Side Effects

Monday 10 December

.

First there was the intense, yellow white light-the sunlight of another world. Then, subtly, colors began to appear, reds and pinks, purples and blues. Kate felt herself drifting downward, Alice drawn by her own curiosity over the edge and down the rabbit's hole. How many times had she focused her microscope in on a slide? Tens of thousands, perhaps even hundreds of thousands.

Still, every journey through the yellow-white light began with the same sense of anticipation as had her first. The colors darkened and coalesced into a mosaic of cells, the cells of Beverly Vitale's left ovary, chemically fixed to prevent decay, then embedded in a block of paraffin, cut thin as a slick of oil, and finally stained with dyes specific for coloring one or another structure within the cell. Pink for the cytoplasm, mottled violet for the nuclei, red for the cell walls.

With a deep breath calculated at once to relax herself and to heighten her concentration, she focused the lenses and her thoughts on the cells, now magnified a thousand times. Her efforts were less successful than usual. Thoughts of Sandy and Ellen, of Jared and the 26-S discussion they had had following her return from the hospital the previous night, continued to intrude. She had come home late, almost eleven, after meeting with Tom Engleson, interviewing Beverly Vitale, examining the frozen section of her ovary, and finally spending an hour in the hospital library. Her expectations had been to find the former roommates in the den, comatose or nearly so, with the essence of a half a case of Lowenbrdu permeating the room. Instead, she had found only a somber and perfectly sober Jared. "Hi, " he said simply. "Hi, yourself." She kissed him on the forehead and then settled onto the ottoman by his chair.

"When did Sandy leave?"

"A couple of hours ago. Did you get done whatever it is you wanted to?"

Kate nodded. His expression was as flat and as drained as his words. No surprise, she realized. First his wife stalks out of the house with no real explanation, then he has to listen to the agonies of the breakup of his best friend's marriage. "I… I guess I owe you an apology for the way I acted earlier. Some sort of explanation." Jared shrugged. "I'll take the apology. The explanation's optional."

"I'm sorry for leaving the way I did."

"I'm sorry you left the way you did, too. I could have used some help-at least some moral support."

"Sorry again." The three feet separating them might as well have been a canyon. "Anything decided?"

"He went home to tell Ellen and to move out, I guess. It got awful quiet here after you left. Neither of us was able to open up very well. We each seemed to be wrapped up in our own bundle of problems."

"Three I'm sorries. That's my limit." She unsnapped her barrette, shook her hair free, and combed it out with her fingers. The gesture was natural enough, but at some level she knew she had done it because it was one Jared liked. "After what happened this morning-in the car, I mean-I couldn't listen to Sandy just brush off Ellen and their marriage the way he did. I mean, here I am, scrambling to do a decent job with my career and to be a reasonably satisfying friend and wife to you, and there's Ellen able to do both of those so easily and raise three beautiful, talented children to boot, and…"

"It's not right what you're doing, Kate."

"What's that?"

"You're comparing your insides to Ellen's outsides, that's what. She looks good. I'll give you that. But don't go and cast Sandy as the heavy just because he's the one moving out. There are things that are missing from that relationship. Maybe things too big to overcome. What's that got to do with our discussion this morning, anyway?"

"Jared, you know perfectly well what it has to do. Having children is a major responsibility. As it is, I feel like a one-armed juggler half the time. Our lives, our jobs, the things we do on our own and together…

Toss in a baby at this point, and what guarantee is there I won't start dropping things?"

"What do you want me to say? I'm almost forty years old. I'm married. I want to have children. My wife said she wanted to have children, too.

Now, all of a sudden, having children is a threat to our marriage."

"Christ, Jared, that's not what I mean… and you know it. I didn't say I won't have children. I didn't say it's a threat to our marriage. All I'm trying to say is there's a lot to think about-especially with the opportunities that have arisen at the hospital. It's not the idea I'm having trouble with so much as the timing. A mistake here and it's a bitter, unfulfilled woman, or a neurotic, insecure kid, or… or a twenty-six-year-old stewardess. Can you understand that?"

"I understand that somewhere inside you there are some issues you're not facing up to. Issues surrounding me or having children or both."

"And you've got it all together, right? " Kate struggled to stop the tears that seemed to be welling from deep within her chest. "I know what I want."

"Well, I don't. Okay?

And I'm the one who's going to have to pass up a chairmanship and go through a pregnancy and change my life so that I don't make the same horrible mistakes with our child that my mother made with us. I…

Jared, I'm frightened." It was, she realized, the first time she had truly recognized it. "Hi, Frightened. I'm Perplexed. How do you do?"

"You know, you could use a little better sense of timing yourself."

"Okay, folks, here we go. It's time once again to play let's-jump-all over-everything-Jared-says. Well, please, before you get rolling, count me out. I'm going to bed."

"I'll be in in a while."

"Don't wake me."

The section from Beverly Vitale's left ovary was unlike any pathology Kate had ever encountered. The stroma-cells providing support and, according to theory, critical feminizing hormones-were perfectly normal in appearance. But the follicles-the pockets of nutrient cells surrounding the ova-were selectively and completely destroyed, replaced by the spindle-shaped, deep pink cells of sclerosis-scarring. Assumin'g the pattern held true throughout both ovaries-and there was no reeison to assume otherwise-Beverly Vitale's reproductive potential was as close to zero as estimate would allow. For nearly an hour, Kate sat there, scanning section after section, taking notes on a yellow legal pad. Why couldn't Jared understand what it all really meant to her? Why couldn't he see what a godsend medicine had been to a life marked by aimlessness and a self-doubt bordering on self-loathing. "My God, woman, if I didn't know better, I'd swear you were a model the Zeiss Company had hired to plug their latest line of microscopes."

"Aha, " Kate said melodramatically, her eyes still fixed on the microscope, "a closet male chauvinist pig. I expected as much all. along, Dr. Willoughby." She swung around and, as always, felt a warm jet of affection at the sight of her department head. In his early sixties, Stan Willoughby was egg bald save for a pure white monk's fringe. The pencil-thin moustache partially obscured by his bulbous nose was a similar shade. His eyes sparkled from beneath brows resembling endstage dandelions. In all, Jared's likening him to the wise imp Yoda was, though inappropriate, not inaccurate. Willoughby packed his pipe and straddled the stool across the table from Kate. "The young lady on Ashburton Five? " he asked. Kate nodded. "This a good time for me to take a look-see?"

Although Willoughby's primary area of interest was histochemistry, thirty-five years of experience had made him an expert in almost every phase of pathology. Every phase, that is, except how to administer a department. Willoughby was simply too passive, too nice for the dogmaim-dog world of hospital politics, especially the free-for-all for an adequate portion of a limited pool of funds. "Stan, I swear I've never seen, or even heard of, anything like this."

The chief peered into the student eyepieces on the teaching microscope-a setup enabling two people to view the same specimen at the same time.

"All right if I focus? " Kate nodded. Ritualistically, he went from low power magnification to intermediate, to high, and finally to thousand-fold oil-immersion, punctuating each maneuver with a "hmm" or an "uh huh." Through the other set of oculars, Kate followed. They looked so innocent, those cells, so deceptively innocent, detached from their source and set out for viewing. They were in one sense a work of art, a delicate, geometrically perfect montage that was the antithesis of the huge, cluttered metal sculptures Kate had built and displayed during her troubled Mount Holyoke years. The irony in that thought was immense. Form follows function. The essential law of structural design.

Yet here were cells perfect in form, produced by a biologic cataclysm tantamount to a volcano. A virus? A toxin? An antibody suddenly transformed?

The art of pathology demanded that the cells and tissues, though fixed and stained, never be viewed as static. "Did you send sections over to the electron microscopy unit? " Willoughby asked. "Not yet, but I will."

