The Inquisitor

Chapter 8

Later that same evening, 5:45 p.m. CEO's office, St. Paul's Hospital

Dr. Paul Hurst threw down the article Earl had shown him. "But they're supposed to die. It's a terminal ward."

"I still thought you should know."

"On the basis of… what did you say? A fall in average length of stay from twenty-seven days to twenty-four about three months ago, and a point-five increase in the number of deaths reported each morning? That's infinitesimal."

"Not exactly. It's a rise of fourteen deaths a month, all of them occurring at night. And three months before that there had been a similar change, an increase of about eleven deaths a month, again mainly at night. In the previous years, the rate appeared to hold steady, about three-point-three deaths a day, and only half of them on that shift."

Hurst rolled his eyes at the ceiling. "Will you listen to yourself? You sound like my stockbroker pitching nonexistent returns. Besides, it could be that patients are admitted at a later stage of the disease these days and therefore die sooner once they're here. Hell, it sounds like something you should applaud, a reduced length of stay and more efficient use of beds. You spearheaded that trend everywhere else in the hospital to keep ER from getting overcrowded. Why not in palliative care?"

Most doctors were comfortable with inevitable death, considering it as natural as life, but Earl had never heard one of his profession suggest it be celebrated as part of efficient bed use. The majority were aware enough of their own mortality not to be so callous. However, there were exceptions.

Paul Hurst, originally a general surgeon, had had his first heart attack in his mid-forties and had looked ashen ever since. That had been twenty years ago. At the time he stopped practicing medicine and assumed the post of VP, medical, having made the dubious calculation that hospital politics would be less stressful than the OR.

It hadn't worked out that way.

Earl had become his enemy a decade ago by exposing an accounting scandal Hurst had attempted to cover up. In the aftermath Hurst had tried to get Earl fired more than once, and failed.

But during the last few years, once Hurst had succeeded in getting what he'd been after all along, to be CEO of St. Paul's, a watchful state of quiet had existed between the two men. Not a truce exactly, but more an admission that Earl Garnet gave as good as he got- that had been the consensus of those who followed hospital power games the same way they did baseball.

Their pronouncement had given Earl no small amount of satisfaction.

"Sure, it could be later admissions," he conceded, picking up the New England Journal article and shoving it back at Hurst. "I just want to make sure we haven't got our own angel of death up there taking it on herself to ease their suffering."

The report had made national headlines in the mid-eighties. It appeared after a case in New York City where police charged a nurse with poisoning children on a pediatric ward with intravenous digoxin, yet a court of law found her innocent. A group of epidemiologists subsequently looked at several hospitals with clusters of unexplained cardiopulmonary arrests; their goal was to provide a tool that would prevent such wrongful accusations in the future or, in the case of actual foul play, more accurately pinpoint the culprit. For each of the institutions they examined, they plotted all such mysterious occurrences against the work schedule of the nurses who'd had access to the patients; in several instances they found a particular nurse who had been on duty when most of the deaths occurred. The results led to the successful prosecution of four serial killers, one of whom had been active in two states. Ever since, any unexplained rise in a hospital's mortality rate had administrators nervously eyeing their nursing rosters.

Hurst grabbed the article from him and tapped the opening paragraph with his gloved hand. Even enclosed in latex, his surgeon's fingers matched the rest of him- long and thin. "I suggest you take another look at the criteria for what you're insinuating." He peered over the top of stylishly small eyeglasses with wire frames and read, " 'Suspicions should be raised only when clusters of deaths and cardiopulmonary arrests occur that are either unexpected in timing or inconsistent with a patient's previous clinical course.'" He broke off and again threw the paper back on his massive mahogany desk. "You haven't shown any of that."

"I intend to check further."

"Oh, Jesus!" He reached up as if to rub his eyes, then, as if the sight of the gloves made him think otherwise, made a pyramid with his fingers in front of his mask.

Earl had watched this gesture at hundreds of meetings over the years, albeit without the protective gear. It usually preceded Hurst making a calculated move to undercut anyone who dared oppose him. He braced for what his longtime opponent would say next. As he waited, the incongruity of two men completely garbed in OR wear amid the luxurious setting of a wood-paneled room, inch-thick broadloom, and floral-covered antique chairs that any museum would die for made the moment surreal.

"You know, Earl," Hurst began, his voice uncharacteristically weary, "despite our former differences, I welcomed your appointment as VP, medical, even spoke on your behalf to the board."

