The Inquisitor

Chapter 11

The dreams came at the end of sleep this time.

Sometimes I stood at the top of the stairs and called down to her.

No answer.

No lights on in the basement either.

Yet I'd definitely heard a noise down there.

Other times I walked along the corridor leading to his office.

The lights were dim.

As I drew closer I heard the sound of water running. Lots of water. Like someone filling up a bathtub.

Except there should be no such thing down here.

Or the dream would begin with no hint where it would ultimately take me. It could start in the middle of a sunny day at a park with green grass, cool caressing breezes, and warmth under the blaze of orange and yellow leaves. Or were those clues as well? Had it been sunny that day? Did we go to the park? I couldn't remember. But yes, the season would be fall. Not that I recalled seeing the colors of the foliage. I knew because of the date, November 9, 1989- a date that had become lodged in my head like a bullet, a day the world changed for the better but my universe collapsed.

Was that why he'd chosen that day- to make sure no one would ever forget the anniversary?

Maybe.

Or perhaps our imminent visit had precipitated the choice- he couldn't face us- and he simply took advantage of a coincidence of history, a time when everybody else would be glued to the television and wouldn't interrupt.

Sometimes the points of view got changed about, and I would be inside Jerome's head, forced to experience how alone he must have felt in those desperate yet methodical moments.

And then I'd be back at the beginning again, dreading but not precisely knowing the events to come.

But no matter how or where they started, all the dreams led me to the same spot and all ended the same way.

I stood in darkness, listening to the cascade of water on the other side of the door. There were also strains of barely audible music. The dripping from my shoe when I took a step made me realize that a puddle had spilled under the threshold to form around my feet.

I called out again.

No answer.

I tried the handle.

Unlocked.

I turned it and pushed.

It swung open, and the sound of the streaming torrents trebled in volume. I could also recognize the song now.

"Hello?" I raised my voice to be heard above the din and peered into the semiblackness of the laboratory.

Still no response.

The digital readouts on the equipment, fluorescent green and fire red, cast a neon glow that shimmered on the surface of the flooded floor. At the middle, like an inverted fountain, a huge cascade of water spouted from what must have been a broken pipe in the ceiling. The spray caught enough illumination to glitter like a downpour of emerald and ruby sparkles, but something dark and solid hung in its center.

I should have just turned and left, gone for a maintenance man.

But that dark shape drew me forward.

As I stepped closer, it became a human form, like someone standing under a shower, head slumped forward and shoulders rounded to receive the full force of the streaming water on the neck and upper back. Nearer still, I felt droplets from the spray as it cascaded off the top of the person's crown, creating a domed effect. Knowing I shouldn't, I ducked inside the watery cupola and looked up to see a downturned face looking at me. Its wet skin reflected the ambient light, making it seem coated in a sheen of olive and purplish paint. The eyes bulged as if he were enraged, his cheeks were bloated to the bursting point, and a tongue swollen to the girth of a Polish sausage hung twisted from the side of his mouth.

I screamed and woke in a sweat.

For an instant I felt the relief that always flooded through me when I escaped the nightmare.

But dawn slashed across my eyes, a light shredded by the horizontal blinds, and reminded me of the old woman's room.

And Garnet's ambush.

The never-ending dread of getting caught settled in for another day. I could hardly escape it anymore. Even in my other self, it would leech through from time to time, which meant someone might spot that I'm scared and get suspicious.

Shit.

At least Earl hadn't recognized me; if he had, the police would already be at the door.

But what the hell had he been doing there? And how did he know to get the old lady to safety? Could he be on to everything, could he have figured it all out? Christ, he might even have been the creeper on the ward last week.

My skin grew clammy again, adding to the sour aroma from the already damp sheets. I threw them off in disgust, retreated to the shower, and turned the cold water on full. The blast of icy needles overrode my runaway thoughts and helped me focus, not that that offered much comfort. As I tried to rein in my worst fears and sort out pure imaginings from fact, a few gnawing realizations shoved everything else into the shadows.

Whoever had been the figure in the hallway, it didn't change the fact that Garnet had been skulking around last night. And whatever reason Garnet had had to move the old lady out and keep watch in her room, he now knew for certain that she'd been in danger. Which meant he'd be more watchful than ever up there, and there'd be no delaying or diverting him until he got at the truth.

The trouble would be, which truth? The one I planned for him to discover, or the reality behind it? But false leads might not fool the likes of Earl. All the pieces in their entirety were there to be found, and he definitely had the smarts not only to find them but also to fit them into place.

Time to accelerate the plan.

Sunday, July 13, 6:10 p.m.

"Sit down, Thomas." Jane felt eerily calm and totally in charge. She'd had a sense of complete control all weekend, first refusing to see him, then instructing him to show up at her apartment. That he'd arrived twenty minutes early only enhanced her heady my-way-or-the-doorway attitude.