"And the young woman is bleeding as well? "

"Platelets thirty thousand. Fibrinogen fifteen percent of normal." 7. all "Ouch!"

"Yes, ouch. I spoke with her at some length last night. No significant family history, no serious diseases, nonsmoker, social drinker, no meds …"

"None?"

"Vitamins and iron, but that's all. No operations except an abortion at the Omnicenter about five years ago." The two continued to study the cells as they talked. "She's a cellist with the Pops."

"Travel history?"

"Europe, China, Japan. None to third world spots. I told her how envious I was of people who could play music, and she just smiled this wistful smile and said that every time she picked up her cello, she felt as rich and fulfilled as she could ever want to feel. I only talked to her for half an hour or so, Stan, but I came away feeling like we were… I don't know, like we were friends." Spend a day here sometime, Jared.

Come to work with me and see what I do, how I do it. "The hematology people are talking autoimmune phenomenon. They think the ovarian problem is long-standing, a coincidental finding at this point."

"Never postulate two diseases when one will explain things." Willoughby restated the maxim he had long since engrained upon her. "I suppose they're pouring in steroids."

"Stan, she's in trouble. Real trouble."

"Ah, yes. Forgive me. Sometimes I forget that there's more to this medicine business than just making a correct diagnosis. Thanks for not letting me get away with that kind of talk. Well, Doctor, I think you may really have something here. I have never encountered anything quite like it either."

"Neither had Dr. Bartholomew."

"That fossil? He probably has trouble recognizing his own shoes in the morning. Talk about a menace. AJI by himself he's an epidemic."

"No comment."

"Good. I have enough comments for both of us. Listen, Kate. Do you mind if I try a couple of my new silver stains on this material? The technique seems perfect for this type of pathology."

"I was about to ask if you would."

Willoughby engaged the intercom on the speaker-phone system one of the few innovations he had managed to bring into the department. "Sheila, is that you?"

"No, Doctor Willoughby, it's Jane Fonda.

Of course it's me. You buzzed my office."

"Could you come into Dr. Bennett's office, please? " There was no response. "Sheila, are you still there?"

"It's not what it sounds like, Dr. Willoughby," she said finally. "Not what what sounds like?"

"Sheila, " Kate cut in firmly, "it's me. We're calling because we have a specimen we'd like to try the silver stain on."

For a few moments there was silence. "I… I'll be over shortly, " the technician said. Willoughby turned to Kate, his thick brows presaging his question.

"Now what was that little ditty all about?"

"Nothing, really-, "Nothing? Kate, that woman has worked for me for fifteen years. Maybe more. She's cynical, impertinent, abrasive, aggressive, and at times as bossy as my wife, but she's also the best and brightest technician I've ever known. If there's trouble between the two of you, perhaps I'd best know about it. Is it that study of the department I commissioned you and your eomputer friend, Sebastian, to do?"

"It's nothing, Stan. I mean it. Like most people who are very good at what they do, Sheila has a lot of pride. Especially when it comes to her boss of fifteen years. I know it's not my place to decide, but if it's okay, I'd like the chance to work through our differences without involving you. Okay?"

Willoughby hesitated and then shrugged and nodded. "Thanks, " she said.

"If I were ever to take over the chairmanship of the department, I'd like to know I had a solid relationship with my chief technician-especially if she were someone as invaluable as Sheila Pierce."

"Invaluable is right. I keep giving her raises and bonuses even though she puts a knot in my ninny just about every time she opens her mouth.

Say, did I hear you just give me the green light to submit your name to Reese?"

"I said if and you know it."

Willoughby grinned mischievously. "Your voice said if, but your eyes…"

"You rang? " Sheila Pierce saved Kate from a response. Fortyish, with a trim, efficient attractiveness, she had, Kate knew, earned both bachelor's and master's degrees while working in the department. By the time Kate had begun her residence, the one-time laboratory assistant had become chief pathology technician. "Ah, Sheila, " Willoughby said. "Come in."

"Hi, Sheila."

Kate hoped there was enough reassurance in her expression and her voice to keep the woman from any further outburst, at least until they had a chance to talk privately. Their eyes locked for a fraction of a second, then, mercifully, Sheila returned the greeting. The problem between them had, as Stan Willoughby suspected, arisen during Kate's computer-aided study of the pathology department's budget and expenditures, specifically in regard to a six hundred and fifty dollar payment for an educational meeting in Miami that Sheila could not document ever having attended. Kate had decided to drop the matter without involving the department chief, but the technician was clearly unconvinced that she had done so. "How's my new batch of silver stain coming?" Willoughby asked. "It's much, much thicker than the old stuff, " Sheila said, settling on a high stool, equidistant from the two physicians. "Fourteen hours may be too long to heat it."

"I seem to recall your warning me about that when I suggested fourteen hours in the first place. Is it a total loss?"

"Well, actually I split about half of it off and cooked that part for only seven hours."

"And… "

"And it looks fine… perfect, even."

Willoughby's sigh of relief was pronounced. "Do you know how much that stain costs to make? How much you just saved me by… T' "Of course I know. Who do you think ordered the material in the first place, the Ghost of Christmas Past?"

Willoughby shot Kate a what-did-I-tell-you glance, then he picked up the slides and paraffin blocks containing tissue from Beverly Vitale's ovary. "Dr. Bennett has an interesting problem here that I think might be well suited to my silver stain. Do you think you could make some sections and try it out?"

"Your command is my command, " Pierce said, bowing. "Give me an hour, and your stain will be ready." She turned to Kate. "Dr. Bennett, I think you should have a little review session with our chief here on the basics of hypertension. On his desk, right next to his blood pressure pills, is a half-eaten bag of Doritos. Bye, now."

Sheila Pierce dropped off the paraffin block in histology and then returned to her office. On her desk was the stain Willoughby had referred to as "his." Pierce laughed disdainfully. If it weren't for her, the stain that was soon to be known by his name would be little more than an expensive beaker of shit. There they sat, she thought, Willoughby and that goddamn Bennett, sharing their little physician jokes and performing their physician mental masturbations and issuing orders to a woman with an IQ-a proven IQ-higher than either of theirs could possibly be., One-fifty. That's what her mother said. Genius level. One hundred and fucking fifty. So where was the MD degree that would have put her where she deserved to be?

Pierce glared at the small framed photo of her parents, carefully placed to one side of her desk. Then her expression softened. It wasn't their fault, being poor. Just their fate. They didn't want the stroke or the cancer that had forced their daughter to shelve her dreams and begin a life of taking orders from privileged brats who, more often than not, couldn't come close to her intellectual capacity. One hundred and fifty.

What was Kate Bennett? One-ten?

One-twenty tops. Yet there she was with the degree and the power and the future. Listen, Sheila, you're terrific at your job. I don't see that there's anything to gain by bringing this up to Dr. Willoughby, or even by making you reimburse the depailment. But never again, okay?

"Patronizing bitch."

"Who's a bitch?"

Startled, Sheila whirled. Norton Reese stood propped against the doorjamb, eyeing her curiously. "Jesus, you scared me."

"Who's a bitch? " Reese checked the corridor in both directions then stepped inside and closed the door behind him. "Bennett, that's who."

"Ah, yes. What's our little Rebecca of Sunnybrook Farm up to now?"

"Oh, nothing new. It's that damn American Society meeting."

"Miami?"

"Yes. The time you assured me there was no way anyone would ever find out I didn't go."

"She is a resourceful cunt, " Reese mumbled. "I'll say that for her."

"What?"

"Didn't she say she was going to do her Girl Scout good deed for the month and let the whole matter drop?"

