Flashback

CHAPTER SIXTEEN

For Zack, the day had resembled some of those during his residency. Two consults on the floors, assisting one of the orthopedists with a back case, admitting a three-year-old who had fallen off a swing, hit her head, and then had a seizure, and finally, seeing half a dozen patients in the office. It was the sort of pace on which, ordinarily, he thrived.

This day, it was all he could do to maintain his concentration. Six days had passed since his initial contact with Toby Nelms, and he was still unable to put together the pieces of the child's diagnosis. For a time after his abortive interview with Jack Pearl, he had tried, as an exercise, to give the anesthesiologist the beiiefit of the doubt-to concoct another explanation that would jibe with the facts. He had cancelled his schedule for the day and driven to Boston for consultations with several anesthesiologists at Muni. He had also spent four hours in the county Medical Library at Harvard, reviewing every article he could find on Pentothal, isoflurane, and their complications.

By the end of his search, he considered himself qualified as one of the experts in the field. Always, though, his efforts brought him back to his original hypothesis, and back to a single word, Metzenbaums. Now, in a few days, he would meet again with the boy and his mother. This time, Zack knew, Barbara Nelms would not settle for evasions and half-truths.

The woman was desperate. She had every right to be. It was just after four in the afternoon. From the west, dusky mountain shadows inched up the valley toward Sterling. Zack had just finished a detailed discussion of Meni amp;re's disease with the last of his office patients. "I know exactly what you have, " he had told the elderly man, who had come because of intermittent dizziness and a persistent, most unpleasant hum in his ears. "Unfortunately, I also know there is very little we are going to be able to do beyond teaching you how to live with it."

He had ordered some tests in hopes of coming upon one of the rare, treatable causes of the condition, had passed on the address of the national society dealing with Meniere's, and had expressed his regret at not being able to do more. The man's disappointment was predictable and understandable, but it was nonetheless painful for Zack. It's not going to get you, Toby, Zack vowed as he watched his crestfallen patient shuffle from the office. The practice of medicine provided more than enough of the frustration and heartache that came from having no answers. In Toby Nelms's case, the answers were there. And somehow, someone was going to supply them. Just hang in there, kid. natever's going on, whatever they've done to you, it's not going to get you. Zack sent his office nurse home early, alerted the answering service that he would be on his beeper, and spread the boy's folder on his desk. Most of what he was rereading he knew by heart. After just a few minutes, he snatched up the phone and called Frank's office. There was no alternative but to share his suspicions with his brother and try to enlist his help in another confrontation with Pearl. Frank was gone for the day, and his secretary had no idea where he was or when he would be back. A call to Mainwaring's office gave him only the answering service, and the information he already had, that the surgeon was out of the state until the following Monday and was being covered by Greg Ormesby.

"Answers, " he canted, drumming a pen on the edge of his desk. "There have got to be answers… Where are you, Jason?… Who are you?…

What do you know?"

On an impulse, he checked his hospital directory and dialed the pathology department. Takashi Yoshimura answered on the first ring.

"Kash, " he said, "if you can do it, and if it wouldn't put you on the spot, I need a name…"

Ten minutes later, Zack was on the line with a Dr. Darryl Tarberry at Johns Hopkins. "Dr. Tarberry, " he said after explaining how he had come by the man's name, and after listening patiently to ebullient praise of Kash Yoshimura and his work, "I am calling for a recommendation, but not for Dr. Yoshimura. Fortunately, we already have him on our staff. The man I'm interested in is Dr. Jason Mainwaring. Kash said you might have worked with him when he was at Hopkins."

For a few seconds there was only silence. "Who did you say you were?"

Darryl Tarberry asked finally. From his recollection of the man, Yoshimura had guessed that Tarberry was in his mid-sixties by now. But from the harsh crackle in his voice, Zack wondered if he might be years older than that. "My name's Iverson. Zachary Iverson, " he repeated.

"I'm a neurosurgeon, and I'm on the credentials committee here."

Again there was a pause. "Mainwaring's applying for surgical privileges at your place?"

"That's right."

"Well, I'll be," Tarberry said. "Where did you say that hospital of yours was?"

"New Hampshire, sir. Listen, I don't want to put you on the spot, Dr.

Tarberry, but we would certainly appreciate any information you can give us."

"This call being recorded?"

Zack groaned. "No, I promise you it isn't."

"I'm not putting anything on paper, now."

"That's fine."

"Mainwaring and his lawyers had this place tied up in knots for I don't know how long. Damn lawyers. Ended up costing the hospital a small fortune to settle even though we were one hundred percent in the right as far as I'm concerned. One of my colleagues got ulcers from it. I swear he did. I don't want that happening to me. I'm too damn old for that kind of nonsense."

"You have my word."

"Your word… Iverson, huh. That Swedish?"

"English. It's English, " Zack said, staring upward for some sort of celestial help. "Well, Iverson, I don't know all the details."

"That's okay."

"And as far as I'm concerned, we never had this conversation."

"Promise."

"Well, " the man said, drawing out every letter of the word, "let me tell you first that Mainwaring may be the most ambitious sonofabitch God ever put in a mask and gown, but he is one fine surgeon. Maybe the best I've seen, and I've seen plenty."

"Go on, " Zack said… After fifteen minutes of prodding and cajoling, Zack felt he had extracted as much from Darryl Tarberry as he was likely to-at least over the phone. There was more to the story, he knew.

Probably much more. But even so, a huge piece had fallen into place in the puzzle of Toby Nelms. Zack was just finishing writing a synopsis of the interrogation when the door to his waiting room opened and closed.