He didn't stretch out on her living room rug as he usually did while waiting for supper, but took one of the upholstered chairs, which seemed a size too small, making him bend like a half-folded lawn chair.

The sight of him made her giggle.

He immediately smiled. "Well, that's better. God, I thought you had bad news, it felt so serious in here."

She said nothing.

Immediately he leaned forward, his features funneling into a pointed look of concern. "What's up, J.S.?"

She never really liked how he'd appropriated Dr. G.'s nickname for her. It felt like an intrusion on something private she shared with a special friend.

She studied Thomas's sleek, sturdy frame and lean, bearded face, thinking how his appearance had fed her schoolgirl ideal of a Tennessee woodsman, hard as an oak ax handle, yet still more boy than man. Well, time to grow him up. See what he could make of himself.

"I'm pregnant."

He appeared to stop breathing.

The seconds crept by in discreet silence, as if trying not to eavesdrop.

"Thomas, did you hear me?"

"Jesus, Jane, give me a moment. That's quite a shock."

"Really? Uh, how many times have we made love? A hundred, maybe? And do you remember putting on a new condom each time we sampled seconds? Look, I may have been as lax as you, but we were a team in this one. Do me a favor and spare me the surprise." The impatience she felt surprised her. But what the hell, let it rip. She'd no time for bullshit. Not now.

He gaped up at her as if she were a stranger.

She put a hand on his head, running her fingers through his hair. "Forget kind lies, Thomas. I need to know. Do you want your baby and to be a daddy, or not?" Her voice sounded serene despite the abruptness of her words.

His jaw slipped another notch.

"And I won't beg, damn it. If you don't want to share the child, you're out of here, and I get a lawyer."

He seemed to fold up a little more in his chair.

Think only of the baby, she reminded herself, and the freedom exhilarated her, liberated her in a dozen ways. From Mom's inevitable disappointment in her, from the disapproval of all Grand Forks, from the clucking tongues at St. Paul's- their hold on her slipped like chains to the ground. Second-guessing and hesitation about what to do vanished. Work? She'd keep her job as long as possible. Where to go? She'd stay here in her apartment. Whom to count on for no shit about how she ought to have been more careful? Her little brother, Arliss.

Decisions and answers flew into place- snap, snap, snap. She felt weightless.

Thomas stared up at her in absolute awe.

His expression fueled her exuberance over having taken charge.

"I've never seen you this way," he said, sounding totally incredulous. "You're… you're… radiant."

It's the hormones, stupid, she wanted to say, but didn't. Yet her silence caused a weight to tug on the middle of her chest, as if she'd allowed him to snag her in flight and pull her back toward the ground.

"I mean it, Jane. You're absolutely glowing." He got to his feet, walked to where she stood, and put his arms around her.

She resisted. "No. Tell me what you want."

"I love you."

"Yeah, right. How about the child?"

He grinned. "I'd be proud to be a daddy with you."

She watched his eyes dilate as fully as she'd ever seen, even in lovemaking. But from desire? Not this time. He looked more as if he'd been caught in the middle of telling a joke and a bomb had gone off.

Her scrutiny must have made him feel defensive. "What?" he said, his grin widening.

"Proud?"

"Yeah, proud. I'm surprised but proud." He grinned wider still, seeming to warm to the word he'd chosen, and lowered his head to kiss her.

She ducked out from under his lips and held him at arm's length. "Proud!" she said, as if she found the term repulsive.

All at once he looked even less sure of himself.

It made her want to attack harder. "What the hell does proud mean? You intend to put a notch on your… your… well, your whatever, because you knocked me up?"

The pupils pulsed bigger than ever, then narrowed to pinpoints.

She'd only seen people's eyes do that in a strobe light.

He mouthed air a few times, but no words came out.

Her impatience hit the stratosphere. "Well, here's a news flash, buddy. I'm not your or anyone else's trophy." She knew somewhere in her head that her behavior had careened from bitchy to totally unreasonable and back. Yet as he flinched under her onslaught, she loved it.

"Shit, Jane, I'm sorry-"

"So am I."

"But don't be so angry."

"Why not? I feel angry."

"But-"

"But what? Speak up, Thomas."

To her astonishment, a nervous chuckle bubbled out of him. He tried to stifle it, but instead he broke into a loud, rolling guffaw that rumbled from deep within his chest. "You're a real firecracker tonight," he managed to say, and knelt in front of her. "Forgive me, beat me, scold me, but I am delighted, proud, happy, surprised, eager, ecstatic- stop me if I get the right word- to be the father of your child."

All her anger melted away.

He held out his arms to her, beckoning with that damned seductive grin of his.

