Cook Robin

Harmful Intent

Robin Cook - Harmful Intent

ACKNOWLEDGMENTS

As with all my projects, I have benefited significantly from the experience and expertise of friends, colleagues, and friends of friends for the writing of Harmful Intent. Since the story bridges two professions, it is understandable that professionals have been the primary source. Those whom I would particularly like to acknowledge are:

Physicians.- Tom Cook Chuck Karpas Stan Kessler

Attorneys.- Joe Cox Victoria Ho Leslie McClellan

Judge.- Tom Trettis

School-based therapist. Jean Reeds

All of them generously donated many hours of their valuable time.

Once again for Audrey Cook, my wonderful mother

"The first thing we do, let's kill all the lawyers." -Henry VI, Part II

PROLOGUE

SEPTEMBER 9, 1988

11:45 A.M.

BOSTON, MASSACHUSETTS

From the first twinges of cramps that began around nine-thirty that morning, Patty Owen was sure that this was it. She had been worried that when the time came she wouldn't be able to distinguish between the contractions that signaled the onset of labor and the little kicks and general discomfort of the final trimester of her pregnancy. But her apprehension proved groundless; the twisting and grinding pain she was experiencing was entirely different from anything she had ever felt. It was familiar only in the sense that it was so classically textbook in its nature and regularity. Every twenty minutes, like clockwork, Patty felt a steady stab of pain in her lower back. In the intervals between, the pain vanished only to flare again.

Despite the increasingly acute agony she was only beginning to endure, Patty couldn't repress a fleeting smile. She knew little Mark was on his way into the world.

Trying to remain calm, Patty searched through the scattered papers on the planning desk in the kitchen for the phone number of the hotel that Clark had given her the day before. He would have preferred to have skipped this business trip since Patty was so close to term, but the bank hadn't given him much choice. His boss had insisted that he follow through with the final round of negotiations that would close a deal he'd been working on for three months. As a compromise, the two men had agreed that no matter the state of the negotiations, Clark would be gone for only two days. He'd still hated to leave, but at least he'd be back a full week before Patty was due to deliver...

Patty found the hotel's number. She dialed and was put through to Clark's room by a friendly hotel operator. When he didn't pick up by the second ring, Patty knew Clark had already left for his meeting. Just to be sure, she let it ring five more times

in hopes that Clark was in the shower and would suddenly answer, out of breath. She was desperate to hear his reassuring voice.

While the phone rang, Patty shook her head, fighting back tears. For as happy as she'd been to be pregnant this, her first time, she had been troubled by a vague premonition from the start that something bad would happen. When Clark had come home with the news that he had to go out of town at such a critical juncture, Patty had seen her sense of foreboding confirmed. After all the Lamaze classes and exercises they'd done together, she would have to tough it out alone. Clark had assured her she was overly concerned, which was natural, and that he'd be back in plenty of time for the delivery.

The hotel operator came back on the line and asked if Patty wanted to leave a message. Patty told her that she wanted her husband to call her as soon as possible. She left the number for Boston Memorial Hospital. She knew that such a terse message was bound to upset Clark, but it served him right for going away at a time like this.

Next, Patty called Dr. Ralph Simarian's office. The doctor's booming, high-spirited voice momentarily quelled her fears. He told her to have

Clark take her over to the BM, as he humorously referred to the Boston

Memorial, and get her admitted. He'd see them there in a couple of hours.

He told her that twenty-minute intervals meant she had a lot of time.

"Dr. Simarian?" Patty said as the doctor was about to disconnect. "Clark is out of town on a business trip. I'll be coming in by myself."

"Great timing!" Dr. Simarian said with a laugh. "Just like a male. They like to have the fun, then disappear when there's a little work to be done."

"He thought there was another week," Patty explained, feeling like she had to defend Clark. She could be irritated at him but no one else could.

"Just joking," Dr. Simarian said. "I'm sure he will be crushed not to be involved. When he comes back, we'll have a little surprise for him. Now don't be a bit alarmed. Everything's going to be okay. Do you have a way of getting to the hospital?"

Patty said she had a neighbor who had agreed to drive her in case there were any surprises while Clark was away.

"Dr. Simarian," Patty added, hesitantly, "with my Lamaze partner gone, I think I really am too nervous to go through this.

I don't want to do anything to hurt the baby, but if you think I could be anesthetized the way we discussed..."

"No problem," Dr. Simarian said, without letting her finish. "Don't you worry your pretty little head about these details. I'll handle everything.

I'm going to call over there right this minute and tell them that you want the epidural, okay?"

