Side Effects

Sunday 16 December

The night was heavy and raw. Crunching through slush that had begun to gel and shielding her face from blowgun darts of sleet, Kate crossed Commercial Street and plowed along Hanover into the North End. Traffic and the weather had made her twenty minutes late, but Bill Zimmermann was not the irritable, impatient type, and she anticipated a quick absolution. Demarsco's, the restaurant they had agreed upon, was a small, family-owned operation where parking was as difficult to find as an unexceptional item on the menu.

Initially, when Kate had called and asked to meet with him, Zimmermann had proposed his office at the Omnicenter. It was, perhaps, among the last structures on earth she felt like entering on that night.

Unfortunately if there were a list of such things, Demarsco's, his other suggestion, might also have been on it. Demarsco's was one of her and Jared's favorite spots. And now Jared was gone. "A sort of separation, but not a separation, " he had called it in the note she had found waiting for her at three o'clock on Saturday morning. He had taken some things and gone to his father's, where he would stay until leaving for business in San Diego on Monday. "A sort of separation, but not a separation."

There was no lengthy explanation. No apology. Not even any anger.

But the hurt and confusion were there in every word. It was as if he had just discovered that his wife was having an affair-an up-and-down, intense, emotionally draining affair-not with another man, but with her job, her career. "Space for both of us to sort out the tensions and pressures on our lives without adding new ones, " he had written. "Space for each of us to take a hard look at our priorities."

Kate wondered if, standing in the center of his fine, paneled study, his elegant mistress awaiting him on his black satin sheets, Winfield Samuels, Jr., had raised a glass to toast his victory over Kate and the return of his son and to plan how to make a temporary situation permanent. It was a distressing picture and probably not that far from reality. However, as distressing to her as the image of a gloating Win Samuels, was the realization that her incongruous emotion, at least at that moment and over the hour or so that followed before sleep took her, was relief. Relief at being spared a confrontation. Relief at being alone to think. Someone was trying to sabotage her reputation and perhaps her career. Her close friend was lying in a hospital bed bleeding from a disorder that had killed at least two other women-a disorder that had no definite cause, let alone a cure. And now, there was the discovery that she herself had been exposed to contaminated vitamins, that her own body might be a time bomb, waiting to go off-perhaps to bleed, perhaps to die. Priorities. Why couldn't Jared see their marriage as a blanket on which all the other priorities in their lives could be laid out and dealt with together? Why couldn't he see that their relationship needn't be an endless series of either-ors?

Why couldn't he see that she could love him and still have a life of her own?

Demarsco's was on the first floor of a narrow brownstone. There were a dozen tables covered with red-and-white checkered tablecloths and adorned with candle-dripped Chianti bottles-a decor that might have been tacky, but in Demarsco's simply wasn't. Bill Zimmermann, seated at a small table to the rear, rose and waved as she entered. He wore a dark sport jacket over a gray turtleneck and looked to her like a mix of the best of Gary Cooper and Montgomery Clift. A maternal waitress, perhaps the matriarch of the Demarsco clan, took her coat and ushered her to Zimmermann with a look that said she approved of the woman for whom the tall dashing man at the rear table had been waiting. "They have a wonderful soave, " Kate answered, settling into her seat, "but you'll have to drink most of it. I haven't been getting much sleep lately, and when I'm tired, more than one glass of wine is usually enough to cross my eyes."

"I have no such problem, unfortunately, " he said, nodding that the ample waitress could fill his earlier order. "Sometimes, I fear that my liver will desert me before my brain even knows I have been drinking. It is one of the curses of being European. I stopped by the hospital earlier to see your friend Mrs. Sandler."

"I know. I was with her just before I came here. She was grateful for your visit. Whatever you said had a markedly reassuring effect."

Kate smiled inwardly, remembering the girlish exchange she and Ellen had had regarding the Omnicenter director's uncommon good looks and marital status. "Maybe I could rent him for a night, " Ellen had said, "just to parade past Sandy a time or two."

Zimmermann tapped his fingertips together. "The lab reports show very little change."

"I know, " Kate said. "If anything, they're worse. Unless there are several days in a row of improvement, or at least stability, I don't think her hematologist will send her home." She felt a heaviness in her chest as her mind replayed the gruesome scene on Ashburton Five during Beverly Vitale's last minutes. Ellen's counts were not yet down to critical levels, but there were so many unknowns. A sudden, precipitous fall seemed quite possible. The stream of thoughts flowed into the question of whether with Ian Toole's findings, Kate herself should have some clotting measurements done. She discarded the notion almost as quickly as she recognized it. "I hope as you do that there will be improvement, " Zimmermann said. He paused and then scanned the menu.

"What will it be for you?" he asked finally. "I'm not too hungry. How about an antipasto, some garlic bread… and a side order of peace of mind?"

Zimmermann's blue-gray eyes, still fixed on the leather-enclosed menu, narrowed a fraction. "That bad?"

Kate chewed at her lower lip and nodded, suddenly very glad she had gone the route of calling him. If, as seemed possible, a confrontation with Redding Pharmaceuticals was to happen, it would be good to have an ally with Bill Zimmermann's composure and assuredness, especially considering the fragility of her own self-confidence. "In that case, perhaps I had best eat light also." Zimmermann called the waitress over with a microscopic nod and ordered identical meals. "I want to thank you for coming out on such a grisly night, " Kate began. "There have been some new developments in my efforts to |! make sense out of the three bleeding cases, and I wanted to share them with you."

"Oh? " Zimmermann's expression grew more attentive. "You know I've had sample after sample of medications from the Omnicenter analyzed at the State Toxicology Lab."

"Yes, of course. But I thought the results had all been unremarkable."

"They were… until late Friday afternoon. One of the vitamin samples I had analyzed contained a painkiller called anthranilic acid. The basic chemical structure of the drug is contained in several commerical products-By mid, from Sampson Pharmaceuticals, and Levonide, from Freeman-Gannett, to name two. However, the form contaminating the vitamins is something new-at least in this country. Ian Toole at the state lab is going to check the European manuals and call me tomorrow."

"Is he sure of the results?"

"He seemed to be. I don't know the man personally, but he has a reputation for thoroughness."

"What do you think happened?"

"Contamination." Kate shrugged that there was no other explanation that made any sense. "Either at Redding Pharmaceuticals or perhaps at one of the suppliers of the vitamin components, although I would suspect that a company as large as Redding can do all the manufacturing themselves."

"Yes. I agree. Do you think this anthranilic acid has caused the bleeding disorders in our three women?"

"Bleeding and ovarian disorders, " Kate added, "at least ovarian in two of the women. We don't know about Ellen. The answer to your question is I don't know and I certainly hope not."

"Why?"

"Because, Bill, the vitamins that were finally positive for something were mine. Ones you prescribed for me."

Zimmermann paled. The waitress arrived with their antipasto, but he did not so much as glance up at her. "Jesus, " he said softly. It was the first time Kate had ever heard him use invective of any kind. "Are you sure this Toole couldn't have made a mistake? You said yourself there were any number of samples that were negative."

"Anything's possible, " she said. "I suppose Ian Toole and his spectrophotometer are no more exempt from error than… Redding Pharmaceuticals."