She lunged, knocking him on his back, and pinned him under her, then straddled his chest, her knees on his arms. "So you want to be a dad?"

"I want to be a dad."

"And you want me?"

"I love you."

"You want to love, hold, and obey?"

"Oh, yeah. Especially the obey part. Or you kill me, right?"

"Right!"

She felt jubilant, as if she'd won a great victory, stood up to the fates, spat in their eye, seized the brass ring, and cliche of all cliches, done it all her way.

And gotten herself a sexy woodsman from Tennessee to boot.

Just like Daisy Mae.

Monday, July 14, 9:30 p.m.

Earl leaned back in his study chair and let the speed dial of his cellular ring through to Michael's house. The man would have to run the department during death rounds tomorrow and needed a heads-up. Should the anticipated fireworks take place, it could be a long session.

"Hello?" Donna answered with the throaty slur of someone who's been asleep.

"Donna, it's Earl. Did I wake you? Sorry. I wanted to speak with Michael. I thought you guys would be up." They were one of the last holdouts in his age bracket who stayed up to watch the eleven o'clock news.

"But he's in ER this evening."

Oh, shit. "Of course, how stupid of me. I can't keep up with the schedule anymore," he said quickly, wanting to get off the line. "I'll call him there. You get back to sleep. Good night." He hung up before she could say anything.

He'd made other calls over the years to the homes of staff members only to be told by a puzzled spouse that the person should be in ER. And he always played the absentminded professor, claiming to have forgotten the schedule. But he could no more forget what shifts he'd assigned to people than his own phone number. Everyone had their regular slots. They knew them; he knew them. An ER physician's life revolved around the damn schedule: who gets what vacations, who works Christmas, who does New Year's Eve. There's no steadier headache for a chief than making sure every hour of every day of every year is covered. Michael didn't do Monday evenings. So unless he had pulled a last-minute switch with someone- not a total impossibility- he had lied to Donna about where he'd gone.

Catching someone out always cost Earl. He didn't like knowing the personal problems of people he worked with. But trouble at home often translated into trouble at work. So he kept a close eye on the men and women whose secret lives he'd unintentionally discovered. But to find it out about his friend, colleague, and acting chief of the department meant worry on all three fronts and having to walk on eggshells at a whole new level.

Please let me be wrong about this one, he thought, ringing ER. "Hi, it's Dr. Garnet. Who's on call tonight?"

"Dr. Green and Dr. Kradic," said the clerk, naming the two veterans who had manned the shift for years. "Do you wish to speak to one of them?"

"Actually, I wondered if anyone saw Michael. Maybe he's working in his office?"

"One moment. I'll check."

He took a deep breath and watched the trees outside his window toss in the wind as yet another storm threatened. Their leafy branches swept back and forth in front of the streetlamps, covering and uncovering the lights in a frenzied semaphore.

"I'm sorry, Dr. Garnet, but no one's seen him."

Tuesday, July 15, 7:00 a.m.

Pathology Conference Room, St. Paul's Hospital

The remains of Elizabeth Matthews lay in open Tupperware containers arranged end to end along the length of a massive polished oak table. Earl scanned her ocher-colored liver, a pair of charcoal-tinted smoker's lungs, two glistening gray kidneys, and a maroon heart coated with yellow fat, the four cardiac chambers sliced open like the inner compartments of a large red pepper. A separate tray displayed the piece de resistance: an amorphous knobby-shaped mass of pearl-colored tumor that had penetrated the ovaries and uterus, reducing much of the structures to an unrecognizable reddish brown mush. The final two specimens, a coil of bowel and the halves of her brain, were parked to one side, too anticlimactic for comparison.

Pre-SARS, the aroma of fresh coffee would partly cut the acrid fumes at these sessions, but not anymore. Nothing was served at morning rounds these days. Signs posted throughout the hospital read NO EATING ON THE JOB, and cartoons of people raising their masks to gobble down donuts bore stamps of big red circles with lines slashed through them. Most found this new form of prohibition harder to take than the clampdown on cigarettes. Smokers were a minority. Restrictions on food left everyone hungry, in caffeine withdrawal, and snarly as hell.

Even so, death rounds remained popular with staff and trainees. A pathologist's knife spared nobody in exposing the final diagnosis and laid bare the mistakes of all, from the loftiest chief to the lowliest student. The combined prospect of picking up teaching pearls and witnessing the great equalizer of a public stripping-down usually packed them in.

Except today Earl had invoked his powers as VP, medical and limited participation to the players directly involved in the case. What he had in mind required them and only them, not a general audience. Hurst had gladly gone along with the ruling, never even questioned it, always eager to keep anything controversial as secret as possible, SARS or no SARS. And it still wasn't clear if Mr. Matthews would launch a lawsuit.

Earl looked around at the invited guests.