Patty thanked Dr. Simarian and hung up the phone just in time to bite her lip as she felt the beginnings of another contraction.

There was no reason to worry, she told herself sternly. She still had plenty of time to make it to the hospital. Dr. Simarian had everything in hand. She knew her baby was healthy. She had insisted on ultrasound and amniocentesis, even though Dr. Simarian had advised it was unnecessary since Patty was only twenty-four years old. But between her ominous premonition and genuine concern, Patty's determination carried the day. The results of the tests were extremely encouraging: the child she was carrying was a healthy, normal boy. Within a week of receiving the results, Patty and Clark were painting the baby's room blue and deciding on names, ultimately settling on Mark.

All in all, there was no reason to expect anything but a normal delivery and a normal birth.

As Patty turned, intending to retrieve her packed overnight bag from the bedroom closet, she noticed the dramatic change in weather outside. The bright September sunlight which had been streaming through the bay window had been eclipsed by a dark cloud that had blown in suddenly from the west, plunging the family room into near darkness. A distant rumble of thunder sent a shiver down Patty's spine.

Not superstitious by nature, Patty refused to take this storm as an omen.

She edged over to the family room couch and sat down. She thought she'd call her neighbor as soon as this contraction was over. That way they'd almost be at the hospital by the time the next one began.

As the pain reached a crescendo, the confidence that Dr. Simarian had engendered disappeared. Anxiety swept through Patty's mind just as a sudden gust of wind raked across the backyard, bending the birches, and bringing the first droplets of rain. Patty shuddered. She wished it were all over.

She might not be superstitious, but she was frightened. All the timing-this storm, Clark's business trip, her going into labor a week earlyseemed off.

Tears rolled down Patty's cheeks as she waited to phone her neighbor. She only wished she weren't so afraid.

"Oh, wonderful," Dr. Jeffrey Rhodes said sarcastically as he glanced up at the main anesthesia scheduling board in the anesthesia office. A new case had appeared: Patty Owen, a delivery with a specific request for an epidural. Jeffrey shook his head, knowing full well that he was the only anesthesiologist currently available. Everyone else on the day shift was tied up on a case. Jeffrey called the delivery area to check on the patient's status and was told there wasn't any rush since the woman hadn't arrived from admitting yet.

"Any complications I should know about?" Jeffrey asked, almost afraid to hear. Things hadn't been going well for him on this particular day.

"Looks routine," the nurse said. "Primipara. Twenty-four. Healthy."

"Who's the attending?"

"Simarian," the nurse replied.

Jeffrey said he'd be over shortly and hung up the phone. Simarian, Jeffrey pondered, thinking it a wash. The guy was technically fine but Jeffrey found his patronizing manner toward patients a bit trying. Thank God it wasn't Braxton or Hicks. He wanted the case to go smoothly and hopefully quickly; if it had been either of the others, that wouldn't have been the case.

Leaving the anesthesia office, he headed down the main OR corridor, passing the scheduling desk and its attendant bustle of activity. The evening shift was due in a few minutes; the changing of the guard inevitably spelled momentary chaos.

Jeffrey pushed through the double swing doors of the surgical lounge and yanked off the mask which hung limply on his chest, dangling by its elastic. He tossed it into the waste receptacle with relief, he'd been breathing through the blasted thing for the last six hours.

The lounge was abuzz with staff members coming on shift. Jeffrey ignored them and passed through to the locker room, which was just as crowded. He paused in front of the mirror, curious to see if he looked as bad as he felt. He did. His eyes seemed to have receded, they appeared so sunken.

Below each was a dark indelible crescent-shaped smudge. Even Jeffrey's mustache seemed the worse for wear and tear, though what could he expect after having kept it under the wraps of the surgi-. cal mask for six solid hours.

Like most doctors resisting the chronic'hypochondriasis induced by medical school, Jeffrey often erred at the other ex-

treme: he denied or ignored every symptom of illness or sign of fatigue, until it threatened to overwhelm him. Today was no exception. From the moment he'd awakened that morning at six, he'd felt terrible. Although he'd been feeling run down for days, he first ascribed the light-headedness and chills to something he'd eaten the night before. When the waves of nausea came midmorning, Jeffrey was quick to attribute it to too much coffee. And when the headache and the diarrhea started in the early afternoon, he pinned it on the soup he'd had for lunch in the hospital cafeteria.

Only as he confronted his haggard reflection in the miffor of the surgical locker room did Jeffrey finally admit he was ill. He was probably coming down with the flu that had been going around the hospital for the last month. He put the flat of his wrist to his forehead for a rough check of his temperature. There was no doubt about it: it was hot.

