to have been her who spilled the beans. Yet it does seem out of keeping with how you described your relationship and certainly out of proportion to your going on her computer without permission.”

“I did something else that I didn’t tell you about,” Noah said. He went on to admit that he’d gone to her boss behind her back with minor but nagging concerns about her professional performance in a couple critical situations.

“Ouch,” Leslie said. “To my way of thinking, that could be interpreted as betrayal more than accessing her computer, especially if she is as dedicated to her work as you say. How did she find out you went to her chief? Do you know?”

“He told her.”

“Double ouch,” Leslie said. “Now all this is making more sense. If she did blow the horn on your thesis, it could be a kind of sick tit-for-tat by forcing the surgery department to question your ethical competence.”

“That’s gone through my mind,” Noah said.

“Is there a reason to question her competence?” Leslie asked.

“No,” Noah said, “not really. She’s a well-trained anesthesiologist who is religious about keeping up with her specialty. She’s done thousands of cases at the BMH over the last five years. I’ve been told she passed her written and oral anesthesia boards with flying colors, which is no mean accomplishment. And to be hired by the BMH, she had to be seriously vetted. There is no doubt about her general competence.”

Noah reached his building but hesitated going inside. He was afraid he’d cut Leslie off.

“Did you see the lawyer today?” Leslie asked.

“I did, but it was a bust. He must have just graduated from law school and got assigned all the crap cases. I can’t imagine he’ll be any help.”

“I’m sorry.”

“Thank you.”

After saying goodbye, Noah hung up. Once inside his building he began to slowly climb the stairs. His legs felt strangely heavy again, as if they didn’t want to return to his apartment any more than he did.

31

MONDAY, AUGUST 14, 7:15 P.M.

After getting into his apartment, Noah peeled off his damp shirt and tie, turned on the window air conditioner in the bedroom, and collapsed on his couch. It had been a discouraging day. Even the phone call with Leslie hadn’t cheered him. Instead it had increased the anxiety and irritation he felt about Ava. And Ava’s continued overtly defensive reactions whenever he tried to voice his misgivings about her three anesthesia deaths only heightened the concerns he had about her anesthesia training. It could have been so easy for Ava to reassure him, and if she had, he never would have even considered the misguided idea of going to Dr. Kumar, which ended up aggravating the situation. One way or another, Noah thought that the issue of Ava’s sensitivity to questions about her professional training and competence demanded more attention if for no other reason than to take his mind off his own problems. It was also a type of therapy for his smoldering resentment in how Ava was treating him.

The question for Noah was how to go about doing it. Since Dr. Mason was the only other person who questioned Ava’s competence, Noah thought for a fleeting moment about approaching him to ask if his opinion was based on anything other than using Ava as an easy mark for the Vincent case. The idea of attempting to have such a conversation brought a smile to Noah’s face as he considered the absurdity of it. He doubted if the vain blowhard would even talk to him other than to gloat that he’d succeeded in getting Noah dismissed, and Noah couldn’t imagine the conversation staying civil. Noah knew that he’d be unable to resist demanding to know who had alerted him to the Ph.D. issue.

And how the hell did his bound Ph.D. thesis end up on Dr. Mason’s desk? The main MIT library where the bound theses were stored did not allow them to circulate now that all Ph.D. theses were available online. If people wanted to see the originals, they had to go to the library.

Noah checked the time. It was quarter past seven. He couldn’t remember the summer hours of the main MIT library on Memorial Drive, but he assumed it would be open until at least 8:00 and possibly as late as midnight. Impulsively, he decided to visit as a way of getting out of his apartment. He knew the place well from having spent considerable time there when he was writing his thesis. What he had in mind was to find out who had borrowed his thesis and how it had been arranged.

Since it was a hot, muggy summer evening, a T-shirt, jeans, and tennis sneakers without socks sufficed. A few minutes later he was heading down Revere Street. His goal was the MBTA station at Charles Street. There were a lot of people out and about, particularly on Charles Street. When Noah restricted his life to the hospital and his apartment, it was always a minor shock to be reminded he was in the middle of a world-class city.

The subway station at Charles Street was elevated above the street at the Boston side of the Longfellow Bridge. Noah used the stairs instead of the escalator for a bit of exercise. Except for the trip to the lawyer’s office and several excursions to Whole Foods, Noah had been vegetating in his apartment since Tuesday afternoon.

The platform was crowded, particularly at the head of the stairs but less so at the far end. Still, Noah held back, knowing it was best for him to be toward the rear of the train. He was only going one stop to Kendall Square. It was for that reason that he had a view back down the stairs he’d just come up. With a minor start, he once again caught a view of the African American fellow who was on his way up on the escalator. When Noah had first emerged from his building, he’d looked for his followers but didn’t see them. He didn’t care one way or the other, as he’d become inured to their presence. If they had meant him harm, it would have already happened.

Noah studied the man as he approached. For a brief moment their eyes met. There was no sign of recognition on the part of the African American. Whoever he was, it was becoming clear to Noah that he was a professional, even if not as subtle in his technique as his colleague. When the man reached the platform, Noah toyed with the idea of approaching him and asking him if he was working for the hospital but then discarded the notion. Intuitively, he knew the man would deny trailing Noah just as he had the last time Noah spoke with him. Instead, Noah merely watched the man as he disappeared into the waiting crowd farther along the platform.

After detraining at the Kendall Square stop, Noah searched for his tail but didn’t see him, at least not immediately. It wasn’t until he was a few blocks away from the MIT Library that he saw him again when he looked over his shoulder. The man was at some distance but coming in Noah’s direction. He was clearly not in a hurry but rather moving at Noah’s moderate pace, seemingly content to keep Noah in sight. Noah shrugged, finding it mildly curious that the man’s presence no longer caused him any concern, although he was still puzzled about the situation. The hospital would only care if he was on the hospital grounds, not what he was doing elsewhere.

As Noah reached the front door of the library, he noted it was open until 11:00 P.M. so there was no need to rush. He used his hospital ID to be admitted, which worked, since there was general sharing of research facilities among several of the academic institutions in the Boston area. Once inside he went directly to the library office to talk with one of the librarians on duty. The sole person available was named Gertrude Hessen.

“You are correct,” Gertrude said in response to Noah’s question. “Bound Ph.D. theses do not circulate. It has been a policy in place since all of them have been digitized.”

Noah explained that he was a surgical resident at BMH and had been surprised to see a copy of his MIT thesis on a professor’s desk. “Is there an exception to the rule for professors?” he asked.

“Not to my knowledge,” Gertrude said. “Are you quite sure it was an original copy of your thesis?”

“There was no doubt,” Noah said. “Would you mind if I checked the thesis room?”

“Not at all,” Gertrude said. “Let me get you the key.”

A few minutes later Noah was in the subterranean stacks of the library, standing at the locked wire cage that contained all the MIT theses going back to the nineteenth century. The key was attached to a wooden paddle by a short chain. Once he was inside, the heavy steel-and-wire door swung closed on its own. The click of the lock seemed loud in the total, mausoleumlike stillness. Noah noticed that the key was needed even to get out, giving him a creepy feeling. With so much material available online, few people ventured into library stacks anymore. Noah wondered how long it would take for him to be rescued if something went wrong and he couldn’t get out of the cage, especially if Gertrude forgot she’d given out the key.

With some mild unease about his being isolated and locked in, Noah searched quickly for the section where his thesis would be located. The works were filed alphabetically by author rather than by subject matter. It didn’t take him long to find the R’s, and when he did, he was soon looking at the spines of two copies of his bound thesis. There was space for a third copy, but it was empty. Someone had managed to get the volume out of the library against the rules.

Happy to be back in the library office, Noah told Gertrude one of his bound volumes was definitely missing.

“I don’t know what to say,” Gertrude admitted with a flutter of her eyelids. “But what I will do is leave a note for the day people to investigate the matter. If you want to leave your mobile number, I can have someone get back to you.”

When Noah emerged from the library, the sun had set but it was still light. The view of Boston reflected in the Charles River was stunning from the library steps. Noah hesitated for a moment to appreciate it and then scanned the area for his tail, but he was nowhere to be seen. Somewhat surprising himself, he again felt oddly ignored, similar to how he’d felt on leaving the lawyer’s office. As lamentable as it sounded, his followers had been Noah’s main connection with the outside world since Tuesday afternoon.

Several times on his way back to the subway stop at Kendall Square, he glanced over his shoulder, but there was no one there. Once he’d gotten to the underground station, Noah was happy his tail had disappeared. On his way to the library when he’d been followed, it had crossed his mind that he’d feel vulnerable on the way home, thinking that if anyone meant him harm, a deserted inbound platform would have been a perfect location. Now, as he waited for the subway, there was only one other person, and he was way down at the other end.

Noah felt a certain relief when the train thundered into the otherwise silent station, and he was able to board the front car with its complement of people. Ten minutes later he was on busy Charles Street, feeling comfortable being back in his neighborhood. As he passed the Thai restaurant that had supplied many of the take-out dinners he’d enjoyed with Ava, he hesitated. For the first time since the meeting in Dr. Hernandez’s office, he felt hungry. After a moment of indecision, he went into the crowded restaurant and ordered what he’d eaten with Ava on so many occasions.

As the only solo diner in the entire restaurant, Noah felt out of place and wished he’d ordered take-out. He ate quickly and was soon back out on the street. It was now dark, with the iconic Beacon Hill gaslights providing the bulk of the ambient light. Hiking up Revere Street, he paused several times to look back, strangely hoping he’d see the African American. There were plenty of people. A neighbor whom he recognized from having seen over the years said hello to him as he passed in the opposite direction even though they had never spoken.

As he neared his building and dreaded being alone, he thought about returning to Ava’s to see if she might relent and be willing to iron out their problems. But remembering her attitude, he thought the chances were slim and just showing up again might make things worse.

Climbing the stairs, he fished out his key so that by the time he was standing at his door he had it ready. Unfortunately, he didn’t need it. Once again the door had been forced, and on this occasion, it hadn’t just been forced. This time it was apparent a crowbar or something similar had been used, as there was a split between the doorknob and the jamb, with a portion of the jamb missing.

A wave of anger spread through Noah. Busting his door seemed unnecessarily aggressive, adding insult to injury. Using just his index finger, he pushed it open slowly. He reached within and flipped on the light. From where he was standing, everything seemed entirely normal. He listened intently for fear whoever had broken in might still be there, but the apartment was silent. All he could hear was some music with a heavy bass coming from the unit above.

32

MONDAY, AUGUST 14, 9:37 P.M.

Noah stepped over the threshold and went immediately to the folding table. He was relieved to see that on this occasion his laptop had not been moved. It was still positioned exactly as he had left it, aligned perfectly with the sides of the folding table. Quickly, he flipped open the computer and booted it up. A moment later he was able to check his browser’s history. He wanted to see if it had been cleared as it had been on the recent break-in. It hadn’t. He could see all the websites he’d visited that day. At least no one had been using his computer as had happened on the previous occasion.

After checking the kitchen for his few appliances, since a toaster had disappeared in the past, he was relieved to see that none were missing. Moving into the bedroom he immediately noticed that a small stack of spare change and a few single-dollar bills were gone. Otherwise, the room seemed the same as he had left it, including his rumpled bed that hadn’t been made in more than a week.

Moving on into the bathroom, he noticed the mirrored medicine cabinet door was slightly ajar. He opened it and looked inside. Immediately, it was apparent that something else was missing. On the second shelf there had been an unopened prescription for Percocet that he’d been given after breaking his nose during the hospital softball game that spring. Now it was gone.

Believing his life was unraveling in all sectors, it took Noah some time and a hot shower to calm down from the trauma of yet another violation of his personal space. What bothered him the most on this occasion was the unnecessary physical damage to the door and the jamb. In the grand scheme of things, losing some spare change and an unwanted vial of Percocet was small potatoes in comparison to having to take the time and effort to convince the landlord to do a decent repair and do it immediately since the door couldn’t be secured in its present state. And while he was in contact with the landlord, he was going to demand that the woman tenant above be strongly advised to limit her open-door policy with her many boyfriends. On the positive side, Noah was thankful the intruder didn’t trash the apartment in frustration of finding so little of value.

When he was able to relax enough to think, Noah returned to his computer to learn more about Brazos University, its medical center, and its medical school. Comfortably clad only in his skivvies, he rebooted his machine.

Captivated by the extent of the material available, he learned that the university had grown at an impressive rate during the nineties, thanks to the beneficence of a large group of wealthy West Texas oilmen. Sam Weston, honored by the eponymous simulation center, was one of them. The medical school had opened in the mid-nineties upon completion of the nine-hundred-bed hospital, whereas the dental school had to wait until the early aughts. The medical school initially started with only thirty-five students, drawn mostly from West Texas high schools, although they did actively recruit American students who had been forced to attend medical schools in the Caribbean and Europe.

Noah went on to read that the Brazos University School of Medicine quickly had reached its present class size of 145 students. Graduate residency programs were started the same year the hospital opened its doors but initially limited to family practice, surgery, anesthesia, and internal medicine. Within just a few years a full complement of graduate education programs were added in all the specialties associated with a major tertiary care academic medical center with the openly stated goal to supply a wide range of medical talent for West Texas.

Next Noah turned specifically to the Brazos University Department of Anesthesiology, learning that it had recruited professors from a good number of the topflight medical centers around the country. The chief of Anesthesia had been brought in from Johns Hopkins, one of the USA’s top academic medical centers, which impressed Noah considerably. He ascertained that all aspects of anesthesia were quickly integrated into the residency program, including sophisticated cardiac surgery, neurosurgery, and transplantation medicine. He also learned that twenty residents were admitted each year, and all residents were required to have performed at least twenty thousand cases during their training.

Noah rocked back from leaning over his laptop. As he stretched, he stared up at the ceiling. He no longer had any doubt that Ava had trained at a fully accredited institution with probably more than adequate supervision, especially considering that the Brazos University Medical Center handled more than twenty thousand major surgeries per year, which was about the same as the BMH. Brazos University might not be Ivy League, but from Noah’s perspective, he thought it sounded perfectly adequate.

Noah wasn’t completely satisfied, however, thinking it wasn’t enough to learn she had been in an okay program. He craved more personal information, like exactly how many cases she had handled personally, what was the breakdown of the types of anesthesia, and if there had been any problems. After all, wanting to find out her residency case load had been his misguided motivation for going on her computer. Of course, he did recognize that her being hired by the BMH suggested she had done extraordinarily well, and Dr. Kumar had bragged that she had passed her anesthesia boards with flying colors. Yet Noah found himself motivated to find out more for three reasons. First, he was bored silly from being locked out of the hospital; second, he was infatuated with her and maybe even in love and eager to find out anything he could; and third, he was lonely, frustrated, and, most important, seriously pissed off at her for the way she was treating him despite his effusive and sincere apologies and his willingness to throw pride to the wind by ringing her doorbell. Whether she had anything to do with the thesis issue he tried not to even think about.

Rocking forward again, Noah suddenly had in mind to check what kind of firewall Brazos University had, if they had one, and if they did, whether it had ever been upgraded. It had been Noah’s experience that young, rapidly growing institutions like Brazos U often lagged in cyber-security, often relegating it to a low level of priority with a constant demand for funds elsewhere. Although Noah guessed that the hospital most likely had up-to-date digital security to satisfy HIPAA regulations, he thought the rest of the institution might be a relative pushover.

With his natural computer aptitude, Noah had engaged in some innocent hacking in his teenage years, purely for fun. Now he had the opportunity to apply these skills. What he was hoping to find were details of Ava’s medical school and residency records, which he imagined were going to be stellar. Having just finished the resident evaluations for the BMH crew, he knew what kind of information was potentially available.