"I'm here," he called out. "What a coincidence. So am I" Suzanne appeared at his office door, wearing a lab coat over an ivory blouse and ankle-length, madras skirt. "Got a minute? " she asked. "For you?

Years." He set the Tarberry notes in Toby Nelms's folder and pushed it to one side of the desk. "Trouble with Annie?

"

"No, no. Nothing like that. She's doing amazingly well. I think Sam Christian's going to do her hip tomorrow."

"Excellent. I'm so pissed off about what's happened to her. Every time I think about what Don Norman did, I want to hunt him down and flatten that pudgy little nose of his."

"Zack, I'm as upset as you are about Annie, but I don't see how you can lay all the blame on Don. He didn't do anything with malicious intent."

"That depends on your definition of malicious. He was sedating her so that she wouldn't object to being sent to a nursing home, so that Ultramed could continue to rake in profits from her care. If that's not malicious, I don't know what is."

"Hey, easy does it, okay?"

"What do you mean?"

"that's your opinion. But it happens not to be everyone's. Couldn't YOU just let up on this place a bit?"

"Huh?"

"Zack, Frank just left my office."

"So, that's where he's been. I've been trying to reach him."

"He's really upset with you."

"I know. Is that why he went to see you?"

"As a matter of fact, it is. He… he wanted me to talk to you-to ask you to let up on your criticism of this place."

"He could have come and asked me himself."

"He says he tried."

"He was drunk. He threatened me. That's not what I would call the Optimal approach… So, now he's chosen to involve you. I can't believe this place."

"Zachary, I didn't come up here to pick a fight. I just wanted to do what I could to smooth things over between you two. I owe Frank a lot. I thought you understood that from all I told you of what happened to me."

"Sorry, " Zack mumbled. "If I'm touchy, I guess it's that I just wish things were different between me and Frank."

"Well?"

"Suzanne, I can't help it if Frank thinks it's my fault that the Judge is pushing the board of trustees to buy back the hospital from Ultramed."

It was clearly the first she had heard of that development. "My God, Zack, you can't let him do that."

"First of all, " he said.

"I have no more control over that man than Frank or anybody else does.

And second, why not?"

"Well… well because, " she stammered. "If the board threw Ultramed out, Frank would be ruined."

"Nonsense. He knows his job. He could do it just as well for a community corporation as he could for an operation like Ultramed. Better, probably. Suzanne, listen to me. Something's wrong around here.

Something's terribly wrong."

"Dammit, Zachary, what is the matter with you? Don't you have regard for anyone but yourself? I come here to ask you to let up on a man who is partly responsible for saving my career, to say nothing of his being your brother, and all you can do is… is tear down his hospital."

"It's not his hospital. Look, I don't want to get into a fight. I have too much on my mind."

"Like what?"

Every instinct was clamoring for him to change the subject, to keep his theories to himself-at least as long as they were no more than that. He stared down at his hands. Darryl Tarberry's revelations about Jason Mainwaring were too fresh in his mind. "Suzanne, " he said slowly. "I have reason-good reason-to believe that human experimentation is being conducted at this hospital."

"Now that is the wildest-"

"And, " he cut in, "I have just as much reason to believe that you might have been one of the subjects."

Suzanne listened in wide-eyed disbelief as he recounted his experiences with Toby Nelms and Jack Pearl, his brief study of the gallbladder surgery performed by Mainwaring and Greg Ormesby, and finally, his conversation with Tarberry. "Apparently, a woman died of an anaphylactic reaction to a local anesthe ic she received in Mainwaring's office.

Mainwaring claimed it was Xylocaine, but there was plenty of documentation that the woman had received that drug on numerous occasions with no problems. A nurse of his, who was very upset with what happened, charged that Mainwaring had been testing something out that wasn't Xylocaine. Although investigators could never prove that was true, they did apparently discover that our friend Jason was part owner of a pharmaceutical house somewhere in the South."

"This is crazy!" Suzanne said. "Did that man you talked to at Hopkins happen to know what company this might have been?"

Te couldn't remember." He… couldn't… remember… Zack, this is exactly the sort of thing Frank was protesting. These are terrible, disruptive charges you're making on very little hard evidence."

"I'm not making any charges, " he said, feeling his composure beginning to slip. "I'm sharing a disturbing theory with a friend whose clinical judgment I value and trust. I would think you'd be frantic at the thought that someone might have been fooling around with your body while you were asleep."

"Well, I'm not frantic, I'm worried-about you. Zack, you've only been here a couple of weeks.

In that time, you've clashed with Wil Marshfield, had words with Jason, fought with Don Norman, upset your brother, fostered a move to buy back the hospital, and now, on nothing more than the flimsiest circumstantial evidence, you're accusing the finest surgeon and anesthesiologist on the staff of a terrible crime."

Zack pushed back his chair. "Suzanne, listen to ine-"

"No, you listen. How do you explain the fact that there hasn't been one other case like Toby Nelins's?"

"I… I don't know. Maybe it's a rare complication of whatever it is they're using. Maybe people have had episodes like his but they've happened in other places, or haven't been brought to a doctor's attention. Maybe there's some sort of sensory trigger involved that Just doesn't happen to everyone. You told me yourself that you hadn't been feeling right since your operation."

"I've been tired. That's a far cry from having a psychotic seizure."

"What about that episode in the field?"

"What are you talking about?"

"You went blank."

"I did nothing of the sort."

"You did. It was as if someone threw a switch, and all of a sudden you weren't there."

"Zack, this is crazy. You've got to back off. You've hit this place like an earthquake."

"Suzanne, that child is dying."

"Maybe so. But it's not from something Jason or Jack Pearl did to him.