Leaving the sink, Jeffrey went to his locker, grateful that the day was almost over. The idea of bed was the most appealing vision he could conjure.

Jeffrey sat on the bench, oblivious to the chatting crowd, and began to twirl his combination lock. He felt worse than ever. His stomach gurgled unpleasantly; his intestines were in agony. A passing cramp brought beads of perspiration to his brow. Unless someone could relieve him, he'd'still be on duty for another few hours.

Stopping at the final number, Jeffrey opened his locker. Reaching within the neatly arranged interior, he retrieved a bottle of paregoric, an old remedy his mother used to force on him when he was a child. His mother had consistently diagnosed him as suffering from either constipation or diarrhea. It wasn't until he got to high school that Jeffrey realized these diagnoses were just excuses to get him to take his mother's cherished cure-all. Over the years, Jeffrey had developed a confidence in paregoric, if not in his mother's diagnostic skills. He always kept a bottle on hand.

Unscrewing the cap, he tilted his head back and took a healthy swig. Wiping his mouth, he noticed an orderly sitting next to him watching his every move.

.'Want a swig?" Jeffrey asked, grinning, extending the bottle toward the man. "Great stuff."

The man gave him a disgusted look and got up and left.

Jeffrey shook his head at the man's lack of a sense of humor. From his reaction you'd have thought he'd offered him poison.

With uncharacteristic slowness, Jeffrey took off his scrubs. Briefly massaging his temples, he then pushed himself to his feet and went in to shower. After sudsing and rinsing, he stood under the rushing water five minutes before stepping out and drying himself briskly. Brushing his wavy, sandy-brown hair, Jeffrey dressed in clean scrubs, donned a new mask and a new hat. He felt considerably better now. Except for an occasional gurgle, even his colon seemed to be cooperating-at least for the moment.

Jeffrey retraced his steps through the surgical lounge and down the OR corridor and pushed through the connecting door that led to the delivery area. The decor there was a welcome antidote to the stark utilitarian tile of the OR. The individual delivery rooms may have been as sterile, but the delivery area and labor rooms were painted in pastels, with framed

Impressionist prints on the walls. The windows even had curtains. The feeling was more like a hotel than a major urban hospital.

Jeffrey went to the main desk and inquired about his patient.

"Patty Owen is in fifteen," a tall, handsome black woman said. Her name was

Monica Carver, and she was the nursing supervisor for the evening shift.

Jeffrey leaned over the desk, thankful for the momentary rest. "How's she doing?" he asked.

"Just fine," Monica said. "But it's going to be awhile. Her contractions aren't strong or frequent, and she's only dilated four centimeters."

Jeffrey nodded. He would have preferred to have things further along. It was standard practice to wait until the patient had dilated six centimeters to put in an epidural. Monica handed Jeffrey Patty's chart. He went through it quickly. There wasn't much there. The woman was obviously healthy. At least that was good.

"I'll have a chat with her," Jeffrey said, "then I'll be back in the OR. If something changes, give me a page."

"Sure thing," Monica said cheerfully.

Jeffrey started down toward room fifteen. About halfway down the hall he got another intestinal cramp. He had to stop and lean against the wall until it passed. What a nuisance, he thought. When he felt well enough, he continued to room fifteen and knocked. A pleasant voice told him to come in.

"I'm Dr. Jeffrey Rhodes," Jeffrey said, extending his hand. "I'll be your anesthesiologist."

Patty Owen grasped his outstretched hand. Her palm was

damp, her fingers cold. She appeared considerably younger than twenty-four.

Her hair was blond and her wide eyes looked like those of a vulnerable child. Jeffrey could tell the woman was frightened.

"Am I glad to see you!" Patty said, not willing to let go of Jeffrey's hand immediately. "I want to tell you straight off that I'm a coward. I'm really not very good with pain."

"I'm sure we can help you," Jeffrey said reassuringly.

"I want an epidural," Patty said. "My doctor said I could have it."

"I understand," Jeffrey said, "and have it you will. Everything is going to be fine. We have a lot of deliveries here at the Boston Memorial. We'll take good care of you and after all is said and done, you'll wonder why you were so apprehensive in the first place."

"Really?" Patty asked.

"If we didn't have so many happy customers, do you think so many women would be coming back a second, a third, or even fourth time?"

Patty smiled wanly.