Going back to the websites of Brazos University School of Medicine and the Department of Anesthesia, he had it in mind to request application forms be emailed to him from both. Once that was done he planned to use the email headers to see if he could get into their systems. But as he waited for the first website to come up on his screen, alarm bells went off in his brain, reminding him that what he was about to attempt was illegal and certainly not ethical. If there was good security, there was a slight chance he could be discovered. With his upcoming Surgical Residency Advisory Board meeting, being caught committing a cyber-felony was hardly advisable. In fact, it was downright stupid.

Suddenly, Noah had an idea. He knew he could not risk hacking into the Brazos University computer system, but that didn’t mean someone else couldn’t possibly get the same information in another, legal fashion. Noah had never thought of hiring a private detective. He’d never even met one and only knew of their existence from watching crime movies, where they seemed to play an oversized role. But here was a situation where a local private investigator would probably be able to get a significant amount of information and do it entirely aboveboard. The idea was, under the circumstances, decidedly appealing on a multitude of levels.

Having no idea what to expect, Noah googled Private Investigators in Lubbock, Texas. An instant later he was astounded at the selection of both PI firms and PI individuals. He looked at a few websites of the firms and decided they were too imposing and probably not sufficiently private for his comfort zone. If Noah was going to employ someone, which he hadn’t completely decided, he wanted just an individual, not an entire organization, and one who worked out of the home and didn’t even have a secretary. Although Noah knew what he was proposing was legal, he didn’t want it to get back to Ava. As mad as she had been about his talking with Dr. Kumar, he certainly didn’t want her finding out he’d hired a private investigator to look into her training. Yet he was progressively warming to the idea. He didn’t see any other way to get answers without putting himself in jeopardy.

After looking over the websites of a dozen individuals, Noah found one that seemed promising. Her name was Roberta Hinkle. Part of her attraction was that she advertised she had gone to Brazos University where she had obtained a degree in Criminal Justice. Another plus was that she listed “background check” as one of her specialties, which was essentially what Noah wanted. He also appreciated that she listed her hourly rate, whereas most of the other people did not. Although Noah initially thought $60 per hour was high, it was less than most of the other sites that did list their fee. Impulsively, he decided to find out more.

Roberta Hinkle’s website invited either phone or email contact for more information. Since it was after 11:00, Noah opted to use email. To make it easy there was an online form to be filled out with his name, email address, and the kind of investigation desired. Along with his name he included his title of M.D. In the investigation section to make it sound like a group effort, he wrote: “We are interested in a strictly confidential, full background check on an anesthesiologist on our staff by the name of Dr. Ava London. We need to know more details of her professional training and her earlier schooling. All information made available will be appreciated including psychosocial factors. Dr. London grew up in Lubbock, attended Brazos University School of Medicine and trained at the Brazos University Hospital but now works in Boston, Massachusetts.”

In the section of the form labeled “payment preference,” Noah wrote “PayPal” to make it simple. In the section labeled “start date,” he wrote “ASAP if it is decided to move forward.”

After Noah clicked send, he again felt a letdown similar to when he realized the idea of his hacking the Brazos University computer system was off the table. Again, with the PI idea, he had gotten himself worked up, and now he had to sit on his hands and wait. He wondered when he might hear back from Roberta Hinkle, understanding it depended completely on her schedule. If she were busy, it might be days. If she wasn’t, then it could possibly be within twenty-four hours. Vaguely, he wondered how busy Lubbock PI’s were in mid-summer. Unfortunately, there was no way to know answers to any of these questions. The only thing he could do was call Roberta’s phone number in the morning.

For lack of anything else to do, Noah decided to go on Facebook to see if Gail Shafter or Melanie Howard, meaning Ava, were online. Yet he didn’t want to do it as Noah Rothauser. Instead, he decided to create his own sockpuppet, calling himself Butch Cassidy, in deference to one of his favorite old movies. That would make it such that Ava wouldn’t know she was dealing with him if she happened to be on Facebook. But then he changed his mind about the name. As smart as Ava was, he was afraid she might recognize the name as too much of a coincidence, as they had talked about movies on several occasions. Instead, he decided to call himself Harvey Longfellow, which he just pulled out of the air. At least it sounded appropriately New England.

As Noah was creating the profile of a thirty-year-old love-starved insurance salesman who hated Ivy League snobs, a point he thought Ava might appreciate, he was alerted to an incoming email. Since he wasn’t finished with Harvey’s profile, he used his phone to see who had emailed him, hoping it might be Roberta Hinkle, and it was.

Amazed at the rapidity of Roberta’s reply, Noah minimized his profile of Harvey Longfellow and immediately began a long email back to Roberta:

After rereading the email and making a few minor changes, Noah sent it off. He then brought up the profile he had been creating for his fake Facebook account. No sooner had he reread what he had written about Harvey Longfellow when a second email came in from Roberta Hinkle.

Noah went back to staring up at the ceiling, trying to decide what to do. He had an immediate good feeling about Roberta Hinkle and liked that she was eager and could start right away. With the same impulsivity that had encouraged him to respond to Roberta’s website, he decided to go ahead with hiring her. He knew that if he changed his mind overnight, he could stop her efforts. He emailed her back to give her the go-ahead. Almost immediately a reply came back:

Impressed with Roberta’s rapid responses and seeming professionalism, Noah emailed her back that he would be looking forward to her email. Once again, he cautioned her that discretion was paramount. She responded that she understood perfectly and emphasized that strict confidentiality was the nature of the business. She told him not to worry.

After the final email with Roberta, Noah tried to go back to his fake profile, but found he couldn’t concentrate. He kept wondering what Roberta might find above and beyond all the complimentary stuff he expected, since Ava certainly had to have done extremely well. Despite Roberta’s reassurances, he worried if her questioning might somehow get back to Ava and, if it did, what effect that might have. Would Ava suspect that Noah was behind it? He doubted she would, but who was to know? For a few moments, he thought about emailing back and canceling the investigation, but then he changed his mind again. He’d wait for her morning email. Tonight, Roberta was only going to see what she could learn online.

At that point, Noah noticed it was after midnight. More important, with the feeling he had done something that was potentially promising to dispel once and for all his misgivings about Ava, he felt as if he could finally sleep. He turned off his laptop and the overhead light in the living room, pushed his couch against his broken door for an attempt at security, and went into the bedroom.

33

TUESDAY, AUGUST 15, 2:52 P.M.

For the first time in a week Noah had slept reasonably well and woke up refreshed. He attributed it to having hired the private investigator in Lubbock. Engaging the PI gave him the feeling he was doing something positive about Ava, and he was comfortable with the decision. He would have much preferred she was willing to discuss the nettlesome questions he had about her performance in her three deaths, but clearly that wasn’t going to happen. Short of his hacking into the Brazos University computer system, it was the only way it might be accomplished. He justified it as ultimately being in her best interests. Just as he expected to be reinstated at the Advisory Board meeting, he was hopeful that Ava was going to ultimately accept his heartfelt apologies and let bygones be bygones. They were too well suited for each other and had been too close in mind and body for any other outcome. And the next time she voiced any thoughts about leaving clinical anesthesiology, he wanted to be sure of her competence.

At 8:00 A.M., Noah surprised himself by going out for eggs and bacon at a local greasy spoon. He’d even read The New York Times like a normal person. He’d also gotten some bread and cold cuts for a later lunch before returning to his apartment. His plan had been to finish creating his Harvey Longfellow sockpuppet and then go on Facebook to try to friend both Gail Shafter and Melanie Howard. His hope had been that, come evening, he could be messaging back and forth with an unsuspecting Ava.

It was at 2:52 in the afternoon that the reasonably pleasant day started to fall apart when his mobile phone went off, startling him. Snapping it up, he looked at the screen, hoping it might be Ava. But it wasn’t. It was the MIT Library.

“Is this Dr. Rothauser?”

“Yes, it is.”

“This is Telah Smith calling. I got a note from Gertrude Hessen that you were interested in finding out why a copy of your bound thesis had been removed from the thesis room. Are you still interested? Because I was the assistant librarian responsible for letting it circulate.”

“I am,” Noah said, impressed that they were getting back to him so quickly.

“Several FBI agents had come into the library and requested the volume, saying it was needed for a short time as part of an ongoing investigation.”

Noah was stunned. He couldn’t believe what he was hearing. “FBI?”

“We get occasional requests of this sort,” Telah explained. “It is less frequent now that all theses are available in digital form, but it does happen.”

“Did they have a warrant?” Noah asked. He was astounded that Dr. Mason would go to the extreme of involving the FBI. And he was even more astounded that the FBI would be interested in becoming involved.

“No, they didn’t,” Telah said. “They spontaneously mentioned getting a warrant if it was necessary, but they preferred to keep the case on a low-key basis as it was not a criminal investigation. They said that although the material was available online, it would speed things up for them to have the hard copy, and they would be extremely careful with it and need it for only a few days. I brought the issue up with the head librarian, who authorized it to be released for one week, as the library has had good relations with the FBI in the past. The two agents were very nice about it. They were very young and personable and rather handsome.” Telah laughed. “I know that doesn’t sound very professional, but the visit was a nice break from what normally goes on around here.”

“Thank you for letting me know about this,” Noah said, searching for something to say. After he disconnected the call, he stared out the window for several minutes, totally taken aback by involvement of the FBI. He couldn’t help but feel nervous about such an unexpected development, and it unpleasantly undermined the optimism he had been recently feeling about the Advisory Board meeting. The mere involvement of the FBI gave the accusation that he’d fabricated data a credibility it did not deserve.

In the middle of this new confusion, Noah’s phone chimed to indicate he’d just gotten an email. Trying to calm down, he saw it was from Roberta Hinkle. Hoping for some more comforting news, he used his laptop to read what Roberta had written. It didn’t take long for his hopes to be dashed.

Noah shook his head in frustration, wondering why Roberta would not have told him directly what the problem was. As he typed a reply asking to be told the problem, he tried to imagine what the PI had uncovered. Whatever it was, it must have been surprising and off-putting. Roberta responded immediately with another email.

Snatching up his phone, Noah called Roberta’s cell phone number. Impatiently, he waited for the call to go through. He couldn’t help but feel irritated that she was dragging out telling him what she had learned. Even when she answered, she didn’t tell him right away but instead asked him to hold on while she went outside the library. As he waited, Noah began restlessly drumming his fingers on his folding table.

“All right, I’m back,” Roberta said. She had a pleasant voice with a slight twang that appropriately reminded him of Ava’s voice. “I apologize if this all sounds rather mysterious. Here’s the problem: Everything you said about Ava London’s high school experience was true except that she had gone to Brownfield High School and not Coronado. But, more important, she did not graduate.”

“Excuse me?” Noah questioned. He wasn’t sure he’d heard correctly.

“Ava London committed suicide during her senior year exactly twelve months after her father and used the same gun in the same fashion and in the same room of the house. After I discovered this unexpected fact from the memorial in the high school yearbook, I went back and looked at the appropriate issue of the local newspaper published during the week following the event. There were a lot of articles because the tragedy was a major, upsetting episode for the entire town and sparked an investigation by the local authorities. Both the father and the daughter were popular figures in the town. Although no one was ultimately blamed or charged for the tragedy, it was thought by many that Ava’s suicide might have been an early case of cyberbullying. Of course, it wasn’t yet called cyberbullying, but that was what they were describing. At least three of Ava’s classmates were named, and it was considered probable that more were involved. The names of the three were Connie Dugan, Cynthia Sanchez, and Gail Shafter.”

For almost a full minute neither Roberta nor Noah spoke. Noah was stunned for the second time within the hour, and even more so than learning the FBI had been responsible for Dr. Mason getting his thesis. It was Roberta who broke the silence after giving Noah enough time to absorb what she had told him. “Do you want me to continue my investigations?”

“Hold off for now,” Noah said. “Let me digest this weird revelation. I’ll call you back.”

After disconnecting the phone, Noah got up to pace in an attempt to get his mind around what he had learned. With the size of the room, there wasn’t nearly enough space. After four steps, he had to turn around. But he felt he had to move. For a few minutes as he walked back and forth, he fantasized about confronting Ava that afternoon when she came home from the hospital to tell her he’d discovered that Ava London was the sockpuppet, not Gail Shafter. But he gave up on the idea as a childish urge for a bit of revenge that she, too, had been harboring a secret a lot stranger than his having had to make estimates on his thesis project to get it in on time. Besides, he didn’t know for certain if she had anything at all to do with his current thesis fracas.

Instead, Noah picked his phone back up with the idea of reconnecting with Roberta Hinkle. But that turned out to be problematic for the time being. On his screen was a text from her:

Noah responded by email:

Sending off the email, Noah stared at his computer, wondering what he could find out about Ava using his BMH super chief log-in information. Since he was technically still a member of the surgical staff despite his current suspension, his position allowed him access to a very wide range of BMH data banks, possibly even employee information. Suddenly, he thought it would be ironic after considering hacking into Brazos University if he could get access perfectly legally to Ava’s BMH records and possibly see who from the Brazos University Department of Anesthesia had written recommendations for her and possibly read them.

After typing in a bit of information and a few clicks, he was in the BMH computer. A few moments later he was poised to try to go into employee records, but he hesitated. With his computer savvy, he knew that the BMH computer would be recording everything he did while he was logged in. It was standard procedure. His concern was that someone, knowing he had been suspended, might have set it up so that his use of the computer would be flagged. If that were the case, it could reflect badly on him during the upcoming Advisory Board meeting that he had been snooping in employee records. It wouldn’t be as bad as hacking into the Brazos University computer, but bad enough.

“Damn!” Noah voiced. It was frustrating to feel thwarted at every turn. Just as he was in the process of logging out from the BMH computer, there was a ping from his phone, indicating that he’d just received an email. Quickly switching to his email inbox on his laptop, he saw it was from Roberta Hinkle. But before he could open it, he noticed that it has been read before he clicked on it. Noah stared in confusion where the little blue dot had been. He looked at the time of the email. As he suspected, it had just arrived, so there was no way he would have read it. Then the blue dot suddenly returned.

Noah froze as a chill descended his spine. He lifted his hands off his keyboard, staring at the blue dot. Slowly he turned his laptop around first one way and then the other, looking at all the expansion slots. He didn’t see anything, but that didn’t relieve his fear. Knowing what he did about computers, he instantly knew he’d been hacked, perhaps with Spyware and a Keylogger. Someone had read his incoming email, meaning they had also been reading his outgoing email. Someone was spying on him, digitally watching him. Could it have something to do with the two men who had taken turns following him? In his mind’s eye, he saw the face of the African American he’d confronted. Then Noah remembered the woman from the MIT library describing the men who had come for Noah’s thesis as attractive. Could they have been the same men following him, and if they were, why would the FBI be following him? If they were FBI?

If someone was monitoring his computer use in real time, Noah was relieved he hadn’t tried to look up Ava’s hospital employee record. His next thought was the realization that the break-in yesterday hadn’t been for spare change and a Percocet prescription, but rather to bug his computer. Quickly, Noah reached forward and pressed the power button, turning the blasted laptop off. He got up and went to the window. He couldn’t help but worry that whoever had broken into his apartment could be close, watching him physically as well as digitally. There were a few vans double parked on Revere Street. As crowded as Beacon Hill was, it was difficult for electricians, plumbers, and other services to ply their trades. There was never any place to park. So there was no specific reason to suspect any of the vans were there for malicious purposes, but they could have been.

A wave of paranoia spread through Noah, making him painfully aware of his absolute vulnerability. The thought again occurred to him that perhaps the hospital was behind all these shenanigans to buttress their case against him. But he dismissed the thought as totally unrealistic. The issue of a possible minor ethical violation a decade ago on a thesis project hardly warranted continuous and possibly illegal surveillance. Noah searched for something bigger, more sinister, but what? Nothing came to mind other than his questioning Ava’s competence, irritating her lobbying boss. But that seemed ridiculously far-fetched. He even mockingly laughed at the idea that the Nutritional Supplement Council might be taking issue with Noah’s questioning Ava’s ability with an advanced laryngoscope. It was an absurd notion.