"That's what she said, but she and Dr. Willoughby are like that." Sheila held up crossed fingers. "Either she's already told him or she's going to hold the thing over my head forever. Either way She shook her head angrily. "Easy, baby, easy, " Reese said, crossing to her and slipping his hands beneath her lab coat. Sheila grimaced, but allowed herself to be embraced. Balding, moderately overweight, and wedded to three-piece suits, Reese had never held sex appeal for her in any visceral sense.

Still, he was the administrator of the entire hospital complex, and time and experience had taught her that true sex appeal was based not so much on what a man could do to her as for her. "You have the most beautiful tits of any woman I've ever known, " Reese whispered. "Baby, do you know how long it's been?"

She blocked his move toward her breasts with an outstretched hand. "It's not my fault, Norty. I'm divorced. You're the one with all the family commitments. Remember?"

Reese gauged the determination in her eyes and decided against another advance. "So, " he said, settling into the chair by her desk, "Wonder Woman has been at it again, huh? Well, believe it or not, she's the reason-one of the reasons-I came down here."

"Oh? "

"Maybe you'd better sit down." Reese motioned her to her chair and then waited until she had complied. "Did you know that old Willoughby has decided to resign?"

"No. No, I didn't, actually." She felt some hurt that Reese had been told of the decision before she was. "He's giving health as a reason, but I think the old goat just can't cut it anymore. Never could, really."

Sheila shot him a look warning against any further deprecation of the man she had worked under for fifteen years. "That's too bad, " she murmured. "Yeah? Well, baby, hang onto your seat. You don't know what bad is. For his successor, your Willoughby wants to recommend one K. Bennett, MD."

Sheila fought a sudden urge to be sick. For years she had, in effect, run the pathology department, using Willoughby for little more than his signature on purchase orders and personnel decisions.

With Bennett as chief, she would be lucky to keep her job, much less her power and influence. "You said wants to recommend, " she managed.

"Bennett refuses to give him the go-ahead until she's talked it over with her husband."

She picked a tiny Smurf doctor doll off her desk and absently twisted its arm. "How do you feel about it? " she asked. "After what she did last year, writing what amounted to a letter of complaint about me to the board? How do you think I feel?"

"So? " The blue rubber arm snapped off in Sheila's hand. "I won't have that woman heading a department in my hospital, and that's that."

"What can you do?"

The forcefulness in Reese's voice softened. "There, at least for the moment, is the rub. I've started talking to some of the members of the board of trustees and some of the department heads. It turns out that as things stand, she would have no trouble getting approval. It seems only a few beside me-" he smiled conspiratorially, "and now you know what an incredible pain in the ass she is."

Sheila flipped the arm and then the body of the doll into the trash. "So we both know, " she said.. "Baby, I need something on her. Anything that I can use to influence some people. The prospect of dealing with Bennett's crusades month after month is more than I can take. Keep your eyes and ears open. Dig around. There's got to be something."

"If I do find something, " Sheila said, "I'll expect you to be grateful.

"I'll be very grateful."

"Good," Sheila said sweetly. "Then we shall see what we shall see." She rose and kissed him on the forehead, her breasts inches from his eyes.

"Very grateful, " she whispered. "Now don't you forget that."

She backed away at the moment Reese reached for her. "Next time, Norty.

Right now I've got work to do."

The Braxton Building was more impressive as an address than it was as a structure. At one time, the twenty-eight story granite obelisk had been the centerpiece of Boston's downtown financial district. Now, surrounded by high-rise glass and steel, the building seemed somehow iu at ease. No uninformed passerby could possibly have predicted from the building's exterior the opulence of the lobby and office suites within, especially the grandeur of the twenty-eighth floor, most elegant of the three floors occupied by the law firm of Minton/Samuels. J. Winfield Samuels selected a Havana-made panatella from a crystal humidor and offered it to his son. Jared, seated to one side of the huge, inlaid Louis Quatorze desk, groaned. "Dad, it's not even eleven o'clock. Didn't Dr. What's-his-face limit the number you're supposed to smoke in a day?"

"I pay Shrigley to fix me up so I can do whatever the hell I want to do, not to tell me how many cigars I can smoke." He snipped the tip with a bone-handled trimmer and lit it from the smokestack of a sterling silver replica of the QE 11. "I swear, if Castro had found a way to keep these little beauties from making it to the States, I would have found a way to cancel the bastard's ticket years ago. Think of it. We'd probably have world peace by now because of a cigar." He took a long, loving draw, blew half of it out, inhaled the rest, and gazed out the floor-to-ceiling window at the harbor and the airport beyond. Jared sipped at his mug of coffee and risked a glance at his watch.

Win Samuels had summoned him and Win Samuels would tell him why when Win Samuels was good and ready to do so. That was the way it had always been between them and, for all Jared knew, that was the way Jared Winfield Samuels, Sr. had related to Win. The notion left a bitter aftertaste.

Beyond his grandfather, the family had been traced through a dozen or more generations, three centuries, and three continents. Not that he really cared about such things. His years of rebellion in Vermont had certainly demonstrated that. But now, with the possibility that he represented the end of the line he was… more aware. "So, how's Kate?

" The older Samuels was still looking out the window when he spoke.

"She's okay. A little harried at work, but okay." It was unwise, Jared had learned over the years, to offer his father any more information than asked for. At seventy, the man was still as sharp as anyone in the game. What he wanted to know, he would ask. "And how are the negotiations coming with the union people at Granfield?"

"Fine. Almost over, I think. We're meeting with them this. afternoon. If that idiot shop steward can understand the pension package we've put together, the whole mess should get resolved with no more work stoppage."

"I knew you could do it. I told Toby Granfield you could do it."

"Well, like I said, it's not over yet."

"But it will be." The words were an order, not a question. "Yes, " Jared said. "It will be."

"Excellent, excellent. How about a little vacation for you and Kate when everything is signed and sealed. Goodness knows you deserve it. Those union thugs are slow, but they're tough. Bert Hodges says his place in Aruba is available the week after next. Suppose we book it for you, "I don't… what I mean is I'll have to talk with Kate. She's got quite a bit going on at the hospital."

"I know." Win Samuels swung around slowly to face his son. At six feet, he was nearly as tall as Jared and no more than five pounds heavier. His rimless spectacles and discreetly darkened hair neutralized the aging effects of deep crow's feet and a slightly sallow complexion. "What?"

"I said that I knew she was having a busy time of it at the hospital."

Samuels paused, perhaps for dramatic effect. "Norton Reese called me this morning."

"Oh? " The statement was upsetting.

For five years, Jared had handled all of Boston Metro's legal affairs.

There was no reason for Norton Reese to be dealing directly with his father, even allowing that the two of them had known each other for years. "He tells me the head of pathology is retiring." Jared nodded that the information was not news. "He also said that this head pathologist, Willoughby, wants Kate to take over for him."

"She mentioned that to me, " Jared understated. "Did she now? Good. I'm glad you two communicate about such minor goings on." The facetiousness in Samuels's voice was hardly subtle. Kate's independence had been a source of discussion between them. on more than one occasion. Somewhere in the drawer of that Louis Quatorze desk was a computer printout showing that while he had received forty-nine percent of the total vote cast in the congressional race, he had garnered only forty-two percent of the women's vote. To Win Samuels, the numbers meant that if Mrs.

Jared Samuels had been out stumping for her husband instead of mucking about elbow deep in a bunch of cadavers, Jared would be packing to leave for Washington. Self-serving, contrary, disloyal, thoughtless-the adjectives had, from time to time, flown hot and heavy from the old man, though never in Kate's presence. Toward her, he had always been as cordial and charming as could be. "Look, Dad, " Jared said, "I've still got some preparation to do for that session at Granfield. Do you think …"

"Donna, " Samuels said through the intercom, "could you bring in another tea for me and another coffee for my son, please?"