Jeffrey spent another quarter hour with her, questioning her about her health and allergies. He sympathized with her when she told him her husband was out of town on a business trip. Her familiarity with epidural anesthesia surprised him. She confided that not only had she read about it, her sister had had it for her two deliveries. Jeffrey explained why he wouldn't be giving her the epidural immediately. When he told her that she could get some Demerol in the meantime if she wanted it, Patty relaxed.

Before leaving her, Jeffrey reminded her that any drugs she got, the baby got. Then he told her again there was no reason to worry; she was in good hands.

Coming out of Patty's labor room and suffering through another intestinal cramp, Jeffrey realized he would have to take more drastic steps against his own symptoms if he was to get through Patty's delivery. Despite the paregoric, he was feeling progressively worse.

Passing back through the connecting doors to the OR suite, Jeffrey returned to the anesthesia alcove next to the OR, where he'd spent most of the day.

The room was empty and probably wouldn't be used again until the following morning.

Glancing up and down the OR corridor to make sure the coast was clear,

Jeffrey pulled the drape closed. Although bed finally

acknowledged being sick, he wasn't about to admit it to anyone else.

From the drawer of his Narcomed III anesthesia machine, Jeffrey got out a small-gauge intravenous scalp needle and an infusion setup. He pulled a bottle of Ringer's Lactate IV fluid down from the shelf and snapped off the cover over the rubber port. With a decisive shove, he pushed the IV tubing into the bottle and hung the bottle up on the IV stand over the anesthesia machine. He ran fluid through the tubing until it was free of air bubbles, then he closed the plastic stopcock.

Jeffrey had only started IVs on himself a couple of times, but he was practiced enough in the procedure to be adept. Using his teeth to hold one end of the tourniquet, he secured it around his bicep and watched as his veins began to distend.

What Jeffrey had in mind was a trick that he'd learned as a resident. Back then, he and his colleagues, especially the surgical residents, refused to take any sick time for fear they'd lose the competitive edge. If they got the flu or symptoms like the ones Jeffrey was now experiencing, they would simply take time out to run in a liter of IV fluid. The results were almost guaranteed, suggesting most flu symptoms were due to dehydration. With a liter of Ringer's Lactate coursing through your veins, it was hard not to feel better. It had been ages since Jeffrey had last resorted to an IV. He only hoped the efficacy would be as strong as it had been when he'd been a resident. Now forty-two, he found it hard to believe that last time he had been almost twenty years younger.

Jeffrey was about to push the needle in when the curtain to the alcove was pulled aside. Jeffrey looked up into the surprised face of Regina Vinson, one of the evening nurses.

"Oh!" Regina exclaimed. "Excuse me."

"No problem," Jeffrey started to say, but Regina was gone as quickly as she had appeared. As long as she'd inadvertently caught him in the act, Jeffrey had half a mind to ask her to lend a hand by attaching the IV to the scalp needle once he got it into the vein. Reaching out, he pulled back the curtain in hopes of catching her, but Regina was already far down the crowded hall. He let the curtain fall back into place. He was just as well off without her.

Once the IV tubing was attached, he opened the stopcock. Almost at once he felt the cool sensation of the fluid as it flowed rapidly into the arm. By the time most of the bottle had run in, Jeffrey's upper arm was cool to the touch. After he pulled out

the IV needle, he put an alcohol swab over the site and bent his elbow to hold it in place. He disposed of the IV paraphernalia in the wastebasket, then stood up. He waited for a moment to see how he felt. The light-headedness and headache were totally gone. So was the nausea. Pleased with the speedy results, Jeffrey pulled open the curtain and headed back to the locker room. Only his colon still troubled him.

The evening shift had now taken over and the day shift was in the process of leaving. The locker room was full of cheerful people. Most of the showers were occupied. First Jeffrey used the toilet. Then he got out his paregoric and took another hefty swig. He shuddered at the taste and wondered what made it so bitter. He tossed the now empty bottle into the wastebasket. Then he took a second shower and put on another set of clean scrub clothes.

When he walked out into the surgical lounge he almost felt human. He intended to sit down for a half hour or so and read the paper but before he had a chance his beeper went off. He recognized the number. It was delivery.

"Mrs. Owen is asking for you," Monica Carver told him when he phoned.

"How is she doing?" Jeffrey asked.

"Just fine," Monica said. "She's a little apprehensive, but she hasn't even asked for analgesia even though her contractions are now coming frequently.

She's somewhere between five and six centimeters."

"Perfect," Jeffrey said. He was pleased. "I'll be right over."