"Do you have more of a sample? Can we have the findings rechecked at another lab?"

Kate shook her head. "It was an old prescription. There were only half a dozen left. I think he used them all."

Zimmermann tried picking at his meal but quickly gave up. "I don't mean to sound doubtful about what you are saying, Kate. But you see what's at stake here, don't you?"

"Of course I do. And I understand your skepticism. If I were in your position and the Omnicenter were my baby, I'd want to be sure, too. But Bill, the situation is desperate. Two women have died. My friend is lying up there bleeding, and I have been unknowingly taking a medication that was never prescribed for me. Someone in or around Redding's generic drug department has made an error, and I think we should file a report with the FDA as quickly as possible. I spoke to the head pharmacist at Metro about how one goes about reporting problems with a drug."

"Did you mention the Omnicenter specifically? " Zimmermann asked. "I may be nervous and frightened about all this, Bill, but I'm neither dumb nor insensitive. No. Everything I asked him was hypothe ical."

"Thank you."

"Nonsense. Grandstand plays aren't my style." She smiled. "Despite what the papers and all those angry Red Sox fans think. Any decisions concerning the Omnicenter we make together." Kate nibbled on the edge of a piece of garlic bread and suddenly realized that for the first time since returning home to Jared's note, she had an appetite. Perhaps, after the incredible frustrations of the week past, she was feeling the effects of finally doing something. She passed the basket across to Zimmermann. "Here, " she offered, "have a piece of this before it gets cold."

Zimmermann accepted the offering, but deep concern continued to darken his face. "What did the pharmacist tell you?"

"There's an agency called the U. S. Pharmacopia, independent of both the FDA and the drug industry, but in close touch with both. They run a drug-problem reporting program. Fill out a form and send it to them, and they send a copy to the FDA and to the company involved."

"Do you know what happens then?"

"Not really. I assume an investigator from the FDA is assigned to look into matters."

"And the great bureaucratic dragon rears its ugly head."

"What?"

"Have you had many dealings with the FDA? Speed and efficiency are hardly their most important products. No one's fault, really.

The FDA has some pretty sharp people-only not nearly enough of them."

"What else can we do? " Absently, Kate rolled a black olive off its lettuce hillock and ate it along with several thin strips of prosciutto.

"I need help. As it is, I'm spending every spare moment in the library.

I've even asked the National Institutes of Health library to run a computer cross on blood and ovarian disorders. They should be sending me a bibliography tomorrow. I've sent our slides to four other pathologists to see if anyone can make a connection. The FDA seems like the only remaining move."

"The FDA may be a necessary move, but it is hardly our only one. First of all I want to speak with Carl Horner and our pharmacist and see to it that the use of any Redding products by our facility will be suspended until we have some answers."

"Excellent. Will you have to bring in extra pharmacists?"

"Yes, but we've had contingency plans in place in case of some kind of computer failure since… well, since even before I took over as director. We'll manage as long as necessary."

"Let's hope it won't be too long, " Kate said, again thinking of Beverly Vitale's lifeless, blood-smeared face. "If we go right to the FDA it might be."

"Pardon?"

"Kate, I think our first move should be to contact Redding Pharmaceuticals directly. I think the company deserves that kind of consideration for the way they've stood up for orphan drugs and for all the other things they've done to help the medical community and society as a whole. Besides, in any contest between the bureaucratic dragon and private industry, my money is on industry every time. I think it's only fair to the Omnicenter and our patients to get to the bottom of matters as quickly as possible."

Kate sipped pensively at her wine. "I see what you mean… sort of," she said. "Couldn't we do both? I mean contact Redding and notify the FDA?"

"We could, but then we lose our stick, our prod, if you will. The folks at Redding will probably bend over backward to avoid the black eye of an FDA probe. I know they will. I've had experience with other pharmaceutical houses-ones not as responsive and responsible as Redding. They would go to almost any length to identify and correct problems within their company without outside intervention."

"That makes sense, I guess, " she said. "You sound uncertain, Kate.

Listen, whatever we do, we should do together. You said that yourself.

I've given you reasons for my point of view, but I'm by no means inflexible." Zimmermann drained the last half of his glass and refilled it. Kate hesitated and then said, "I have this thing about the pharmaceutical industry. It's a problem in trust. They spend millions and millions of dollars on giveaways to medical students and physicians.

They support dozens upon dozens of throwaway journals and magazines with their ads. I get fifty publications a month I never ordered. And I don't even write prescriptions. I can imagine how many you get."

Zimmermann nodded that he understood. "In addition, I have serious questions about their priorities-you know, who comes first in any conflict between profit and people."

"What do you mean?"

"Well, look at Valium. Roche introduces the drug and markets it well, and the public literally eats it up. It's a tranquilizer, a downer, yet in no time at all it becomes the most prescribed and taken drug in the country. Unfortunately, it turns out to be more addicting than most physicians appreciated at first, and lives begin to get ruined.

Meanwhile, a dozen or so other drug houses put out a dozen or so versions of Valium, each with its own name and its own claim. Slower acting. Faster acting. Lasts all night. Removed more rapidly. Some busy physicians get so lost in the advertising and promises that they actually end up prescribing two of these variants to the same patient at the same time. Others think they're doing their patients a big favor by switching.

Some favor."

"Pardon me for saying it, Kate, but you sound a little less than objective."

"I'm afraid you hear right, " she said. "I had some emotional stresses back in college, and the old country doctor who served the school put me on Valium. It took a whole team of specialists to realize how much my life came to revolve around those little yellow discs. Finally, I had to be hospitalized and detoxed. So I just have this nagging feeling that the drug companies can't be trusted. That's all."

Zimmermann leaned back, rubbed his chin, and sighed. "I don't know what to say. If speed is essential in solving this problem, as we both think it is, then the route to go is the company. I'm sure of that."

He paused. "Tell you what. Let's give them this coming week to straighten out matters to our satisfaction. If they haven't done so by Friday, we call in the FDA. Sound fair?"

Kate hesitated, but then nodded. "Yes, " she said finally. "It sounds fair and it sounds right. Do you want to call them?"

Zimmermann shrugged. "Sure, " he said, "I'll do it first thing tomorrow.

They'll probably be contacting you by the end of the day."

"The sooner the better. Meanwhile, do you think you could talk to some of your Omnicenter patients and get me a list of women who would be willing to be contacted by me about having their medications analyzed?"

"I certainly can try."

"Excellent. It's about time things started moving in a positive direction. You know, there's not much good I can say about all that's been happening, except that I'm glad our relationship has moved out of the doctor-patient and doctor-doctor cubbyholes into the person-person.

Right now I'm the one who needs the help, but please know that if it's ever you, you've got a friend you can count on."

Zimmermann smiled a Cary Grant smile. "That kind of friend is hard to come by, " he said. "Thank you."

"Thank you. Except for Tom Engleson, I've felt pretty much alone in all this. Now we're a team." She motioned the waitress over. "Coffee? " the woman asked. "None for me, thanks. Bill? " Zimmermann shook his head.

"In that case could I have the check, please?"

"Nonsense, " Zimmermann said, "I won't… "-the reproving look in Kate's eyes stopped him in mid-sentence-"… allow you to do this too many times without reciprocating."