But there was one thing Noah was certain about: he did not want to remain a sitting duck in his isolated apartment with its door busted. Anyone could walk in at any moment by just giving the door a forceful push. Besides, if his computer was bugged, which was 99 percent certain as far as he was concerned, the apartment itself could be bugged. Someone could be literally watching him at that very moment. With that thought in mind, he glanced around the room, knowing how small a wireless, wide-angle video recorder could be and how easily it could be hidden.

Making a snap decision to vacate, he leaped up and dashed back into his bedroom. Getting a backpack out of his closet, he tossed in some toiletries and some clothes. He then changed into his whites, or the usual outfit he wore as a surgical resident. Although he hadn’t thought of all the potential repercussions, his immediate plan was to go to the hospital and hole up in the on-call suite with its lounge and multiple bedrooms. He didn’t know how long he would be able to get away with staying there, as rampant as hospital gossip was, but he thought he’d feel safer than he did in his apartment.

He grabbed his cell phone. His hospital tablet was already in his jacket pocket. He left the laptop on the folding table but took the time to align it as he normally did. He even opened the lid slightly so that when he returned he could tell if someone had disturbed it.

After a quick glance around, trying to think if there was anything else he should take, he went out into the stairwell. It was then that he thought about rigging something so that he could tell if his door was opened while he was away. But then he accused himself of being overly melodramatic. What he’d done with the computer was enough. It was the computer tampering that upset him. It suggested sophistication.

He closed his apartment door gently to avoid further damage. Unless someone looked carefully, the split wasn’t obvious as the major jamb damage was on the inside. With his backpack slung over his shoulder, he rapidly descended the stairs. As he neared the bottom, he slowed as the view out onto Revere Street came into focus through the small decorative panes of glass in the upper section of the front door. His view was limited to the car parked directly in front of his building. He didn’t see any pedestrians, which concerned him. At that time on a summer afternoon there were usually people all over Beacon Hill.

Descending the remaining steps, Noah opened the door. A young woman in cutoff jeans and a halter top popped into view not six feet away, heading down the street. She warily glanced up at Noah, as if she was wondering why he was standing motionless in an open doorway. In the next instant, she was gone.

From Noah’s perspective, seeing the girl was reassuring. Still, he felt decidedly uneasy. Leaving the building door ajar, he descended the three outdoor steps within the building’s exterior alcove. His intention was to look up and down the street. Since it was a one-way street coming up the hill, Noah looked in that direction first. What he saw was not encouraging. Three buildings down was a black late-model Ford van with two men in the front seats. It didn’t look like the usual service truck. It was too new and shiny and had an out-of-state license plate. Worse yet, the moment Noah appeared, it lurched forward with a squeal of its tires and came rapidly in Noah’s direction.

As fearful and keyed up as Noah was, he reacted by pure reflex. A second later he was back inside his building, slamming the door, throwing the deadbolt, and taking the stairs at a run. Outside he heard the Ford van screech to a stop, which only increased his panic. He didn’t bother using his key on his own door but rather just broke through it using his shoulder. He slammed the door behind him and pulled the couch over in front of it. He knew it wouldn’t prevent someone from coming in, but it might at least slow them down.

Without another second’s hesitation, he ran into his bedroom and over to the window, throwing up the sash. A moment later he was out on the rickety fire escape, plunging down the narrow metal steps and leaping into the building’s postage-stamp-size yard. After first tossing his backpack over the ramshackle back fence, Noah scaled it himself, dropping into the neighboring yard. He did the same thing with a series of dilapidated fences that defined an entire warren of tiny backyards behind the four- and five-story buildings that lined Revere Street, the adjacent Grove Street, and the parallel Phillips Street. Although Noah had never been in the courtyard, he had been able to see a good portion of it from his bedroom window over the years. What he was counting on was finding an exit that he hoped would eventually lead out onto Phillips Street.

The going was not easy. Not only were the fences in poor repair, which made climbing them difficult, but some of the backyards were filled with all kinds of trash, including discarded baby carriages, mattresses, and old tires. At one point, he had to climb down a short, rocky precipice, since Phillips Street was at a significantly lower elevation than Revere Street. Eventually, he was able to reach Phillips Street by way of a narrow alley that ran alongside a building that was part of the Black Heritage Tour of Beacon Hill.

A few passersby on Phillips Street gave Noah a strange look, but no one said anything or acted alarmed. Noah assumed his medical uniform helped calm any suspicions that he was a burglar. But by the time he had finished his tortuous backyard journey, his white pants and jacket were a bit worse for wear, and he had lost the collection of pens that normally occupied his jacket’s breast pocket.

With no late-model Ford van in sight, Noah ran down to Cambridge Street. There he turned east, heading for the Boston waterfront and the BMH complex. He slowed his gait and tried to act calm even though he didn’t feel calm. He kept looking ahead and behind for a shiny new Ford van or for his followers.

After several blocks Noah paused long enough to remove his backpack, dust off his clothes, and straighten his tie in an effort to make himself a bit more presentable. Fifteen minutes later he walked up the circular drive at the front entrance to the Stanhope Pavilion, feeling his pulse quicken. Ahead was BMH security. Though Noah knew many of the security personnel by sight, and they surely knew him, he worried he might be stopped if his suspension was common knowledge, especially since he looked moderately bedraggled, which might have raised suspicions.

Holding up his hospital ID as he normally did but without making eye contact, Noah walked at a brisk clip past the security desk, pretending to be in a rush. At any second he half expected to hear someone calling his name, but it didn’t happen. Relieved, he ducked into the first stairwell he passed. He knew better than to use the elevator.

Entering the expansive on-call facility, which was empty at that hour of the day, Noah first went to the laundry room and got clean pants and jacket. Then he put his name down on the master list for one of the dozen bedrooms and took the appropriate key. Before going to the room, he went to his locker. Every resident at the BMH had a locker where they stored their heavy coats during the winter and kept personal items.

The rooms were spartan and windowless but perfectly adequate for a few hours of needed sleep during a busy night. The furniture consisted of a simple single bed, a bureau, and a desk with a hospital monitor. There was a small bathroom with a shower stall en suite. Towels and linen were changed every day.

Noah felt immediately at home. Over the previous five years he had used the on-call facility far more than anyone else, simply because he spent far more time in the hospital than anyone else. Never once in all the times he had been there had all the bedrooms been utilized, which was the reason he thought he could get away with staying there. How long he could get away with it, he didn’t know, but he wasn’t interested in returning to his apartment until everything was sorted out.

He changed into the clean clothes, then checked his phone to see if Roberta Hinkle had emailed him back. She had:

Noah immediately emailed back:

With that out of the way, his mind switched to Ava. He missed her and the relationship that they had, despite his irritation at her behavior. If only he had resisted the temptation to check her computer that evening, he might very well be comfortably staying with her at her fabulous manse instead of at the utilitarian BMH Ritz, as it was jokingly called by the resident staff.

34

WEDNESDAY, AUGUST 16, 1:37 A.M.

The sleek Citation X jet taxied up to the area in front of the General Aviation section of the Preston Smith Airport in Lubbock, Texas. The flight had been chartered by ABC Security and had left Bedford, Massachusetts, a little after 9:00 Tuesday night. Passengers Keyon Dexter and George Marlow had used the flight time to do the necessary due diligence on Private Investigator Roberta Hinkle. They had been informed by their handler that she was considered a threat of the highest order, which necessitated the night flight.

Roberta Hinkle lived in a small ranch-style house to the west of town and just inside the city’s ring road. Her main specialty as a private investigator involved domestic disputes and infidelity investigations, which both Keyon and George assumed would have created lots of enemies for her, which would provide a handy cover for what they were about to do. She was also divorced, which increased the chances that she would be alone. The only problem was that she had an eleven-year-old daughter. Both Keyon and George were worried that could be a problem if the child awoke. Although they were both emotionally acclimatized to the nature of their work, they were still squeamish about a few things.

As soon as the copilot opened the plane’s door and lowered the steps, Keyon and George deplaned. A few minutes later they were on their way in a rented Chevy Suburban ABC Security had arranged to be waiting for them. Within fifteen minutes of touchdown, the men were already traveling south toward the city center on Interstate 27.

George was driving, and it soon irritated him that Keyon had almost immediately fallen asleep with his seat cranked back as far as it would go. Out of spite George did a little S-maneuver by yanking on the steering wheel, creating enough force to jostle Keyon awake.

“What the hell?” Keyon blurted. He’d grabbed the armrest to steady himself even though the seat belt would have sufficed.

“Must have been an armadillo,” George said, pretending to be looking in the rearview mirror. “I don’t know if I hit him or not.”

Keyon cast a quick look behind them. The road was clear. He turned back to George. “Are you bullshitting me or what?”

George laughed. “Well, maybe it wasn’t an armadillo. Maybe it was a coyote or whatever else they have running around out here in this godforsaken country.” The land was desertlike and as flat as a pancake, with only a bit of scrub. It reminded him of parts of Iraq, which wasn’t a pleasant memory. “But I would like to point out that this is a two-man job.”

“All right, all right,” Keyon complained, but he’d gotten the message. He straightened up his seat and took a few deep breaths.

“You know,” George said, “I’m really pissed we weren’t given the go-ahead to get rid of Rothauser as soon as he was suspended. I thought that was the plan instead of just keeping him under surveillance. The way he was acting, it would have been easy to make it look like a suicide. I knew he was going to be trouble from the word go.”

“It pisses me off he got away from us,” Keyon said. “I wonder what spooked him.”

“No way to know,” George said.

“I never thought there was a way to get out of that backyard maze, except back onto Revere Street.”

“Obviously, we should have checked it out more than we did,” George said. “At the same time, there was no way to anticipate him bolting. But it could be worse. At least we know where the hell he is, thanks to pinging his mobile phone.”

“But there’s not much we can do with him staying in the hospital other than wait for him to come out into the real world.”

“I’m shocked he’s there at all, considering he was suspended,” George said. “It can’t last more than a night or so. The hospital admin’s not going to tolerate it. I thought he’d go to a hotel or a friend’s house.”

“Me, too,” Keyon said. “But the nerd’s got an attitude. He had the balls to confront me when I ended up having to walk past him the other day. He even grabbed my arm.”

“I wonder what the hell motivated him to hire a damn PI?” George said.

“No clue,” Keyon said. “He’s a loose cannon. And the longer we wait, the more trouble he’s likely to cause. At this point he’s got to be neutralized ASAP.”

“I think we should let the higher-ups know how we feel. Maybe they just don’t get it, having us dick around for a week like they have.”

“I think they finally get it,” Keyon said. “It’s the only explanation for why they’re willing to spend the money having the Citation Jet wait for us. They want us back in Boston tonight. Otherwise, they would have had us go back commercial in the morning.”

“How long do you think this job should take?”

“Unless something goes wrong, it shouldn’t take us long, maybe an hour at most.”

“We’re coming up to the Ring Road Two Eighty-nine,” George said. “We’re supposed to head west, correct?”

“Yup,” Keyon said, looking at his Google Maps on his phone. “And then a right on Route Sixty-two and we’re almost there.”

35

WEDNESDAY, AUGUST 16, 9:00 A.M.

Cocooned in the familiar on-call room and feeling safe, Noah slept like a baby. The previous evening he’d remained in the room and avoided the lounge area for fear of running into surgical residents who would invariably question what he was doing there. He was certain they’d be sympathetic and would not blow the whistle, yet it would invariably start gossip that would go around the hospital like an influenza outbreak, eventually alerting the powers that be. Hunger had finally driven him to make a quick visit to the cafeteria after 11:00 P.M. when he thought it would be mostly deserted. As luck would have it, Dr. Bert Shriver, the on-call chief resident, was also there, having a late supper after being caught in surgery all evening.

Bert was aware of Noah’s suspension and had immediately voiced the hope that Noah would be reinstated following the Surgical Residency Advisory Board meeting. Since Noah knew that Bert sat on the board, he had taken the opportunity to clarify the details, which Bert had been unaware of because Dr. Mason had been the source of the gossip. Bert had been under the mistaken impression that it was an established fact that Noah had fabricated all the data for his thesis. When Bert had learned the truth from Noah, he promised to clue in the other resident board members.

When asked why he was in the hospital cafeteria so late, Noah admitted he was staying the night in the on-call room because of a break-in at his apartment. Since Bert was also a Beacon Hill resident in a similar absentee-landlord building with a number of student tenants, he understood immediately why Noah would feel vulnerable.

Although Noah had asked Bert to keep Noah’s presence in the on-call room a secret, Noah knew that it was just a matter of time before word got out. As a consequence, the first thing he did that morning when he awoke was call his landlord, demanding his apartment door be replaced and the woman above be warned about giving out front-door keys.

By 9:30 A.M. Noah was ready to try his luck at getting to the hospital cafeteria without being noticed. As he was about to leave his hideout, his mobile phone began to ring. It was an unknown number, yet he recognized the 806 area code as the same as Roberta Hinkle’s. Thinking it might be her, he answered.

“Is this Dr. Noah Rothauser?”

“It is,” Noah answered. Without knowing why, he immediately felt on edge.

“This is Detective Jonathan Moore of the Persons Crimes Section of the Lubbock, Texas, Police Department. I have a few questions as part of an investigation. Is this a convenient time to talk?”

“I guess,” Noah said. Instinctively, he knew he was not going to be happy about this unexpected telephone call. Coming from the police, there was no way it could be good news.

“First and foremost, I would like to ascertain that you retained Roberta Hinkle for investigative services?”

“Why are you asking?” Noah said hesitantly. This was not the confidentiality he had expected.

“Your phone number was found on Roberta Hinkle’s phone record,” Detective Moore said. “We are calling all her clients. You are the only one from out of town.”

“Yes, I did retain Ms. Hinkle,” Noah said reluctantly. He had no idea what this was about. His immediate worry was that it had something to do with the hospital, his suspension, and the hacking of his computer. Whoever had hacked his computer would have been privy to his email exchange with the private investigator.

“Was your interest in Roberta Hinkle’s services because of a marital or domestic issue of some kind?” Detective Moore asked.

“Absolutely not,” Noah said quickly. He was caught off guard by such a question coming out of the blue. “Is she all right?”

“Usually I am the one who asks the questions,” Detective Moore said emphatically. “Would you be willing to tell me what kind of investigative work Roberta Hinkle was doing for you? But before you answer, let me remind you that you could be subpoenaed to do so, meaning that it would save time and effort if you are cooperative. Otherwise, you might be forced to come here to Lubbock.”

“It was merely an employment background check,” Noah said with equal rapidity. His sense was that this unexpected call had nothing to do with BMH.

“Did you know that Roberta Hinkle’s main specialty was domestic or marital issues?”

“I did not,” Noah said. “Her website said she did background checks, which is what was needed. It also said she had graduated from Brazos University, which seemed convenient. The employee she was investigating attended the same university.”

“You found Roberta Hinkle online?”

“I did,” Noah said. “And we communicated first by email and then several phone calls.”

“Did you ever meet Roberta Hinkle in person?”

“I did not,” Noah said.

“What hospital are you with?”

“The Boston Memorial,” Noah said. “I am a surgical chief resident.” He purposely did not let on that he was currently suspended from active duty.

“Okay,” Detective Moore said. “Thank you for your time and cooperation. And one piece of advice. You’d better find yourself another local private investigator for your background check.”

“Why?” Noah asked.

“She was a homicide victim last night,” Detective Moore said. “We believe it involved the spouse of one of her marital discord clients. She had standing restraining orders pertaining to several that we know of.”

36

WEDNESDAY, AUGUST 16, 9:21 A.M.

Very slowly Noah put his phone down on the utilitarian Formica desk and stared at it as if it were responsible for the shocking news. Any thought of hunger completely vanished. The idea of the private investigator he had retained only the day before being murdered seemed like too much of a coincidence. At the same time, he recognized that he was suffering from a certain amount of understandable paranoia due to what was happening in his own life, which would tend to make him think this new development somehow involved him.