Jared sank back in his seat and stared helplessly at the far wall, a wall covered with photographs of politicians, athletes and other celebrities, arm in arm or hand in hand with his father. A few of them were similar shots featuring his grandfather, and one of them was an eight by ten of Jared and the President, taken at a three-minute meeting arranged by his father for just that purpose. With a discreet knock, Samuels's sensuous receptionist entered and set their beverages and a basket of croissants on a mahogany stand near the desk. Her smile in response to Jared's "Thank you" was vacant-a subtle message that her allegiance was to the man on the power side of the Louis Quatorze. "So,

" Samuels said, settling down with a mug of tea in one hand and his Havana in the other, "what do you think of this business at Metro?"

"I haven't given it much thought, " Jared tied. "As far as I know, nothing formal has been done yet."

"Well, I'd suggest you start thinking about it."

"What?"

"Norton Reese doesn't want Kate to have that position and, frankly, neither do I. He thinks she's too young and too inexperienced. He tells me that if she gets the appointment, which incidentally is doubtful anyhow, she'll run herself ragged, burn out, and finally get chewed to ribbons by the politicians and the other department heads. According to him, Kate just doesn't understand the way the game is played-that there are some toes that are simply not to be stepped on."

"Like his, " Jared snapped. "Jared, you told me that the two of you were planning on starting your family. Does Kate think she can do that and run a department, too? What about her obligation to you and your career?

It's bad enough she's married to you and doesn't even have your name.

Christ, her looks alone would be worth thousands of votes to you if she'd just plunk her face in front of a camera a few times. Add a little baby to that, and I swear you could make a run for the Senate and win."

"Kate's business is Kate's business, " Jared said with neither enthusiasm nor conviction. "Take her to the Caribbean. Have a talk with her, " Samuels reasoned calmly. "Help her see that marriage is a series of… compromises. Give and take."

"Okay, I'll try."

"Good. Kate should see where her obligations and her loyalties lie. Ross Mattingly may be on a downhill slide, but he still managed to hang on and win the election. Don't think he's going to roll over and play dead next time. The fewer liabilities we have the better. And frankly, the way things stand, Kate is a minus. Have I made my thoughts clear?"

"Clear." Jared felt totally depleted. "Fine. Let me know when the Granfield business is done, and also let me know the date you two decide on, so I can tell Bert Hodges." With a nod, Winfield Samuels signaled the meeting over. In his sea-green scrub suit and knee-length white coat, Tom Engleson might have been the earnest young resident on a daytime soap opera, loving his way through the nurses one moment, stamping out disease the next. But his eyes gave him away. Kate saw the immense fatigue in them the moment she entered the resident's office on the fourth floor of the building renovated by the Ashburton Foundation and renamed in memory of Sylvia Ashburton. It was a fatigue that went deeper than the circles of gray enveloping them, deeper than the fine streaks of red throughout their sclerae. "Been to sleep at all? " Kate asked, glancing at the clock as she set two tinfoil pans of salad on the coffee table. It was twenty minutes of two. Engleson merely shook his head and began to work off the plastic cover of his salad with a dexterity that was obviously far from what it had been when he had started his shift thirty and a half hours before. Studying the man's face, Kate wondered how residency programs could justify the ridiculous hours they required, especially of surgical trainees. It was as if one generation of doctors was saying to the next, "We had to do it this way and we came out all right, didn't we? " Meanwhile, year after year, a cardiogram was misread here, an operation fumbled there, never a rash of problems, just isolated incidents at one hospital then another, one program then another-incidents of no lasting consequence, except, of course, to the patients and families involved. "I hope you like blue cheese, " Kate said. "Gianetti's has great vinaigrette, too. I just guessed."

"It's fine, perfect, Dr. Samuels, " Engleson said between bites. "I've missed a meal or two since this Vitale thing started yesterday morning."

"Eat away. You can have some of mine if you want. I'm not too hungry.

And it's Xate. We pathologists have a little trouble with formality."

Engleson, his mouth engaged with another forkful of salad, nodded his acknowledgment. "Sorry I missed you when I was here last evening. The nurse said you were in the delivery room."

"A set of twins."

"How's Beverly Vitale?"

"Her blood count's down this morning. Twenty-five. She's due for a recheck in an hour or two. Any further drop, and we'll give her more blood."

"Her GI tract?

" Kate asked, speculating on the site of blood loss. "Probably. There's been some blood in every stool we've checked. She's on steroids, you know."

"I do know. Withhold steroids, and her antibodies run wild, destroying her own clotting factors, use them, and she risks developing bleeding ulcers. It's one of those situations that makes me grateful I decided on pathology. Stan Willoughby and I reviewed the ovary sections this morning. His impression is that the findings are unique. He's doing some special stains now and has sent slides to a colleague of his at Johns Hopkins, whom he says is as good as anyone in the business at diagnosing ovarian disorders. He also is calling around town to see if anything like this has turned up in another department."

"Etiology?"

"No clues, Tom. Virus, toxin, med reaction. All of the above, none of the above, A and B but not C. She told you she wasn't on any meds, right?"

"None except vitamins. The multivitamin plus iron we dispense through the Omnicenter."

"Well I'm living proof those don't cause any problems. I've taken them for a couple of years. Make frail pathologist strong like bull." Kate flexed her biceps. "Make pathologist excellent teacher, too."

"Why, thank you." Kate's green eyes sparkled. "Thank you very much, Tom." For a moment, she saw him blush. "How about we go say hello to Beverly. I'd like to make extra sure about one or two aspects of her history. Here, you can stick this salad in that refrigerator for later."

"Provided the bacteria who call that icebox home don't eat it first,"

Tom said. The two were heading down the hall toward the stairway when the overhead page snapped to life. "Code ninety-nine, Ashburton five-ohtwo, code ninety-nine, Ashburton five-oh-two."

"Oh, Jesus."

Tom was already racing toward the exit as he spoke. Kate was slower to react. She was almost to the stairway door before she realized that Ashburton 502 was Beverly Vitale's room. It had been a year, perhaps two, since Kate had last observed a cardiac arrest and resuscitation attempt. She was certified in advanced cardiac life support, but training and testing then had been on Resusciannie, a mannequin. Her practical experience had ended years ago, along with her internship. At the moment, however, none of those considerations mattered. What mattered was the life of a young woman who loved to make music. With an athlete's quickness, Kate bolted after Tom Engleson up the stairs from Ashburton Four to Ashburton Five. There were more than enough participants in the code. Residents, nurses, medical students, and technicians filled room 502 and overflowed into the hall. Kate worked her way to a spot by the door, from which she watched the nightmare of Beverly Vitale's final minutes of life. It was a gastric hemorrhage, almost certainly from an ulcer eroding into an artery. The woman's relentless exsanguination was being complicated by the aspiration of vomited blood. Cloaked in abysmal helplessness, Kate witnessed Tom Engleson, desperation etched on his face, issuing orders in a deceptively composed tone, the organized chaos of the white-clad code team, pumping, injecting, monitoring, reporting, respirating, suctioning, and through the milling bodies, the expressionless, blood-smeared face of Beverly Vitale. For nearly an hour the struggle continued, though there was never a pulse or even an encouraging electrocardiographic pattern. In the end, there was nothing but another lesson in the relative impotence of people and medicine when matched against the capriciousness of illness and death. Tom Engleson, his eyes dark and sunken, shook his head in utter futility. "It's over, " he said softly. "Thank you all. It's over."