On this side of the table Thomas Biggs sprawled in a chair a few spaces away. Dressed in a crisp white coat, he sleepily inspected the open containers from under drooping eyelids, the aftereffect of a recent string of night calls.

Beside him Jimmy sat upright and alert, leaning forward and raring to go, but wearing a king-sized frown, obviously baffled at why he'd been included.

Everyone else had chosen to sit opposite Earl, face-off style.

Midpoint in the lineup, Paul Hurst formed his graceful fingers into an elongated triangle and absently beat a tattoo with them on the front of his mask.

His sister, Madelaine Hurst, director and chief of all things to do with nursing at St. Paul's, occupied the place at his right side. No surprise there. She always took that position, either oblivious of or indifferent to its symbolic right-hand-man implication. An asthenic woman with austere gray eyes, and known to protect her domain as fiercely as her brother defended the hospital, she clamped her steel gaze on Earl. It felt cold and hard as shackles.

Next to her sat Mrs. Quint, seemingly relaxed, her expression a thousandfold more congenial than her boss's. Earlier she'd even wished Earl good morning. But her corpulent figure exuded an air of authority, and as acting supervisor at the time of the incident, she'd be defending her "girls" just as vigorously as Madelaine

Hurst would.

The most openly hostile pair, Peter Wyatt and Monica Yablonsky, glared at him in unison from the far end of the table. Having placed themselves near the large, wall-mounted video screen that would be used for the upcoming presentation, they'd picked the prime spot to make sure everyone else would witness their show of disapproval.

Predictable, Earl thought.

Stewart Deloram, however, surprised him. He'd positioned himself at Paul Hurst's left elbow and, with surprising charm, cozied up to him from the minute they sat down together, chatting breezily while studiously avoiding eye contact with Earl.

Now what could that be all about?

Len Gardner, habitually occupying the oversized chair at the other end of the table, rose to his feet. "We might as well begin," he said, and with a touch of a finger to his laptop computer, the wall-mounted screen sprang to life. A swirl of pink lines and blue dots appeared, the primal color scheme pathologists use when staining body tissues so that they will be visible under a microscope. This particular pattern, wavy mauve strands reminiscent of a van Gogh, were woven beneath an array of tiny purple dots worthy of a Monet. Together they depicted normal uterine muscle lined with disintegrated mucosa.

Len clicked through a series of such images- the strands of muscle and sheets of mucosa appearing successively more shredded- to document the tumor's relentless progress. "Invasion by increments," he described it, "destroying Elizabeth Matthews's reproductive system cell by cell."

Earl recalled the ghastly distortions on the woman's wan face as she'd endured what they were seeing.

As the demonstration continued, Stewart occasionally whispered something in Hurst's ear and pointed to the screen, seemingly adding his own spin to the narrative. He still hadn't looked in Earl's direction.

Len moved on to pictures that confirmed the cancer hadn't yet disseminated throughout the rest of her body, flicking through shots of the other vital organs and showing them to be free of any metastatic spread. "Certainly her neoplasm had not reached a stage such that it would be incompatible with life," he emphasized.

Laying down his laser pointer, he removed the tumor from its container and, sticking here and there with a steel stylet as long as a knitting needle, demonstrated in macroscopic terms the assault on Elizabeth Matthews's womb.

"Any questions?" he asked when finished.

No takers.

Earl often worried how voyeuristic and sicko these sessions would seem to the outsider. Yet they remained at the heart of learning medicine, exposing the profession's victories and errors with a certainty that no other part of the discipline could provide. Should they ever suffer the ax of public outrage because the media exposed them to lay scrutiny, doctors wouldn't be flying blind, but it would be as if they'd lost an eye.

Len gestured to Stewart. "Dr. Deloram has volunteered to present and interpret the biochemistry of the case, including the postmortem drug screens."

"Thanks, Len." Stewart stood up, and with a click of a remote, a slide projector mounted on a steel table began to whir noisily. A few more clicks, and its carousel advanced with a loud rattle. Pushing another button, he caused a movie screen to descend from the ceiling and come to a stop above the video monitor.

It's a wonder he didn't play the theme from 2001, Earl thought.

Enlarged charts of lab values sprang into focus on the white surface.

"As you can see, aside from a raised calcium level, the result of the tumor having eaten into the bones of her pelvis," Stewart began, "the hematological and biochemical values remained mostly normal until the time of death. In other words, as Dr. Gardner has so elegantly demonstrated, multiple organ failure had not yet become part of the picture." More numbers flicked by. "Specifically, I draw your attention to the patient's normal liver and kidney function, since this will have a bearing on our ruling about the cause of death." He turned to address the nurses. "You no doubt recall that morphine is broken down in the liver and excreted in the kidney. After looking at these standard values, a physician might reasonably conclude the patient ought to have been able to metabolize a dosage increase of the magnitude Dr. Garnet ordered, especially since previously prescribed amounts of the narcotic hadn't treated the woman's pain."