En route to the delivery area, Jeffrey stopped at the anesthesia office to glance at the big board to see about the evening assignments. As he expected, everyone was busy with ongoing cases. He took a piece of chalk and wrote that whenever someone was free he or she should come over to delivery and relieve him.

When Jeffrey arrived in labor room fifteen, Patty was in the middle of a contraction. An experienced LPN was with her and the two women were functioning like a practiced team. Beads of sweat dotted Patty's brow. Her eyes were shut tightly, and she was gripping the nurse's hands with both of hers. Strapped to her abdomen was the rubber monitor keeping track of the progress of the labor as well as the fetal heartbeat.

"Ah, my white knight in blue," Patty said as the pain abated and she opened her eyes to see Jeffrey standing at the foot of the bed. She smiled.

"How about that epidural?" Jeffrey suggested.

"How about it!" Patty echoed.

All the equipment Jeffrey needed was on a cart he had wheeled in with him upon his return. After putting a blood pressure cuff in place, Jeffrey removed the rubber monitor from Patty's abdomen and helped position her on her side. With gloved hands he prepped her back with an antiseptic solution.

"First I'm going to give you the local anesthetic we talked about," Jeffrey said as he prepared the injection. He made a small weal with the tiny needle midline in Patty's lower back. She was so relieved to be getting it, she didn't even flinch.

Next, he took a Touhey needle from the epidural tray and made sure the stylet was in place. Then, using both hands, he pushed the needle into Patty's back, advancing it slowly but de liberately until he was certain he had reached the ligamentous covering of the spinal canal. Withdrawing the stylet, he attached

I an empty glass syringe. Jeffrey put slight pressure on the sy ringe's plunger. Feeling resistance, he expertly returned to ad vancing the needle. Suddenly the resistance on the plunger disappeared. Jeffrey was pleased: he knew he was in the epidural space.

"Are you okay?" Jeffrey asked as he used a glass syringe to draw up a test dose of 2 cc's of sterile water containing a tiny amount of epinephrine.

"Are you flnished?" Patty asked.

"Not quite," Jeffrey said. "Just a few minutes more." He injected the test dose and immediately tested Patty's blood pressure and pulse. There was no change. If the needle had been in a blood vessel, Patty's heart rate would have increased immediately in response to the epinephrine.

Only then did Jeffrey seize the small epidural catheter. With practiced care, he threaded it up the Touhey needle.

"I feel something funny in my leg," Patty said nervously.

Jeffrey stopped pushing the catheter. It was only in about one centimeter beyond the tip of the needle. He asked Patty about the sensation, then explained that it was common for the epidural catheter to touch peripheral nerves as they traversed the epidural space. That could account for what she was feeling. When the paresthesia subsided, Jeffrey gingerly advanced the catheter another one and a half centimeters. Patty didn't complain.

Finally, Jeffrey pulled the Touhey needle out, leaving the small plastic catheter in place. Then he prepared a second test

dose of 2 cc's of.25% spinal-grade Marcaine with epinephrine. After injecting this second dose, he monitored Patty's blood pressure and her sense of touch on her lower extremities. When there were no changes even after several minutes, Jeffrey was absolutely sure that his catheter was in the proper place. Finally, he injected the therapeutic dose of anesthetic:

5 cc's of.25% Marcaine. Then he capped off the catheter.

"That's all there is to that," Jeffrey said as he put a sterile bandage over the puncture site. "But I want you to stay on your side for a while."

"But I don't feel anything," Patty complained.

"That's the idea," Jeffrey said with a smile.

"You're sure it's working?"

"Just wait until your next contraction," Jeffrey said with confidence.

Jeffrey conferred with the LPN to let her know how frequently he wanted

Patty's blood pressure taken. Then he helped her put the labor monitor back in place. He remained in the labor room through Patty's next contraction, using the time to complete his habitually meticulous anesthesia record.

Patty felt reassured. The discomfort she had been experiencing was much improved, and she thanked Jeffrey effusively.

After telling Monica Carver and the LPN where he would be, Jeffrey went into one of the darkened empty labor rooms to lie down. He was feeling better, but certainly not normal. Closing his eyes for what he thought would be just a few minutes and soothed by the sound of rain against the window, he surprised himself by falling fast asleep. He was dimly aware of the door being opened and closed several times as different people checked on him, but no one disturbed him until Monica came in and gently shook his shoulder.

"We've got a problem," Monica said.

Jeffrey swung his legs over the side of the bed and rubbed his eyes.

"What's wrong?"

"Simarian has decided to do a Caesarean on Patty Owen."