One other case, Zachary. Just find me one other case like Toby Nelms and I'll listen. Even then I may not believe you, but I'll listen. In the meantime, I think you owe your brother, and all the rest of us for that matter, a little breathing room." She stood up. "Back off, Zack. Please.

Do what you can to keep your father from destroying what your brother has worked so hard to build, and give us all a rest." She snatched up her handbag and, without waiting for a response, raced from the office.

For a time, Zack sat numbly, staring out the window at the waning afternoon. A trigger, or a sequence of triggers. Perhaps that was the key. Suzanne had no recollection of the episode at the Meadows during their picnic, but something weird had happened to her. A switch had been thrown. But what? A word? A sound? A smell?

Zack drummed his long fingers on the desk. He felt his thoughts darting out at the answer again and again, like the tongue of a snake. But each time not quite far enough… not quite far enough… Finally, he slid Toby Nelms's file back in front of him and opened it, — ice again, to the first page. They're not going to get you, kid, " he whispered. "I swear, they're not going to get you." Come, here. So., ong the best of the old New England inns, the Granite House "Darral. The slanting, hardwood floors, beamed ceilings, and oddly regard foroms, each with a stone hearth, were rated by the guides as man who is Vess wonderful than the cuisine and service. being your brotin had chosen the spot carefully for his first encounter tal." egional trustees, specifically, this night, a successful "It's not his hccrook, and Whitey Bourque, the rotund, often outtoo much on my mithe local A amp; P. "Like what? " I gone well-better than he had dared hope.

Every instinct wated the conversation beautifully, weaving accounts his theories to himstsses and plans in with reminiscences of some golf He stared down at. d with Crook, and some interested queries about Mainwaring wqhter, Renee, one of the finest young horsewomen in the "Suzanne, ` lieve that humey sat in the otherwise deserted Colonial Room, sipping "Now smoking after-dinner cigars, he felt ready to nail the two "And.". might bre were twenty-one members of the board. Frank considered six Srm to be all but in the bag-either because of their relationship enci him or because of business they would lose if Ultramed was forced sut of Sterling. Allowing for two no-shows at the meeting-and given the board's track record, that was a conservative estimate-he would need only three or four more votes to block the buy back regardless of the Judge's position. And at least half of those votes were right there at the table, sitting, it seemed, in the palm of his hand. All he needed to do, ever so carefully, was close his fingers.

Unlimited potential… Frank allowed himself the flicker of a smile.

Don't go too far away, Ms. Baron, he thought, eyeing the two men over his snifter. I'm coming. "They sure know how to do it right here, don't they, " he began. Bill Crook, logy from the meal and the drinks, mumbled agreement.

He was a slap-on-the-back Ivy Leaguer with a reputation for enthusiastically supporting the ideas of others while never coming up with an original one of any substance. Whitey Bourque belched and dabbed at his lips with the corner of his napkin. Frank noticed the tangles of fine veins reddening his cheeks. "Good beef, " he humphed. "Nothing we don't have at the store, but good."

"Lisette always said yours is the only place in town to buy meat, Whitey, " Frank said. "As a matter of fact, I think I'll have her stop by tomorrow and stock up our freezer… So, now, before we break up and head home to our families, I want to be sure I've answered all the questions either of you might have about just what Ultramed has on the drawing board for our hospital.

Bill?"

The banker thought for a moment, and then shook his head. "Sounds like a pretty ambitious and exciting set of objectives to me, Frank, " he said.

"And don't forget for a moment that Ultramed plans to finance every one of these projects with local money. Sterling National Bank money, if I have my way. Whitey?"

Bourque shook three sugars into a cup of coffee and drank it in one gulp. "No questions, " he said. "I'll have details of our proposal for competitive bidding on our dietary service in your hands by the end of the month."

"That'll be fine, Frank. Fine."

"Excellent." Frank glanced at the check, and then handed it and his Gold Card to the waitress. "Bring us a few more of those little mints, honey,

" he said. He cleared his throat and turned back to the table. "So, gentlemen, I've enjoyed sharing this meal with you both, and I presume Ultramed and I can count on your support at the board meeting Friday."

The two men looked at one another, silently selecting a spokesman.

Whitey Bourque was chosen. "Well, Frank, " he said, "all we can tell you at this time is, that depends."

Frank felt suddenly cold. "Depends on what?"

"On what your father comes up with these next couple of days. He called us yesterday, Frank, and asked us to keep our minds open on this business until he had checked up on a few things. I felt that considering how much help he was to me during last year's fund raiser for the new parish house, that was the least I could do."

"And I owe him for the way he stepped in when my boy Ted experimented with that damn dago red wine and had that accident," Crook chimed in.

"He saved the kid's buns for sure."

"Gentlemen, please, " Frank said, struggling to keep any note of desperation from his voice. "I'm not arguing against the good works the Judge does around this town. For goodness sakes, that's a given. And I'm proud to be his son. But it's apples and oranges. What we're talking about here is support for your hospital and the good works we've been doing. Renee's broken wrist, Whitey. Remember that?

Or… or how about that coronary your mother had last year, Bill?

People say that if it weren't for our new unit and our new cardiologist, she would have died."

"I… I understand," Crook said, staring down into his empty glass. well? 77 Whitey Bourque sighed. "Frank, we're sorry, " he said. "We'd like to help you out, but we gave the Judge our word we'd wait and follow his recommendation. He's the chairman of the board, and he's doin' all the legwork on this thing. All we want is what's best for Sterling. Since we're all too busy to do in-depth research of any kind, we're sort of counting on him to steer us in the right direction. I hope things work out. And whatever happens, I intend to help you and the hospital in any way I can."

"Ditto for me, Frank, " Crook said. "Well, then… I guess there's nothing more I can say, is there."