Simultaneously with hearing the report from the WEEI traffic helicopter of a monumental backup stemming from the Mystic/Tobin Bridge, Kate became part of it. Commuting to the city from the North Shore was an experience that she suspected ranked in pleasantness somewhere between an IRS audit and root canal work. Although Tuesday was normally a low-volume day, this morning she had encountered rain, sleet, snow, and even a bizarre stretch of sunlight during her thirty-mile drive, far too much weather for even Boston drivers to attack. With a groan, she resigned herself to being half an hour late, perhaps more, for the appointment Stan Willoughby had arranged for her at White Memorial Hospital. The pathology chief's call had punctuated another confusing, bittersweet morning with Jared. It seemed as if the intensity and caring in their relationship was waxing and waning not only from day to day but from hour to hour or even from minute to minute. In one sentence the man was Jared Samuels, the funny, sensitive, often ingenuous fellow she had married and still loved deeply, in the next he was calculating and distant, a miniature of his father, intransigent on points they should have been working through as husband and wife. At last, after an awkward hour of lighting brush fires of dissension and then scurrying to stamp them out, Jared had suggested a week or ten days together in Aruba, away from the pressures and demands of their careers. "What do you say, Boots? " he had asked, calling on the pet name she favored most of the four or five he used. "Aruba you all over." The expression in his eyes-urgency? fear? — belied his levity. "Aruba you too, Jared, " she had said finally. "Then we go?"

"If Stan can give me the time off, and if you can stand the thought of trying to hang onto a woman swathe in Coppertone, we go."

At that moment, Jared looked reborn. "Grumper-to-grumper, stall-and-crawl traffic headed in a snail trail toward the bridge, thanks to a fender bender in the left-hand lane." The Eye-in-the-Sky was sparing none of his cliches in describing the mess on Route 1 south.

Kate inched her Volvo between cars, but gained little ground. Finally, resigned to the situation, she settled back, turned up the volume on the all-news station, and concentrated on ignoring the would-be Lothario who was winking and waving at her from the Trans-Am in the next lane. The news, like Stan Willoughby's call, dealt with the sudden death of Red Sox hero Bobby Geary, a homegrown boy who had played his sandlot ball in South Boston, not a mile from the luxurious condominium where he was found by his mother following an apparent heart attack. Stan's name was mentioned several times as the medical examiner assigned to autopsy the man who had given away thousands of free tickets and had added an entire floor to Children's and Infants' Hospital in the name of "the kids of Boston."

"Kate, " Willoughby had begun, "I hope I'm not interrupting anything."

"No, no. Just getting ready for work, " she had said, smiling at Jared, who was nude by the bathroom door dancing a coarse hula and beckoning her to the shower with a long-handled scrub brush. "Well, I don't want you to come to work."

"What?"

"I want you to go to White Memorial. You have an appointment in the pathology department there at eight-thirty. Leon Olesky will be waiting for you. Do you know him?"

"Only by name."

"Well, I called around town trying to see if anyone had seen a case similar to our Miss Vitale's. Initially there was nothing, but late last night Leon called me at home. From what he described, the two cases — his and ours-sound identical. I told him you'd be over to study his material."

"How old was the woman? " Kate had asked excitedly. "I don't remember what he said. Twenty-eight, I think."

I)m "Cause of death?"

"Ah ha! I thought you'd never ask. Cerebral hemorrhage, secondary to minor head trauma."

"Platelets?

Fibrinogen? " Her hand was white around the receiver. "Leon didn't know.

The case was handled by one of his underlings. He said he'd try to find out by the time you got there."

"Can't you come?"

"Hell, no. Haven't you heard the news about Bobby Geary?"

"The ball player?"

"Heart attack late last night. Found dead in bed. I'm posting him at ten-thirty. In fact, I'd like you back here before I finish, just in case I need your help."

"You've got it. You know, you are a pretty terrific chief, Stanley. Are you sure you want to retire?"

"Yesterday, if I could arrange it, Katey-girl. You hurry on back to Metro after you see Olesky, now. No telling what this shriveled brain of mine might miss."

White Memorial Hospital, an architectural polyglot of more than a score of buildings, was the flagship of the fleet of Harvard Medical School affiliated hospitals. Overlooking the Charles River near the North End, WMH had more research facilities, professors, grants, and administrative expertise than any hospital in the area, if not the world. Metropolitan Hospital had once held sway, reportedly supplying ninety percent of all the professors of medicine at all the medical schools in the country, but that time had long since been buried beneath an avalanche of incompetent administrators, unfavorable publicity, and corrupt city politicians. Although Metro had made a resurgence of sorts under the guidance of Norton Reese, there was little likelihood of its ever recapturing the prestige, endowments, and fierce patient loyalty of the glory days, when at least one man was known to have had "Take Me To Metro" tattooed across his chest. It had been some time since Kate had had reason to visit the pathology unit at White Memorial, and she was uncomfortably impressed with the improvements and expansion that had occurred. Equipment her department congratulated itself on acquiring, this unit possessed in duplicate or triplicate. Corridors and offices were brightly lit, with plants, paintings, and other touches that made the work environment less tedious and oppressive. Almost subconsciously, Kate found herself making mental lists of things she would press to accomplish as chief — of pathology at Metro. Leon Olesky, a mild, Lincolnesque man, brushed off her apologies for her tardiness and after exchanging compliments about Stan Willoughby, left her alone in his office with the material from the autopsy of Ginger Rittenhouse. On a pink piece of paper by his elegant microscope were the data on the woman's blood studies. Only two of many parameters measured were abnormal, fibrinogen and platelets. The levels of each were depressed enough to have been life threatening.

Her hands trembling with anticipation, Kate took the first of the ovarian sections and slid it onto the stage of the microscope. A moment to flex tension from the muscles in her neck, and she leaned forward to begin another journey through the yellow-white light. Forty-five minutes later, the one had become three. Leon Olesky hunched over one set of oculars of the teaching microscope, controlling the focus with his right hand and moving the slide with his left. Across from him, in the seat Kate had occupied, was Tom Engleson. "You know, " Olesky said, "if Stan hadn't called me about your case, the findings on our young woman would have slipped right past us. I mentioned the matter last night at our weekly department conference, but no one responded. An hour later, Dr.

Hickman came to my office. Young Bruce is, perhaps, the brightest of our residents, but at times, I'm afraid, a bit too quick for his own good."

Kate sighed. Olesky's observations described many of the so-called hotshot residents she had worked with over the years. "I'll take methodical over genius any day of the week, " she said. "Both is best,"

Olesky responded, "but that's a rare combination, indeed.

I might mention, though, that it is a combination your mentor feels he is lucky to have found in you."

"Methodical, yes, " Kate allowed, "but I've yet to receive a single membership application from Mensa."

"She's only the best in the hospital, " Tom interjected somewhat impetuously. "Finish telling us about your resident."

Kate withheld reaction to Engleson's enthusiasm, sensing that what she felt was, in equal parts, flattered and embarrassed. "Well, it seems our Dr. Hickman was uncertain about the pathology he was seeing in this woman's ovaries. However, rather than think that the finding might be unique, he assumed, although he won't say so in as many words, that the condition was one he should have known about, and hence one he would look foolish asking for help with. Since the cause of death was unrelated to the ovaries, he chose to describe his findings in the autopsy report and leave it at that."

"No harm done, " Kate said. "Quite the contrary, in fact. This event may be the pinprick Hickman's ego needs so he can reach his full potential as a physician. It will make even more of an impression if, as Dr. Willoughby and now yours truly, suspect, this pathology turns out to be one never before described."

Kate and Tom exchanged excited glances. "How would you explain its showing up in two women in the same city at about the same time?" she asked. The professor's eyes, dark and deeply serious, met first Engleson's and then Kate's. "Considering the outcome of the illness in both individuals, I would suggest that we work diligently to find an answer to that question. At the moment, I have none."

"There must be a connection, " Engleson said. "I hope there is, young man."