A chill ran through Earl. When Hurst started to butter someone up, look out. "Yeah, right," he said with a sarcastic laugh, to serve notice he wouldn't be fooled.

"No, I'm serious. You care about this old place as much as I do. We just sometimes differ on what's best for it."

Really? That would be because you're a control freak who cares a little too much about St. Paul's and much too little about patients, Earl quipped to himself, keeping his mouth shut.

"And I couldn't think of a tougher team than you and me to get St. Paul's through this SARS mess. So what do you say we bury the hatchet and fight the real enemy together?" He stood, reached across the cluttered broad expanse of the desk, and held out his hand.

Earl hadn't expected the gesture. He looked at the waiting palm as if regarding a venomous snake.

"Come on, Earl. It's the right thing to do, and you know it. You're the most brilliant, hardheaded son of a bitch I ever went up against. There's no telling what we could accomplish by working together."

Earl made the shake, though tentatively.

"Now, about this business in Palliative Care. Let me ask you something: would you be so ready to investigate the place if you weren't the doctor involved in the Matthews case?"

Earl immediately went back on the defensive, feeling suckered. "Now wait a minute, this isn't about me trying to save my ass."

"Just give me an honest answer. That's all I ask. Would you press ahead, or wait and see what happens at death rounds?"

Earl hesitated, taken by the earnestness in Hurst's voice, yet not sure that the man wouldn't try to snooker him.

"Come on now. The evidence of clusters isn't that strong. And you know the effect that kind of inquiry would have on the nurses. Do you really want to distract them like that now, when the slightest lapse in the SARS protocol could be a death sentence?"

Earl hesitated, then reluctantly conceded that Hurst had a point. "No, I guess I'd wait."

"Good. Then I'll see you at death rounds. How's Janet doing, by the way? Planning to work until the last minute, same as last time?"

"She's fine," he replied, feeling as uneasy with the old man's new friendliness as he ever had with their previous snarling matches.

6:50 p.m.

The pathology lab occupied a cul-de-sac in the subbasement that had to be the oldest, most out-of-the-way part of the hospital. Though the facilities themselves had been renovated, the passageway leading to them hadn't. Residents called it "the tunnel." Even the lighting belonged to another era. Naked bulbs in green metal shades provided cones of yellow illumination at fifty-foot intervals while the spaces in between remained in relative darkness.

Janet Graceton hurried along the poorly lit corridor. The faint yet unmistakable aroma of decomposition emanated from the heavy wooden door to the morgue. She paid the scent little heed, being more aware, as always, of the plexus of pipes and cobwebs that ran the length of the ceiling not a foot above her head. She'd never seen the spiders that made their home up there, but more than once she'd wondered how they survived where no other insects flew or crawled. What did they eat? She refused to believe the lore handed down through generations of technicians- that scraps from the dissecting tables provided the necessary nutrition and that the resident arachnids had achieved the size of bread-and-butter plates. But inevitably, each time she walked through here on her way toward the pathology labs, scurrying noises from those darker recesses sounded all too close, and she picked up the pace.

Farther on, the autopsy suites stood empty with their doors open, the stainless-steel tables gleaming and ready for business. Here the pungent odors of chemical preservatives lingered in the air, easily breaching her mask. The sting that spread along the lining of her nose brought on a case of watery eyes.

Next were several large rooms lined with workbenches, their silver surfaces also spotlessly shiny. On them stood dozens of microscopes, stacks of flat, wide cases containing rows of glass slides, and innumerable racks loaded with bottles of reagents or stains in colors that rivaled those of Brendan's first-grade art class.

The people who used all these tools to make diseased tissues and cells yield up their secrets had long since left for the day.

She walked up to the door with Len Gardner's name on the opaque glass and knocked.

No answer.

She'd had a pass card to his premises for years, always needing to slip in after hours to pick up path reports. Using it now, Janet entered the anteroom where his secretary normally worked. She had also done what sensible folks did in the evening: gone home to her family. At least Janet presumed so, having delivered all three of the woman's children, two girls and a boy. Their pictures adorned an otherwise empty desk. The sight of them set off a pang for her own son, and for the ten millionth time she grappled with her anxiety over being an absent mother. From the beginning she'd refused to try to rationalize her guilt. The only explanation that mattered she owed to Brendan, and while words might comfort adults, the sole language that soothed his psyche involved the feel of her arms and the sound of her voice as she held him.

She crossed to the inner door and knocked again.

Still no answer.