"So soon?" Jeffrey asked. He glanced at his watch. He blinked several times. The room seemed dimmer than before. Checking his watch, he was surprised to see that he'd been asleep for an hour and a half.

"The baby is an occiput posterior and hasn't been progressing," Monica explained. "But the main problem is that the baby's heart has been slow to return to a normal rate after each contraction."

"Time to do a Caesarean," Jeffrey agreed as he got unsteadily to his feet.

He waited a beat until his mild dizziness cleared.

"Are you all right?" Monica questioned.

"Just fine," Jeffrey said. He sat down on a chair to slip on his OR shoes.

"What's the time frame?"

"Simarian will be here in twenty minutes or so," Monica said, studying

Jeffrey's face.

"Is something wrong?" Jeffrey asked. He ran his fingers through his hair in fear it was standing on end.

.'You look pale," Monica said. "Maybe it's the lack of light in here."

Outside it was raining even harder.

"How's Patty doing?" Jeffrey asked, heading for the bathroom.

"She's apprehensive," Monica said from the door. "Painwise, she's fine, but you might consider giving her some kind of tranquilizer just to keep her calm."

Jeffrey nodded as he turned on the light in the bathroom. He wasn't wild about the idea of giving Patty a tranquilizer, but given the circumstances, he'd consider it. "Make sure she's on oxygen," he told Monica. "I'll be out in a second."

"She's on oxygen," Monica called over her shoulder as she left the room.

Jeffrey examined himself in the mirror. He did look pale. Then he noticed something else. His pupils were so contracted, they looked like twin pencil points. They were as small as he'd ever seen them. No wonder he'd had trouble seeing his watch in the other room.

Jeffrey splashed his face with cold water, then dried it roughly. At least that woke him up. He looked at his pupils again. They were still miotic. He took a deep breath and promised himself that as soon as he got through this delivery, he would make tracks for home and put himself to bed. After ad- justing his hair with his fingernails, he headed for labor room fifteen.

Monica had been right. Patty was embarrassed, scared, and nervous about the upcoming Caesarean. She was taking the failure of the labor personally.

Tears came to her eyes when she again voiced anger at her husband's absence. Jeffrey felt sorry for her and made a big effort at reassuring her that everything would be fine and that she certainly wasn't at fault. He also gave her 5 mg of diazepam IV, which he thought would have minimal effect if any on the unborn child. It had a rapid calming effect on Patty.

"I'll be asleep during the Caesarean?" Patty asked.

"You'll be very comfortable," Jeffrey replied, skirting the question. "One of the big benefits of continuous epidural anesthesia is that I can extend it now that we need a higher level, without disturbing Patty junior."

"It's a boy," Patty said. "His name is Mark." She smiled weakly. Her lids had become a little droopy. The tranquilizer was clearly taking effect.

, The transfer from the delivery area to the OR suite was accomplished without incident. Jeffrey kept Patty on oxygen by mask during the short trip.

The OR had been advised as to the decision to do a Caesarean. By the time

Patty was transferred, the room was almost set up for the procedure. The scrub nurse, already scrubbed, was busy laying out the instruments. The circulating nurse helped guide the gurney into the room and transfer Patty to the OR table. Patty still had the fetal monitor on, which was left in place for the time being.

Jeffrey wasn't as familiar with the evening personnel, and he hadn't met the circulating nurse before. Her name tag read: Sheila Dodenhoff.

"I'm going to need some.5% Marcaine," Jeffrey told Sheila as he changed

Patty from portable bottle oxygen to oxygen delivered through his Narcomed

III anesthesia machine. He then reapplied the blood pressure cuff to

Patty's left arm.

"Coming up," Sheila said cheerfully.

Jeffrey worked quickly but deliberately. He checked off every procedure in his anesthesia record once it had been performed. In sharp contrast to most other doctors, Jeffrey prided himself on his exquisitely legible handwriting.

After hooking up the EKG leads, he attached the pulse oximeter to Patty's left index finger. He was replacing Patty's IV with a more secure intracath when Sheila returned.

"Here you go," she said, handing Jeffrey a 30 cc glass vial of.5%

Marcaine. Jeffrey took the drug and, as he always did, checked the label.

He set the vial on top of his anesthesia machine. From the drawer, he took out a 2 cc ampule of spinal grade.5% Marcaine with epinephrine and drew it up into a syringe. Maneuvering Patty onto her right side, Jeffrey injected the 2 cc's into the epidural catheter.

"How's everything going?" a booming voice called out from the door.

Jeffrey turned to see Dr. Simarian holding a mask to his face while he held open the door.