"You gave a good presentation, Frank," Bourque said, standing. "A damn good presentation. Your father'd be proud."

"Hey, what the heck. We'll work it out, Whitey. I'm sure of it."

Frank forced the words through a noose of anger and frustration tightening about his throat. He walked the two men to the dirt parking lot, shook their hands amiably, and watched until their taillights had disappeared into the night. Then he turned and landed a vicious kick on the door of the Porsche, leaving a dent and a small scrape. Heedless of the damage, he leapt behind the wheel and skidded from the lot, spraying a retired salesman and his wife with sand and stones. From the moment she had heard the Porsche screech into the drive and the screen door slam, Lisette knew it was going to be another one of those nights. With a mumbled greeting and not so much as a peck on the cheek, Frank stormed past her and into his den. She stood in the darkened hallway, waiting for the clink of ice in his glass. Frank did not disappoint her. Now, as she brewed a pot of the herbal tea that Frank had once introduced to her as "the only drink I ever touch after ten, " she battled the urge to bury herself in bed. She set the pot, two cups, some sliced lemon, and some sugar wafers on a tray and carried them to the study. Frank was standing in one corner, his back to her, reading. "Hi, what's the book?

" she asked. "Nothing."

He shoved the volume back into the bookcase and turned to her, but she had caught enough of a glimpse to know. It was his high school yearbook.

"Frank, are you okay?"

"Yeah, sure, I'm great. Do me a favor and just leave me alone, will you?

" His words were already beginning to slur. "I brought you some tea."

"I don't want any fucking tea."

"Frank, please."

"I said I don't want any goddamn tea!"

He swiped his arm across hers, sending the tray spinning across the room. Tea splattered on the wall. The fine china, a wedding gift from her mother, shattered. Stunned, she stared at the mess. "Frank, something's wrong with you, " she said as calmly as she could. "You need help. Please, honey. I love you. The girls love you. For our sake, you've got to get some help." She stepped toward him, her arms extended.

"I don't need any help! " he screamed. "What I need is to be left alone! "

"Please."

She took one more tentative step forward, and he hit her-a swift, backhand slap to the side of the face that sent her reeling against a chair. "I don't need you. I don't need my fucking father. I don't need goddamn Ultramed. I don't need anyone! I'm going to make it, and nothing any of you can do is-" He stopped in mid-sentence and looked down at her as if noticing her for the first time. Instantly, the fury in his face vanished.

"Baby. Oh, Jesus, are you all right? " he asked, moving toward her.

Lisette backed away, forcing herself not to touch the burning in her cheek. Then she turned and bolted from the room. BARON stared thoughtfully at the receiver in her hand, and then set it gently in its cradle. "Frank just lied to me, Ed," she said. "I don't like it. I don't like it at all."

As she sipped her coffee, she gazed out of her thirtieth-story office window, across Boston harbor to the airport. It was just after eight in the morning, and traffic was, as usual, badly backed up coming into the Sumner tunnel. She had spent the night in the city, working into the early morning on several impending Ultramed acquisitions and then catching a few hours of sleep on the fold-out in her office. The RIATA CEO, still perspiring from his daily seven-mile run, scanned the list of the Davis Regional Hospital board of trustees. "Which two did he meet with? " he asked. "The top two on that sheet, Bourque and Crook. He told me just now that the session went well and that both men were as good as in the bag."

"Those were his words?"

"Precisely. The only problem is that Stan Ogilvie, our man on the board, told me last night that Judge Iverson had contacted all of them, and that Bourque and Crook had both given their word to go along with anything he recommended."

"So maybe Frank talked them into changing their position?"

"Possible, but doubtful. Ed, he's scrambling. I just know it. He refuses to admit that he's in over his head. No matter how big the writing on the wall becomes, he keeps thinking he's going to pull this off."

She filled two crystal goblets with fresh orange juice and passed one over. gcthis is your baby, Leigh, " Blair said. Leigh nodded grimly.

Three more New England hospitals were close to coming over, but all of them were holding out until the Davis Regional sale was final. Blair was watching her performance as closely as she was watching Frank's. And the genius behind RIATA International was hardly one to tolerate a failure of this magnitude from anyone. "Well, " she said, "I guess it's time I took a little trip up north."

"I think, my friend, that is a wise decision. You've done an excellent job with Frank Iverson-an amazing job, all things considered. But it's becoming increasingly clear that the man is limited. It would seem he has gone about as far as he can go."

"And then some, " she observed. She sighed. "What is it? " Blair asked.

"Surely you can't be upset about pulling the plug on a man who's so blatantly put his own concerns ahead of yours or our company's?"

"No, " she said. "But I can't help thinking that I'll miss him at all the regional meetings."

"Miss him?"

"Yes." She smiled wistfully. "Frank Iverson may be a little short on principles and a little long on ego, but he's been great visuals."

The pain, a gnawing, empty ache centered beneath the very tip of Frank's breastbone, had begun soon after his fight with Lisette and had intensified throughout the night. He had thrown up several times, and he suspected-although he had not turned on the bathroom light to check-that the last time had been blood. A bottle and a half of Maalox had helped calm the burning some and enabled him to shave and dress and make it to his office in reasonable shape, but he sensed that it was only a matter of time before the searing pain resurfaced. It was Lisette's own damn fault that he had hit her. If she had only been more patient, more understanding of the stress he was under, she could have been a wife, and not just another strain on his life. Zack, the Judge, Mainwaring, Leigh Baron-as if he didn't have enough balls in the air without Lisette taking potshots at him, what goddamn nerve, telling him he needed to get some help when she should have been giving it to him. It was a miracle his stomach hadn't gotten fucked up long before this. He snatched up the phone and dialed the hospital pharmacy. "Sammy, it's Frank Iverson.