After orienting himself to time, place, and person by taking a few deep breaths, Noah got up from the desk and stumbled into the small bathroom to splash cold water on his face. Then he stared at himself in the mirror while holding on to the edge of the sink for support. What was reverberating in his mind was the idea that whoever had broken into his apartment and bugged his computer would have known he’d hired Roberta Hinkle. Could this individual be responsible for her untimely death? If that were the case, then Noah himself was at least indirectly responsible.

Noah visibly shuddered and looked away from his own image. The idea was horrifying, and he knew he had to get a grip on himself. Such thoughts had to be wild, paranoid conjecture. He understood ever since the awful day in Dr. Hernandez’s office, his mind had been in overdrive, and now it was at its worst, like a runaway train.

Looking back at himself in the mirror, he used his fingers to rearrange his hair and straighten his tie as a way of organizing his thoughts. Returning to the bedroom, he sat back down in the desk chair. He even picked up his phone with the sudden idea of calling back Detective Moore to voice his fear about his possible involvement, but then he caught himself. Such a self-implicating statement would have pulled him into the vortex of a murder investigation without a shred of actual evidence. Such a situation would have serious, unknown effects on his own life, which wasn’t going that well. With the upcoming Advisory Board meeting to determine if his ethics suspension would be reversed, the last thing he needed was to be involved with a homicide in any capacity.

Quickly, Noah abandoned the phone by tossing it back onto the desk as if it had suddenly become too hot to hold. Yet the shock of realizing how close he had come to causing himself great harm had the unexpected effect of calming him and allowing him to think more clearly. Surely Roberta Hinkle’s death had to be due to her marital investigative work as the Lubbock detective believed, especially with there being restraining orders already on file. Finding the murderer would just be a matter of time.

With his mind under a semblance of control, Noah went back to puzzling over his apartment being broken into, not for burglary but apparently to bug his computer. Why and who could have been responsible? It was far-fetched to think it could have been the hospital. And why was he being followed? And why and how was the FBI involved?

The only thing that would incorporate all these disparate aspects, especially if the murder of Roberta Hinkle was thrown in, would be the involvement of organized crime. Ridiculous as the idea might seem, it was in a far-fetched way supported by Ava’s moonlighting lobbying job with the Nutritional Supplement Council. Noah had often joked over the years with resident colleagues that organized crime and the nutritional-supplement industry shared some similarities, both operating more or less in the open and making a ton of money robbing the public while thumbing their noses at the authorities. The only difference was that organized crime robbed the public literally while the nutritional-supplement industry did it figuratively.

As was his wont on occasion when deep in thought, Noah got up and paced back and forth in the small room. What he was mulling over was his acknowledged belief the nutritional-supplement industry had to think of Dr. Ava London as a gift from heaven. For her lobbying efforts, she couldn’t be better qualified. Considering her credentials, smarts, attractiveness, and outgoing personality, she had enormous and possibly unmatched credibility and effectiveness. In Noah’s mind, there was no wonder that they paid her as well as they apparently did.

Suddenly, Noah stopped in the middle of the room as the corollary idea occurred to him that the NSC would understandably be ferociously protective of Ava’s well-being and reputation, and they might even do it behind her back. Could his questioning her competence have been the source of all this hullabaloo? If it were the case, it certainly was a major overreaction since Noah truly thought of her as a terrific anesthesiologist. There had been only those few misgivings...

Resuming his pacing, Noah’s mind veered off in another direction. If what he was thinking was true, maybe it wasn’t an overreaction on NSC’s part but rather indicative that there was some potential problem with Ava’s training. He couldn’t imagine what it could be that wouldn’t have come out when the BMH Anesthesia Department had done their due diligence before hiring her. Yet it made a certain amount of sense.

Noah stopped again as the idea of hiring another Lubbock private investigator occurred to him. Why not? he thought. It could possibly serve the purpose of ruling out something that the NSC was worried about but was inconsequential. After all, Ava had more than proved herself by handling all the anesthesia cases she had without incident before the three recent unfortunate episodes.

Picking up his phone Noah had in mind again to google “Lubbock private investigators” to hire another one, but he hesitated. Thinking about his being under surveillance, possibly by the cyber-proficient FBI and not just some amateur putting Spyware and a Keylogger on his laptop, now he felt reluctant to use any electronic communication, even his phone. There was also the issue that if there was any validity whatsoever of his putting Roberta Hinkle in jeopardy, he didn’t want to repeat such a situation. And knowing what he did about the ability of authorities to ping phones and determine their location by triangulation from various cell towers, he removed the battery. He knew it wasn’t enough just to turn it off.

So instead of hiring another PI, a new idea occurred to him that two minutes earlier he would never had suspected. Maybe he should secretly travel to Lubbock, as it would solve a lot of problems. He didn’t know how long he could get away with staying in the on-call room, so going to Texas would temporarily solve that issue. If he was still being followed and possibly threatened, leaving town had a definite appeal. And he thought he would be far better equipped to check up on Ava’s training than any PI. All he would need to do was walk into the Brazos Medical Center and chat up fellow residents, perhaps implying he was looking for a fellowship program. Using the residents as contacts, he was sure he could get to talk to faculty, particularly relatively young faculty. In any residency program, there were always a few who joined the staff, just as Noah planned to do at BMH. Noah imagined there was a very good chance he could even find someone who trained with Ava. As for specifics, he thought he’d start out in Brownsfield and look at the 2000 high school yearbook.

With a new sense of purpose and direction, Noah repacked his backpack, leaving his white jacket and tablet in his locker. Then he headed to the hospital ATM, where he withdrew several thousand dollars. With cash in hand, he went down to the front entrance of the Stanhope Pavilion. Since he was reluctant to use his cell phone and had disabled it by removing its battery, he couldn’t take advantage of Uber or Lyft. He didn’t even want to use the taxi queue, which required waiting his turn standing outside the door. What he had in mind was to wait for a taxi to pull up to discharge a passenger, which he would commandeer by rushing out and jumping in. The taxi drivers waiting in line weren’t going to like it, nor were the doormen or the people waiting in line, but Noah didn’t care. He wanted to be sure not to be followed, and he thought the less exposure out in the open, the better. Although he hadn’t seen his tails since Monday, he didn’t want to take any chances.

37

WEDNESDAY, AUGUST 16, 9:58 A.M.

“Hey! Wake up!” Keyon shouted, giving George a slap on the shoulder. Keyon had lost the coin toss to decide who had to take the first watch. He and George were in the Ford van, parked with the engine idling in a no parking zone across the street from the Boston Memorial Hospital’s main entrance. They had arrived back to the Bedford Airport just after 8:00 that morning and had driven directly to the BMH after a quick stop at their office in the Old City Hall Building. A moment after winning the coin toss, George had fallen asleep in the passenger seat. Although both had gotten a few hours of sleep on the plane, they were exhausted.

“Did you see him?” George questioned while sitting up straight. He blinked in the bright morning sunlight, trying to focus on the hospital entrance. There was a lot of activity, with cars pulling up and people coming and going.

“I’m not sure,” Keyon admitted, glancing in the rearview mirror to facilitate a U-turn. “I just got a quick glimpse. Whoever it was bolted out of the hospital entrance like they had just robbed a bank and jumped in that white taxi that just pulled away.”

“Do you think one of us should stay here in case it wasn’t him?” George asked.

“No!” Keyon said without hesitation. “It’s got to be him. Who else would leave the hospital like that?”

“Good point,” George said. “Of course, it means he’s onto us.”

“We already knew that was the case,” Keyon said. After making the U-turn, he accelerated after the taxi, which now was in the distance. He was hoping not to lose sight of it.

“Has he used his cell?” George asked, raising the back of his seat.

“He got an incoming call, but he hasn’t called out. And then I couldn’t even get a GPS ping, meaning he knows enough to take out the damn battery.”

“That’s not a good sign,” George said. “If we lose him, it is going to be hard to find him without the help of his mobile.”

“As if I didn’t know,” Keyon said.

“Don’t get caught at this traffic light,” George said. Just ahead, the light had turned yellow.

“What do you think, I was born yesterday?” Keyon said derisively. Instead of slowing, he accelerated. As they entered the intersection the light was red.

With aggressive, Boston-style driving Keyon was able to close the gap to a degree, and seeing the direction the taxi was going, they could guess it was heading for the Callahan Tunnel to East Boston.

“I don’t like this,” George said. “Do you think he’s going to Logan Airport? If he is, it’s ironic he’s fleeing town just when we get the okay to move on him.”

“I’m afraid there’s not much else in East Boston,” Keyon said.

By the time they exited from the Callahan Tunnel, Keyon had managed to get within four car lengths of the taxi in question. A few minutes later the taxi bore to the right, heading for the entrance to Logan Airport.

“Shit,” George said. “This is becoming a worst-case scenario! Now we’ve got to find out where the hell he’s going, because there’s not much we can do to him here with all the security around.”

“It’s going to be up to you,” Keyon said. He smiled inwardly. Earlier, he’d regretted losing the coin toss requiring him to take the first shift; now he was glad. George would have to do the legwork.

The taxi pulled into terminal A and headed for the passenger drop-off area. The Ford was right behind but pulled into the limo line. George quickly got out after it was definitively ascertained it was Noah who had alighted from the cab. “Let’s use the radio to keep in touch,” he said before slamming the door behind him.

“Roger,” Keyon called after him. “Good luck.”

George gave Keyon the finger over his shoulder without looking back.

38

WEDNESDAY, AUGUST 16, 7:25 P.M.

Noah climbed into a rental Ford Fusion and started the engine. He then keyed “Brazos University Medical Center” into the GPS. Although he intended to start his investigative work by driving out to Brownfield in the morning, he thought he’d take a quick look around the Brazos hospital complex just to get the lay of the land, since it was still light and relatively early.

It had taken far longer to get to Lubbock, Texas, than Noah had anticipated, mainly because there had been no nonstop flight or even a direct flight. He’d initially gone to the Delta counter to inquire, thinking a flight through Atlanta might work, but he’d learned that the shortest flight time was on American through their principal hub, Dallas.

Since he’d had almost an hour layover in Dallas, Noah had used the time to eat and investigate hotel accommodations in Lubbock. He’d settled on the Embassy Suites, because it had a business facility with available computers. Noah had always known he depended heavily on electronic media, but he wasn’t aware to what extent. What he needed was access to the Internet to help with his investigations.

He’d had plenty of time to think about his impetuous decision to take the trip. The more he thought about it, the more appropriate it seemed for so many reasons, although the principal one remained his being the best person for the job. A local PI might have been able to uncover information about Ava’s training but not the specifics that Noah was interested in.

Noah’s first impressions of the Lubbock area were close to what he imagined. It was hot yet dry and in that sense, less oppressive than Boston at that time of year. As he looked out at the flat desertlike terrain, he wondered if he could live in such an environment, accustomed as he was to hills and lush vegetation.

Driving was easy compared to his limited experience in Boston. Not only was there less traffic, but the other drivers seemed gracious, which was a huge difference. Following the easy GPS directions, Noah soon found himself at the medical center’s campus. In contrast with the BMH, all the buildings were modern, appeared to have been designed by the same architects, and looked relatively new. There was lots of bronze-tinted glass and red brick. In contrast with the Stanhope Pavilion, the main hospital building was only five stories tall.

On an impulse, Noah followed the signs directing him to the emergency area. There were a few empty ambulances backed up against a loading dock, but no people visible. Pulling his rental car to a stop in the ER visitor’s parking area, Noah debated if he should go in or wait until he’d returned when the hospital was in full swing as he had originally planned. Following the same impulse that had directed him to drive into the ER parking, Noah got out of the car. His thought was that if things were quiet, which they appeared to be, it might be a good time to have a preliminary conversation with the surgical resident assigned to the ER. Having the name of someone might make his job significantly easier tomorrow when the hospital was busy.

The emergency room was as quiet as it was outside. There were only five people in the sitting area looking at cell phones, flipping through magazines, or reading newspapers. Most of the activity was behind the check-in desk, where a number of nurses, orderlies, and a few residents were relaxing and socializing. As Noah approached, he wondered when the last time the BMH emergency room looked equally calm.

“Excuse me,” Noah said to the admitting clerk who’d greeted him. “I’m a surgical resident from Boston, and I am interested in talking to someone about fellowships at this hospital. Is there a surgical resident who might be willing to talk with me?”

“I don’t know,” the woman said. She seemed mildly flustered by the unexpected request. “Let me ask one of the doctors.”

Five minutes later Noah found himself in the hospital coffee shop with a third-year surgical resident from Argentina by the name of Dr. Ricardo Labat, who was very impressed that Noah was training at the BMH. He was a handsome, friendly fellow with a charming accent. Noah commented how quiet the emergency room seemed. Ricardo’s response was to explain that Lubbock had no shortage of hospital beds, naming Texas Tech’s medical center, Methodist, and Convenant as just a few of the hospitals with significant capacity and emergency room services.

“How is the anesthesia department here?” Noah asked casually.

“It gets high marks, as far as I am concerned,” Ricardo said.

“I’d be interested in talking with a couple of their residents,” Noah said.

“I could go up to the OR and see if any of the on-call residents are available,” Ricardo said. “But I doubt it. I happen to know there are several emergency cases under way.”

“No problem,” Noah said. “I plan on coming back tomorrow. Let me ask you something else. We have a staff anesthesiologist who trained here, finishing up about five years ago. Her name is Dr. Ava London. Does that name ring a bell? My thought is that she must have been a local celebrity of sorts, coming directly from here to the BMH.”

“I never heard of her,” Ricardo said. “But I’m not surprised. This entire university, including the medical center, has been expanding so fast with residents coming from all over the world. The training is excellent, in my estimation, which is why I am here. Last year one of the surgical residents went to Johns Hopkins for a fellowship, and the year before one went out to Stanford and one to Columbia-Presbyterian.”

“I’m impressed,” Noah said, and he was.

“I could call upstairs if you want and see if the staff anesthesiologist on call knows of her.”

“No need, but thanks,” Noah said. “I’ll ask about her tomorrow.”

Fifteen minutes later Noah was back in the rental car setting up the GPS to get him to his hotel. He had been encouraged by his short conversation with Dr. Labat. Learning that recent resident graduates had been going to big-name tertiary-care institutions suggested that Ava’s jump from Brazos to BMH wasn’t all that exceptional. His assumptions that her training had been totally satisfactory seemed to be on the mark.

His room was as generic as Noah expected and far more spacious and luxurious than he needed. After taking a quick shower, he went down to the business center to use the computer. He wanted to go on the Brazos University Department of Anesthesiology website to get the names of the principal faculty members who had been there for more than five years. He also wanted to write down the names of the current residents. The more information he had, the more rewarding he thought his visit would be.

Noah was about to leave the website when he thought he’d see if there was a photo of the current residents. There was, and it looked to him like an impressively cosmopolitan group. He then noticed something else of interest. There were archived photos going back to the first year of the residency program. Noah brought up the photo for 2012, the year Ava had finished, and began searching for her. At first he didn’t find her, but then he did. She was in the back row peering directly at the camera between two much larger male colleagues. To Noah, she looked exactly as she did currently, although her hair seemed significantly blonder.

After closing down the computer, Noah exited the business center. His plan was to go back to his room and attempt to sleep. As keyed up as he was, he knew it was going to be a struggle, especially in unfamiliar surroundings. In many ways, Noah was a creature of habit. Even when it came to the on-call room in the hospital, he usually always slept in the same one. Not relishing lying in the bed for hours tossing and turning and giving his paranoia free rein, Noah decided to go to the hotel’s bar for a beer. It was out of the ordinary for him to do such a thing, but this was not an ordinary time. He thought the diversion and the small amount of alcohol might help calm him.

39

THURSDAY, AUGUST 17, 6:13 A.M.

“A bit more than twenty-four hours ago, I had never even heard of Lubbock, Texas,” Keyon complained. “Now I’ve been here twice.”

“Who would have guessed,” George said.