She opened it a crack and peeked in. Not that she expected to find Len, but he'd promised to leave her a pathology report on one of her patients. The woman waited upstairs with her husband to know if her ovarian cancer had spread beyond what Janet had been able to remove.

Among the clutter of papers she saw an envelope with her name on it propped against a stack of files.

She ripped it open, scanned the contents, and knew that the woman would be dead in six months.

She walked back out to the deserted corridor and slumped against the wall.

Nothing loomed heavier than the task of saying, "I'm sorry, but the news is bad." She steeled herself, preparing to give the support required from her, yet dreaded the moment when, as soon as she walked in the room, the couple's last hopes would shatter against the look in her eye. She'd never learned to mask that dark gaze. It inevitably emerged when it came time to pass a death sentence.

Her unborn son stirred in her and delivered a sharp kick, a reminder of his presence, as if she'd needed any. By this time of day, her belly pulled so heavily on her that she felt it had doubled in weight and size. But such a cherished load to carry and a lifetime of working with thousands of other pregnant women didn't lessen the wonder of it any. She'd pretty well decided to take maternity leave much earlier this time. Why not? She could be with Brendan more, and when he came home from school they could make plans together for his new little brother. They'd also enjoy evenings and weekends uninterrupted like never before in his young life. Hell, why not give him that-

An odd popping noise and the tinkle of falling glass interrupted her thoughts. The sounds had come from the far end of the tunnel, near the elevators. As she looked along the islands of light, she realized that that section of the corridor had fallen into complete darkness.

Had a lightbulb blown down there?

She heard more glass break, but heavier, like that of a jar or bottle, and this smash had some force behind it.

What the hell?

She pushed off from where she'd been leaning. "Hello? Is somebody there?" She peered toward the distant murk but could see no one.

Yet a soft brushing shuffle no louder than a whisper echoed out of the darkness. Paper shoe covers on the floor? She couldn't be sure. "I said, is someone there?"

In the distance the door to a lit stairwell swung open and a silhouetted figure left the basement.

"Hey!"

The door closed behind, leaving her alone once more.

Somebody must have knocked something over in the dark, somebody who shouldn't have been down here in the first place, judging by their quick exit. No matter. She'd advise maintenance to clean up the broken glass before anyone got cut.

She started toward the elevators, hoping there'd be enough light to see her way once she got that far.

She'd walked well past the wooden door to the morgue, her mind focused on what she'd say to her patient, when she noticed a peculiar yet familiar odor that hadn't been there when she came in. Mildly irritating at first, it soon penetrated her nose and seared the back of her throat.

That's awful, she thought, and pressed her mask to her face, hoping to block out the fumes.

But the irritation continued, and her eyes began to burn.

She squinted into the darkness ahead, wondering if she could make the elevator. Probably. She couldn't see it directly, but the soft glow of the button looked to be about fifty feet away. Hold her breath and run for it, she decided.

After a few strides she immediately felt worse. What had that idiot spilled? She knew the storerooms down here contained no end of toxic liquids. The fluids that preserved organs and tissues in death were lethal to them in life, and any woman working down here who got pregnant went on immediate leave.

The button seemed to be only thirty feet away. Should she go back? She sprinted faster. Hell, ten seconds more and she could be out of here. All she had to do was hold her breath a bit longer.

As she ran, her free hand outstretched, she tried to remember where she'd smelled this before. It had a medicinal aroma, so strong she could practically taste it, and a cool, bitter sensation on her tongue. So familiar, yet-

Oh, my God!

Now she remembered it from her med school days- when they'd done basic lab experiments on white rats and anesthetized them with chloroform!

Jesus Christ, she thought, her head rapidly growing woozy. What felt like an ice cream headache began to set itself up in her temples.

She tried to stop and turn back but skidded, no longer finding any traction. At first she thought it must be the paper coverings on her shoes, but then noticed the floor glistening in the half-light, covered with fluid. At the same instant particles of glass crunched under her soles. She'd blundered into the middle of the spill.

Like a cartoon character trying to reverse direction, she ended up running on the spot; then, losing her balance, she fell heavily on her hands and knees. She cried out, and her lungs emptied, but she struggled not to breathe in. A stinging pain pierced her palms, and patterns of crimson spread under the latex of her gloves like petals. My hands! she thought, they being as precious to a surgeon as to a pianist. She instinctively flexed her fingers, verifying no tendons were cut, despite feeling about to faint more from trying to hold her breath than breathing in the anesthetic. The sparkling fragments that had sliced into her skin glittered up at her. She'd pull them out later.