Olesky rose from his stool. "And I hope the two of you will be able to find it. I have a class to teach right now at, the medical school. This evening, I leave for meetings in San Diego, and from there, I go to the wedding of my son in New Mexico. My office and our department are at your disposal."

"Thank you, " they said. Olesky replaced his lab coat with a well-worn mackintosh. He shook hands first with Engleson and then with Kate. A final check of his desk and he shambled from the office. Kate waited for the door to click shut. "I'm glad you were able to get here so quickly,

" she said. "Did you have any trouble getting the records people to let you take Beverly's chart out of the hospital?"

"None. I just followed Engleson's first law of chutzpah. The more one looks like he should be doing what he's doing, the less anyone realizes that he shouldn't. I'll have to admit that the crooks with moving vans and uniforms who pick entire houses clean thought of the law before I did, but I was the first one I know to put it in words. Are you okay? I went to find you after the code was over yesterday, but you were gone.

Before I could call, I was rushed to the OR to do an emergency C-section."

"I was okay." She paused. "Actually, I wasn't. It hurt like hell to see her lying there like that. I can't remember the last time I felt so helpless." At the thought, the mention of the word, Arthur Everett's grotesque face flashed in her mind, his reddened eyes bulging with the effort of forcing himself inside her. Yes, I do, she thought. I do remember when. "How about you? " she asked. Engleson shrugged. "I think I'm still numb. It's like I'm afraid that if I let down and acknowledge my feelings about her and what happened, I'll never set foot in a hospital again."

Kate nodded her understanding. "You know, Tom, contrary to popuiar belief, being human doesn't disqualify you from being a doctor. Are you married? " Engleson shook his head. "I think it's hard to face some of the things we have to face and then have no one to talk them out with, to cry on, if necessary, when we get home." She thought about the difficult morning with Jared and smiled inwardly at the irony of her words. "Had you known Beverly outside the hospital?"

"No. I met her when she came into Metro. But I thought about trying to start up a relationship as soon as she His voice grew husky. He cleared his throat. "I understand, " Kate said. "Look, maybe we can talk about our work and our lives in medicine some day soon. Right now, we've got to start looking for some common threads between these women. I'm due back at Metro in, " she checked her watch, "-shoot, I've only got about twenty minutes."

Tom was thumbing through the thin sheaf of papers dealing with Ginger Rittenhouse. "It shouldn't take long to check. They have next to no information here. Ginger Louise Rittenhouse, twenty-eight, elementary school teacher, lived and worked in Cambridge, but she was running along the Boston side of the river when she collapsed. Apparently she lived long enough to get an emergency CAT scan, but not long enough to get to the OR."

"Married?". Kate asked. "No. Single. That's the second time you've asked that question about someone in the last two minutes." He narrowed one eye and fingered his moustache. "You have, perhaps, a marriage fixation?"

Kate smiled. "Let's leave my fixations out of this. At least for the time being, okay? What about family? Place of birth? Next of kin? Did they document any prior medical history?"

"Hey, slow down. We obstetricians are hardly famous for our swift reading ability. No known medical history. Next of kin is a brother in Seattle. Here's his address. You know, world's greatest hospital or not, they take a pretty skimpy history."

"It doesn't look like they had time for much more, " Kate said solemnly.

There had to be a connection, she was thinking. The two cases were at once too remarkable and too similar. Somewhere, the lives of a teacher from Cambridge and a cellist from a suburb on the far side of Boston had crossed. "Wait, " Engleson said. "She had a roommate. It says here on the accident floor sheet. Sandra Tucker. That must be how they found out about her family."

Kate again checked her watch. "Tom, I've got to go. I promised Dr.

Willoughby I'd help out with the post on Bobby Geary. Do you think you could try and get a hold of this Sandra Tucker? See if our woman has seen a doctor recently or had a blood test. Don't teachers need yearly physicals or something?"

"Not the ones I had.. I think their average age was deceased."

"Are you going to call from here? " Engleson thought for a moment and then nodded. "Fine, give me a ring when you get back to Metro. And Tom'?

Thanks for the compliment you paid me before." She reached out and shook his hand, firmly and in a businesslike manner. Then she left. With the pistol-shot crack of bat against ball, thirty thousand heads snapped in horror toward the fence in right center field. "Jesus, Katey, it's gone,

" was all Jared could say. The ball, a white star, arced into the blue-black summer night sky.

On the base paths, four runners dashed around toward home. There were two out in the running, the ninth running. The scoreboard at the base of the left field wall in Fenway Park said that the Red Sox were ahead of the Yankees by three runs, but that lead, it appeared, had only seconds more to be. Kate, enthralled by the lights and the colors and the precision of her first live baseball game, stood frozen with the rest, her eyes fixed on the ball now in a lazy descent toward a spot beyond the fence. Then into the corner of her field of vision he came, running with an antelope grace that made his movements seem almost slow motion.

He left the ground an improbable distance from the fence, his gloved left hand reaching, it seemed, beyond its limits, up to the top of the barrier and over it. For an instant, ball and glove disappeared beyond the fence. In the next instant, they were together, clutched to the chest of Bobby Geary as he tumbled down onto the dirt warning track to the roar of thirty thousand voices. It was a moment Kate would remember for the rest of her life. This, too, was such a moment. The body that had once held the spirit and abilities of Bobby Geary lay on the steel table before her, stripped of the indefinable force that had allowed it to sense and react so remarkably. To one side, in a shallow metal pan, was the athlete's heart, carefully sliced along several planes to expose the muscle of the two ventricles-the pumping chambers-and the three main coronary arteries-left, right, and circumflex. Images of that night at Fenway more than four years ago intruded on Kate's objectivity and brought with them a wistfulness that she knew had no place in this facet of her work. "Nothing in the heart at all? " she asked for the second time. Stan Willoughby, leprechaunish in green scrubs and a black rubber apron, shook his head. "Must a bin somethin' he et, " he said, by way of admitting that, anatomically at least, he had uncovered no explanation for the pulmonary edema, fluid that had filled Bobby Geary's lungs and, essentially, drowned him from within. Kate, clad identically to her chief, examined the heart under a highiotensity light. "Teenage heart in a thirty-six-year-old man. I remember reading somewhere that he intended to keep playing until he was fifty. This heart says he might have made it."

"This edema says no way, " Willoughby corrected. "I'm inclined to think dysrhythmia and cardiac arrest on that basis. Preliminary blood tests are all normal, so I think it possible we may never know the specific cause." There was disappointment in his voice. "Sometimes we just don't,

" Kate said. The words were Willoughby's, a lesson he had repeated many times to her over the years. Willoughby glared at her for a moment, then he laughed out loud. "You are a saucy pup, flipping my words back at me like that. Suppose you tell me what to say to the police lieutenant drinking coffee and dropping donut crumbs right now in my office, or to the gaggle of reporters in the lobby waiting for the ultimate word.

Ladies and gentlemen, the ultimate word from the crack pathology department you help support with your taxes is that we are absolutely certain we have no idea why Bobby Geary went into a pulmonary edema and died."

Kate did not answer. She had grabbed a magnifying glass and was intently examining Geary's feet, especially between his toes and along the inside of his ankles. "Stan, look, " she said. "All along here. Tiny puncture marks, almost invisible. There must be a dozen of them. No, wait, there are more."

Willoughby adjusted the light and took the magnifier from her. "Holy potato, " he said softly. "Bobby Geary an addict? " He stepped back from the table and looked at Kate, who could only shrug. "If he was, he was a bloomin' artist with a needle."

"A twenty-seven or twenty-nine gauge would make punctures about that size."

"And a narcotics or amphetamine overdose would explain the pulmonary edema." Kate nodded. "Holy potato, " Willoughby said again. "If it's true, there must be evidence somewhere in his house."