What's the name of the stuff that's good for stomach troubles?… No, no, not that stuff, the pills… Cimetidine. Yeah, that's it. Listen, could you bring me up a week's supply?… I know it's a prescription drug, dammit. I don't need any lectures. What I need are those pills..

.. Good. And not a word about this to anyone, right? " All he needed was a rumor going around that Frank Iverson had a bleeding ulcer. He slammed down the receiver and took another long swig of Maalox. It might have been a mistake not to have leveled with Leigh Baron about Bourque and Crook, but this battle was between him and the Judge, and the encounter with those two spineless yes-men was no more than a skirmish. By the meeting, he would have more than enough votes to block the buy back. He thought about calling Mainwaring for a progress report. If anything could help calm down his stomach, it was a few reassuring words from him. Two hundred fifty thousand back in the Ultramed-Davis account and $750, 000 left over to build on. Just the notion of that kind of money was enough to ease the queasy sensation. He simply had to calm down, ignore Lisette's behavior, and concentrate on the Judge and the board.

The ultimate success, both within the company and without, was so close he could taste it. He culled Mainwaring's Atlanta number from his Rolodex and was in the process of dialing when his secretary cut in on the intercom. "Mr. Iverson, it's Annette."

Her voice instantly stirred up images of their sensual, uncomplicated, unselfish evenings together-evenings in sharp contrast to those he had been enduring with Lisette. Annette was the perfect low-stress woman for high-stress times, and Frank made a mental note to have her work late again as soon as possible. "Yes, Annette, " he said, "go ahead."

"Mr. Iverson, Dr. Jack Pearl is here to see you. He knows he doesn't have an appointment, but he says it's quite important."

Pearl. Frank could think of nothing the distasteful little fairy could have to say that he would ever possibly want to hear. "Annette, ask Dr.

Pearl if whatever it is can wait until later on this — oh, never mind.

Have him just come on in," Pea ri, looking, as usual, as if he hadn't shaved in two days, entered Frank's office with a sheaf of papers in one hand and a cup of coffee in the other, and immediately caught his foot on the doorjamb and stumbled, sloshing most of his coffee onto the Persian rug. "Oh shit… oh fuck, " he mumbled, dropping to his knees and dabbing at the spill with a handleerchief that was far from virginal. Frank was about to insist that he simply get up and leave the mess to housekeeping. Instead, he threw Pearl a towel from the bathroom and watched with some amusement as the physician crawled about the floor, alternately swearing to himself and clucking like some obscene, gigantic chicken. "Enough, Jack, enough, " Frank said finally. "Take a seat. I'll have Annette get you a replacement for your coffee-unless you want to wring that towel out into your cup." He laughed heartily.

"Sorry, Jack, I was just kidding, just kidding. Seriously, do you want some more?"

"N-No, Frank. No, thank you."

"Okay, then. So, what is this matter of such earthshaking importance?"

Pearl shifted uncomfortably. "Go ahead, " Frank said. "I'm not going to bite you."

"There'sum.."

Pearl coughed and cleared his throat. "There've been a couple of things that have come up… problems… with Serenyl." Frank's eyes grew narrow and hard. "What the fuck are you talking about, Jack? " The anesthesiologist began to tremble. "Well, " he managed, "what I meant was, not problems, exactly… um, a… more like potential problems. I really needed to talk to you, Frank. You haven't been around."

"Business, Jack, I had business. For Chrissake, get to the point."

"I had a visitor in my office Monday morning, Frank"-his words began to come a bit more easily-"a doctor who is on the verge of figuring out that Mainwaring and I aren't using the anesthe ics my operative notes say we are."

"That's impossible, " Frank said, his mind already churning through the implications of discovery at this final stage of the game. Awkward, certainly, he concluded, perhaps even expensive if some sort of payoff was needed. But not catastrophic. The testing was complete. The whole project had been designed to make Jason Mainwaring comfortable enough with Serenyl to buy it, and in that sense, the project was already a total success. "I warned you this might happen, " Pearl was saying. "I warned both of you."

"What are you talking about, Jack?"

"The recovery time. I told you and Mainwaring someone might pick up on it, but you wouldn't listen to me. And now, someone has." His word, initially stuttered and uncertain, began spilling out like a slot machine payoff. "And that's not all, either. There's this kid we operated on last January for a hernia, and… and he's been having these nightmares, and-"

"Okay, okay, " Frank said, holding his hands up, "enough of this bullshit. I want you to slow down, calm down, go back, and start at the beginning. Got that?… Good. Now, first of all, Jack, exactly who are we talking about?"

"Well, Frank, it… it's your brother. Your brother Zachary."

Zack again! For Frank, the minutes that followed were the purest torture. He listened impassively, struggling to maintain his concentration and composure in the face of the grotesque little man and the fireball of hatred that was tearing at his gut. He studied the notes Pearl had brought-Zack's review of the gallbladder cases and the hospital record of Toby Nelms. Then he insisted Pearl go through the entire story again, step by step. Midway through that recounting, he excused himself for a few minutes, citing the need to get some papers signed and in the mail to Boston. Then he strolled placidly through his outer office and down the hall to an empty men's room, where he threw up. Twenty minutes later, he had picked up the cimetidine and some more Maalox at the pharmacy and stood confronting himself in another men's room mirror. As a quaterback, he had learned that plays seldom went exactly as the coaches had diagrammed them in the playbook. A lineman stumbles, and everybody's timing is thrown off, a halfback is thinking about a fight he has had with his girlfriend, and misses a crucial block. The quarterback worth his salt always kept his head, always expected the unexpected. And it was in this area, Frank reminded himself — the instinctive, reflex ability to react and to adjust-that Frankie Iverson had been the very best. This time, as in so many sticky situations on so many playing fields, his edge would lie in keeping a cool head. He had picked through Pearl's story a piece at a time, and realized that things weren't yet nearly as bleak as he had initially perceived. When he returned to his office he was scrubbed, combed, and outwardly calm. Annette Dolan, dressed in a short-sleeved pink sweater with a band of fine beadwork flowing over her breasts, looked even more alluring than usual. Much work to do. Keep tonight open if you can.