The same Citation X plane that had taken the two men back and forth the previous day had again been pressed into service by ABC Security and had just touched down at the Preston Smith Airport. The urgency for the second trip was considered just as critical as it had been for the first. Dr. Noah Rothauser had to be sanctioned immediately.

As soon as George had determined Noah had left Boston on a plane bound for Dallas, Texas, the previous morning, he assumed that Noah’s ultimate destination had to be Lubbock. Rushing back to Keyon in the van, they had immediately called their controller at the home office to give him the surprising and disturbing news. At first it gave them a sense of vindication, since they had been complaining about Noah for a week without getting the go-ahead to take care of him. But any pleasure was short-lived because they were ordered to return to Lubbock and do what needed to be done. The only problem was that the pilots who were cleared to work for ABC Security had to take their FAA-required rest. To add to the delay, there was a minor mechanical problem with the aircraft that had to be fixed. The result was that Keyon and George had not left Bedford, Massachusetts, until a little after 2:00 A.M.

They had used the delay to good advantage, getting some needed rest and then using their resources in their Boston office to locate Dr. Noah Rothauser at room 504 at Embassy Suites Hotel. They also used the time and the equipment they had to make up a fake Massachusetts driver’s license using George’s picture.

Again, there was a Chevrolet Suburban waiting for them at the General Aviation terminal, and within twenty minutes of touchdown they were on the Interstate, heading toward Lubbock.

“This place doesn’t look that much different in the daytime,” Keyon commented, looking out at the vast horizon. He was driving.

“It’s as flat as parts of Iraq,” George said.

“Don’t remind me,” Keyon answered.

Arriving at the hotel before 7:00 A.M., there was no activity in the parking lot. George parked as close to the entrance as possible, putting the ignition key behind the visor in case one of them had to leave without the other. Before they got out, both checked their respective weapons, the Smith and Wesson for George and the Berretta for Keyon.

“Ready?” George questioned.

“Let’s do it,” Keyon said.

They walked quickly but not too quickly, to avoid being conspicuous. There were four taxis waiting in queue, with all four drivers sipping coffee in their respective vehicles. Inside the building, the reception area was deserted except for a single person standing at the front desk being helped by a single hotel employee. George and Keyon walked up and stood in line.

Dressed in their normal suits and ties, Keyon and George were confident that they wouldn’t attract any attention. They were just two traveling businessmen like so many others, including the man in front of them.

“Can I help you?” the hotel employee said pleasantly when it was their turn.

“You certainly can,” George said with a smile. “I left my room card in the room. My name is Noah Rothauser, and I’m staying in room five-oh-four.”

“Certainly,” the hotel employee said. “Would you mind showing me some identification?”

“Not at all,” George said. He pulled out his wallet and handed over the fake driver’s license.

The hotel employee briefly glanced at it and handed it back. After placing a blank room card in the appropriate slot, he produced a room key, and with a few clicks on his keyboard, he handed it over.

“Much obliged,” George said, brandishing the key.

George and Keyon went to the elevators, making small talk for the benefit of the employee behind the desk. They boarded the car that was waiting. Keyon pressed five. A moment later the door closed and the car rose.

“It’s looking good so far,” Keyon said. “Nice and quiet.”

George nodded but didn’t speak. He was never as calm as Keyon and always felt tense until the action started. He’d had no trouble engaging in the banter, but now that they were alone, he preferred to concentrate on what was going to happen in the next ten minutes and think about possible contingencies.

Arriving at the fifth floor, they stepped out into the main corridor that ran the length of the building. They could see there were exit stairwells at both ends, which could be important if there were problems. No one was in sight.

They exchanged a silent glance, then moved down to room 504 and took up positions on either side of the door. After checking their weapons in their shoulder holsters, Keyon leaned forward and put his ear against the door’s upper panel. He listened for a moment, then gave a thumbs-up sign.

Following a final glance up and down the hallway, George inserted the card key. There was a quiet click and a small green light materialized above the handle. After a final nod between the two, George opened the door and the two men rushed inside the room with their pistols in their hands.

They expected to find Noah in the bed, but it was empty. Using hand signals, Keyon pointed toward the closed bathroom door. George nodded and they repeated the maneuver they had used on the outer door. A moment later they were shocked and dismayed to find the bathroom dark and empty.

“Shit!” Keyon snapped.

“I thought it was going too well,” George said. “The bastard must be down at breakfast.” Both men reholstered their weapons.

They returned to the main part of the room. Keyon closed the outer door, which they had left open in their haste. George took the club chair by the window. Keyon stretched out on the king-size bed after pulling the bedspread up over the pillows. He put his hands comfortably behind his head. They thought it best to wait for Noah’s return rather than seeking him out in the breakfast room.

“How long do you think we should wait?” George asked after just a few minutes. “I don’t like this. He could be off causing trouble already.”

“Let’s give him thirty minutes,” Keyon said. “If he hasn’t shown up, one of us should go down to the breakfast room and reconnoiter.”

“Maybe we should let the home office know there’s been a hiccup,” George said. “Keeping that plane waiting out there at the airport costs a fortune.”

“Let’s just cool it for a half-hour,” Keyon said. “If he doesn’t show up, then we switch to plan B.”

“What’s plan B?”

“Your guess is as good as mine,” Keyon said with a laugh. “I suppose we’ll just have to stake out the Brazos University Medical Center, where we know he will turn up, unless he’s already there, which I doubt. Of course, we can always hope he’ll use his cell and give us a location.”

40

THURSDAY, AUGUST 17, 9:05 A.M.

Noah paid his tab and stepped out into the sunshine in Brownfield, Texas. The temperature had risen considerably since he’d gone into the restaurant.

He’d slept poorly the previous night despite the two beers he’d had at the bar. The problem had been that he couldn’t stop his mind from wondering what he was going to learn that day, first at Brownfield and then at the Brazos Medical Center. His intuition was telling him it was going to be significant, and he hoped it would be in a positive way, but he worried it might not be.

By 5:30 he’d given up going back to sleep and had gotten up. Something had awakened him at about 5:00. After a shower, he’d gone out to his rent-a-car and set out for Brownfield around 6:30. Although he’d put the Kendrick Public Library in the GPS, he hadn’t needed to because the route was a straight shot southeast down Route 62 that branched off the Lubbock Ring Road, close to where his hotel was located.

Noah seldom had driven on such a straight, flat road, passing through an almost iridescent red, arid landscape. There were several small towns on the way, and Brownfield itself was smaller than he had expected. Route 62, which assumed the name of Lubbock Road and then South First Street once he was in the town, brought him right into the center. The Kendrick Library was on a cross-street.

Noah had pulled up to the library and noticed his was the only car, which he should have taken as a hint he might have been a bit early. Instead he was taken by the library’s appearance, which defied classification. It was a unique, single-story, red-brick structure with steeply gabled roofs sporting several purely decorative dormers. Getting out of the car, Noah was so taken with the building’s appearance that it wasn’t until he got all the way to the front door that he had learned the library didn’t open until 9:00 A.M.

Taking the delayed opening in stride, Noah had driven around the town, passing the high school where Ava had gone when she was presumably Gail Shafter. Nearby, he’d come across a pleasant-looking breakfast place. Having an hour and a half to kill, he had gone in for pancakes and coffee and a chance to read the local weekly newspaper, The Brownfield Gazette.

Once inside the library, Noah went directly to the circulation desk. The middle-aged woman manning the desk was the spitting image of the prim-and-proper but mildly scary woman he remembered as a young child in his own town library. Despite the similarities appearance-wise, the Brownfield librarian was inordinately friendly, directing him to the end room, which she called the “reading room,” to locate the Brownfield High School yearbooks and even offered to accompany him.

“I’m sure I’ll be able to find them,” Noah said.

In the center of the reading room was a low, two-sided bookcase containing more than fifty years of Brownfield High School yearbooks. Noah took the volume for 2000 and sat down at an oak table.

He first looked at Ava London’s photo. He was surprised because the woman in the black-and-white photo did resemble the Ava he knew, with streaked blond hair, remarkably white teeth, a small sculpted nose, and a strong chin line. She also reflected Ava’s confident stare. Beneath the photo was an impressive résumé of activities including cheerleading captain, student council, senior play, and many clubs. Below that was a short in memoriam, mentioning her death on April 14, 2000.

Noah’s eyes went back to study the photo. He again admitted to himself the individual did look surprisingly similar to his Ava, but he wasn’t sure he would have been able to pick her out if there hadn’t been a name. But he didn’t find that surprising, as it was rare in his experience for someone to resemble their high school photo.

Moving on, he looked at the photo of Gail Shafter. The general features were not too dissimilar, although Gail’s nose was larger and appeared as if it were slightly aquiline, and the hair was definitely brunette with just a few blond streaks. Of particular similarity was the way the young woman looked directly into the camera with obvious self-confidence, although with Gail it bordered on brassiness. What was obviously different about the two women was Gail’s lack of social activities.

Taking his cell phone out of his backpack, Noah replaced the battery just long enough to take a couple photos of the two women. He had wanted Roberta Hinkle to send him the photos, and now he had them. As he put the yearbook back in the bookshelf, thinking about the private investigator made him wonder what Detective Moore would say if he knew Noah was in the area. It wasn’t a pleasant thought, and as best as he could, he put it out of his mind. He didn’t want to think about Roberta Hinkle’s untimely end.

Noah returned to the circulation desk and asked the librarian where he could find back issues of The Brownfield Gazette. She directed him to return to the reading room and to look in the shelving against the near wall. She said there were bound volumes of the paper going back to the year it was founded.

It took Noah only a moment to find the correct volume that contained the April 17, 2000, and the April 24, 2000, issues. He took it back to the same seat. As far as he could tell, he was the only visitor in the library.

As Roberta Hinkle had mentioned in her email, there were many articles on Ava London’s suicide, coming as it did almost a year after her father’s. It was quickly apparent to Noah that both father and daughter were indeed local celebrities with the father an active town philanthropist and the daughter a popular teen, cheerleading captain, and junior prom queen. It was also said that the two were very close after the death of the wife/mother from breast cancer two years before.

What Noah found the most interesting from his reading was the apparent role the journalists believed social media had played in goading Ava London to follow in her father’s footsteps. Numerous emails, messages, and group chats were cited blaming her for her father’s suicide and saying she should do the same. The most consistent authors of this progressively relentless harassment were Connie Dugan, Cynthia Sanchez, and Gail Shafter, as Roberta Hinkle had mentioned in her email, although there were other people involved as well, particularly in the group chats. One article claimed that Ava London had become so despondent from this media attention that she had been unable to attend school for the week prior to her suicide. The two social-media sites implicated were SixDegrees and AOL Instant Messenger.

Noah could only imagine the trauma the small town had endured with the tragic loss of two popular members of the community. The fact that the current Ava’s favorite pastime was social media wasn’t lost on Noah. There was no doubt in his mind that once things returned to some semblance of normal with her, he would need to bring up all of this. As personally generous as he considered Ava, he thought he had to give her the benefit of doubt and hear her side of the story. It certainly was a bizarre situation.

Noticing that there was an index at the end of the volume, Noah went back to the shelf and got the volume for 2002. Checking the index, he found multiple articles on Dr. Winston Herbert, the dentist that Ava had said she’d worked for after high school. Noah skimmed the articles and confirmed that Dr. Winston Herbert had been drafted to start the Brazos University School of Dentistry just as Ava had said. With that information, Noah felt encouraged. He wanted to believe in Ava despite the oddball name change.

After returning the two bound volumes back to the shelf and thanking the librarian, Noah stepped out into full West Texas summer heat. He had one more destination in Brownfield before tackling Brazos University Medical Center, and that was the Terry County Courthouse.

“His phone was on long enough to get an approximate fix on him,” Keyon said, looking up from his laptop screen. “That’s the good news. The bad news is that he’s already gone back off the grid. At least we now know he’s in Brownfield. What are your thoughts? There’s only one road between Brownfield and Lubbock, and we know he’s driving a gray Ford Fusion.”

“What does Google Maps say about driving to Brownfield?” George asked. “How long?”

“About an hour from where we are sitting,” Keyon said. He reached back and put away his laptop.

“I think we should just hang here and wait,” George said. “If we try to go to Brownfield, we take the risk of missing him, even if Brownfield might be a safer place for us to do what we need to do.”

After determining that Noah Rothauser was not in his hotel that morning, Keyon and George had debated their course of action. Ultimately, they decided to drive to the medical center, where they searched for Noah’s car in the hospital’s parking lot. They’d been relieved when they didn’t find any gray Ford Fusions. At that point they’d parked where they could see the front of the hospital and the entrance to the parking lot at the same time, waiting for Noah Rothauser to show up. They had the engine idling to keep on the air-conditioning.

“I think you’re right,” Keyon said. He lowered the back of his seat and replaced his feet on the dashboard, where they had been before he’d gotten the signal Noah’s phone had been turned on. His view out the right of the SUV was of the front of the hospital, which was moderately busy with people coming and going.

From the driver’s seat, George could see the parking lot entrance out his side window. Although the lot was almost full, there wasn’t as much activity as there had been when they first arrived just before 8:00 A.M. It was apparent that the people coming on duty had arrived, and the people going off duty had already left. It was the doldrums of the morning.

“Do you think we should let Hank know what’s up?” Keyon said. Hank Anderson was the controller for Keyon and George. He worked directly under Morton Colman, the CEO of ABC Security.

“No,” George said. “We already clued him in there was a problem making contact. He’ll get in touch with us if he wants an update.”

The Terry County Courthouse reminded Noah of his high school. It was a three-story structure constructed of yellow brick with some engaged columns over the front entrance. In contrast with the few times he’d had to visit government offices in Boston, he found the people in the courthouse in Brownfield pleasant and eager to help. Noah was interested in finding whether there were any court records for Gail Shafter legally changing her name. It didn’t take long. There were no such records.

Back out in his rental, Noah retraced his route to Brazos University Medical Center, traveling back up Route 62 toward Lubbock. He felt as if he was making significant progress but knew that the more challenging part was coming up. His plan was to go into the hospital and have Dr. Labat paged. If the Argentine wasn’t in surgery, Noah felt he’d be the best way to start getting introduced to some of the anesthesia residents.

41

THURSDAY, AUGUST 17, 11:20 A.M.

As Noah pulled into the hospital entrance, he passed the turnoff to the right that went to the Emergency Department. The hospital porte-cochere as well as the expansive, general parking lot was to the left. As he entered the nearly full parking lot itself, Noah slowed, searching for a free slot. There were a few people walking to and from the hospital. A short distance ahead he saw a woman with a small child duck between two cars. Noah stopped. As he anticipated, the woman was clearly about to leave as she opened the rear door of one of the cars and proceeded to put the child into a car seat. She then went around to get into the driver’s seat.

Noah put on his blinker to indicate he intended to take the spot once the woman had vacated. Part of the reason he used the blinker was that he’d noticed in the rearview mirror that a large black SUV was coming slowly in his direction, which he assumed was looking for a spot as well. The slot soon to be freed was conveniently located close to the hospital entrance, and Noah wanted it known he planned on taking it.

The moment the woman backed up and then pulled past Noah on her way out of the parking lot, Noah slipped the Ford Fusion into the newly vacated spot.

As he turned off the ignition, he noticed something odd. The black SUV that had been behind him had pulled forward and had now stopped, effectively blocking him from pulling back out if he was so inclined. Noah turned around, confused as to why the vehicle would stop as it did and worried it might be an episode of misdirected road rage over the parking place, something he’d been told that happened in Boston on occasion. What he saw made his blood run cold. A man had exited out of the vehicle’s passenger seat even before the vehicle was completely stopped and was now running around its rear. Noah immediately recognized him. It was the African American who had been tailing him around Boston. In the next instant, a man Noah assumed was the Caucasian leaped from the driver’s seat. As the African American came along the driver’s side of Noah’s car, his colleague went to the passenger side.