Chloroform, like ether, had extreme volatility, vaporized rapidly, and practically poured into the bloodstream when inhaled into the lungs. Which meant if she didn't get out of this puddle, ground zero for the fumes, she'd be sleeping in it. And so would the baby.

She unsteadily got back on her feet, blood now dripping from the perforations in her gloves, and, in a wide stance as if walking on ice, began to teeter back toward the offices she'd just left.

Once there, the fumes wouldn't be too bad. She'd call for help on the phone. Just don't breathe in. Only a few seconds more.

She feared most for the baby. A single exposure to chloroform, if it reached high enough concentrations in his blood, could harm the kidneys and liver.

She felt a wave of nausea.

Oh, God, no. The stuff had definitely hit her circulation. That meant it would be in his.

The floor felt less slippery, and she started to run toward where it should be safe. But it surprised her at how concentrated the fumes still were as they continued to burn her eyes, the inside of her nose, the back of her throat. The guy must have dropped a gallon of the liquid.

Her vision began to dim.

No, she mustn't pass out.

She staggered.

She had to make the nearest door.

The heavy wooden monstrosity seemed to hang at the center of a black funnel. It had an electric lock, like all the doors in pathology. Would her card work?

She fished it out of her pocket, inserted it into the slot, and pulled the stainless-steel handle, which reminded her of the one on her mother's old refrigerator.

It opened.

Cold air flowed over her and she gasped it into her lungs.

The ubiquitous fumes that had followed her down the hall filled her chest as well, and she felt as if she'd inhaled fire.

Her head swam.

She managed a step forward, into the morgue, and marveled at her silver breath while she sank to her knees and slid into darkness.

But she could still hear.

A loud click sounded behind her.

Just like her mother's fridge door when it swung shut.

7:00 p.m.

Earl glanced at his watch and swore. He'd planned to be out of here a half hour ago. But when he returned from Hurst's office, a dozen files awaited him on his desk along with a note from Michael Popovitch.

Can you believe this shit? it had said.

And no, he could not.

In each case a resident had committed what could have been a major error- in all, five missed fractures, three unrecognized pneumonias, four failures to correctly interpret an abnormal electrocardiogram. Fortunately, Michael had caught them all in time.

July jitters. Earl signed off on the twelve incident reports. But in the morning he'd ask Thomas to set up appropriate teaching seminars and patch up the holes in the newcomers' knowledge base.

He reached for the phone and called home, expecting to hear a very impatient Janet wanting him there pronto.

The housekeeper said she hadn't heard from her.

Strange.

"Hi, Daddy," Brendan said when she put him on. "When are you going to be here?"

"Twenty minutes."

"Promise?"

"Promise."

Janet must have gotten stuck in the case room. He dialed the extension, knowing it by heart.

"Sorry, Dr. Garnet. She's not here. Haven't seen her in hours."

He called the operator.

"We've been paging her for the last twenty minutes, Dr. Garnet. One of her patients is expecting her up on the floor."

Very strange.

"Do you want us to have her call you if we reach her?" the operator asked.

"Yes, please."

Now where could she be?

He got up from his chair, stretched, and grabbed his briefcase. Maybe she'd already started to drive home, though he doubted she'd forget a patient.

Nevertheless, he dialed her cellular.

"The person you have dialed is unable to come to the phone-"

He hung up. The recording meant she still had it turned off and probably hadn't left the hospital yet.

Well, no point in them both hanging around here.

He switched the light off and left his office. God, his back and legs felt tired. The burden of being hot and cooped up in double layers of clothing all day while breathing stale air through a mask took its toll physically.

"Any sign of Michael?" he asked, poking his head into the nursing station on his way out. He wanted to thank his astute friend for saving the day twelve times over.

No one had seen him for about an hour.

"Christ, everyone's doing a disappearing act," he muttered.

Earl found him in his office, scowling over what, from a distance, looked like a death certificate. "Hey, Michael, go home. Enough paperwork. Your wife and son are far more important." Donna, a fun lady five years older than he, and Terry, a dynamo kid six months younger than Brendan, were the anchor to this man who could be so obsessed with work. He doted on both of them.

Michael's eyes creased at the corners, the effect of what must have been an attempt to smile, but his morose gaze made a liar out of it. He also not very subtly slid his arm over the top of the paper he'd been filling out.

"Are you okay, Michael?"

"Sure. What's up?"