He paused and cast a glance at each of the women, eyebrows raised like a mime telegraphing that he expected a response.

Mrs. Quint gave a reluctant nod of agreement.

Madelaine Hurst simply stared back at him, unwilling to yield up so much as a blink.

Monica Yablonsky had the startled look of deer blinded by a poacher's light. She started to fidget with her glasses.

Attaboy, Stewart, Earl thought. So far so good.

"And I take it that all present are aware of the sequence of events leading up to this woman's demise," Stewart continued, "Dr. Garnet's doubling of her morphine dose, the times that the nurses administrated it, and the patient's vital signs throughout?"

Nobody indicated otherwise.

"Fine. Now while a lethal level of morphine undoubtedly killed this woman, the source of that toxic concentration is not at all clear."

What?

"The amount present in her blood at the time of death might indicate that approximately double the amount Dr. Garnet prescribed may have been administered to the patient, but this explanation isn't that certain."

Wait a minute. What's this "not all that clear" and "isn't that certain" crap?

"A fall in blood pressure could have resulted in a delayed uptake of the first injection that had been given around nine that evening. Later, should the pressure recover and the uptake of the drug into the patient's bloodstream return to normal, both the remnants of that shot and the entirety of the second dose would enter the circulation simultaneously, leading to the toxic levels that killed her."

No! Wrong! Wrong! Wrong!

"Even though the nursing records indicate no such fluctuations in her vitals," Stewart continued in a fluid, singsong delivery more appropriate to a travelogue than a death review, "they might have come and gone undetected. And to reiterate Dr. Gardner's findings that the woman's cancer, while undoubtedly painful, had not yet brought her near death, it's a known fact that morphine itself can drop a patient's blood pressure. So we are left with two possible scenarios: either someone doubled the second injection, or undetected fluctuations in blood pressure led to a delay in the absorption of the first, leading to an accumulation of the two shots."

Earl leapt to his feet. "What the hell are you talking about?"

Stewart sat down and studied the table between them.

"That's garbage, Stewart, and you know it."

Stewart said nothing, still avoiding eye contact, but Earl saw the black of his pupils grow wider.

Like a variation on Pinocchio's nose, the lying son of a bitch. "Why are you doing this, Stewart?"

"Doing what?"

"You know damn well. All that 'fluctuating pressure' bullshit." But Earl had already guessed the reason: to provide a scenario that could give Hurst an out. Not a good one with legs, but enough to confound the findings and keep the table from reaching a definitive conclusion. Then the whole mess would end in limbo, and he'd avoid a public scandal.

"Patients fluctuate wildly near death," Stewart said with a shrug. "They can be nearly comatose one day and rally the next, the improvement there for no more apparent reason than a need to say good-bye, and it all happens with no change in their metabolic numbers. It's a part of cancer we don't understand, almost as if bad humors were at work-"

"Level with me, you son of a bitch." Earl nearly grabbed him by the collar.

"How can you be sure it isn't so?" Paul Hurst said, maintaining his finger pyramid as he looked up at Earl. His voice remained as calm as a pond locked in ice. "Actually, both scenarios seem reasonable to me. Do you have proof to support one over the other?"

"There were never any serious dips in Matthews's blood pressure, not that night, not ever," Earl said, controlling his anger.

"Not recorded, no. But without continuous monitoring, how can you say for sure?"

"It's unlikely as hell, and you know it." He turned to Len. "Do you agree with this?"

The pathologist's scowl said it all. "Of course not. No way shock had anything to do with this woman's death. Stewart, this is a crock."

"Hey," the intensivist said, locking eyes with him, "I'm just laying out all the possibilities. You guys decide which one's most probable." He sounded miserable.

"You were told to pull this stunt, weren't you?" Earl said. "I might have expected as much from some." He gestured toward the Hursts. "But you?"

Stewart shook his head as if denying the accusation and finally looked directly at Earl. The pitiful gloom in his eyes admitted everything. "Don't you understand? A hung jury here gets you off the hook too," he said, as if that justified what he'd done. "This way neither you nor the nurse can be officially cited for negligence. The matter dies."

Paul squinted imperiously over the top of his bifocals at Len. "Of course, as a former surgeon I know enough never to go against the pathologist as far as cause of death is concerned. Morphine overdose, right? There we are in agreement?"

"Yes. But I repeat, shock did not play a role in that overdose."

"And the minutes will record your opinion. As for the rest, we'll just have to agree to disagree on this one."

His arrogance took Earl's breath away. In a court of law he'd never get away with such a bald-faced attempt to distort the facts. But death rounds had no legal status. Touted as a sacred crucible of final clinical truths, nothing guarded its integrity but good faith between physicians.