Kate beamed at the man's insight. "Deal, " she said, smiling broadly.

"Deal, " Zimmermann echoed. The two shook hands warmly and, after Kate had settled their bill, walked together into the winter night. Numb with exhaustion, John Ferguson squinted at the luminescent green print on the screen of his word processor. His back ached from hunching over the keyboard for the better part of two full days. His hands, feeling the effects of his disease more acutely than at any time in months, groped for words one careful letter at a time. It had been an agonizing effort, condensing forty years of complex research into thirty pages or so of scholarly dissertation, but a sentence at a time, a word at a time, he was making progress. To one side of his desk were a dozen internationally read medical journals. Ferguson had given thought to submitting his completed manuscript to all of them, but then had reconsidered. The honor of publishing his work would go only to The New England Journal of Medicine, most prestigious and widely read of them all. The New England Journal of Medicine. Ferguson tapped out a recall code, and in seconds, the title page of his article was displayed on the screen. STUDIES IN ESTRONATE 250 A Synthetic Estrogen Congener and Antifertility Hormone John N. Ferguson, MD It would almost certainly be the first time in the long, distinguished publication of the journal that an entire issue would be devoted to a single article. But they would agree to do that or find the historic studies and comment in Lancet or The American Journal of Medicine. Ferguson smiled. Once The New England Journal's editors had reviewed his data and his slides, he doubted there would be much resistance to honoring his request. For a time he studied the page. Then, electronically, he erased the name of the author. There might be trouble for him down the road for what he was about to do, but he suspected not. He was too old and too sick even for the fanatic Simon Weisenthal to bother with. With a deliberateness that helped him savor the act, he typed Wilhelm W. Becker, MD, Phd where Ferguson's name had been. Perhaps, he thought with a smile, some sort of brief funeral was in order for Ferguson. He had, after all, died twice-once in Bataan, forty years ago, and a second time this night.

With the consummate discipline that had marked his life, Willi Becker cut short the pleasurable interlude and advanced the text to the spot at which he had left off. Because of a pathologist named Bennett, Cyrus Redding had picked up the scent of his work at the Omnicenter. Knowing the man as well as Becker did, he felt certain the tycoon would now track the matter relentlessly. There was still time to put the work on paper and mail it off, but no way of knowing how much. He had to push.

He had to fight the fatigue and the aching in his muscles and push, at least for another hour or two. The onset of his scientific immortality was at hand. Furtively, he glanced at the small bottle of amphetamines on the table. It had been only three hours. Much too soon, especially with the irregular heartbeats he had been having. Still, he needed to push. It would only be a few more days, perhaps less. Barely able to grip the top of the small vial, Becker set one of the black, coated tablets on his tongue, and swallowed it without water. In minutes, the warm rush would begin, and he would have the drive, however artificial and short lived, to overcome the inertia of his myasthenia. "You really shouldn't take those, you know, father. Especially with your cardiac history."

Becker spun around to face his son, cursing the diminution in his hearing that enabled such surprises. "I take them because I need them," he said sharply. "What are you doing sneaking up on me like that? What do you think doorbells are for?"

"Such a greeting. And here I have driven out of my way to stop by and be certain you are all right."

Three blocks, Becker thought. Some hardship. "You startled me. That's all. I'm sorry for reacting the way I did."

"In that case, father, it is I who should be sorry."

Was there sarcasm in his son's voice? It bothered Becker that he had never been able to read the man. Theirs was a relationship based on filial obligation and respect, but little if any love. For the greater portion of his son's years, they had lived apart, Becker in a small cottage on the hospital grounds where he worked, and his wife and son in an apartment twenty miles away. It was as necessary an arrangement as it was painful. Becker and his wife had tried for years to make their son understand that. There were those, they tried to explain, who would arrest Becker in a moment on a series of unjust charges, put him in prison, and possibly even put him to death. In the hysteria following the war, he had been marked simply because he was German, nothing more than that. For their own safety, it was necessary for the boy and his mother to keep their address and even their name separate from his.

Although Becker would provide for them and would visit as much as he could, no one would ever know his true relationship to the woman, Anna Zimmermann, and the boy, William. "So, " Becker said. "Now that we have apologized profusely to one another, come in, sit down, pour yourself a drink."

William Zimmermann nodded his thanks, poured an inch of Wild Turkey into a heavy glass, and settled into an easy chair opposite his father. "I see you've started putting your data together, " he said. "Why now?"

"Well, I… no special reason, really. It would seem that the modifications I made have greatly, if not completely, eliminated the bleeding problems we were experiencing with the Estronate. So what else is there to wait for?"

"Which journal will you approach?"

"I think The New England Journal of Medicine. I plan to submit the data and discussion but to withhold several key steps in the synthesis until a commission of the journal's choosing can take charge of my formulas and decide how society can best benefit from them."

"Sounds fine to me, " Zimmermann said. "With all that's been happening this last week, the sooner I see the last of Estronate Two-fifty, the better."

"Have any further bleeding cases turned up?"

Zimmermann shook his head. "Just the Sandler woman I told you about. The one who's the friend of Dr. Bennett's. She was treated over eighteen months ago, in the July/August group, the last group to receive the unmodified Estronate."

"How is she doing?"

"I think she is going to end up like the other two."

"Couldn't you find some way of suggesting that they try a course of massive doses of delta amino caproic acid and nicotinic acid on her?"

"Not without risking a lot of questions I'd rather not answer. I mean I am a gynecologist, not a hematologist. Besides, you told me that that therapy was only sixty percent effective in such advanced states."

Becker shrugged. "Sixty percent is sixty percent."

"And my career is my career. No, father, I have far too much to lose. I am afraid Mrs. Sandler will just have to make it on her own."

"Perhaps you are right, " Becker said. The men shook hands formally, and William Zimmermann let himself out. Twelve miles away, on the fourth floor of the Berenson Building of Metropolitan Hospital of Boston, in Room 421, Ellen Sandler's nose had again begun to bleed. Monday 17 December "Now, Suzy, promise Daddy that you will mind what Mommy tells you and that you will never, never do that to the cat again… Good..

.. I have to go now, sugar. You better get ready for your piano lesson..

.. I know what I said, but my work here isn't done yet, and I have to stay until it's finished… I don't know. Two, maybe three more days … Suzy, stop that. You're not a baby. I love you very much and I'll see you very soon. Now, tell Daddy you love him and go practice that new piece of yours… Suzy?…"

"Damn." Arlen Paquette slammed the receiver down. He had protested to Redding the futility of remaining in Boston over the weekend, but the man had insisted he stay close to the situation and the Omnicenter. As usual, events had proven Redding right. Paquette stuffed some notes in his briefcase and pulled on his suitcoat. Right for Redding Pharmaceuticals, but not for Suzy Paquette, who was justifiably smarting over her father's absence from her school track meet earlier in the day.