Frank scribbled the words on a scrap of paper, signed the note with a smiley face, and set it by her elbow as he passed. She glanced at it and, almost imperceptibly, smiled and nodded. Now there, Frank thought, as he opened the door to his office, was an understanding woman. The office was empty. "Annette, did Dr. Pearl leave? " he asked over his shoulder. "No. Just you, " she said. At that moment, the toilet in his private bathroom flushed. The notion of Jack Pearl sitting on his john was enough to start the acid percolating again in Frank's gut. He would have to get housekeeping to scrub the whole place down before he so much as stepped foot in there again. Pearl emerged from the room wiping his nose with one hand and tugging at his still-open fly with the other.

"Hope you didn't mind my using your head, Frank, " he said. "This whole business has really messed up my insides, and I've got the shits something awful."

Frank smiled plastically and vowed that after the sale of Serenyl was completed, sending Jack Pearl as far from Sterling as possible would rank in priority only slightly below dealing with Zachary. "Okay, Jack,

" he said, "tell me what it is, exactly, that you want."

Pearl cleared his throat. "Well, the more I've thought about the properties of the drug I built Serenyl from-the more I realize that it's possible your brother might be right about that kid."

"That's ridiculous."

"Why?"

"Jack, you and Mainwaring have done five hundred cases. Five hundred!

Have you encountered even one problem?"

"No, but-"

"But what, Jack?"

"If the kid's problem is due to the drug, then it's some sort of delayed reaction. A flashback-that's what your brother called it. If he's right, maybe some others are having them, but they just haven't connected the episodes with the anesthe ic. If I knew for sure that was going on, I could fix it, Frank. I know every molecule in that drug. I could do it."

"Jack, please, " Frank said. "The whole thing is absolute nonsense. The kid is haviniz niizhtmares from something he saw on TV-probably on that goddarn@]Z'va show. They're always showing babies being delivered and people being operated on and shit like that, for Chrissake. It's a wonder more kids haven't gotten screwed up."

"Frank, we can check. A hundred or so calls, and we can see if anyone's having-"

"No!"

"But-"

"Jack, I've tried to be patient with you, but now I've just about had it … Frank snapped a pencil in two for emphasis. "Mainwaring's going to finish presenting Serenyl to his partners, and he's going to come back here, and he's going to give us each… half a million dollars, and we're going to give him the drug. That's how we planned it, and that's what we're going to do."

"But-"

"No fucking buts, Jack. If you don't want to believe me when I tell you that kid is just a coincidence, that's your problem. But I'll be damned if you're going to make it mine. Now listen, and listen good, if you say one word about all this to Mainwaring or anyone else, one fucking word, the Akron authorities will be here to scoop up what's left of you quicker than you can blink. I got them off your back, and I can get them back on. Clear?"

Pearl wiped his nose with the handleerchief he had used on the coffee spill and lit a cigarette. Frank Iverson had him between a rock and a hard place. It was a spot he knew well. "C–Clear, " he said. "It had better be." Frank shook a finger at him as he spoke. "Because I'm telling you, Jack, I want that drug sold, and I want that money in the bank. Don't fuck with me on this one."

"I won't," Pearl said. "But "But what?"

"Frank, what harm would it do to make a few calls? If there's a problem with Serenyl, I can fix it. I know I ca-" Frank sprung around the desk, grabbed the anesthesiologist tightly by the shirt, and pulled him up onto his tiptoes. "Dammit, Jack, I said no!"

He shook the little man like a terrier breaking a rat, and then slammed him back into his seat. Pearl cowered before the onslaught. "Okay, okay,

" he whined, shielding his face. Why did his life always come down to scenes like this? ny? "That's better, " Frank said. He patted Pearl on the shoulder. "That's much better…" He returned to his desk chair.

"Hey, buddy, don't look so glum. Like I said, the kid is just a coincidence. That Serenyl of yours is just as perfect as you told me it was."

"What about your brother?"

"You let me worry about my brother. Just stay away from him. If he tries to confront you again, tell him to speak to me or… or to call your lawyer.

Here… here's a name to give him. But unless you want a long-term vacation in Akron after your long-term stay in an ICU, that's all you give him, right?… Well, right?… That's perfect, Jack. Just like that little anesthe ic of yours-absolutely perfect."

"Okay, Frank, " Pearl said, stubbing out his cigarette and shuffling to the door, "you win."

The door opened and closed, and Pearl was gone. You win… That's right, Frank thought excitedly. I do. He had handled the distasteful little pervert brilliantly. After tough go-rounds with Leigh, the Judge, and the two board members, it felt splendid to be back in control again.

All he had to do now was keep Zack at bay and off balance for another week. And whatever it took to accomplish that, he would do. Meanwhile, some well-placed pressure on a couple of weak trustees, and the future of Ultramed-and of Frank Iverson-at the hospital would be secure. After that, he would be in a position to deal in a more definitive way with both his goddamn vindictive brother and Pearl… Frank, Frank, he's our man. If he can't do it the intercom crackled on. "Mr. Iverson, it's Annette again. There's a Mr. Curt Largent on three. He says he's a neighbor of yours."