Noah reacted by reflex and hit the door-lock button to make sure the doors were secure. He then fumbled with his cell phone to get it out of his pocket and try to get the battery back in. There was no doubt in his mind. He needed to dial 911.

“Open the door!” one of the men shouted. “FBI!” Someone pounded on the top of Noah’s car.

Noah turned and looked up into the face of the African American who was holding an FBI badge against the car window. Looking in the opposite direction, he saw the Caucasian was doing the same with his badge. Thinking he had no choice with law enforcement involved, Noah reached for the door release handle, but as he did so he heard his phone indicate it was on.

Another glance at the African American’s face made Noah hesitate. There was an expression of anger that seemed inappropriate for the situation. Instead of opening his door, Noah hastily began punching 911 into his phone.

Before Noah was even finished with the three digits, there was the sound of shattering glass and small shards rained down along the side of his face. Looking up, Noah could see that the African American was using the butt of an automatic pistol in an attempt to punch through the driver’s-side window. Luckily, the window was resisting, but it wasn’t going to last. In desperation, Noah threw his torso to the right to extract his left leg from beneath the steering wheel. Placing his foot against the door and releasing the lock at the same time, Noah straightened his leg with as much force as he could possibly muster. The door slammed against the African American, pinning him for a fleeting moment against the neighboring car.

In the next instant Noah was out of the car. His only hope was to get inside the hospital and let hospital security deal with these two men, whether they were real FBI agents or not. But he didn’t get far. Although the African American had been momentarily stunned, Noah was aware he’d recovered quickly enough to get a hold of Noah’s shirt, slowing Noah enough so that the Caucasian was able to come around the back of Noah’s car and join the melee. The Caucasian grabbed Noah’s neck with his right hand and Noah’s arm with his left. Despite Noah’s attempt to free himself, he was forced down onto the hot, dusty pavement face-first.

Noah tried to cry out for help, but a hand was roughly clasped over his mouth, holding his jaw tightly closed. In the next instant Noah’s arms were wrenched behind him and his wrists clasped with handcuffs. A moment later he felt a sharp, stinging sensation in his buttocks, followed by a sudden localized pain. As a physician, he knew he’d been injected. Within seconds he felt like he was falling, and then blackness.

“Shit,” Keyon said through clenched teeth. “He’s feisty!” He and George together hoisted Noah up to his feet using their hands under Noah’s armpits. Once they had him upright, they started toward the Suburban. Keyon had to walk awkwardly with his legs apart, since Noah’s trick with the car door had caught him in the testicles. Noah was semiconscious from the powerful tranquilizer and would have fallen into a heap had he not been supported. A few people either going or coming from the hospital had stopped to watch the rapidly unfolding spectacle. They were all dumbfounded. It had happened so quickly and unexpectedly.

“FBI!” George called out, holding his fake badge up for all to see. “Everything is under control here. Sorry for the scene. This man is wanted in a half-dozen states.”

Reaching the Suburban, Keyon and George quickly got Noah into the backseat and buckled him in with the seat belt. Noah’s head lolled forward.

“Do you think he should be kept upright?” George said.

“How the hell am I supposed to know?” Keyon complained.

“That was a walloping dose we gave him. What’s that going to do to his blood pressure?”

“Oh, all right,” Keyon said with resignation. He lifted the shoulder strap over Noah’s head, leaving the waist belt in place. Noah slumped over on his side. “Satisfied?”

“Hey, we both know that if this bastard was delivered as damaged goods, we’d most likely be out of a job.”

42

THURSDAY, AUGUST 17, 10:38 P.M.

Noah became aware of his surroundings gradually, just the opposite of how he had lost consciousness that morning almost twelve hours ago, something he wasn’t going to learn until later. The first thing he realized was that he was on a much more comfortable surface than the macadam he’d been on when the proverbial lights went out. With his left hand he could feel it was a bed. His right hand was shackled over his head, and when he tried to move it, the binding cut into his wrist. He tried to open his eyes, but they refused to open, even when he strained to use his forehead muscles as an additional aid.

Forcing himself to calm down and relax, he took a few deep breaths. It was a good ploy. A moment later his eyes opened on their own, and he found himself looking up at a plaster ceiling. Raising his head, he could see he was in a narrow, elongated bedroom that was tastefully decorated with chintz curtains and flowery wallpaper. A moment later he realized he wasn’t alone. There was a man dressed in a dark suit in a nearby club chair, his face hidden behind a newspaper.

Glancing up over his head, he could see that his wrist was in a pair of handcuffs that was also attached to a brass headboard. As Noah’s mind continued to clear, he could see he was still wearing the clothes he’d put on that morning, which brought back where he’d been. My God, he thought, I’m in Texas! Then, like an avalanche of bad memories, he recalled the details of the terrorizing episode of his being boxed in by the black SUV, the men flashing FBI badges at his windows, his car window being busted in, and his vain attempt to flee. It was like reliving a bad dream.

With some effort, Noah tried to shift his position, which caused the handcuffs to rattle against the brass headboard. At the sound, the man in the chair lowered his paper. Noah recognized him. He was the African American, and as Noah watched, he tossed his paper aside and got to his feet. But he didn’t say anything. He merely walked out of the room.

“Hey,” Noah called out. “Come back here! Where am I? Are you really FBI?” It was adding insult to injury that the man ignored him. If the man was FBI, what in God’s name was Noah doing fettered in an upscale bedroom?

Left on his own, Noah tried to sit up by throwing his legs over the right side of the bed. As soon as he did so, he felt a wave of dizziness overwhelm him, forcing him to lie down and raise his feet back onto the bed. He closed his eyes and hoped for the dizziness to subside.

“You have decided to wake up and join us,” a familiar female voice said a few minutes later in a solicitous tone. “I’m so pleased. I was a little worried you’d been severely overdosed.”

With a sense of shock and fearing he was hallucinating, Noah’s eyes popped open. Standing at the bedside, hands on hips, was Dr. Ava London. Noah stared at her, half expecting her to disappear like an apparition, but she didn’t. Behind her appeared the African American, whose presence quickly assured him he wasn’t hallucinating.

“What are you doing here?” Noah managed.

Ava laughed her unique lucent laugh. “Where do you think ‘here’ is?”

“Someplace in Lubbock, Texas,” Noah said.

Ava laughed again. It was natural and spontaneous. “Sorry to disappoint you,” she said. “We’re not in Lubbock. We are in Boston — more specifically, in my house. You’ve been sleeping off your tranquilizer doses in one of my guest bedrooms.”

Noah could see that the African American was standing off to the side.

“Who is that man?” Noah demanded.

“This Keyon Dexter,” Ava said, gesturing over her shoulder.

“Does he work for you?” Noah said.

Ava laughed yet again. “No, he doesn’t work for me.”

“Is he with the FBI?” Noah asked.

“I don’t think so,” Ava said. She turned to Keyon. “You aren’t with the FBI, are you?”

“No, ma’am,” Keyon said politely.

“What the hell is going on?” Noah demanded.

“I’ll tell you what is going on,” Ava said in a sternly fake voice as evidenced by a simultaneous smile. She waved a finger at Noah as if he were a naughty child. “You have been causing all sorts of trouble and forcing me and a few other people to lose sleep. Thankfully, all that’s in the past.” Ava’s smile broadened. “We need to talk to clear up a few things.”

Noah suppressed a strong urge to indulge in serious sarcasm, but he held his tongue as everything that had happened to him over the previous week began to come back to him in a progressive rush, particularly the untimely murder of Roberta Hinkle. He rattled his restraint against the brass headboard. “Why am I handcuffed?”

“I don’t know,” Ava admitted. She turned to Keyon. “Why is he in handcuffs?”

“He wasn’t cooperative in Lubbock,” Keyon said evasively.

“Well, take them off!” Ava said.

“Are you sure, ma’am?” Keyon questioned. “George and I think he’s a flight risk, and we found him to be on the feisty side.”

“Take them off!” Ava repeated.

Keyon did as he was told, then stepped back to his former place, available if needed.

Noah sat up on the bed and rubbed his sore wrist. He was dizzy for a moment, but it cleared quickly. He felt reassured that the African American was taking orders from Ava.

“How do you feel?” Ava asked sympathetically. “I understand they gave you a bit more midazolam than I had suggested and then a few hours later repeated it.”

“You suggested?” Noah questioned angrily. “So you are behind all this!”

“Listen, my friend!” Ava said, becoming serious. “If it weren’t for my efforts, I’m not sure what shape you would be in, and you certainly wouldn’t be sitting here in my guest room. Let’s not be judgmental until you’ve heard the whole story. As I said, we need to talk.”

“Does he need to be in here?” Noah asked, nodding toward Keyon. The mere presence of the man had him on edge, whether he followed orders from Ava or not.

Ava shrugged. “Not as far as I am concerned.” She turned to Keyon. “Perhaps you could wait out in the hall.”

“Yes, ma’am,” Keyon said. A moment later he was gone.

“Happy?” Ava questioned.

“Hold the sarcasm!” Noah said. “How the hell did I get here?”

“After Keyon and George met you in Lubbock, they invited you on a private jet that had been chartered for them.”

“Invited!” Noah spat. “Ha. They dragged me out of a rental car whose window they busted. What the hell is going to happen to the rental? Jesus!”

“You’re incredible,” Ava said. “You’re really worried about a rental car?”

“I was the one who rented it,” Noah said. “The rental company has my driver’s license information.”

“Good God!” Ava said. “You’re so damn compulsive.” Without warning, she called out for Keyon, who was back into the room in a flash. From his expression, it was apparent he’d feared the worst.

“Keyon,” Ava said with exasperation, “what was done about Dr. Rothauser’s rental?”

“Hank Anderson took care of it,” Keyon said. “He arranged for an agent to go and get it and turn it in. The agent also took care of the insurance deductible.”

“Thank you, Keyon,” Ava said. “That will be all.”

“Right, ma’am,” Keyon said as he touched his forehead with his right hand in a form of salute.

“Satisfied?” Ava asked after turning back to Noah.

“Who is Hank Anderson?” Noah said.

“He is Keyon and George’s immediate boss,” Ava said.

“This is going in circles,” Noah complained. “Who exactly are Keyon Dexter and George whatever his name is?”

“George Marlowe,” Ava said. “You’ve seen him here. I call George my personal trainer. In actuality, he is a security person, but he’s into exercise as much as I am, so it seemed convenient to do it together.”

Noah nodded. In his mind’s eye, he suddenly associated the man he’d known as Ava’s personal trainer with the Caucasian who’d been following him and then as one of the men who had attacked him in Lubbock. On a few occasions when he’d caught a decent glimpse of the man’s face, he’d had the sense he recognized the man on some level.

“Keyon and George work for a security company called ABC Security,” Ava explained. “One of the conditions of my working for the Nutritional Supplement Council from day one has been to accept Keyon and George as my” — Ava groped for the right word — “minders or monitors, or, if you want to be totally pejorative, my babysitters. At first I rarely saw them, but that changed over the last year or so when things with my social media activities got out of hand.”

“What on earth does that mean?” Noah said. Although his mind was clearing, he still felt ungrounded as if in a dream state. “How did they help you with social media?” The idea seemed preposterous.

“There had been a few incidents of serious cyberstalking of my sockpuppets, particularly one called Teresa Puksar. Keyon and George had to take care of it before I was directly involved. Truthfully, I don’t know what they did, but they solved it and also any future problem by making sure I have proper encryption. And now that the Dr. Mason issue has died down and you are brought into the fold, I imagine I’ll see a lot less of them.”

“What do you mean when I am brought into the fold?” Noah said heatedly.

“That’s what we need to talk about,” Ava said. “But before we do, how do you feel, health-wise?”

“Reasonable, I guess,” Noah said, forcing himself to calm down. His emotions were all over the map. “I was dizzy when I first sat up, but that’s gone. The main problem is feeling totally out of it mentally.”

“Let me check your vital signs again,” Ava said. “You had quite a dose of midazolam. I’m surprised you don’t have more significant anterograde amnesia.” She used his right wrist to take his pulse. Then she used a blood-pressure gauge and a stethoscope that had been on the bedside table. Noah watched her as she concentrated, avoiding his line of vision as she wrapped the cuff around his upper arm, inflated it, and then gradually deflated it. A moment later, she was done. “Okay, your vitals are fine. Try to stand up and see how it goes.” She extended a hand, and holding on to Noah’s, she urged him to slide off the bed.

“Well?” Ava questioned once he was standing.

“I’m okay,” Noah said. He teetered a bit. “At least I’m not dizzy.”

“So far so good,” she said. “Would you like to use the bathroom? Your bladder must be about to burst.”

“Now that you mention it, I would,” Noah admitted. Until that moment it hadn’t occurred to him, but now that it was brought up, it seemed urgent.

In the bathroom with Ava waiting just outside, Noah’s mind was progressively moving into overdrive as he urinated. Although he remembered being knocked to the ground in the medical center parking lot, everything else was a blank, and it was disorienting not to have been aware of being transported all the way back to Boston and into Ava’s house. It was as if the Lubbock trip had been a dream. But there was one thing he was aware of for certain. Any suspicions he’d entertained about the NSC being ferociously protective of Ava were absolutely on the money. A private jet had been involved in getting him back to Boston, and he couldn’t even imagine what it might have cost.

“The reason I had you put in this bedroom is that it’s on the same floor as the study,” Ava said when Noah opened the door.

Holding on to the jamb to support himself, Noah stepped out of the bathroom.

“If you are up to it, we could go in there to talk,” Ava continued. “You might find it more comfortable and familiar. There is also some food and drink that I brought up from the kitchen in case you are hungry. What do you say?”

There were so many thoughts going through Noah’s mind that he didn’t have the ability to object. He had no idea of what time it was although he’d noticed the windows were dark. Ava urged him forward. Out in the hallway he saw Keyon and George. Dutifully they got out of the way as Noah and Ava passed. Noah glanced at their faces, impressed with their nonchalance. It was apparent they were professionals. And he did recognize George as the reputed physical trainer.

Ava helped Noah seat himself in his usual chair. She put a plate of small cocktail-style sandwiches, water, and Diet Coke within reach. There was also a plate of potato chips.

“I could get you some wine,” Ava said, as she watched Noah take one of the sandwiches.

“This is fine,” Noah said. After he took a couple bites, he poured himself some Diet Coke over ice. He thought the caffeine might help organize his thoughts, and his mouth was dry. He had no interest in wine.

Keyon and George had quietly followed them into the room and were standing off to the side, leaning against a floor-to-ceiling bookcase. Both had their arms crossed over their chests with the same calm, cool, in-control attitude they’d exhibited in the hallway.

“Do these thugs have to hang around?” Noah questioned, purposefully loud enough for Keyon and George to hear.

“I suppose not,” Ava said. “But they are party to all the details of this affair, as they have been the principal investigators. If it makes you more comfortable, they can wait downstairs.”

“It would make me more comfortable,” Noah said without hesitation.

“Would you mind?” Ava called out to Keyon and George. “If you are worried about him being a flight risk, how about waiting down by the front door?”

“Yes, ma’am,” Keyon said. Without another word the two men filed out, and they could be heard tramping down the stairs.

“All right,” Ava said. She sat down in her usual chair. “Let’s get this over with.”

“Fine by me,” Noah snapped. “What the hell is going on?”

“Calm down,” Ava said. “Keep in mind all this rigmarole has been caused by you and no one else.”

Noah laughed mockingly. “I hardly think that’s the case,” he said. As his mind had continued to clear, his irritation had mounted; so did his fears. “Before we talk of anything else, I want to know if your NSC friends had anything to do with the murder in Lubbock that’s been haunting me.”

“I don’t know anything about any murder,” Ava said. “Whose murder?”

“I had hired a private investigator who I’d found on the Internet. Her name was Roberta Hinkle. The night after I’d hired her, she was killed in her own home, supposedly by the disgruntled lover of one of her clients. Her investigative specialty was domestic issues.”

“Why on earth did you hire a domestic-issue private investigator?” Ava asked.