How could he explain to a seven-year-old that the very thing that was keeping him away from home was also the sole reason she could attend a school like Hightower Academy? He straightened his tie and combed his thinning hair with his fingers. How could he explain it to her when he was having trouble justifying it to himself? Still, for what he and his family were gaining from his association with Redding, the dues were not excessive. He glanced down at the photographs of Kate Bennett piled on the coffee table. At least, he thought, not yet. The cab ride from the Ritz to Metropolitan Hospital took fifteen minutes. Paquette entered the main lobby through newly installed gliding electronic doors and headed directly for Norton Reese's office, half expecting to have the woman whose life and face he had studied in such detail stroll out from a side corridor and bump into him. "Arlen, it's good to see you. You're looking well." Norton Reese maneuvered free of his desk chair and met Paquette halfway with an illdefined handshake. Theirs was more an unspoken truce than a relationship, and no amount of time would compensate for the lack of trust and respect each bore the other. However, Paquette was the envoy of Cyrus Redding and the several millions of Redding dollars that had sparked Reese's rise to prominence. Although it was Reese's court, it was the younger man's ball. "You're looking fit yourself, Norton,"

Paquette replied. "Our mutual friend sends his respects and regards."

"Did you tell him about our speed freak outfielder and the letters to the press and TV?"

"I did. I even sent a packet of the articles and editorials to him by messenger. He commends your ingenuity. So, incidentally, do I." Try as he might, he could put no emotion behind the compliment. Still, Reese's moon face bunched in a grin. "It's been beautiful, Arlen, " he gushed.

"Just beautiful. I tell you, ever since that story broke, Kathryn Bennett, MD, has been racing all over trying to stick her fingers in the holes that are popping open in her reputation. By now I doubt if she would know whether she had lost a horse or found a rope."

"You did fine, Norton. Just fine. Only, for our purposes, not enough."

"What? " Reese began to shift uneasily. "A diversion. That's what Horner asked me for, and by God, that's what I laid on that woman. A goddamn avalanche of diversion."

"You did fine, Norton. I just told you that."

"Why, she's had so much negative publicity it's a wonder she hasn't quit or been fired by the medical school." Reese chattered on as if he hadn't heard a word. "In fact, I hear the Medical School Ethics Committee is planning some kind of an inquiry."

Paquette silenced him with raised hands. "Easy, Norton, please, " he said evenly. "I'm going to say it one more time. What you did, the letter and all, was exactly what we asked of you. Our mutual friend is pleased. He asked that I convey to you the Ashburton Foundation's intention to endow the cardiac surgical residency you wrote him about."

"Well, then, why was what I did not enough? " Reese realized that in his haste to defend himself, he had forgotten to acknowledge Redding's generosity. Before he could remedy the oversight, Paquette spoke. "I'll convey your thanks when I return to Darlington, " he said, a note of irritation in his words. "Norton, do you know what has been going on here?"

"Not… not exactly, " he said, nonplussed. Paquette nodded indulgently. "Dr. Bennett, in her search to identify the cause of an unusual bleeding problem in several women, has zeroed in on the Omnicenter. Although the women were Omnicenter patients, we see no other connection among them."

"The… the work you're doing… I mean none of the women got…"

After years of scrupulously avoiding the Omnicenter and the people involved in its operation, Reese was uncertain of how, even, to discuss the place. Paquette spared him further stammering. "From time to time, each of the women was involved in the evaluation of one or more products," he said. "However, Carl Horner assures me that there have been no products common to the three of them. Whatever the cause of their problem, it is not the Omnicenter."

"That's a relief, " Reese said. "Not really, " Paquette said, his expression belying his impatience. "You see, our Dr. Bennett has been most persistent, despite the pressures brought about by your letter."

"She's a royal pain in the ass. I'll grant you that, " Reese interjected. "She has tested several Omnicenter products at the State Toxicology Lab, charging the analyses, I might add, to your hospital."

"Damn her. She didn't find anything, did she? Horner assured me that there was nothing to worry about."

Paquette's patience continued to fray. "Of course she found something, Norton. That's why I'm here. She even had Dr. Zimmermann phone the company to tell us about it."

"Oh. Sorry."

"Our friend in Kentucky has asked that we step up our efforts to discredit Dr. Bennett and to add, what was the word you used? distraction?… no, diversion, that was it-diversion to her life. We have taken steps to obscure, if not neutralize, her findings to date, but there is evidence in dozens of medicine cabinets out there of what we have been doing. If Dr. Bennett is persistent enough, she will find it. I am completely convinced of that, and so is our friend. Dr. Bennett has given us one week to determine how a certain experimental painkiller came to be in a set of vitamins dispensed at the Omnicenter. If we do not furnish her with a satisfactory explanation by that time, she intends to file a report with the US Pharmacopia and the FDA."

"Damn her, " Norton Reese said again. "What are we going to do?"

"Not we, you. Dr. Bennett's credibility must be reduced to the point where no amount of evidence will be enough for authorities to take her word over ours. The letter you wrote was a start, but, as I said, not enough."

Once again, Reese began to feel ill at ease. Paquette was not making a request, he was giving an order-an order from the man who, Reese knew, could squash him with nothing more than the eraser on his pencil. He unbuttoned his vest against the uncomfortable moistness between the folds of his skin. "Look, " he pleaded, "I really don't know what I can do. I'll try, but I don't know. You've got to understand, Arlen, you've got to make him understand. Bennett works in my hospital, but she doesn't work for me." There was understanding in Paquette's face, but not sympathy. Reese continued his increasingly nervous rambling.

"Besides, the woman's got friends around here. I don't know why, but she does. Even after that letter, she's got supporters. Shit, I'd kill to make sure she didn't…" His voice trailed away. His eyes narrowed.

Paquette followed the man's train of thought. "The answer is no, Norton,

" he said. "Absolutely not. We wish her discredited, not eliminated, for God's sake. We want people to lose interest in her, not to canonize her.

She has already involved Dr. Zimmermann, a chemist at the state lab, and a resident here named Engleson. There may be others, but as far as we can tell, the situation is not yet out of control. We are doing what we can do to ensure it remains that way. Dr. Bennett's father-in-law does some business with our company. I believe our friend has already called him and enlisted his aid. There are other steps being taken as well." He rose and reached across the desk to shake Reese's hand. "I know we can count on you. If you need advice or a sounding board, you can reach me at the Ritz."

"Thank you, " Reese said numbly. His bulk seemed melted into his chair.

Paquette walked slowly to the door, then turned. "Our friend has suggested Thursday as a time by which he wants something to have been done."

"Thursday? " Reese croaked. Paquette nodded, smiled blankly, and was gone. Half an hour later, his shirt changed and his composure nearly regained, Reese sat opposite Sheila Pierce, straightening one paper clip after another and thinking much more than he wanted to at that particular moment of the chief technician's breasts. "How're things going down there in pathology? " he asked, wondering if she would take off her lab coat and then reminding himself to concentrate on business.

The woman was going to require delicate handling if she was going to put her neck on the line to save his ass. "You mean with Bennett? " Sheila shrugged. "She's getting some letters and a few crank phone calls every day, but otherwise things seem pretty much back to normal. It's been..

amusing."

"Well, " Reese said, "I know for a fact that the Bobby Geary business is hardly a dead issue."

"Oh?"

"I've heard the matter's going to the Medical School Ethics Committee."

"Good, " Sheila said. "That will serve her right, going to the newspapers about that poor boy the way she did." They laughed. "Do you think, " she went on, "that it will be enough to keep her from becoming chief of our department?"

Inwardly, Reese smiled. The question was just the opening he needed.