Major Curtis Largent, US ARMY, Ret. was the way the aging war hero had painted his mailbox. Confined to a wheelchair by an errant piece of shrapnel during a battle for some village or church in Italy, Largent was the unofficial security guard of Frank's neighborhood, surveying the area for hours at a time from his upstairs porch and noting down in a book all suspicious comings and going, as well as virtually every license number of every car he did not know. Twice over the years his vigilance actually had thwarted crime-in one case the theft of a bicycle, and in the other, the illegal dumping of some landfill off the end of the turnaround. "Hello, Major, it's Frank Iverson." The last words of the cheer were still reverberating in this thoughts. "What can I do for you?"

Largent, despite a college education-engineering of some sort, Frank thought-still spoke with a pronounced down-east accent. "Well, Frank," he said, "I called mostly cause I hadn't hud anythin' about yoah movin'."

"That's because we're not."

"Well, that's strange, that's very strange."

"What, Major? What are you talking about?"

"Well, I'm up he-ah on m' po-arch. You know, where I like to sit?…

Well, down the street, right in front of yo-ah house, is a truck. And a couple of young bucks been loadin' stuff into it for more'n an ow-ah now. "Are you sure it's our place, Major?"

"Do bay-ahs shit in the woods? Course I'm shu-ah."

"Do you see any sign of Lisette around?"

"Nope… Wait now, maybe I do… Let me get my bi-nocs just to be certain… Oh, it's her all right. She's with them cute little ones of yo-ahs, right by the truck, watchin' em load."

"Major, thank you, " Frank said. "Thank you for calling me."

He hung up and dialed home. Twenty or more rings brought no answer.

Fifteen minutes later he brought the Porsehe screeching around the corner and up the hill to his house."… Fucking Lisette," he had kept muttering throughout the trip home. "Goddamn, fucking Lisette…"

Lisette, the children, and the truck were gone. Most of the house was still intact, but she had taken her jewelry, the microwave, the largest television, hers and the twins' bureaus, their toys, bicycles, and beds, and had left all the liquor bottles she could find smashed to bits in the kitchen sink, including the two-hundred-dollar bottle of Chateau Lafite Rothschild he had given her on her birthday and was saving to celebrate the Serenyl sale. The note, carefully printed on Lisette's lavender stationery, was pinned to a pillow on their bed. You will never hit me again. Please do not try to find us. I'll contact you when I'm good and ready… Was it worth it?

Frank slapped the bedside lamp to the floor and then balled the note in his fist and threw it across the room. "You'll see, " he muttered angrily. "A million fucking dollars from now, you'll see what was worth it and what wasn't, you disloyal bitch."

He started for the liquor cabinet, but then remembered the mess in the kitchen sink and, instead, stormed from the house and drove off. As he spun out of the driveway, from the corner of his eye Frank caught a glimpse of Major Curtis Largent, U. S. Army, Ret., sitting on his upstairs porch, rocking and watching. The afternoon felt as close to normal-as close to the way afternoons once were-as any Barbara Nelms could remember. Sunlight was streaming through the bay windows in the living room and kitchen, bathing a house that was spotlessly clean.

Stacked on the dining room table were the dishes she would use to serve dinner to the first company she and Bob had invited over in more than half a year. Toby lay on his belly on the living room carpet, leafing through the pages of a glossy, coffee-table book on the history of aviation. On an impulse, Barbara had stopped and bought the book on the way home from the boy's outdoor session with Dr. Iverson. That impulse had proven to be inspired. Over the days that had followed, Toby had spent hours quietly examining the photographs and paintings. And more importantly, he had not had a single seizure since then. Predictably, Bob had wanted to rush right out and buy a model kit to begin building with their son, but she had cautioned him to go slow, and for the moment, to leave well enough alone. Even the psychiatrist, Phil Brookings, had been a help. Although he had declined to see Toby until after Dr. Iverson had finished his evaluation, he had seen Barbara herself for two sessions and was encouraging her to bring Bob in for some family counseling as well.

As she strhightened out the bookshelves and polished the already glistening clock on the mantel, Barbara mentally ticked through the meal she had planned and the music she would choose. Perhaps after dessert and coffee, if she could nudge someone into a request, she might even play for them herself. It had been so long since she had allowed herself the luxury of such mundane thoughts. "Toby, " she ventured, "how would you like to help me put together the dinner we're going to make for Billy's mom and dad tonight?"

Toby continued to flip through his book, occasionally reaching out to run his fingertips over one of the planes. "Okay, " she said cheerfully.

"Suit yourself. Just let me know if you get bored with your book. I'll be right in the kitchen."

It had been worth a try. Minutes later, as Barbara stood by the sink washing vegetables, she heard a soft noise behind her. Suddenly tense, she whirled. Toby was standing by the kitchen door, the corners of his mouth crinkled upward in something of a smile. Barbara felt a surge of excitement. "Hi, " she said, swallowing against the forceful beating of her heart. "Want a job?"

The boy hesitated And then, ever so slightly, he nodded. "Great! … I mean, that's fine, honey. I could really use the help. Here, let me get your little stool."

She put the wooden stool by the sink and handed Toby the peeler. "Okay,

" she said. "Now all you have to do is scrape this over the carrots until they all look like this one, see?… That's it. Perfect. Listen, I'm going to the laundry room to fold some clothes. When you finish with the carrots, I'll get you started on the potatoes."

Normal. Barbara had never dreamed she would cherish the feeling so much.

As she headed toward the laundry room she glanced at the wall clock.

"Hey, To be, " she said, returning to the kitchen, "guess what it's time for."