The constriction in Earl's gut coiled even tighter. He looked over at Yablonsky. She blanched and began to use her glasses as worry beads.

"Do you have anything to say, Monica?" he asked. "This leaves you much more out on a limb than it does me, and you know it."

Jimmy shot him a disapproving glance, as if to tell him to cut his losses and run.

Madelaine Hurst hunched forward, and her brow acquired the sharp-edged contours of a hawk's. "Now see here, Dr. Garnet-"

"I'm waiting for an answer, Monica," he said, ignoring them both.

Paul Hurst leaned closer to his sister. His normally colorless skin became dusky gray, the change suffusing up his temples, across his forehead, and down from under his mask to his neck like creeping smoke. "Garnet, we agreed not to discuss this-"

"I agreed to wait and hear the pathology reports before I took any action, not to cover them up."

"You can't be serious, throwing the hospital into a tumult at a time when-"

"What tumult? That's why I restricted this gathering to the people most directly involved. I'm betting someone in this room knows the truth about Elizabeth Matthews's death and the deaths of other patients on this ward. We can get at it, here and now, behind closed doors."

"You still aren't seeing the bigger picture."

"Oh, no?" He pointed at Yablonsky. "The bigger picture is that she tried to shift the blame for this patient's death onto me. And my chief resident, Thomas Biggs, tells me there's also been a rise in the number of people who die on the ward but are discovered only in the early morning. Clearly no one is keeping close watch during the night. A few days ago I witnessed that for myself, and our hospital chaplain, Jimmy Fitzpatrick, will back me up. Not only could I sneak onto the ward, but some other intruder came prowling around as well. I don't think we can ignore events like that, can we, Paul, what with a rise in the mortality rate and the possibility that Elizabeth Matthews's death might be part of a cluster-"

"No!" shrieked Monica Yablonsky, her eyes wide with fright. "I won't be your scapegoat." Her voice soared into the high, thin register that jangles the human ear and makes dogs howl. "I won't!"

Bingo! Earl thought. This was shaping up to be a "You can't handle the truth" moment.

Despite working on the numbers all weekend, even with Janet's help, Earl hadn't been able to conclude whether the statistics really indicated a cluster of suspicious deaths. He certainly hadn't been able to incriminate Yablonsky in anything specific. Nor could he tell whether his assailant had played a role in it all. But he'd come here to squeeze Yablonsky, because all her anxiety told him she knew something about what had been going on, and this in itself gave her good cause to be afraid.

Why? Ever since that groundbreaking article in the New England Journal, it was the nurses whom investigators went after when patients died and the reason wasn't clear. She'd know that, and it would scare her, whether she'd accidentally overdosed a single patient and lied about it, or done much worse, or hadn't done anything herself but covered up for the real culprit. Earl intended to rattle her enough that she'd drop her guard and let slip her secret, whatever it might be.

At least, that had been his plan, and it seemed to be working.

But then Jimmy sprang to her side, his arms protectively around her shoulders. "For the love of God, Earl, back off!"

Mrs. Quint quickly walked over to join them. "Monica, calm down," she said, rubbing her underling's back the way she would a child's. Her voice, no louder than usual, but ice smooth, rang out like a command.

Monica looked desperately from her to Jimmy and back again. "Calm down? It's not you he's after."

Madelaine turned on her brother. "Paul, stop this disgraceful attack on the good name of a fine nurse."

"Garnet!" Peter Wyatt roared, getting to his feet like some smoldering volcano rising from the sea. "I'm formally charging you with making libelous comments against my department."

"And I'm suspending your authority as VP, medical," Hurst chimed in, as if singing a duet with Wyatt, "pending a hearing into charges of unprofessional conduct."

Earl ignored them all and kept his sights on Yablonsky. "How about it, Monica? Stop lying now or I'll go to the police, and this business will finish you-"

"No!" Her voice once more cracked into soprano territory. "I won't be hung out to dry!"

"That's enough, Monica!" Madelaine Hurst's glare launched a thousand scalpels at her. "The subject's closed."

Monica's eyes flashed a counterstrike. "No, it's not closed. Not by a long shot." She swung back to face Earl, her pupils so dilated with fright that they squeezed her irises into thin brown rims. "Dr. Garnet, you wanted to know what the patients who reported a near-death experience told their nurses?"

Stewart sat bolt upright.

"That's right," Earl answered evenly. "Apparently no supervisor, including you, could find a single nurse who remembered anything."

"Because they were told to keep quiet-"

"Shut up, Monica," Madelaine Hurst shrieked.

"I won't, not when he's talking about clusters of unexplained deaths and hinting at allegations of murder." As she spoke, she trained her eyes only on Earl, as if forming a corridor that linked them together and excluded everyone else.