"Doubtful, " he said grimly. "Very doubtful."

"Too bad."

"You don't know the half of it."

"What do you mean?"

"Well…" He tapped a pencil eraser on his desk. He closed his eyes and massaged the bridge of his nose. He chewed at his lower lip. "I got a call this morning from Dr. Willoughby. He requested a meeting with the finance and budget committee of the board, at which time he and Kate Bennett are going to present the results of a computer study she's just completed. They plan to ask for six months worth of emergency funding until a sweeping departmental reorganization can be completed."

Sheila Pierce paled. "Sweeping departmental reorganization?"

"That's what the man said."

"Did he say anything about… you know."

Reese sighed. "As a matter of fact, baby, he did. He said that by the time of the meeting next week, Bennett will have presented him with a complete list of lost revenues, including the misappropriation of funds by several department members."

"But she promised."

"I guess a few brownie points with the boss and the board of trustees outweigh her promise to a plain old technician."

"Chief technician, " she corrected. "Damn her. Did it seem as if she had already said something about me to Willoughby?"

The bait taken, Reese set the hook. "Definitely not. I probed as much as I could about you without making Willoughby suspicious. She hasn't told him anything specific… yet."

"Norty, we've got to stop her. I can't afford to lose my job. Dammit, I've been here longer than she has. Much longer." Her hands were clenched white, her jaw set in anger and frustration. "Well, " Reese said with exaggerated reason, "we've got two days, three at the most.

Any ideas?"

"Ideas?"

"I don't work with the woman, baby, you do. Doesn't she ever fuck up?

Blow a case? Christ, the rest of the MD's in this place do it all the time."

"She's a pathologist, Norty. Her cases are all dead to begin with.

There's nothing for her to blow except…" She stopped in mid-sentence and pulled a typed sheet from her lab coat pocket. "What is it?"

"It's the surgical path schedule for tomorrow. Bennett and Dr. Huang are doing frozen sections this month." She scanned the entries. "Well?"

Sheila hesitated, uncertainty darkening her eyes. "Are you sure she's going to report me to Willoughby?"

"Baby, all I can say is that Dr. Willoughby asked me for a copy of the union contract, expressly for the part dealing with justifiable causes for termination."

"She has no right to do that to me after she promised not to."

"You know about people with MD degrees, Sheila. They think they're better and smarter than the rest of us. They think they can just walk all over people." Sheila's eyes told him that the battle-this phase of it at any rate-was won. "We'll see who's smarter, " she muttered, tapping the schedule thoughtfully. "Maybe it's time Bennett found out that there are a few people with brains around who couldn't go to medical school."

"Make it good, baby, " Reese urged, "because if she's in, you're out."

"No way, " she said. "There's no way I'm going to let that happen.

Here, look at this."

"What?"

"Well, you can see it's a pretty busy schedule. There's a lung biopsy, a thyroid biopsy, a colon, and two breast biopsies. Bennett will be working almost all day in the small cryostat lab next to the operating rooms. Usually, she goes into the OR, picks up a specimen, freezes it in the cryostat, sections it, stains it, and reads it, all without leaving the surgical suite."

"And?"

"Well, there are a lot of ifs, " Sheila said in an even, almost singsong voice. "But if we could disable the surgical cryostat and force Bennett to use the backup unit down in the histology lab, I might be able somehow to switch a specimen. All I would need is about three or four minutes."

"What would that do?"

Sheila smiled the smile of a child. "Well, with any luck, depending on the actual pathology, we can have the great Dr. Bennett read a benign condition as a malignancy. Then, when the whole specimen is taken and examined the next day, her mistake will become apparent."

"Would a pathologist make a mistake like that? " Reese asked. Again Sheila smiled. "Only once, " she said serenely. "Only once." + Louisburg Square, a score of tall, brick townhouses surrounding a raggedy, wrought-iron-fenced green on the west side of Beacon Hill, had been the address in Boston for generations. Levi Morton lived there after his four years as vice president under Benjamin Harrison. Jennie Lind was married there in 1852. Cabots and Saltonstalls, Lodges and Alcotts-alll had drawn from and given to the mystique of Louisburg Square. Kate had the cab drop her off at the foot of Mount Vernon Street, she used the steep two-block walk to Louisburg Square to stretch her legs and clear her thoughts of what had been a long and trying day at the hospital. Two committee meetings, several surgical specimens, and a lecture at the medical school, combined with half a dozen malicious phone calls and an equal number of hate letters, all relating to her callous treatment of Bobby Geary and his family. Ellen's nose had begun bleeding again-just a slow trickle from one nostril, but enough to require Pete Colangelo to recauterize it. Her clotting parameters were continuing to take a significant drop each day, and the unencouraging news was beginning to take a toll on her spirit. Late that afternoon, the National Institutes of Health library computer search had arrived. There were many articles listed in the bibliography dealing with sclerosing diseases of the ovaries, and a goodly number on clotting disorders similar to the Boston cases. There were none, however, describing their coexistence in a single patient. Expecting little, Kate had begun the tedious process of locating each article, photocopying it, and finally studying it. The project would take days to complete, if not longer, but there was a chance at least that something, anything, might turn up that could help Ellen. At the turnoff from Mount Vernon Street, Kate propped herself against a gaslight lamp post and through the mist of her own breath, reflected on the marvelous Christmas card that was Louisburg Square.

Single, orange-bulbed candles glowed from nearly every townhouse window.

Tasteful wreaths marked each door. Christmas trees had been carefully placed to augment the scene without intruding on it. Having, season after season, observed the stolid elegance of Louisburg Square, Kate had no difficulty understanding why, shortly after the death of his agrarian wife, Winfield Samuels had sold their gentleman's farm and stables in Sudbury and had bought there. The two-the address and the man-were made for one another. Somewhat reluctantly, she mounted the granite steps of her father-in-law's home, eschewed the enormous brass knocker, and pressed the bell. In seconds, the door was opened by a trim, extremely attractive brunette, no more than two or three years Kate's senior. Dressed in a gold blouse and dark straight skirt, she looked every bit the part of the executive secretary, which, in fact, she had at one time been. "Kate, welcome, " she said warmly. "Come in. Let me take your coat."

"I've got it, thanks. You look terrific, Jocelyn. Is that a new hairstyle?"

"A few months old. Thanks for noticing. You're looking well yourself."

Kate wondered if perhaps she and Jocelyn Trent could collaborate on a chapter for Amy Vanderbilt or Emily Post, "Proper Conversation Between a Daughter-in-law and her Father-in-law's Mistress When the Father-in-law in Question Refuses to Acknowledge the Woman as Anything Other Than a Housekeeper."

"Mr. Samuels will be down in a few minutes, " Jocelyn said. "There's a nice fire going in the study. He'll meet you there. Dinner will be in half an hour. Can I fix you a drink?"

Mr. Samuels. The inappropriate formality made Kate queasy. At seven o'clock, the woman would serve to Mr. Samuels and his guest the gourmet dinner she had prepared, then she would go and eat in the kitchen. At eleven or twelve o'clock, after the house was quiet and dark, she would slip into his room and stay as long as she was asked, always careful to return to her own quarters before any houseguest awoke. Mr. Samuels, indeed. "Sure, " said Kate, following the woman to the study. "Better make it something stiff. As you can tell from your houseguest the last few days, things have not been going too well in my world."