“I didn’t know it was her specialty,” Noah said irritably. “Her website didn’t suggest it. I hired her to do a background check.”

“Was this background check on me?” Ava asked.

“Yes,” Noah said. It was time for the truth, and he expected her to instantly become indignant, but to his surprise she didn’t.

“I don’t know anything about any murder,” Ava repeated calmly, “but I can tell you this: A private investigator nosing around in my personal business at this particular point in time would have made my employers at NSC very nervous and unhappy, to say the very least.”

“Are you suggesting the NSC was involved?” Noah said. He was horrified at the implications, as it would mean he, too, was indirectly responsible for the woman’s death.

“Certainly not directly,” Ava said. “The NSC would never do anything illegal. But what ABC Security might do, that’s another question. Do you remember Blackwater, the security company that was active in Iraq during the Iraq War?”

“I think so,” Noah said. He had no idea where Ava was going.

“I believe ABC Security is a similar organization, but I don’t know for sure. What I do know is that this is a highly sensitive period of time for the NSC, and the last thing they would want is for my credibility to be questioned in any way. Currently, I am the key NSC lobbyist dealing with quite a few congressmen and senators who are on the fence about amending or repealing the Dietary Supplement Health Education Act of 1994.

“Remember that article that was coming out in The Annals of Internal Medicine that presented a large study that was critical of the nutritional-supplement industry? We talked about it in my kitchen.”

“I think so,” Noah said.

“It had a big impact and caused a sizable number of legislators to express reservations about DSHEA, and I’m the only person who has been able to get them to reverse course. Ergo, it is a super-critical time for the NSC to make sure the FDA stays out of the picture as far as any regulation of the industry is concerned. It’s the reason I’ve had to spend so much time in Washington. I’m the point person to do damage control.”

Noah stared at Ava as his drugged mind wrestled with what he was hearing and began to connect the dots, lending support to his worst fears. Maybe there was some hidden reason to question the depth or quality of Ava’s anesthesia training, which the NSC knew about and did not want to be exposed. It was also the reason he’d hired Roberta Hinkle.

As if reading Noah’s mind, Ava lifted her legs off her ottoman and moved herself forward to sit on it, bringing her closer to Noah. She leaned toward him and lowered her voice, presumably to keep the men on the floor below from hearing. “Before I tell you what I plan to tell you, I want to ask what the private investigator found that made you suddenly fly the hell off to Lubbock?”

Noah felt himself stiffen. They had reached a critical juncture, a crossroads, a moment of truth. Although he felt nervous about Keyon and George being in the house, emphasizing her home-court advantage, he thought it was time to fish or cut bait, whatever the consequences.

43

THURSDAY, AUGUST 17, 11:15 P.M.

Noah debated how to start. He girded himself for what was to come as he settled on presenting the information in the order he had learned it. “I had told Ms. Hinkle you had graduated from the Coronado High School in Lubbock in 2000, so she started there,” he said. “Unexpectedly, she found that there had not been an Ava London in the Coronado High School for the last fifty years.”

Noah paused, watching Ava and her reaction, which he’d expected would be a mixture of anger and defensiveness as she had been caught in a blatant lie. Instead, she just nodded as if she expected what Noah had said and took it in stride.

“The private investigator decided on her own to look for Ava London at high schools in the Lubbock area,” Noah said, watching Ava’s lack of response with continued disbelief. It seemed that she never ceased to surprise him. Here was yet another layer of the onion. He went on: “And after considerable searching Ms. Hinkle was successful. She found an Ava London who’d attended Brownfield High School in a small town of the same name about forty miles southeast of Lubbock.”

Ava nodded again. “Is that all?” she questioned, in response to Noah’s second pause.

“No, it’s not all,” Noah said. “Ava London was in the class of 2000, but she didn’t graduate. Ava London committed suicide on a Friday night, April fourteenth, 2000. It was almost a year to the day from her father’s suicide carried out with the same gun in the same room. After the event, it was thought that Ava London had been harassed on social media following her father’s death and urged and browbeaten to emulate her father. It seems as if it was an early case of cyberbullying.”

“She was a very capable private investigator,” Ava said with little or no emotion.

“Ms. Hinkle didn’t tell me all those details,” Noah said. “I read several issues of the Brownfield Gazette that were published after the event. It was big news in Brownfield.”

“And I’m sure there must be more tidbits the private investigator discovered,” Ava said almost mockingly.

“There were,” Noah said. “She found out that there was a Gail Shafter in the same class as Ava London. I had told Ms. Hinkle that was your Facebook user name.”

“Very interesting,” Ava said with a semi-smile. “What else?”

“That’s it,” Noah said. “Ms. Hinkle was planning on moving her investigation to the Brazos University Medical Center yesterday, but before she could do so, she was murdered in her home. What worries and horrifies me is that it wasn’t a coincidence that it happened when it did.”

“I’m afraid I have to agree with you,” Ava said, suddenly becoming serious. “The timing is just too coincidental.”

Noah shuddered and stared at Ava. Here was yet another surprise. To his utter dismay, she was agreeing with his worst fears that he had played an indirect role in Roberta Hinkle’s death. “Who are you?” Noah asked existentially.

“I’m Ava London,” Ava said without a moment’s hesitation, regaining her aplomb. “I have so completely become Ava London that occasionally I forget that I wasn’t always she. As an example, I often truly believe my father committed suicide. It’s like what you were suggesting one night when we were talking about how people on social media can get confused with what is true and what they have made up to make their lives look and sound better.”

“What about Ava London committing suicide?” Noah asked. “How does that fit in?” He was having trouble understanding how the Ava he knew could be so insouciant about the history she was cavalierly revealing, especially if she had played a role in the online harrassment.

“Obviously, I changed the narrative in that regard,” Ava said. “I can imagine you find all this shocking, but understand I had always been jealous of Ava London and had always wanted to be her. Her death was what made it possible, and my need for a new identity was the stimulus. And it was easy. We looked a lot alike, although she was prettier. All it took was a quick nose job, which I always wanted to do anyway, hair color change, and a few forms to be filled out at Lubbock County Courthouse to make it legal.”

“Why didn’t you do the legal work in Brownfield?” Noah asked. He hadn’t thought about checking the court records in Lubbock.

“I’m not sure they would have let me do it in Brownfield,” Ava said. “When you want to change your name, the authorities discourage and often deny celebrity names, and Ava was a local celebrity.”

“You said you had a need for a new identity,” Noah said. “I don’t understand. Why?”

“I was being held back by my old identity,” Ava said. “When I moved with my dentist boss to Lubbock and got a taste of what an education could do for you, I needed a new beginning. Becoming Ava London was that new beginning. She had had a different outlook on life and a different scholastic record. She would have gone to college and become something more than a dental assistant. She would have at least been the dentist.”

“In the articles I read in The Brownfield Gazette, you, as Gail Shafter, as well as two other classmates were named as having harassed Ava London after her father’s suicide on AOL Instant Messaging to encourage her to follow her father’s lead,” Noah said. “Was that true?”

“It might have been, on some level,” Ava admitted. “But there were a lot of girls who were jealous of Ava London, and she was an entitled snob. What irked me and a sizable number of other female classmates at the time was that she began using her father’s suicide to her advantage, looking for more acclaim and status because she was supposedly suffering, the poor dear. It made a lot of us sick, and I wasn’t afraid to tell her. But I never encouraged her to kill herself.

“She and I had been friends, or at least as friendly as was possible with the most popular girl in the class who was never satisfied with her status. But when I was honest with her about using her father’s suicide as she was, she ostracized me and got me harassed big time about being a slut. And one other thing. When I was in the ninth grade I got harassed so much online I couldn’t go to school for a week, and Ava London and two of her then closest friends were the culprits.” Ava shook her head. “Growing up is getting progressively more difficult with social media providing instant, nonstop communication. And I think it is harder for girls than boys with the mixed messages we must deal with about sex. If you don’t indulge, you’re a prude. If you do, you’re a slut. I wasn’t a slut. I only had one boyfriend in high school and that was short lived.”

“And you didn’t harass Ava to follow in her father’s footsteps?”

“Never,” Ava said, “but I was clear about how it was for her to try to benefit from the tragedy.”

“Why didn’t you tell me about this identity change earlier in our relationship, as intimate as we’d become?” Noah asked.

“I don’t know,” Ava said. “What might surprise you is that I don’t think about it that often. I’ve adjusted to my new reality, and I much prefer it to the old one. I might have told you eventually, but then I might not have. I don’t see it as important. And thinking about what is important leads me to another more serious issue I want to bring up with you.”

Ava moved even closer to Noah by pulling the ottoman she was sitting on against his chair so she could lower her voice even more. “Before I say what I plan to say, I want you to know that I like you, Noah Rothauser. I really like you and respect you, which is why we have gotten along as well as we have, and I hope our relationship can continue and hopefully even blossom. I think we were made for each other, but whether or not it happens is going to depend on your cooperation.”

“Cooperation on what?” Noah asked hesitantly.

“That you join the team,” Ava said “My team! Above and beyond my personal interest, I think you could be a big help to the NSC. You and I together. Understand that I have lobbied for you strenuously, which is ironic, me lobbying a lobbying organization! My success at this particularly lobbying effort is why you are sitting here at this moment rather than having disappeared to God knows where, which would have been easy as no one knew you had gone to Lubbock or why.”

A chill descended Noah’s spine, making him tense.

“I’ve had to make a huge pitch to have you brought back to Boston to have this talk,” Ava said. “I even essentially ransomed several planned trips to Washington to make it happen, threatening not to go. Now, I want to remind you of the metaphor you used the first evening you visited my home to plan for the initial M&M Conference, and that was when you described us as ‘two peas in a pod.’ Do you remember?”

“Of course I remember,” Noah said. “It was when I learned how similar we were in our total commitments to medicine and our specialties.”

“Unfortunately, it seems that the metaphor is not as apropos as I was counting on,” Ava said.

“What does that mean?” Noah said. He knew intuitively that something was coming that he was not going to like.

“Believing that you felt as committed to surgery as I feel toward anesthesia, I was sure that if you were suspended from your super chief resident position that you would be so totally consumed by getting yourself reinstated that you wouldn’t have time or energy to cause trouble for anyone else — namely, me.”

A sudden feeling of anger and betrayal surged through Noah’s brain. He regarded Ava with disbelief. “Are you telling me that you were responsible for my suspension?”

“Only indirectly,” Ava said. “All I did was tell my babysitters, Keyon and George, that you had somehow fudged or fabricated data on your Ph.D. thesis. I also told them that Dr. Mason was eager to have you fired. With that little bit of information and their considerable resources, they were able to accomplish getting you temporarily furloughed.”

Noah could feel his face redden. It was almost too much to believe that he had been jilted by someone he’d felt so very close to and trusted.

“I can see you are upset,” Ava continued in the same even tone she’d been maintaining. “But before you allow yourself a paroxysm of righteous indignation, I want to tell you that I wasn’t completely confident you would stop causing me potential trouble with your supposed misgivings about my competence even after your suspension. Accordingly, for backup, I encouraged Keyon and George to use the full investigative power of ABC Security to delve into your background. It is fascinating what they have come up with. It seems that you, Dr. Noah Rothauser, like most people, have a few secrets that seem at odds with the persona you present, which might be more like a Facebook sockpuppet than you would have us believe. Who is the real Noah Rothauser?”

The color of Noah’s face that had so recently appeared now drained away. It took him a minute to organize his thoughts. “Let me ask you a question,” he said in a halting voice.

“Please do,” Ava said.

“Why are you and the NSC so against my checking into your training? Initially, I was just interested to know how many and what kind of cases you did as a resident, which is all I was trying to do when I used your computer.”

“The NSC doesn’t want my training questioned because I told them emphatically I did not want it questioned,” Ava said. “It is as simple as that.”

“Does the NSC know why you feel that way?”

“No, they don’t,” Ava said. “My turn for a question. Why are you concerned about my training when I have passed my anesthesia boards both written and oral with honors, and as you have reminded me I’ve handled upwards of three thousand cases at BMH without a problem.”

“It’s mostly those niggling questions about the three deaths that I felt ethically obligated to check out. I told them to you.”

“And I explained fully that your concerns were without basis in all three instances,” Ava said. “What else? Let’s clear the slate.”

“Okay, I’ve also wondered about your syntax in your anesthesia notes,” Noah said. He felt embarrassed to bring up such an insignificant issue, but it had been bothering him like a pebble in a shoe. “You use fewer acronyms and more superlatives than other doctors.”

“That’s an absurd notion,” Ava said. “If anything, it’s mainstream medical snobbery. I write my notes the way notes are written in Brazos University Medical Center in Lubbock, Texas. What else?”

“It surprises me that you have no real friends at the hospital,” Noah said. “You keep everyone at arm’s length and apparently prefer social media to face-to-face interaction. Why? It seems so strange to me because I know you as warmly personable. It makes no sense, especially with your ability to read people so well.”

“Isn’t this a little like the pot calling the kettle black?” Ava said. “When it comes down to it, you are the same. Remember: ‘two peas in a pod.’ Maybe you go more out of your way to be superficially friendly with everyone than I, but you’re not close friends with anyone except an alleged girlfriend who no one ever met and who decided she needed more of a relationship, which you weren’t supplying. As for social media, I think you don’t indulge in it because you don’t have the time, at least not until you finish your residency. When you do, the ‘gamer’ in you is going to reassert itself, and currently there is no better online game than social media.

“Here’s the reality. We are both products of the new digital age, where truth and intimacy are becoming less and less important. Thanks to the ubiquity of social media in all its forms, we’re all becoming narcissists, maybe not as overt as our friend Wild Bill Mason, but we all thrive on continuous reaffirmation, which is why you work so damn hard and I love anesthesia. Everyone is becoming an elaborate fusion of the real and the virtual, including you and I.”

Noah stared back at Ava. Earlier he had had a foreboding about where their strange, digressive conversation was going, but now he was sure, and a deep-seated atavistic fear spread through him. It disturbed him to recognize she was in control and not him. She knew all her own secrets and apparently some of his.

“The growing popularity of Facebook and other social-media sites is a harbinger of the future,” Ava said after a pause to see if Noah would speak. When he didn’t, she continued: “People can be what they want to be by managing technology, and those who do it the best, like you and I, will thrive despite our pasts.”

Ava paused again. This time she resolved to wait for Noah to respond. Her expression was a contented semi-smile of the one in control, in sharp contrast with Noah’s clenched, thin-lipped, anxious grimace.

For a moment Noah looked away. Ava’s self-assurance and apparent amusement were galling, as he thought of himself as the injured party who should have been treated as such, rather than being toyed with like one of her cats playing with a mouse. When he looked back, he decided once again it was time to go for broke. What he didn’t expect was another surprise and an even bigger shock.

44

FRIDAY, AUGUST 18, 12:05 A.M.

“Let’s stop beating around the bush,” Noah said irritably. “I want you to tell me directly why you are so protective of your anesthesia training.”

“It’s simple,” Ava said, her smile broadening. “I don’t want people checking into my anesthesia training, because I didn’t do it.”

Noah’s jaw dropped open. Again he stared at Ava, but now it was in total disbelief. “Maybe you better tell me what you mean.”

“I am what you might call a modern-day charlatan, which is a world of difference from a charlatan in the past,” Ava said. “And I’m not talking about the kind of charlatan everyone is becoming today because of little lies on social media. I’m talking about being a full-blown charlatan but of a different ilk. I am a fully competent charlatan.”

“What part of your formal anesthesia training did you not do?” Noah asked with hesitation.

“None of it,” Ava said.

“I’m not sure I understand,” Noah said, dumbfounded.