"We'll be ready in a minute," Jeffrey said.

"How's the little one's ticker?" he asked.

"At the moment, fine," Jeffrey answered.

"I'll scrub up and we'll get this show on the road."

The door swung shut. Jeffrey gave Patty's shoulder a squeeze while he studied the EKG and the blood pressure readout. "You okay?" he asked her, moving the oxygen mask to the side.

"I think so," she said.

"I want you to tell me whatever you feel. Understand?" Jeffrey said. "Do your feet feel normal?"

Patty nodded. Jeffrey went around and tested her sensation. Coming back to the head of the table and checking the monitors again, he was sure that the epidural catheter had not moved and had not penetrated either the spinal canal or one of the pregnancy-dilated veins of Bateson.

Satisfied that all was in order, Jeffrey picked up the via] of Marcaine

Sheila had brought him. Using his thumb, he snapped off the top of the sealed glass container. Once again he checked the label, then drew up 12 cc's. He wanted anesthesia to extend at least to T6, and preferably to T4.

As he put the Marcaine down, his eyes caught Sheila's. She was standing off to the left, staring at Jeffrey.

"Is something wrong?" Jeffrey asked.

Sheila held his gaze for a beat, then spun on her heels and left the OR without speaking. Jeffrey turned to catch the eye of the scrub nurse, but she was still busy setting up. Jeffrey shrugged. Something was going on that he didn't know about.

Returning to Patty's side, he injected the Marcaine. Then he capped off the epidural catheter and returned to the head of the table. After putting down the syringe, he noted the time and the exact amount of the injection in the record. A slight quickening of the beep of the pulse brought his eyes up to the EKG monitor. If there was to be any change in the heart rate, Jeffrey expected a slight slowing from progressive sympathetic blockade. Instead, there was the opposite. Patty's pulse was speeding up. It was the first sip of the impending disaster.

Jeffrey's initial reaction was more of curiosity than concern. His analytical mind groped for a logical explanation for what he was witnessing. He glanced at the blood pressure readout and then the oximeter

LED. They were all fine. He looked back at the EKG. The pulse was still quickening, and even more disturb-

ing, there was an ectopic, irregular heartbeat. Under the circumstances, that was not a good sign.

Jeffrey swallowed hard as fear clutched at his throat. It had only been seconds since he'd injected the Marcaine. Could it have gone intravenous despite the test dose result? Jeffrey had had one other adverse reaction to local anesthetic in his professional career. The incident had been harrowing.

The ectopic beats were increasing in frequency. Why would the heart rate increase and why the irregular rhythm? If the anesthetic dose did go intravenously, why wasn't the blood pres:. sure falling? Jeffrey had no immediate answers to these questions, but his medical sixth sense, born of years of experience, set off alarm bells in his mind. Something abnormal was occurring. Something Jeffrey was at a loss to explain, much less understand.

"I don't feel good," Patty said, turning her head to talk out of the side of the mask.

Jeffrey looked down into Patty's face. He could see it was again clouded with fear. "What's the matter?" he asked, puzzled by these rapid events. He touched her shoulder.

"I feel funny," Patty said.

"How do you mean, funny?" Jeffrey's eyes went back to the monitors. There was always the fear of allergy to the local anesthetic, although developing allergy in the two hours since the first dose seemed a rather farfetched notion. He noticed the blood pressure had risen slightly.

"Ahhhhh!" Patty cried.

Jeffrey's eyes shot to her face. Patty's features were twisted in a horrible grimace.

"What is it, Patty?" Jeffrey demanded.

"I feel a pain in my stomach," Patty managed hoarsely through clenched teeth. "It's high up, under my ribs. It's different from the labor pain.

Please..." Her voice trailed off.

Patty began to writhe on the table, drawing up her legs. Sheila reappeared along with a muscular male nurse who lent a hand in attempting to restrain her.

The blood pressure that had risen slightly now began to fall. "I want a wedge under her right side," Jeffrey yelled as he got ephedrine from the drawer and prepared it for injection. Mentally he calculated how far he'd let the blood pressure drop before he'd inject the pressor agent. He still had no idea of what was happening, and he preferred not to act before he knew exactly what he was up against.

A gurgling sound brought his attention back to Patty's face. He pulled off her oxygen mask. To his surprise and horror she was salivating like a mad dog. At the same time she was lacrimating profusely; tears were streaming down her face. A wet cough suggested that she was also forming increasing amounts of tracheo-bronchial secretions.