Jocelyn smiled understandingly. "For what it's worth, " she said, "I don't think Jared is very pleased with the arrangement either."

"I appreciate hearing that, Jocelyn. Thank you. I'll tell you, on any given Sunday in any given ballpark, marriage can trounce any team in the league." When she could detach the woman from her position, Kate liked her very much and enjoyed the occasional one-to-one conversations they were able to share. "I know, " Jocelyn said. "I tried it once, myself.

For me it was all of the responsibility, none of the pleasure." The words were said lightly, but Kate heard in them perhaps an explanation of sorts, a plea for understanding and acceptance. Better to be owned than to be used. Kate took the bourbon and water and watched as Jocelyn Trent returned to the kitchen. The woman had, she knew, a wardrobe several times the size of her own, a remarkable silver fox coat, and a stylish Alfa coupe. If this be slavery, she thought with a smile, then give me slavery. It was, as promised, several minutes before Winfield Samuels made his entrance. Kate waited by the deep, well-used fireplace, rearranging the fringe on the Persian rug with the toe of her shoe and trying to avoid eye contact with any of the big-game heads mounted on the wall. Samuels had sent Jared away on business-purposely, he made it sound — so that he and Kate could spend some time alone together talking over "issues of mutual concern." Before her marriage, they had met on several occasions for such talks, but since, their time together had always included Jared. Samuels had given no hint over the phone as to what the "issues" this time might be, but the separation-causes and cures-was sure to be high on the list. Kate was reading a citation of commendation and gratitude from the governor when the recipient entered the room. "Kate, welcome, " Win Samuels said. "I'm so glad you could make it on such short notice." They embraced with hands on shoulders and exchanged air kisses. "Sit down, please. We have, " he consulted his watch, "twenty-three minutes before dinner."

Twenty-three minutes. Kate had to hand it to the man. Dinner at seven did not mean dinner at seven-oh-three. It was expected that the stunning cook cum housekeeper cum mistress would be right on time. "Thank you," she said. "It's good to see you again. You look great."

The compliment was not exaggeration. In his twill smoking jacket and white silk scarf, Samuels looked like most men nearing seventy could only dream of looking. "Rejuvenate that drink? " Samuels asked, motioning her to one of a pair of matched leather easy chairs by the hearth. "Only if you're prepared to resuscitate me."

Samuels laughed and drew himself a bourbon and soda. "You're quite a woman, Kate, " he said, settling in across from her. "Jared is lucky to have nabbed you."

"Actually, I did most of the nabbing."

"This… this little disagreement you two are having. It will blow over before you know it. Probably has already."

"The empty half of my bed wouldn't attest to that, " Kate said. Samuels slid a cigar from a humidor by his chair, considered it for a moment, and then returned it. "Bad for the taste buds this close to dinner, particularly with Jocelyn's duck l'orange on the menu."

"She's a very nice woman, " Kate ventured. Samuels nodded. "Does a good job around here, " he said in an absurdly businesslike tone. "Damn good job." He paused. "I'm a direct man, Kate. Some people say too direct, but I don't give a tinker's damn about them. Suppose I get right to the business at hand."

"You mean this wasn't just a social invitation?"

Samuels was leaping to equivocate when he saw the smile in her eyes and at the corners of her mouth. "Do you zing Jared like this, too? " he asked. Kate smiled proudly and nodded. They laughed, but Kate felt no letup in the tension between them. "Kate, " he continued, "I've accomplished the things I've accomplished, gained the things I've gained, because I was brought up to believe that we are never given a wish or a dream without also being given the wherewithal to make that dream, that wish, a reality. Do you share that belief?"

Kate shrugged. "I believe there are times when it's okay to wish and try and fail."

"Perhaps, " he said thoughtfully. "Perhaps there are. Anyhow, at this stage in my life, I have two overriding dreams. Both of them involve my son and, therefore, by extension, you."

"Go on."

"Kate, I want a grandchild, hopefully more than one, and I want my son to serve in the United States Congress. Those are my dreams, and I am willing to do anything within my power to help them come to pass."

"Why? " Kate asked. "Why?"

"Yes. I understand the grandchild wish. Continuation of the family, stability for Jared's home life, new blood and new energy, that sort of thing, but why the other one?"

"Because I feel Jared would be a credit to himself, to the state, and to the country."

"So do I."

"And I think it would be a fulfilling experience for him."

"Perhaps."

Samuels hesitated before adding, "And, finally, it is a goal I held for myself and never could achieve. Do you think me horrid for wanting my son to have what I could not?"

"No, " Kate responded. "Provided it is something Jared wants, too, for reasons independent of yours."

"The time in life when a father no longer knows what is best for his son is certainly moot, isn't it?"

"Win, what you want for Jared, what you want for me, too, will always matter. But the hardest part about loving someone is letting him figure out what's best for himself, especially when you already know-or at least think you know."

"And you think I'm forcing my will on Jared?"

"You have a tremendous amount of influence on him, " she replied. "I don't think I'm giving away any great secrets by saying that." Samuels nodded thoughtfully. "Kate, " he said finally, "humor this old man and let me change the subject a bit, okay?"

Old man. Give me a break, counselor, she wanted to snap. Instead she sat forward, smiled, and simply said, "Sure."

"Why do you want to be the chief of pathology at Metro?" Kate met his gaze levelly and said silent thanks for the hours she had spent answering that question for herself. "Because it would be a fascinating experience. Because I think I could do a credible job.

Because my work-and my department-mean a great deal to me. Because I feel a person either grows or dies."

"Jared tells me you feel accepting the position will delay your being able to start your family for at least two years."

"Actually, I said one or two years, but two seems a reasonable guess."

Samuels rose slowly and walked to the window and then back to the fire.

If he was preparing to say something dramatic, she acknowledged, he was doing a laudable job of setting it up. "Kate, " he said, still staring at the fire, "when I phoned, I invited you to stay the night if you could. Are you going to be able to do that?"

"I had planned on it, yes." Actually, the invitation had been worded in a way that would have made it nearly impossible for her to refuse.

"Good. I'd like to take you for a ride after dinner. A ride and a visit.

I… I know I sound mysterious, but for the moment you'll have to indulge me. This is something I never thought I would be doing." There was a huskiness, an emotion to the man's voice that Kate had never heard before. Was he near crying? For half a minute there was silence, save for the low hiss of the fire. But when her father-in-law turned to her, his composure had returned. "Kate, " he said, as if the moment by the fire had never happened, "do you think that you are ready to handle the responsibilities of a whole department?"

She thought for a moment. "This may sound funny, but in a way it doesn't matter what I think. You see, Dr. Willoughby, the only person who knows both me and the job, thinks I can handle it. It's like becoming a doctor-or, for that matter, a lawyer. You only decide you want to do it. They-the bar or the medical examiners-decide whether or not you can and should. From then on, your only obligation is to do your best."

She paused. "Does that sound smug?"

"Not really."

"I hope not, Win. Because actually I'm scared stiff about a lot of things. I'm frightened of taking the job and I'm frightened of not taking it. I'm frightened of having children and I'm frightened of not having them. And most of all, I am frightened of having to face the dilemma of either losing my husband or losing myself."