"You don't look okay."

"Nothing a little more sleep won't cure."

He sounded as convincing as one of their street junkie regulars promising to go straight.

Earl studied him. Michael had steadfastly denied anything was wrong, no matter how often Earl asked. Whatever had been getting him down lately, Michael either kept it to himself or blamed it on the additional stress of the SARS epidemic. Which of course it could be. Except Earl knew his friend would rather have a root canal than admit to a personal problem. Like most doctors, while inviting everyone to bring him their sick and needy, he viewed asking for help as his own defeat.

"Christ, Michael, will you cut the crap and tell me what's wrong?"

"What are you talking about?"

"Oh, Jesus."

"Jesus?"

"Goddamn it, you are one stubborn idiot. Oh, and by the way, thanks for saving the department from the first-year residents, for about the millionth time."

Michael's eyes creased at the corners again, a bit more convincingly this time, and a chuckle rumbled out of his barrel chest. "You're welcome."

"But like they say in the song, 'You got to tell somebody.'"

Michael picked up a book and threatened to throw it at him.

"Okay, okay!" Earl closed the door and hurried out the triage entrance. What could be wrong with Michael? Had he reached his limit to seeing human beings reduced to flesh, blood, and a wet mess? That tipping point crept up on all doctors who worked the pit, one case at a time. Earl had counseled enough former colleagues through it to know. But burnout victims possessed a haunted look, as if they couldn't shut out the images of what they'd witnessed and were consumed by them. Michael had something else, a wariness about him, a watchfulness, as if on the lookout for something. And why would he conceal what he'd been writing on a death certificate?

At the exit Earl peeled off his protective gear, dumped it in the disposal bin, and stepped outside, where a cool summer breeze carried the fresh scent of open water from Lake Erie. The usual release of having shed pounds of sweaty clothing flooded through him. It felt as if he'd burst free of a dead skin.

He wheeled his car out of the lot and saw Janet's green Mazda convertible, a vintage 1990 model that she drove during the summer, still resting in its spot. A surge of disappointment destroyed his brief euphoria. Not for the first time he raged against the tyranny of obstetrics, but, long resigned to it and determined that Brendan would have at least one parent to tuck him in tonight, he sped toward home.

The cold woke her.

She forced herself to blink, but the absolute darkness remained.

She fought to crawl out of the sleep that still had a hold on her.

No change. Everything remained as black as if her eyelids were clamped shut.

Except they felt open. She also became aware that her head ached, and an acrid burning at the back of her throat made her want to gag.

The chloroform!

Plus something else.

Smells flooded through her head, and she remembered.

She leapt to her feet, swayed heavily, and immediately regretted the sudden move. Reaching into the darkness, hoping to find a place to lean on, her left hand landed on the wooden contours of an open mouth, nose, and cheeks, easily recognizable to the touch under the crinkling plastic of a body bag.

"Shit!" she yelled, but held on to the face to stop from tumbling into something worse.

The spiraling in her head settled, and she turned toward the corpse, intending to feel her way along the shelf it rested on until she reached the door.

How long had she been in here? And why did the stench of chloroform remain so strong? It seemed to be making her woozy afresh, yet the morgue door should have kept much of it out-

The fall!

She'd soaked her protective clothing in the stuff. The cooler temperature in here must have slowed the evaporation enough that there weren't the fumes to keep her unconscious, but she'd have to strip and shower, wash the volatile fluid off her entirely, or the baby might-

The urgency of getting out overwhelmed her.

Bodies be damned. She palpated herself past the top of what felt like a skull with its crown cut open, crossed over a gap, found a pair of feet, and worked up the legs. The torso, neck, and head led her to another pair of feet.

She stopped.

It couldn't be this far to the door. She must have headed deeper into the locker. Muttering more curses and trying to take shallow breaths, she reversed course and worked her way back over the dubious landmarks.

In seconds she reached a wall.

A step left and she felt the door frame. A second later she found the handle and pressed down.

It didn't budge.

Shit!

She tried again.

Nothing.

How could it be locked?

She threw all her weight behind it.

Same result.

This can't be happening, she told herself, trying to remain calm, growing colder by the second, and the contents of her skull once more looping through sickening swirls of an anesthetic haze. Any meat locker she'd ever been in had a round metal disc that released the door, to prevent anyone from being trapped inside. Surely it couldn't be different here. But feeling around, she found no metal disc or any other escape mechanism.