"Go on," he urged.

"Monica!"

"Some of the girls who heard those near-death stories found one particular detail doubly peculiar."

"What?"

"Damn it, Monica, I order you to stop."

"Patients didn't just claim they'd seen lights, tunnels, lost loved ones, or themselves floating above their bodies- all that standard stuff." She rattled off the usual catalog of near-death experiences with the contempt of someone who considered such matters to be utter nonsense.

Paul shot to his feet, toppling his chair backward. "Continue and you'll be suspended permanently, Mrs. Yablonsky." He spoke through clenched teeth.

Earl leaned over the table toward her. "No, you won't. Trust me. Talk now, Monica, and nobody can touch you, not even me. What's said in this forum has automatic immunity." He hadn't lied. Anything stated at death rounds could not be subpoenaed in a court of law. The rule had been intended to protect doctors from legal action if they honestly admitted their mistakes so that the rest of the staff could learn from them. But whether the law would protect Monica from a CEO and a nursing supervisor, he had no idea.

Monica must have believed it could. "A lot of the patients said that someone kept whispering questions at them throughout the whole ordeal," she said, never taking her eyes off him.

"Questions?"

"Yeah. Had they seen God? Were they looking down on themselves? What did heaven look like? Crazy stuff."

"You're kidding."

She retrieved a tissue from her pocket and dabbed her eyes, careful not to touch them with her gloved fingers. "I swear, it's the truth."

Earl felt he'd stepped into an elevator and dropped too fast.

Why should he believe her? This might merely be another attempt to throw suspicion on someone else. But the story sounded too bizarre for her to have made it up, and pieces of the puzzle snapped into place, giving an answer he didn't want.

Reluctantly he looked over at Stewart.

The man's pupils grew to the size of quarters.

Oh, my God, Earl thought, his insides plummeting further. "This is what made you say the reports were bogus?" he said, sounding incredulous despite knowing he'd stumbled on the truth.

Stewart's forehead began to glisten under the overhead lights, the effect of a sudden sheen of sweat. "No, honest-"

"Don't lie to me, Stewart!"

"I'm not. I mean, it's not what you think. Please, Earl, you have to believe me-"

"Of course he's lying about it," Monica said, "to protect his ass!" Fury propelled her voice down to its deepest registers, stripping it raw, and the words scraped against the back of her throat. "Who else around here wanted to talk with the dead?"

Department of Clinical Research, subbasement, St. Paul's Hospital

"I swear to you, Earl, I didn't do anything wrong." Stewart's voice shook. He rose from his desk, fluttering his gloved hands here and there, his fingers as tremulous as wings. A lifetime of data on resuscitation outcomes and volumes of scientific papers about critical care towered about him in stacks. Except now the piles seemed about to fall in on him as he cowered at their center, shot up with fear, eyes as jumpy and desperate as any junkie's.

Earl leaned against the closed door and watched with clinical fascination as Stewart spun and turned, until the sight of him falling apart turned repugnant.

As the meeting had disintegrated into confusion, Stewart had fled death rounds, his eyes straining so far to the side toward his accuser that they nearly disappeared into their sockets. Earl had chased after him to his cubbyhole office.

"You lied to me," he said to Stewart.

"Yes, I know, but only about what those patients told me. I knew if word of that got around, people would react exactly the way everyone else at the table did- think that I had something to do with it." He spoke in short, rapid spurts, alternating between a whimper and a bellow. "All it takes is a whiff of shit to finish you off as a researcher in this game. And I've made more than my share of enemies, believe me, though as far as I can see it's for no reason other than envy."

How about on account of insufferable conceit? Earl thought.

"Oh, there'll be plenty of volunteers to mount a whisper campaign against me," Stewart continued, then blanched whiter still. "Oh, God! My funding, it'll dry up overnight-"

"What, specifically, were you afraid these whisperers would say?" Earl interrupted. He tried hard to sound sympathetic, to keep him talking, but found it difficult.

Stewart reacted with an impatient wave. "You know very well. That I'd badgered dying patients without getting their consent." He expanded his restless movements and started to pace. But in a ten-foot cubicle he still ended up turning in circles. "That I precipitated the near-death state to get more material to publish. That I went after immediate accounts of the experience rather than retellings, to silence critics of my original work. All of it crap, but clever enough to do damage."

Earl shuddered from the creeping realization that just as he didn't know for certain whether Stewart would be capable of something so appalling, neither could he dismiss the possibility. With increased foreboding, he asked, "And how might these so-called accusers explain you could pull such a thing off?"

Stewart immediately came to a standstill, looked at Earl, and went so white around the eyes, he seemed about to faint. He laid a hand on his desk as if to steady himself, and slowly sat down again. "You think I did it too, don't you?"