"There are other possibilities, " Samuels said. "I know that, but I'm not sure Jared does, and to be perfectly honest, until this moment, I wasn't sure you did, either."

"There are always other possibilities, " he said with a tone that suggested he had voiced that belief before. "Kate, you know hospital politics are no different from any other kind of politics. There's power involved and there's money involved, and that means there are things like this handbill involved."

He took the garish orange flyer from his desk drawer and held it up for her to see. Kate shuddered at the sight of it. "Do you think that brilliant effort was aimed at me or at Jared? " she asked. "The truth is it makes no difference. Politics is politics. The minute you start playing the game you have enemies. If they happen to be better at the game than you are, you get buried. It's that simple."

He held up the flyer again. "My sense of this whole business-assuming, of course, that you didn't send Bobby Geary's autopsy report to the papers — is that someone is determined to keep you from becoming head of your department. If they have any kind of power, or access to power, your department could suffer dearly."

"My department?"

"Certainly. Your people end up overworked because of staffing cutbacks and outmoded equipment. Turnover is high, morale low. Quality of work drops. Sooner or later there's a mistake. You may be the best pathologist in the world, Kate, and the best-intentioned administrator, but unless you play the politics game and get past the competition to people like the Ashburton Foundation, you will end up an unhappy, harried, unfulfilled failure. And take it from me, winning that game means plenty of sacrifice. It means that if you know the competition is getting up at six, you damn well better be up at five-thirty."

"I appreciate your thoughts, " she said. "I really do. All I can say is that the final decision hasn't been made yet, and that I was hoping to work the whole thing out with Jared."

"But you have okayed submission of your name."

"Yes, " she said, averting her gaze for the first time. "Yes, I have."

Samuels turned and walked again toward the window. For a time, there was only the fire. "Say, Win, " she said, hoping to lead them in other directions, "how much do you know about the Ashburton Foundation?

" He turned back to her. "I really don't know anything. In the early days of their involvement here, my firm handled some of their correspondence with the hospital. But I haven't dealt with them in years. Why?"

"Just some research I've been doing at work. Nothing, really. Do you by any chance have their address?"

"I don't know, " Samuels said, somewhat distractedly. "In the Rolodex over there on my desk, perhaps. I really don't know. Kate, you know it is my way to reason, not to beg. But for the sake of my son and myself, if not for yourself, I'm begging you to put the chairmanship on the back burner and devote yourself for a few years to your family and to helping Jared get his foot in the political door."

At that instant, a chime sounded from the kitchen. Kate glanced instinctively at her watch, but she knew that it was exactly seven o'clock. She rose. "When is Jared due back? " she asked. "Wednesday or Thursday, I suspect."

"Win, I have no response to what you just asked. You know that, don't you?"

"Perhaps before too much longer you might. Let us eat. After our meal, there is a trip we must take."

With a faint smile, Samuels nodded Kate toward the dining room and then took her elbow and guided her through the door. The IV nurse, a square-shouldered woman overweight by at least thirty pounds, rubbed alcohol on the back of Ellen Sandler's left hand, slapped the area a dozen times, and then swabbed it again. "Now, Ellen, " she said in the patronizing, demeaning tone Ellen had come to label hospitalese, "you've got to relax. Your veins are in spasm. If you don't relax, it will take all night for me to get this IV in."

Relax? Ellen glared at the woman, who was hunched over her hand. Can't you tell I'm frightened? Can't you see I'm scared out of my wits by all that's happening to me? Take a minute, just a minute, and talk to me.

Ask me, and I'll try to explain. I'll tell you how it feels to be seven years old I and to learn that your father, who entered the hospital for a "little operation, " has been taken to a funeral home in a long box with handles relax?

Why not ask me to float off this bed? Or better still, just demand that I make the blood in my body start clotting, so you'll be spared the inconvenience of having to plunge that needle into the back of my hand.

Relax?

"I… I'm trying, " she said meekly. "Good. Now you're going to feel a little stick."

Ellen grabbed the bedrail with her free hand as electric pain from the "little stick" shot up her arm. "Got it, " the nurse said excitedly.

"Now don't move. Don't move until I get it taped down, okay? You know," she continued as she taped the plastic cathe er in place, "you've got the toughest veins I've seen in a long time."

Ellen didn't answer. Instead, she stared at the ceiling, tasting the salt of the tears running over her cheeks and into the corners of her mouth, and wondering where it was all going to end. Apparently blood had begun appearing in her bowel movements. The intravenous line was, according to the resident who announced she was going to have it, merely a precaution. He had neglected to tell her what it was a precaution against. "Okay, Ellen, we're all set, " the nurse announced, stepping back to admire her handiwork. "Just don't use that hand too much. All right?

Ellen pushed the tears off her cheeks with the back of her right hand.

"Sure, " she said. The woman managed an uncomfortable smile and backed from the room. It isn't fair. With no little disgust, Ellen examined the IV dripping saline into her hand. Then she shut off the overhead light and lay in the semidarkness, listening to the sighs of her own breathing and the still alien sounds of the hospital at night. It isn't fair. Over and over her mind repeated the impotent protest until she was forced to laugh at it in spite of herself. Betsy, Eve, Darcy, Sandy, the business, her health. Why had she never appreciated how fragile it all was? Had she taken too much for granted? asked too few questions? Dammit, there were no answers, anyhow. What else could she do? What else could anyone do? Here she was, almost forty, lying in a hospital bed, possibly bleeding to death, with no real sense of why she had been alive, let alone why she should have been singled out to die. It just wasn't fair.

A soft tap from the doorway intruded on her painful reveriestanding there, silhouetted by the light from the hall, was Sandyhe was holding his uniform hat in one hand and a huge bouquet in the other'permission to come aboard, " he said Ellen could feel, more than see or hear, his discomfiture. "Come on in, " she said. "Want the light on?"

"I don't think so. On second thought, I'd like to see the flowers."

Sandy flipped on the light and brought them to her. Then he bent over and kissed her on the forehead. Ellen stiffened for an instant and then relaxed to his gentle hug. "How're you doing? " he asked. "On which level?"

"Any."

"The flowers are beautiful. Thank you. If you set them over by the sink, I'll have the nurse get a vase for them later on."

"Not so great, huh." He did as she asked with the bouquet, then pulled a green vinyl chair to the bedside and sat down. Ellen switched off the overhead light. "You look nice in your uniform. Have you been home yet?"

"Just long enough to drop off my things and look in on the girls."

"How do they seem to you?"

"Concerned, confused, a little frightened maybe, but they're okay. I think it helped when your sister brought them up to see you yesterday.

I've moved back into the house until you're better."

"You may be there a long time."

"That bad?"

"Kate says no, but her eyes, and now this"-she held up her left hand-"say something else."

"But they don't really know, do they?"

"No. No, I guess not."

"Well, then, you just gotta hang in there a day or an hour or if necessary a minute at a time and believe that everything's going to be all right. I've taken an LOA from the air line to be with the girls, so you don't have anything to worry about on that account. I'll see to it that they get up here every day."

"Thanks. I… I'm grateful you're here."

"Nonsense. We've been through a lot these nineteen years. We'll make it through this."