"Unless it happened with other people around and they brought him home and put him to bed. Why don't we send some blood for a drug screen and do levels on any substance we pick up?"

Willoughby glanced around the autopsy suite. The single technician on duty was too far away to have heard any of their conversation. "What do you say we label the tube Smith' or Schultz' or something. I'm no sports fan, but I know enough to see what's at stake here. The man was a hero."

"What about the policeman?"

"His name's Detective Finn, and he is a fan. I think he'd prefer some kind of story about a heart attack, even if the blood test is positive."

"Schultz sounds like as good a name as any, " Kate said. "Are these the tubes? Good. I'll have new labels made up."

"I'll send Finn over to the boy's place, and then I'll tell the newsnoses they will just have to wait until the microscopics are processed. Now, when can you give me a report on the goings on at the WMHT' "Well, beyond what I've already told you, there's not much to report. We've got some sort of ovarian microsclerosis in two women with profound deficiencies of both platelets and fibrinogen. At this point, we have no connections between the two, nothing even to tell us for sure that the ovarian and blood problems are related."

"So what's next?"

"Next? Well, Tom Engleson, the resident who was involved with Beverly Vitale, is trying to get some information from the roommate of the WMH woman."

"And thou?"

Kate held her hands to either side, palms up. "No plan. I'm on surgicals this month, so I've got a few of those to read along with a frozen or two from the OR. After that I thought I'd talk to my friend Marco Sebastian and see if that computer of his can locate data on a woman named Ginger Rittenhouse."

"Sounds good," Willoughby said. "Keep me posted." He seemed reluctant to leave. "Is there anything else? " Kate asked finally. "Well, actually there is one small matter."

"All right, let me have it." Kate knew what was coming. "I… um… have a meeting scheduled with Norton Reese this afternoon. Several members of the search committee are supposed to be there and well… I sort of wondered if you'd had time to Willoughby allowed the rest of the thought to remain unspoken. Kate's eyes narrowed. He had promised her a week, and it had been only a few days. She wasn't at all ready to answer. There were other factors to consider besides merely "want to" or "don't want to." Willoughby had to understand that. "I've decided that if you really think I can do it, and you can get all those who have to agree to do so, then I'll take the position, " she heard her voice say.

The girl's name was Robyn Smithers. She was a high school junior, assigned by Roxbury Vocational to spend four hours each week working as an extern in the pathology department of Metropolitan Hospital. Her role was simply defined, do what she was told, and ask questions only when it was absolutely clear that she was interrupting no one. She was one of twelve such students negotiated for by Norton Reese and paid for by the Boston School Department. That these students learned little except how to run errands was of no concern to Reese, who had already purchased a new word processor for his office with the receipts from having them.

Robyn had made several passes by Sheila Pierce's open door before she stopped and knocked. "Yes, Robyn, what can I do for you?"

"Miss Pierce, I'm sorry for botherin' you. Really I am."

"It's fine, Robyn. I was beginning to wonder what you were up to walking back and forth out there."

"Well, ma'am, it's this blood. Doctor Bennett, you know, the lady doctor?"

"Yes, I know. What about her?"

"Well, Dr. Bennett gave me this here blood to take to she consulted a scrap of paper, "Special Chemistries, only I can't find where that is.

I'm sorry to bother you while you're working and all."

"Nonsense, child. Here, let me see what you've got."

Casually, Sheila glanced at the pale blue requisition form. The patient's name, John Schultz, meant nothing to her. That in itself was unusual. She made it her business to know the names of all those being autopsied in her department. However, she acknowledged, occasionally one was scheduled without her being notified. In the space marked "Patient's Hospital Number" the department's billing number was written. The request was for a screen for drugs of abuse. Penned along the margin of the

requisition was the order, "STAT, Phone results to Dr. K. Bennett ASAP."

"Curiouser and curiouser, " Sheila muttered. "Pardon, ma'am?"

"Oh, nothing, dear. Listen, you've been turning the wrong way at that corridor back there. Come, I'll show you." She handed back the vials and the requisition and then guided the girl to the door of her office.

"There, " she said sweetly. "Just turn right there and go all the way down until you see a cloudy-glass door like mine with Special Chemistries written on it. Okay?"

"Yes. Thank you, ma'am."

Robyn Smithers raced down the corridor., Glad to help… you dumb little shit."

Sheila listened until she heard the door to Special Chemistries open and close, then she went to her phone and dialed the cubicle of Marvin Grimes. Grimes was the department's deiner, the preparer of bodies for autopsy. It was a position he had held for as long as anyone could remember. "Marvin, " Sheila asked, "could you tell me the names of the cases we autopsied today?"

"Jes' two, Ms. Pierce. The old lady Partridge n' the ball player."

"No one named Schultz? " Sheila pictured the bottle of Wild Irish Rose Grimes kept in the lower right-hand drawer of his desk, she wondered if by the end of the day the old man would even remember talking to her.

"No siree. No Schultz today."

"Yesterday?"

"Wait, now. Let me check. Nope, only Mcdonald, Lacey, Briggs, and Ca..

Capez… Capezio. No one named… what did you say the name was?"

"Never mind, Marvin. Don't worry about it."

As she replaced the receiver, Sheila tried to estimate the time it would take the technicians in Special Chemistries to complete a stat screen for drugs of abuse. "Curiouser and curiouser and curiouser, " she said.

The dozen or so buildings at Metropolitan Hospital were connected by a series of tunnels, so tortuous and poorly lit that the hospital had recommended that its employees avoid them if walking alone. Several assaults and the crash of a laundry train into a patient's stretcher only enhanced the grisly reputation of the tunnel, as did the now classic Harvard Medical School senior show, Rats. Kate, unmindful of the legends and tales, had used the tunnels freely since her medical student days, and except for once coming upon the hours-old corpse of a drunk, nestled peacefully in a small concrete alcove by his half-empty bottle of Thunderbird, she had encountered little to add to the lore. The single greatest threat she faced each time she traveled underground from one building to another was that of getting lost by forgetting a twist or a turn or by missing the crack shaped like Italy that signaled to her the turnoff to the administration building. At various times over the years, she had headed for the surgical building and ended up in the massive boiler room, or headed for a conference in the amphitheater, only to dead end at the huge steam pressers of the laundry building.

Concentrating on not overlooking the landmarks and grimedimmed signs, Kate made her way through the beige-painted maze toward the computer suite and Marco Sebastian. Nurses in twos and threes passed by in each direction, heralding the approach of the three o'clock change in shift.

Kate wondered how many thousands of nurses had over the years walked these tunnels on the way to their charges. The Metro tradition, nurses, professors of surgery, medical school deans, country practitioners, even Nobel laureates. Now, in her own way and through her own abilities, she was becoming part of that tradition. Jared had to know how important that was to her. She had shared with him the ugly secrets of her prior marriage and stifling, often futile life. Surely he knew what all this meant. In typically efficient Metro fashion, the computer facilities were situated on the top floor of the pediatrics building, as far as possible from the administrative offices that used them the most. Kate paused by the elevator and thought about tackling the six flights of stairs instead. The day, not yet nearly over, had her feeling at once exhausted and exhilarated. Three difficult surgical cases had followed the Geary autopsy. Just as she was completing the last of them, a Special Chemistries technician had dropped off the results of Geary's blood test. The Amphetamine level in his body was enormous, quite enough to have thrown him into pulmonary edema. Before she could call Stan Willoughby with the results, she was summoned to his office. The meeting there, with Willoughby and the detective, Martin Finn, had been brief.