She stood back and forced herself to settle down, trying to think clearly. Hard to do with a mind still half sodden in chloroform. First she had to get rid of the fumes. And find a light.

More waves of nausea swept up to the base of her tongue.

Take care of the fumes first.

She shed her outer gown, blouse, and skirt, throwing them toward the inner recesses of the long, narrow room, figuring the farther away the better. Finding her underclothing to be dry, she quickly pulled her slip over her shoulders and balled it up over her mask, instantly cutting the noxious scent in half.

Now for light.

With her free hand she rapidly patted down the walls where the switch ought to be, but found nothing.

Must be just missing it, she thought, and, dropping her slip, used two hands, methodically sliding them over the surface, checking a square foot at a time.

But immediately the fumes in that closed space began to work on her nose, eyes, and head again.

Time to get rid of that chloroform wick once and for all. Bunching up her slip as before, she went down on her hands and knees and felt her way along the floor toward the rear of the chamber until she came to her discarded clothing. She then stood up, reached sideways to where she figured the nearest body lay, and inched toward it, her hand outstretched.

Her fingers brushed against the plastic cover and made a rustling sound. She pressed down and felt the telltale struts of a rib cage against her palm. She palpated her way toward the head, past the jagged ends of bones where the sternum had been sawed out, and found the tab of the zipper for the body bag. Pulling it open, she released a swell of the sickeningly sweet decay that, until now, had been but a lingering background odor. The legacy of all the sugar in a body's juices, she thought, trying to objectify the odor by breaking down the science of it, a mind game she sometimes used in the case room to lessen the impact of any foul stench. She also swallowed a lot, her usual technique to keep from throwing up, and stuffed the soaked clothing inside. "Sorry," she said to her unwitting host before yanking the tab closed. It sounded like shutting the front flap on Brendan's play tent.

By the time she worked her way back to the door, she could breathe without using her slip as a filter, and she resumed her search for the switch.

She'd almost given up hope when her hand slid over a flat, slightly raised rectangle. But it had no protruding toggle, which is why she must have passed over it initially. "Please work," she muttered, and pressed it with her fingers. It pivoted slightly, and light flooded the room.

The racks of glistening gray forms in semiopaque body bags, their features partly visible, almost made her prefer the darkness.

No time to be squeamish, she told herself, and returned to the door, searching for some kind of release mechanism.

She saw it in an instant. Not the disc she'd been looking for. Another electronic lock with a slot for her card.

The card she'd left in the outside slot.

The first real flickers of panic began to stir in the pit of her stomach.

If a card is forgotten in a lock at St. Paul's, the security system deactivates the magnetic strip after a few minutes and seals the mechanism to ensure that no unauthorized person who happens on the scene can get in or acquire a functioning key.

The frigid air grew clammy, and a pressure built inside the center of her chest, expanding outward until she thought it would burst.

She couldn't end up stuck here. Not her. Not Dr. Janet Graceton, thirty-five weeks pregnant. No way she'd end up freezing to death in the goddamn morgue of her own hospital.

Yet unless she came up with something soon, that's exactly where things were headed.

She started to shiver.

A phone! Check for a phone. She'd left her cellular in her car, as always, but maybe they had a wall unit somewhere behind one of these racks, for people stupid enough to get locked in.

A quick search found none.

But at the back of the room she spotted what looked like a thermostat. If she jacked up the temperature, would an alarm sound somewhere? On closer inspection, the device seemed only to monitor the degrees, and she could see no way to reset it. Still, somewhere, there might be an alert should the room get too warm.

Whipping off her mask, she used it along with her slip to create an insulated nest around the device. Then, cupping her hands to her mouth, she blew into it. The digital readout jumped ten degrees.

She kept blowing, watching the numbers bounce up and down with each breath, until she felt light-headed again, this time from hyperventilating. As for being out of her mask, she doubted anyone in here would sneeze or cough on her anytime soon.

She frantically continued to exhale, determined to succeed, driven more to save her unborn son than herself.

Her pale swollen abdomen, in which he lay, glistened with moisture in the cold.

And her fury built at the idiot who did this to her… to him.

"That asshole knew," she kept saying, muttering aloud to keep her teeth from chattering. "Heard me yell, yet just ran off. If I get out of here, so help me, whoever it is will pay."

7:45 p.m.

Susanne Roberts met Earl at the ambulance entrance to ER, handing him a full set of protective clothing. "Mrs. Quint and I s me I led the fumes as we were coming down the elevator from a nursing department meeting. She said it reminded her of ether, from the old days, when she'd worked summers in her hometown hospital as a candy striper."