Come across as an ally, Earl told himself. He also sized up Stewart's physique, wondering again if he could have been the man who attacked him. Hard to tell, he thought. Despite spending most of his hours in the darkness of ICU, Deloram had managed to keep reasonably trim. He also had the height and the breadth of shoulders to fit the bill.

"Jesus, Earl," Stewart continued, "you of all people have to believe me. And it could be anyone trying to set me up-"

The ring of his phone cut him off.

"Hello?" he answered. His forehead grew fire red and his skin glistened with sweat again. "No, there's nothing to it," he said to the caller on the other end of the line. "Just some negligent nurse who's trying to blame everyone else…"

His coloring deepened, and his knuckles glowed white under the latex as he tightened his grip on the receiver.

Obviously somebody at death rounds had talked, and word had gotten out. Probably Yablonsky. It fit her style.

"She even tried to incriminate Earl Garnet. I guess it's my turn now. Who knows, maybe next it will be yours." He laughed far too loud and long. "No problem," he cried. His desperate cheeriness set Earl's teeth on edge. In ER, that sound usually accompanied a chilling smile and signaled a person who might go home, open the medicine cabinet, and start counting out pills.

As Stewart continued to reassure his caller, a laptop on his desk began to chime, announcing the arrival of separate e-mails. The noise continued, like a slot machine paying off, and the dread in his eyes deepened at each sound. Still, he managed another pumped-up laugh and gaily suggested, "Let's have lunch sometime soon. Do you like Mexican?"

He hung up and clasped his head in both hands as if he were afraid it would fall off. "This is going to ruin me!" he said, his voice quivering on the edge of a sob. He looked up at Earl with the agonized stare of a man who didn't quite comprehend why his world seemed to be crumbling around him. "I swear, in all my years of research, I never, ever breached a single ethical protocol."

Earl struggled for something to say, but the phone rang again, once more bailing him out of an embarrassing silence.

Stewart frowned, hesitated, then picked it up and repeated the same bravura performance he'd put on minutes earlier, except this time he offered to buy dinner and suggested Chinese.

When he hung up, Earl asked, "Was the show you put on at death rounds about Matthews your idea, or did Hurst approach you?"

He didn't answer, choosing instead to peer at the tropical fish that languidly swam across the screen of his computer.

"Stewart?"

He took a deep breath, as if he were a diver about to take a plunge. "I approached Hurst to warn him that there might be strange stories floating around Palliative Care about near-death experiences that wouldn't do St. Paul's, or me, any good. Up until then, near as I could determine, any nurse who reported the patients' experiences to a doctor or supervisor had been told they had to be hallucinations and not to take them seriously. But I still wanted to make sure no one said anything to implicate me. He promised to silence any such insinuations, but suggested I also put an end to your poking around and stirring up trouble on the ward by making the Matthews inquiry end in a draw. That would be good for St. Paul's, and with no clear wrongdoing, he said, you wouldn't have cause to investigate any further, which would reduce the chances of you also turning up the near-death stories, which would be good for me."

"You were that naive?"

"I was that desperate."

Earl said nothing.

The phone interrupted them again.

Earl watched as he sweated through another frayed showing of high spirits- eyeballs bulging with fear, squirming in his seat, rattling off yet more futile reassurances, his free hand ceaselessly searching for a place to light.

As if babbling frantic lies to a few people could save him, Earl mused. Not in the age of the Internet. After a lifetime of scientific toil, he would be pilloried around the globe with a push of a key.

Stewart issued yet another invitation, jovially suggesting drinks at a nearby Italian bistro this time, then hung up the phone and pulled the cord out of the jack. "Fuck 'em!" he muttered in a bleak attempt at defiance.

Earl lost patience with the bullshit. "What's next, Stewart? You buy me off with a cup of coffee and breakfast? You can't schmooze your way out of this mess by plying everyone who hears about it with food and booze."

Stewart shot out from behind his desk and in two strides stood nose to nose with him. "How can you be as stupid as the rest of those idiots to believe I had something to do with those patients?"

"I don't know what to believe just yet."

"Well, smarten up, damn it. You of all people should realize that none of this mess rings true. Ask yourself why I'd be so idiotic as to risk my career in some clumsy scam to fabricate data about near-death experiences. I mean, it'd be like pointing a finger at myself. Let's get real here."

"You don't get it, do you, Stewart?"

"Get what?"

"Whether or not you committed ethical hanky-panky as a scientist isn't the big question here."

"Oh, no?"

"No. It's whether you'd kill three people and slip two others into a coma to prevent them from saying you did."

Stewart turned crimson again, and up this close, Earl could see the individual beads of sweat that filled his pores.

"You bastard!" he said, his voice guttural, as if gathering phlegm from the back of his throat to spit in his face. "Get out! Get the fuck out of my office."