Evidence found on a careful search of Bobby Geary's condominium had yielded strong evidence that the man was a heavy amphetamine user. It was information known only to the three of them. Finn — was adamant-barring any findings suggesting that Geary's death was not an accidental overdose, there seemed little to be gained and much to be lost by making the revelation public. The official story would be of a heart attack, secondary to an anomaly of one coronary artery. The elevator arrived at the moment Kate had decided on the stairs. ISM She changed her mind in time to slip between the closing doors. Marco Sebastian, expansive in his white lab coat and as jovial as ever, met her with a bear hug. She had been a favorite of his since their first meeting, nearly seven years before. In fact, he and his wife had once made a concerted effort to fix her up with his brother-in-law, a caterer from East Boston. After a rapid-fire series of questions to bring himself up to date on Jared, the job, Willoughby, and the results of their collaborative study, the engineer led her into his office and sat her down next to him, facing the terminal display screen on his desk.

"Now then, Dr. Bennett, " he said in a voice with the deep smoothness of an operatic baritone, "what tidbits can I resurrect for you this time from the depths of our electronic jungle? Do you wish the hat size of our first chief of medicine? We have it. The number of syringes syringed in the last calendar year? Can do. The number of warts on the derriere of our esteemed administrator? You have merely to ask."

"Actually, Marco, I wasn't after anything nearly so exotic. Just a name."

"The first baby born here was He punched a set of keys and then another.

Jessica Peerless, February eighteenth, eighteen forty-three."

"Marco, that wasn't the name I had in mind."

"How about the two hundredth appendectomy?"

"Nope. "The twenty-eight past directors of nursing?"

"Uh-uh. I'm sorry, Marco."

"All this data, and nobody wants any of it." The man was genuinely crestfallen. "I keep telling our beloved administrator that we are being under-used, but I don't think he has the imagination to know what questions to ask. Periodically, I send him tables showing that the cafeteria is overspending on pasta or that ten percent of our patients have ninety percent of our serious diseases, just to pique his interest, remind him that we're still here."

"My name?"

"Oh, yes. I'm sorry. It's been a little slow here. I guess you can tell that."

"It's Rittenhouse, Ginger Rittenhouse. Here's her address, birthplace, and birthdate. That's all I have. I need to know if she's ever been a patient of this hospital, in or out." 64 Keep your eyes on the screen,"

Sebastian said dramatically. Thirty seconds later, he shook his head.

"Nada. A Shirley Rittenhouse in nineteen fifty-six, but no others."

"Are you sure?

" Sebastian gave her a look that might have been anticipated from a judge who had been asked, "Do you really think your decision is fair?"

"Sorry, " she said. "Of course, she still could have been a patient of the Omnicenter."

Kate stiffened. "What do you mean?"

"Well, the Omnicenter is sort of a separate entity from the rest of Metro. This system here handles records and billing for the Ashburton inpatient service, but the Omnicenter is totally self-contained. Has been since the day they put the units in-what is it? — nine, ten years ago."

"Isn't that strange?"

"Strange is normal around this place, " Sebastian said. "Can't you even plug this system into the one over there?"

"Nope. Don't know the access codes. Carl Horner, the engineer who runs the electronics there, plays things pretty close to the vest.

You know Horner?"

"No, I don't think so." Kate tried to remember if, during any of her visits to the Omnicenter as a patient, she had even seen the man. "Why do you suppose they're so secretive? "

"Not secretive so much as careful. I play around with numbers here, Horner and the Omnicenter people live and die by them. Every bit of that place is computerized, records, appointments, billing, even the prescriptions."

"I know. I go there for my own care."

"Then you can imagine what would happen if even a small fly got dropped into their ointment. Homer is a genius, let me tell you, but he is a bit eccentric. He was writing advanced programs when the rest of us were still trying to spell IBM. From what I've heard, complete independence from the rest of the system is one of the conditions he insisted upon before taking the Omnicenter job in the first place.", So how do I find out if Ginger Rittenhouse has ever been a patient there? It's important, Marco. Maybe very important."

"Well, Paleolithic as it may sound, we call and ask."

"The phone?"

Marco Sebastian shrugged sheepishly and nodded. DEAD END. Alone in her office, Kate doodled the words on a yellow legal pad, first in block print, then in script, and finally in a variety of calligraphies, learned through one of several "self-enrichment" courses she had taken during her two years with Art. According to Carl Horner, Marco Sebastian's counterpart at the Omnicenter, Ginger Rittenhouse had never been a patient there. Tom Engleson had succeeded in contacting the woman's roommate, but her acquaintance and living arrangement with Giilger were recent ones. Aside from a prior address, Engleson had gleaned no new information. Connections thus far between the woman and Beverly Vitale, zero. Outside, the daylong dusting of snow had given way to thick, wet flakes that were beginning to cover. The homeward commute was going to be a bear. Kate tried to ignore the prospect and reflect instead on what her next move might be in evaluating the microsclerosis cases, perhaps an attempt to find a friend or family member who knew Ginger Rittenhouse better than her new roommate. She might present the two women's pathologies at a regional conference of some sort, hoping to luck into yet a third case. She looked at the uncompleted work on her desk. Face it, she realized, with the amount of spare time she had to run around playing epidemiologist, the mystery of the ovarian microsclerosis seemed destined to remain just that. For a time, her dread of the drive home did battle with the need to get there in order to grocery shop and set out some sort of dinner for the two of them.

Originally, they had tried to eschew traditional roles in setting up and maintaining their household, but both rapidly realized that their traditional upbringings made that arrangement impractical if not impossible. The shopping and food preparation had reverted to her, the maintenance of their physical plant to Jared. Day-to-day finances, they agreed, were beyond either of their abilities and therefore to be shared. Again she checked out the window. Then after a final hesitation, a final thought about calling home and leaving a message on their machine that she was going to work late, she pushed herself away from the desk. As she stood up, she decided, if it was going to be dinner, then dammit, it was going to be a special dinner. In medical school and residency, she had always been able to find an extra gear, a reserve jet of energy, when she needed it. Perhaps tonight her marriage could use a romantic, gourmet dinner more than it could her moaning about the exhausting day she had endured. Spinach salad, shrimp curry, candles, Grgich Hills Chardonnay, maybe even a chocolate souffle. She ticked off a mental shopping list as she slipped a few scientific reprints into her briefcase, bundled herself against the rush-hour snow, and hurried from her office, pleased to sense the beginnings of a surge. It was good to know she still had one. + In the quiet of his windowless office, Carl Horner spoke through his fingertips to the information storage and retrieval system in the next room. He had implicit faith in his machines, in their perfection.

If there was a problem, as it now seemed there was, the source, he felt certain, was human-either himself or someone at the company. Again and again his fingers asked. Again and again the answers were the same.

Finally, he turned from his console to one of two black phones on his desk. A series of seven numbers opened a connection in Buffalo, New York, four numbers more activated the line to a "dead box" in Atlanta, and a final three completed an untraceable connection to Darlington, Kentucky. Cyrus Redding answered on the first ring. "Carl?"

"Orange red, Cyrus." Had the colors been reversed, Redding would have been warned either that someone was monitoring Horner's call or that the possibility of a tap existed. "I can talk, " Redding said. "Cyrus, a woman named Kate Bennett, a pathologist at Metro, just called asking for information on two women who died from the same unusual bleeding disorder."

"Patients of ours?"

"That is affirmative, although Dr. Bennett is only aware that one of them is. Both women had autopsies that showed, in addition to the blood problems, a rare condition of their ovaries."

"Have you asked the Monkeys about them?"

"Affirmative. The Monkeys say there is no connection here."

"Does that make sense to you, Carl?"

"Negative."

"Keep looking into matters. I want a sheet about this Doctor Bennett "I'll learn what I can and teletype it tomorrow."

"Tonight."

"Tonight, then."

"Be well, old friend."

"And you, Cyrus. You'll hear from me later."