"And you're sure Janet's okay?" he asked, hurriedly pulling on the surgical wear.

"Apart from being as furious as I've ever seen her. She insists whoever dropped the jar deliberately left her down there."

His innards, already knotted, yanked themselves tighter.

"She did sustain some superficial cuts on her palms, though the trail of blood she left and the handprint on the morgue door probably saved her life…"

He pulled on gloves and rushed through the triage area, tying his mask as Susanne continued to explain. He'd gotten her phone call about ten minutes after arriving home. The return trip had taken seven, plus a ten-second tirade at the cop who'd pulled him over, then provided an escort the rest of the way, siren blazing.

He heard Janet the second they entered the inner doors.

"I'm fine, damn it!"

He arrived in a resuscitation room full of people, at the center of which his wife sat on a stretcher, arms defiantly crossed, eyes flashing over the top of her mask, and raising holy hell when anyone tried to touch her.

He relaxed a notch and took in the rest of the scene.

Susanne must have paged everyone she could think of. The inner circle clustered around Janet included an anesthetist and three staff obstetricians, one of them packing up a portable Doppler machine. Outside this group stood Stewart Deloram and Michael. Next was a ring of residents, all offering to draw blood or run batteries of tests, their usual response when they hadn't a clue what to do. To his credit, Thomas stood quietly behind this bunch and attempted to rein in their well-meant enthusiasm. Even Paul Hurst had showed up. He hovered nearby, his gloved fingers held in a pyramid tapping nervously against his mask. Probably afraid of bad publicity, Earl thought, pushing through the crowd.

She saw him. "Earl! Thank God. Now tell these people to let me out of here."

"Of course," he said, grabbing her outstretched hand. "As soon as the doctors looking after you say it's okay."

Immediately the residents fell silent, his authority over them well established. Looks of relief swept through the eyes of her colleagues. Michael gave him a wink, and the anesthetist's shoulders relaxed. At last, they all seemed to say, an adult to take charge. Even Stewart approved, giving a covert thumbs-up signal.

But not Janet. "What are you talking about, Earl Garnet? The Doppler's fine, and I am not staying in this place another second. Now you just tell everyone that we're going home."

"Michael's the doctor in charge, love." He spoke as firmly as he dared, knowing the real reason she sounded so unreasonable. He could always tell when something really scared her, because she started issuing instructions, as if through them she could regain control of a world that frightened her. Threaten her child, and she'd damn well order a whole hospital of doctors to obey her bidding. "Then we'll go, I promise," he added. To further reassure her, he interlaced his latex-covered fingers in hers and squeezed gently, mindful of her cuts.

She glared at him defiantly.

He smiled, knowing she couldn't see it, but hoping his eyes would transmit the message. "Hey, I'm not leaving here without you, trust me," he whispered, leaning closer and touching his forehead to hers.

The darkness in Janet's eyes softened. "All right, I'll be good," she said, her voice a notch lower, but still at a strained pitch.

"Attagirl, Janet," he heard Michael say, and his portly friend stepped up beside her, eyes clearly indicative of a smile. "I'd say you're probably right that there's nothing wrong," he continued, not making the mistake of talking to Earl as if she weren't in the room. His voice resonated with the warmth and encouragement he usually gave to people under his care. Nor was there so much as a trace of the forlornness in his eyes that Earl had seen earlier. "You would have been unconscious a lot longer if your passing out had been the result of chloroform. So I think we can safely conclude you fainted, the consequence of a vasovagal response due to holding your breath."

He referred to how refusing to breathe can slow the heart rate, causing both the blood pressure and the breath holder to drop like a rock.

"Exactly, Michael," she said, "so let me out of here."

"Okay, but why not let me draw one blood test, just to document no significant chloroform levels?"

She studied him. "But won't it have worn off?"

"If there's not even a trace, then you had no significant exposure. If we do pick up a level, however low, we know approximately what time you inhaled it, and can calculate an estimate of what must have been the maximum concentration in your circulation. Either way, it's more reassuring to know, right?"

Only if it's good news, Earl thought. Still, Michael had a point.

Janet seemed to consider his equation as well. "Okay, but just that one test." She scanned her audience of residents. "And no offense, but you lot are a little too eager with the needles. I'd like Michael to do the honors." She held out her arm like a princess expecting a kiss on the hand.