Softly, Ellen began to cry. "Sandy, I feel like such a… a clod, an oaf. I know it's dumb, but that's how I feel. Not angry, not even sick, just helpless and clumsy."

"Well, you're neither, and no one knows that better than I do. Hey, that's the second time you've yawned since I got here. Are you tired, or just bored?"

She smiled weakly. "Not bored. A little tired, I guess. It turns out that lying in bed all day doing nothing is exhausting."

"Then how about you don't pay any attention to me and just go to sleep.

If it's okay with you, I'll sit here for a while."

"Thanks, Sandy."

"It's going to be okay, you know."

"I know."

He took her hand. "Kate's watching out for you, right?"

"She's in twice a day, and she's doing everything she can to find out why I'm bleeding." Her voice drifted off. Her eyes closed. "Don't be afraid."

"I'm not, " he said. "I'm not afraid… It's going to be okay." + The ride in Win Samuels's gray Seville took most of an hour along a network of dark country roads heading south and east from the city.

They rode largely in silence, Samuels seeming to need total concentration to negotiate the narrow turns, and Kate staring out her window at dark pastures and even darker woods, at times wondering about the purpose of their journey and at times allowing disconnected thoughts to careen through her mind. Jared… Stan Willoughby… Bobby Geary … Roscoe… Ellen… Tom… even Ros'beekes, her elementary school principal-each made an appearance and then quickly faded and was replaced by the image of another. "We're here, " Samuels said at last, turning onto a gravel drive. "Stonefield School." Kate read the name from a discreet sign illuminated only by the headlights of their car.

"What town is this?"

"No town, really. We're either in southernmost Massachusetts or northwestern Rhode Island, depending on whose survey you use. The school has been here for nearly fifty years, but it was rebuilt about twenty-five years ago, primarily with money from a fund my firm established."

The school was a low, plain brick structure with a small, well-kept lawn and a fenced-in play area to one side. To the other side, a wing of unadorned red brick stretched towards the woods. They entered the sparsely furnished lobby and were immediately met by a stout, matronly woman wearing a navy skirt, dull cardigan, and an excessive number of gold bracelets and rings. "Mr. Samuels, " she said, "it's good to see you again. Thank you for calling ahead." She turned to Kate. "Dr.

Bennett, I'm Sally Bicknell, supervisor for the evening shift. Welcome to Stonefield."

"Thank you, " Kate said uncertainly. "I'm not exactly sure where I am or why we're here, but thank you, anyway."

Sally Bicknell smiled knowingly, took Kate by the arm, and led her down the hall to a large, blue velvet curtain. "This is our playroom," she said, drawing the curtain with some flair to reveal the smoky glass of a one-way mirror. The room beyond was large, well lit, and carpeted. There were two tumbling mats, a number of inflatable vinyl punching dummies, and a stack of large building blocks. Mo one corner, her back toward them, a chunky girl with close-cropped sandy hair hunched over a row of large cloth dolls. "She's never in bed much before two or three in the morning," Sally Bicknell explained. "Kate, " Samuels said. "I brought you here because I thought that seeing this might help you understand some of my urgency as regards your moving forward with starting your family. Mrs. Bicknell."

The evening shift supervisor rapped loudly on the glass three times, then three times again. The girl in the playroom cocked her head to one side and then slowly turned around. "Kate, meet your sister-in-law, Lindsey."

The girl was, physically, a monster. Her eyes were low set and narrow, her facial features thick and coarse, with heavy lips and twisted yellow teeth. What little there was of her neck forced her head to the right at an unnatural angle. Her barrel chest merged with her abdomen, and her legs were piteously bowed. "That can't be, " Kate said softly, her attention transfixed by the grotesquery. "Jared's sister Lindsey…"

"Died when she was a child, " Samuels finished the sentence for her.

"I'm afraid his mother and I chose not to tell him the truth. It seemed like the best idea at the time, considering that we were assured Lindsey would live only a few years. She has Hunter's Syndrome. You are familiar with that, yes? " Kate nodded. "Severe mental retardation and any number of other defects. Her mother, my wife, was nearly forty when she gave birth."

Kate continued staring through the glass as the gargoylelike child-no, woman, for she had to be in her thirties-lumbered aimlessly about the playroom. Reflected in the window, Kate saw the faces of Sally Bicknell and her father-in-law, watching for her reaction. You are the monster, Win Samuels, not that poor thing, her thoughts screamed. What do you think I am, a piece worker in a factory? Did you think this… this demonstration would frighten me? Do you think I know nothing of amniocentesis and prenatal diagnosis and counseling?

Did you think I would just brush off the enormous lie you have been telling my husband for the past thirty years? Why? Why have you brought me here? Why haven't you included Jared?

"Take me home, " she ordered softly. "Take me home now." The antique clock on Win Samuels's huge desk said two-fifty. It had been nearly two hours since Kate had abandoned her efforts to sleep and wandered into the study searching for reading matter distracting enough to close her mind to the events of the evening. Something was wrong. Something did not sit right in the bizarre scenario to which her father-in-law had treated her. But what?

On the ride home from Stonefield, Samuels had quietly assailed her with statistics relating maternal age to infertility, fetal death, chromosome abnormalities, genetic mutation, spontaneous abortions, and mental retardation. He had, over many years apparently, done his homework well.

The few arguments she had managed to give him on the accuracy of intrauterine diagnosis were countered with more facts and more statistics. Still, nothing the man said could dispel her gut feeling that something was not right. At one time during his presentation-for that is what it was-she came close to crying out that their whole discussion was quite possibly a futile exercise, because a production error at Redding Pharmaceuticals might have already cost her any chance of seeing her forties, let alone conceiving in them. From the direction of Samuels's room on the second floor, she heard a door open and then close softly. Seconds later, the sound was repeated further down the hall. Jocelyn Trent had returned to her room. The study, now divested of its fire, was chilly and damp. Kate shuddered and tightened the robe Jocelyn had given her. It was only around midnight in San Diego. Jared wouldn't mind a call, she thought, before realizing that she had forgotten to ask Win at which hotel he was staying. As she reached for a pad and pen to write herself a reminder, she noticed Samuels's Rolodex file. She spun it to "A." The man was right about having a card for the Ashburton Foundation. On it were an address and a number that had been crossed out. A second, apparently newer, address and number were written in below. Kate copied the new address and added a note to check in the morning on Jared's hotel. She glanced at the clock. Three-fifteen. How many surgicals were scheduled for the day? Five? Six? Too many.

Desperate for sleep, she took her note and an anthology of Emily Dickinson and padded up two flights of stairs to her room. Forty-five minutes of reading were necessary before Kate trusted the heaviness in her eyes and the impotence in her concentration enough to flip off the light. The realization that her drowsiness was continuing to deepen brought a relieved, contented smile. Then, in her final moments of consciousness, she sensed a troublesome notion. It appeared, then vanished, then appeared again like a faint neon sign. It was not the trip or the school or even the girl. No, it was the address-the address of the Ashburton Foundation, not the newer Washington, DC, address, but the one that was crossed out. With each flash, the neon grew dimmer, the thoughts less distinct. There was something, she thought at the moment of darkness, something special about Darlington, Kentucky. Something…