She snapped on the twelve-inch black-and-white set that she kept on the counter to watch soap operas. The cartoon intro for Robin the Good was just ending. Toby stood on his stool, scraping the carrots, washing them in the cool, running water, thinking about airplanes, and looking over from time to time at Robin and his men. "Now, maids and men, " Friar Tuck was saying, "it's time to learn about our Letter of the Day. Today, it's a very special letter, because it's the only one that always has the same letter come after it. It's the letter that starts the words quick and quail and quart. Can you guess what it is? "Q, " Toby said absently. "How many said QT' the friar asked. "Well, if you did say Q, you're right! So now, without further ado, here's Robin and Alan to sing about what letter? Right, our good friend, Q."

Alan-a-Dale strummed his huge guitar several times. Then Robin the Good leapt onto a giant rock and, hands on hips, began to sing. "Alas, my lo-over, you do me wro-ong, I do not thi-ink that thou art true. For thou has ye-et to sing a so-ong, about-out the lee-ter Q-oo… With the first few notes of music, Toby stopped his scraping and began staring at the tiled wall. The peeler slipped from his fingers and clanked into the steel sink. He rubbed at his eyes as the blue and gray tiles grew brighter. It was beginning to happen. Just like all the other times, it was beginning to happen. "Mommy… He called out the word, but heard no sound. They were coming for him. The nurse and the man with the mask.

They were coming for him again. "Mommy, please…"

His eyes drifted downward toward the sink, toward the splashing water.

Stop them! his mind urged. Don't let them touch you again. His hand closed about the black handle of a knife that lay beside the peeler.

Stop them! As he lifted the knife, sunlight flashed off its broad, wet blade. Over the half year since her son's attacks first began, Barbara Nelms had developed a sixth sense about them. It was as if something in the air changed-the electricity or the ions. There had been false alarms times when she had raced through the house, terrified, only to find Toby sitting in the bay window and staring out at the lawn, or lying in the den, mechanically watching a show that held absolutely no interest for him. But there were other times, especially of late, when she had found him thrashing wildly on the floor, or pressed into a corner, his frail body cringing from the recurring horror that was engulfing him from within. Barbara was folding the last of the linen when she began to sense trouble. It started as no more than a tic in her mind-a notion.

The house was too quiet, the air too still. Like a deer suddenly alert to the hum of an engine still too distant for any man to hear, she cocked her head to one side and listened. All she could hear was the soft splash of water in the sink and the sound of the television. Robin the Good was singing his alphabet song-a series of absurd, ill-rhymed tributes to each letter, sung to the tune of "Greensleeves." It was a melody Barbara had actually loved before encountering the portly actor's version. Now, it grated like new chalk. "Toby?…" she called out.

"Toby, can you hear me?

" There was no answer. "Toby, honey?…" She set aside the sheet she had been about to fold and took a tentative step toward the door. Then she began to run. She bolted through the deserted kitchen and was halfway to the living room when she heard the crash of a lamp and her son's terrified scream. "Noooo! Don't touch me! Don't touch me! " he howled. "If you touch me there, I'll cut you. I will… Stop it! Stop it!"

Toby was backing toward the far end of the living room, thrashing his arms furiously at assailants only he could see. It took several seconds for Barbara Nelms to realize that he was wielding a knife-a carving knife with an eight-inch blade. Then she saw the blood. Inadvertently, Toby had cut himself-a wide slash on the front of his thigh, just below his shorts. Crimson was flowing down his leg from the wound, but he was totally heedless of it. "Toby!"

Barbara raced toward him, then slowed a step as his wild-eyed fury intensified. "Stay away from me! Don't touch me!"

"Toby, please. It's Mommy. Please give me that knife."

He backed into the hallway, still slashing at the air. His lips were stretched apart, his teeth bared in a frightening, snarling rictus.

There was no sign that he recognized her. His flailing sent a pair of framed photographs spinning from the wall. The glass exploded at her feet. "Toby, please."

All Barbara Nelms could see now was the blood, cascading down her son's leg and over his foot, leaving grotesque crimson smears on the carpet.

He was nearing the bathroom. If he reached it and locked himself inside … There was simply no way she could let him do that. The hallway was too narrow for any kind of attack from the side. Focusing as best she could on the knife, which Toby was slashing in wild, choppy arcs, Barbara ducked against the wall and dove at him. The point of the blade flashed down, catching her just at the tip of her shoulder and tearing through her flesh and the muscle of her arm. Shocked by the viciousness of the pain, she dropped to her knees, clutching the wound with one hand and trying to hold onto Toby's T-shirt with the other. Blood gushed from between her fingers. Again, the eight-inch blade slashed down.

Reflexively, she pulled away her arm. The glancing blow sliced another gash in the skin by her elbow. Before she could recover, Toby had spun away from her and lurched into the bathroom. "Toby, no! " she screamed as the door slammed shut and the lock clicked. Woozily, she got to her knees and pounded on the door. "Toby, open up! Open up, please! It's Mommy." The only response was the shattering of glass against tile.

Through a sticky trail of her own blood, Barbara Nelms crawled to her bedroom and dialed 911. "This is Barbara Nelms, 310 Ridgeview, " she panted. "My eight year-old son has locked himself in the bathroom. He has a knife and he's already cut himself. Please, please send help."

The walls had begun to spin. She hung up and glanced at her arm. The larger wound, three inches or four, gaped obscenely. Beefy, bleeding muscle protruded from the cut. The room began to dim, and Barbara knew that she was close to passing out. She lay on her back and dialed the hospital. "This is an emergency, " she gasped, forcing hysteria from her voice as best she could. "Please help me. I must speak to Dr. Iverson.

Dr. Zachary Iverson. It is a matter of life and death…"