The corners of his eyes corrugated into even deeper smile lines, and he reached for a tourniquet. "Is everyone agreed that's all we do?" he asked, eyeing the anesthetist and the trio of obstetricians.

They all nodded.

Good old Michael, thorough as always, with just the right touch to get everyone to do his bidding.

"But wait," Stewart said. "She could have liver or renal damage, or both, and there's no telling about the fetus-"

"I'm sure that won't be a factor if there's no significant blood levels of chloroform," Earl said. Then he curtly took Stewart by the elbow and led him away from the stretcher. "What the hell's the matter with you?" Earl whispered once they were out of range for her to hear. He felt furious at the man for his insensitivity. "We all know the risks, especially Janet. She's already worried shitless without you spelling out worst-case scenarios. Are you trying to frighten her to death?"

Stewart's eyebrows shot toward his frizzy black hairline, which no cap in the world was apparently able to contain. His stare grew incredulous, as if he truly didn't understand the fuss. "Hey, no need to take my head off. I'm just trying to be helpful, for fuck's sake." He jerked his arm away from Earl's grip and strode out of the room.

Earl resisted the urge to run after him, not sure he wouldn't throttle the jerk for being so clueless and definitely in no mood to initiate the placating that might avoid a lifetime grudge. It was pointless either way, he decided, fed up with Stewart's petulance at the moment. Besides, nothing could sway that stubborn temperament until it cooled off. He'd deal with Stewart tomorrow. Maybe by then he could also get a clearer story about the business with Wyatt's patients.

"Can I have a word with you, Earl?" Hurst said as he glided up beside him, took his elbow, and led the way to a back corner. The glassy smoothness of the CEO's tone chilled the air. "This insistence of Janet's that whoever dropped the bottle of chloroform knowingly left her in danger," he began, facing away from her. "Can you not persuade her to consider the event only an accident? You and I already agree, everyone is scared enough of SARS. We don't want rumors there may be someone running around maliciously endangering the lives of-"

"My wife is the most cool-headed, most fearless, and least hysterical person I know," Earl interrupted, his tone low and cold, his temper, already primed by Stewart, nearing a boil. He leaned closer to Hurst's ear. "If she says someone knowingly left her in danger, then that's what we're dealing with, understand? That means there won't be any sweep-it-under-the-rug cover-up. What's more, if I find the creep, neither you nor the rest of the staff will need to worry about that person doing more harm anytime soon."

Hurst arched a gray eyebrow at him. "Really, Earl, I would have expected a more balanced, mature response. I suggest you need practice in learning to see the big picture."

Earl switched to Hurst's other ear, as if performing an unconsummated French greeting. "Paul, let's just say I feel about someone trying to hurt Janet the way you do about someone trying to hurt this hospital."

Hurst staggered back a step. "I see," he said, and creased his forehead. "Yes, of course you would-"

"Janet!" Len Gardner barged into the room, one of the strings of his mask trailing out behind him, the whole thing threatening to come undone. "What's this I hear about someone trying to chloroform you near the morgue?"

Hurst visibly stiffened but didn't turn around, remaining outwardly calm with his hands clasped behind his back, the way a host might carry himself upon hearing guests becoming unruly at a cocktail party.

Earl brusquely signaled the pathologist to fasten the ties properly. Goddamn it, he of all people should know better.

"Len," Janet answered. "Just the man I wanted to question. What have you got chloroform down there for, anyway? And who the hell would be carrying a jug of the stuff around?"

"That's what is so weird." Len's authoritative voice began to hush surrounding conversations and command everyone's attention. "We hardly use the stuff anymore, just to make Carnoy's solution to speed up tissue fixation. Even then, no one would ever need the whole jar."

He and Janet continued to speculate about the bizarre sequence of events, all to the rapt attention of the three main gossip groups in St. Paul's: residents, nurses, and doctors.

"You see," Hurst said, pupils boring into Earl's, "this kind of sensationalism won't come to any good." He shook his head in a show of sad disapproval, as if he held Earl personally responsible for the conversation unfolding behind him, and turned to leave.

Only then could Earl see that the long fingers of the surgeon's right hand had curled into a fist.

Tuesday, July 8, 2:30 a.m. Palliative Care, St. Paul's Hospital

Sadie Locke started and sat up.

"Father Jimmy?"

She'd been lying with her eyes closed, waiting for his visit, when she heard the rustle of clothing.

No answer.

A shadow by her door moved.

"Sorry, wrong room," whispered a voice.

The shape retreated to the hallway.