“Let me explain,” Ava said. “Remember I told you I was giving anesthesia under the supposed supervision of my dentist boss, which wasn’t much supervision. What it did was make me very interested in the science of pharmacology and anesthetic gases. When we moved to Brazos University Medical Center, I started going to various lectures and even an anesthesia conference that the school sponsored. My boss was very encouraging. So I started reading in the field online, which turned out to be better for me than the lectures, since I could read with better retention and much faster than professors could talk. I found the information fascinating. I was also impressed with the salary and respect anesthesiologists got and wanted it for myself. I mean, I was kind of doing the same thing but as an assistant in a dental office instead of in an operating room. And I was doing it without the fabulous equipment and support of nurses and residents.”

“So let me understand,” Noah said with mounting incredulity. “You never did an anesthesia residency?”

“No,” Ava said. “I didn’t need to.”

“What about the anesthesia boards?” Noah asked, his mouth agape. “Did you take them?”

“Oh, yes, of course!” Ava said. “I took the boards and passed them with no problem. I even enjoyed them, as it was an affirmation of a lot of effort I had expended preparing for them.”

“But to qualify to take the boards you must do a residency,” Noah sputtered.

“That’s the usual prerequisite,” Ava said. “In my case it was different. I decided to skip the residency part as unnecessary and even exploitive. From my perspective, the residency is a way for the hospital to have people giving anesthesia for three to four years and paying them a pittance in comparison to what the hospital is charging for the service. And the supervision that they are supposed to get is often not all that great.”

“How did you manage to be accepted to take the boards?” Noah asked. He was flabbergasted and wasn’t sure if Ava wasn’t still toying with him.

“It was all relatively easy,” Ava said. “The critical event was moving from Brownfield to Lubbock when my dentist boss became dean of the new school of dentistry. As a founding faculty member, he had administrative status with the Brazos Medical Center computer. Using his log-in, I had full access. With my computer skills, it was not difficult to create an entire record for Ava London that matched the other anesthesia residents, complete with grades, evaluations, and letters of recommendation. What helped enormously was that the entire university and the medical center were growing geometrically. It was almost like a revolving door with new personnel, profiles, and résumés being uploaded daily. It also helped that the system had an almost nonexistent firewall, so I probably could have done it all without my boss’s log-in. But the log-in made it so easy. I was even able to insert pictures of myself with the real residents for the appropriate years.”

Noah found himself nodding. He could remember seeing the photo of Ava with the 2012 resident photo. As astounding as all this was, he was beginning to think she was telling him the truth. “What about your name change?” Noah asked. “When did that happen?”

“That didn’t happen until I had to take the U.S. Medical Licensing Examination,” Ava said. “That was when I needed the new identity. It was before I took the anesthesia boards.”

“So people think that Gail Shafter still exists,” Noah said.

“For sure. It was key,” Ava said. “Particularly my old boss, Dr. Winston Herbert, who is still dean of the Brazos University School of Dentistry. It’s why I keep a Facebook page in her name. Presently, she is working for a virtual dentist in Davenport, Iowa. I mean, at this point I suppose I could kill her off, but why? I enjoy contrasting my old life with the new. It makes me continuously appreciative of what I have achieved.”

“Good Lord,” Noah said. His head was spinning. “Who got the M.D./B.S. degree, Gail or Ava?”

Ava laughed. She was enjoying herself. “Of course it was Ava,” she said.

Although Noah was surprised at this news, he recognized that he shouldn’t have been. “In other words, you didn’t go to medical school, either?”

“Of course not,” Ava said. “Nor college, for that matter. That would have been a bigger waste of time than doing the anesthesia residency. I wanted to become an anesthesiologist. I didn’t want to waste time getting a general liberal-arts education, particularly not the kind you Ivy Leaguers think is appropriate.”

“So that means you are not even a doctor,” Noah snapped.

“That is a matter of definition,” Ava said. “I did take the USMLE as I said, and I did pass it with flying colors in the ninety-fifth percentile because I studied my butt off. According to the State of Massachusetts, I am a doctor. I have an M.D. license. They say that I am a doctor. I feel like a doctor, and I act like a doctor. I have the knowledge of a doctor. I’m a doctor.”

“What about the degree in nutrition?”

“Made up as well,” Ava said. “That was something I realized later that would come in handy. I just read about the field online.”

Noah closed his eyes and ran his fingers through his hair. This was all so incredible he was having difficulty wrapping his mind around what she was telling him. “I’m not sure I believe all this,” he murmured.

“Wake up, my friend!” Ava said. “Come and join the digital age in the twenty-first century! The basis of knowledge has changed. It is not hidden away any longer by professional societies, some more secret and restrictive than others. Knowledge of just about everything is now available online for everyone, not just the few who are lucky enough for whatever reason to go to the right schools. Even professional medical experience and expertise is available in simulation centers with computer-driven mannequins that are better in many respects to the real thing. With the mannequins, a student can learn to handle a problem by doing it over and over until it is reflex, like handling malignant hyperthermia. Most anesthesiologists have never handled a case of MH. I’ve handled seven, to be exact. Six with a simulator and one in real life.”

“So you really did use the simulation center?” Noah said. It was a statement more than a question.

“Absolutely,” Ava said. “Like there was no tomorrow. Within months of my arriving at Brazos University Medical Center, I started my quest to become an anesthesiologist by using the simulators almost every night when the medical students and the residents had gone back to their beds. I did it religiously. I even started writing programs and to trouble-shoot the system because initially there were a lot of bugs in it. But it was a fabulous way to learn, so much better than the standard methodology. It is almost a crime that medical teaching hasn’t been altered for a hundred years, still adhering to a paradigm that started back in 1910, for God’s sake. It’s almost unbelievable because everything else about our culture and technology has changed drastically. Don’t you find it embarrassing that medical education is the most backward of all the pedagogies?”

“I guess I haven’t given it that much thought,” Noah said.

“Well, I certainly have,” Ava said. “Do people really need four years of college to be a terrific doctor? Hell, no! Maybe they did in 1910, but not now. Maybe they think they have a richer life, but even that is open to question. Do people need four full years of medical school to be a terrific doctor? I don’t think so. Maybe they did in 1910, when most medical schools were for-profit diploma mills and a bad joke. Do people need to do research for a couple of years? Hell, no, again, unless they choose research as a career. Otherwise it’s like treading water. The proof of all this is that I am a damn good anesthesiologist, better than some at the BMH whom I have been able to observe, and I have handled more than three thousand cases and supervised my share of residents and nurse anesthetists.

“Now, I know you have had some misgivings about the three recent deaths I’ve had. And believe me, they disturbed me more than anyone because they were my first and hopefully my last. But let’s reassure you yet again that it wasn’t my lack of having had a formal anesthesia residency that was responsible. With Bruce Vincent, we both know that it was the pigheaded Dr. Mason, his fellow, and the patient himself who were at fault. With the Gibson case the problem lay with the departmental rule that it was appropriate for me to supervise two concurrent resident anesthesia cases at the same time and that the resident did not wait for me to be in the room before starting, as I was busy elsewhere. It also didn’t help that there was a computer glitch that created two records, one with the information about the patient’s neck problem and one without, which was the one that the anesthesia resident got. And the malignant-hyperthermia case could not have been handled any better than it was, despite the outcome. This was determined when it was reviewed. And I can tell you that the majority of the anesthesiologists at the BMH have never handled an MH case, either real or virtual. I don’t doubt that they could, but if it were my life on the line, I would rather have me there than them because of my experience. As for why the scrub nurse would tell you I didn’t turn the gas off immediately, I have no idea, because for me it was reflex. Maybe she is upset I am an anesthesiologist and she a nurse, or maybe it is that I am younger and more attractive. Who the hell knows...”

Ava suddenly threw up her hands as if she were surrendering and sat back. “That’s it,” she said. “That’s the whole story, and you are the only person who knows it.” Slowly she lowered her hands, watching Noah expectantly.

“Why have you told me all this?” Noah said. “Why put the burden on me?”

“Two main reasons,” Ava said. “First, to save your skin, and second, your career. The NSC sees you as a major threat in regard to me and has let ABC Security know how they feel. Use your imagination for what that might mean! The second reason is that I like you, and we are in many ways ‘two peas in a pod.’ That is a compliment. I enjoy your company. If you want to know the truth, initially I saw you only as a way to deal with the Dr. Mason problem without involving ABC Security. But that was before I got to know you.”

“I enjoy your company as well,” Noah admitted. “But—”

“There cannot be any ‘buts,’” Ava interjected. “You have to let sleeping dogs lie. I’ve gone out on a limb for you. I know from your perspective I’ve gotten to where I am today following a unique path that you don’t agree with. But understand that I am the future. Medical education is going to change dramatically in the next five or ten years. It has to change. It took me ten years to get where I am, but I had to work to support myself while I was doing it, and if I didn’t, it would have taken half the time. It is inevitable that becoming a specialist like an anesthesiologist will soon take, say, six years or even less from high school to board qualified instead of the current twelve. The costs of healthcare have to go down, and one of them is the cost of training doctors like anesthesiologists. Hell, it’s more like a trade than we like to admit.”

“I don’t think I can do what you are asking,” Noah said. “As a real doctor, I’m afraid that I will feel an ethical responsibility to expose you as the charlatan you are. I’m sorry. Maybe you are right about medical education. Perhaps it is behind the times as you say, but I don’t think I can be the judge and jury.”

“I’m sorry to hear you say this,” Ava said. “If you do out me, then I will feel equally obligated to do the same for you.”

“What do you mean?” Noah asked hesitantly. The fears he’d felt earlier came back in a rush.

“I mentioned a few minutes ago that Keyon and George, using the investigative powers of ABC Security, came up with a few secrets of yours that are certainly more prejudicial than some temporal data fudging on a Ph.D. thesis. Would you like to hear what they discovered?”

Noah nodded reluctantly.

“First and foremost, it was determined that your father did not die of a heart attack but rather is in prison and will be there for a long, long time, possibly for life for drug trafficking, attempted murder, money laundering, and a few other odds and ends amounting to an impressive felonious résumé. His name is Peter Forrester, and your name was Peter Forrester Jr. until it was legally changed to Noah Rothauser, with Rothauser being your mother’s maiden name. I like the choice of Noah, with its biblical connection. Should I go on?”

Noah didn’t move, nor did he even blink, yet perspiration appeared on his forehead as evidence of his inner turmoil.

“I’ll take your silence as a yes,” Ava said. “It was confirmed that you, too, were arrested with your father when you were fourteen for abetting some of your father’s activities, and you too went to prison in South Carolina for a time, but as a juvenile offender, since it had been judged that there had been an element of coercion involved. It was also confirmed that you were released at age eighteen and your felony record was sealed. Unfortunately for you but fortunately for us, nothing disappears in the digital age. In the old days, a page was literally torn out of a court log and thrown away. Today, there is no way to make a record such as yours vanish, and the ABC Security investigators, mostly Keyon and George, found all of it. Now, there were some commendable aspects to your backstory, such as you getting your high school diploma with some AP credits while in prison as evidence to your rehabilitation, to the delight of the prison officials. It is also impressive that the warden, hearing of your desire to become a doctor, made great efforts to get you accepted into Columbia University.”

“My record is officially sealed,” Noah said, finding his voice. “It can’t be used against me.”

“That is correct, to an extent,” Ava said, as the corners of her mouth turned up in a slight but knowing smile. “However, there is the sticky point about the expectation of being truthful. When you filled out the form for your DEA license and there was a place for you to respond to the question of whether you had been convicted of any felonies, you should have marked the box for yes and then on the back of the form in the space provided, you should have explained about having been a juvenile offender and the record sealed. It will be interesting to talk with the DEA about this issue, and see what they say, particularly because your felony involved drug trafficking. The legal opinion is that you will lose your DEA license and thereby make practicing as a doctor all but impossible. It is also interesting to consider how the Residency Advisory Board, which will be ruling on your suspension, will react when they learn that you had lied on your DEA application, which is far more serious than temporarily fudging data on a Ph.D. thesis.”

“They cannot use a sealed record against me,” Noah repeated, but his voice lacked conviction.

“The Residency Advisory Board is tasked with making a value judgment about ethics,” Ava said. “But let’s not get into an argument about details, because there is more to your story. It was confirmed that your mother is in an Alzheimer’s facility. It was also discovered you have a sister with a chromosomal abnormality who is also institutionalized. It was also confirmed that you were forced to spread your medical school career over six years because of financial difficulties involving supporting your mother, your sister, and yourself, which was all very noble. But since you worked for the medical school administration, it was obvious to me that you would have had special access to the medical school’s computer similar to my access to the Brazos University computer. And since we share computer proficiency as part of being ‘two peas in a pod,’ I recommended that Keyon and George use some IT forensics to look at your record. What was found was not pathognomonic but suggestive there had been some alterations. What I am saying is that at this stage it is not known for certain if you had made any changes to your record to help your application to your BMH residency, and further study would be needed to ascertain it. But here is yet another major area where you are vulnerable.”

Ava paused and took a deep breath, watching Noah. She was hoping for more of a reaction, but he just stared back at her, breathing shallowly.

“I can see you are distressed, and for good reason,” Ava continued. “So let’s talk about a resolution. You want to be one of the world’s premier surgeons and have worked stupendously hard to that end. I want to do the same in anesthesia and have worked equally as hard but on a different trajectory. The reason I had you brought back here and have made you privy to all these secrets that no one else knows is that I see our similarities more than our differences, and I like you. I told you all this because there is a solution. What I have intentionally created is a true Mexican standoff, meaning there are three entities pointing guns at each other: you, me, and the NSC. The only way for this to be resolved and we all win is for all of us to agree to the status quo and lay down our weapons. If not, we all lose.”

“Every time you say something, it is another surprise,” Noah said. “Why do you think the NSC is holding a gun on you? You are their darling.”

“If you make an issue about me being a charlatan, I will no longer be their darling but their enemy.”

“So the NSC has no idea you are a charlatan?” Noah said, shocked yet again.

“Absolutely not,” Ava said.

“And how are you holding a gun against the NSC?”

“That’s easy,” Ava said. “I could disrupt what I have already accomplished about keeping the 1994 DSHEA from being amended. Also, over the years I have learned enough about the supplement industry to seriously discredit it.”

Another silence ensued as Noah struggled to put everything he’d learned over the last half-hour into context. Finally, he said in a subdued voice: “What would you have me do?”

“Nothing,” Ava said with a smile. It was clear to her she was making progress. “It is key that you do nothing, but you have to be convincing you are going to do nothing. The NSC has to be absolutely certain that you are not going to try to discredit me in any way at all. As you’ve guessed, they are enamored of me, which is obvious when you consider this house, my Mercedes, my computer, and all my toys and lifestyle I enjoy. Of course, it would be even better and more convincing if you were willing to help the cause.”

“I hope you don’t mean me supporting the nutritional-supplement industry,” Noah said.

“That’s exactly what I mean,” Ava said with a chuckle. “Get down off your high horse, Dr. Rothauser! The industry is trying in some ways to clean up its act. Not all companies are bad; it’s like everything else, including hospitals and doctors, there’s good and bad. The bad ones are really bad, especially the ones who get all their products from China and India, go overboard on their health claims, and really don’t give a damn. But with your participation you could be an effective positive force on the inside, trying to get the bad companies to mend their ways by toning down their absurd claims and making them feel responsible for the poisonous crap that’s in the bottles they advertise and sell. I can tell you that the good companies, the ones which care about their products and are selling legitimate vitamins and such, are very aware of those companies responsible for all the harm and bad publicity. The reality is that you could do a lot more good on the inside than tilting at windmills from the outside.”

Ava paused, aware she was getting carried away. “So what are your thoughts?” she said finally, in a calmer voice.

“I have to think about being supportive,” Noah said.

“Okay, you do that,” Ava said. “But if you feel as strongly as you say about the nutritional-supplement industry, this could be an opportunity for you to do something positive. The industry is not going to change on its own. The problem is, just like the rest of healthcare, there is too much money involved and the industry has a lot of politicians in their pocket. And as a final note, I imagine the potential remuneration you would receive with your Ivy League credentials from the NSC could easily take care of your educational debt and your mother’s and sister’s ongoing care. How bad is that?”