Jeffrey remained the ultimate professional. He had been trained to deal with this type of emergency situation. His mind raced ahead, taking in all the information, making hypotheses, then ruling them out. Meanwhile, he dealt with the lifethreatening symptoms. First he suctioned Patty's nasopharynx, then he injected atropine intravenously, followed by ephedrine. He suctioned Patty again, then injected a second dose of the at- ropine. The secretions slowed, the blood pressure plateaued, the oxygenation stayed normal, but Jeffrey still did not know the cause. All he could think of was an allergic reaction to the Marcaine. He watched the

EKG, hoping that the atropine might have a positive effect on the irregular heartbeats. But they remained irregular. In fact, they became even more irregular as Patty's pulse quickened. Jeffrey prepared a 4 mg dose of pro- pranolol, but before he could inject it, he noticed the muscle fas- ciculations that distorted Patty's features in a series of seemingly uncontrolled twists and spasms. The fasciculations rapidly spread to other muscles until her body became wracked by clonic jerks.

"Hold her, Trent!" Sheila cried to the male nurse. "Get her legs!19

Jeffrey injected the propranolol as the EKG began to register further bizarre changes, intimating there was diffuse involvement of the heart's electrical conduction system.

Patty spewed up green bile which Jeffrey quickly suctioned away. He glanced at the oximeter readout. That was still holding. Then the fetal monitor alarm began to go off, the baby's heart was slowing. Before anyone could react, Patty suffered a grand mal seizure. Her limbs flailed madly in all directions, then her back arched in awkward hyperextension.

"What the hell is going on?" Simarian shouted as he came flying through the door.

"The Marcaine," Jeffrey shouted. "She's having some sort of overwhelming reaction." Jeffrey didn't have time to elaborate as he drew up 75 mg of succinylcholine.

"Jesus Christf" Simarian yelled, coming around the table to help hold Patty down.

Jeffrey injected the succiny1choline as well as an additional dose of diazepam. He was thankful that his compulsiveness had made him change the

IV to a more secure one. The audio portion of the oximeter readout began to fall in pitch as Patty's oxygenation decreased. Jeffrey again cleared her airway and tried to bag her with the 100% oxygen.

Patty's seizure movements slowed as succinylcholine-induced paralysis took effect. Jeffrey slipped in an endotracheal tube, checked its position, and ventilated her well with the oxygen. The sound of the oximeter immediately returned to its higher pitch. But the fetal monitor was still sending out its alarm. The baby's heart had slowed and was not speeding back up.

"We gotta get the baby!" Simarian yelled. He grabbed sterile gloves from one of the side tables and yanked them on.

Jeffrey was still watching the blood pressure, which had started to fall again. He gave Patty another dose of ephedrine. The blood pressure started back up. He glanced at the EKG; it had not improved with the propranolol.

Then to Jeffrey's horror, just as he was watching, the EKG disintegrated into senseless fibrillation. Patty's heart had stopped beating.

"She's arresting!" Jeffrey shouted. The blood pressure fell to zero. Both the EKG and the oximeter alarms began shrieking stridently.

"My God!" Simarian yelled. He had been.hastily draping the patient. He moved up to the table and started external cardiac massage by compressing

Patty's chest. Sheila put out the word to the OR desk. Help was on its way.

The crash cart arrived along with additional OR nurses. With lightning speed, they prepared the defibrillator. A nurse anesthetist also arrived.

She went directly to Jeffrey's side.

The oxygen content of Patty's blood went up slightly. "Countershock her!"

Jeffrey ordered.

Simarian took the defibrillator paddles from one of the nurses. He applied them to Patty's bare chest. Everyone stepped back from the OR table.

Simarian pressed the button. Since Patty was paralyzed with the succinylcholine, there was no apparent effect from the electric current except on the EKG screen. The fibrillation disappeared, but when the phosphorescent blip returned, it did not show a normal heartbeat. Instead, it traced a completely flat line with only a few minor squiggles.

"Restart massagel" Jeffrey ordered. He stared at the EKG. He couldn't believe there was no electrical activity. The muscu-

lar male nurse took over from Simarian and started compressing Patty's chest with good result.

The fetal monitor was still sounding. The child's heart rate was too slow.

"We gotta get the baby!" Simarian snapped again. He changed his gloves and hastily took additional drapes from the scrub nurse. He positioned them as best he could despite the cardiac massage. He grabbed a knife from the instrument table and went to work. Using a generous vertical incision, he sliced Patty's lower abdomen open. With the reduced blood pressure there was very little bleeding. A pediatrician arrived on the scene and prepared to take the baby.

Jeffrey's attention stayed with Patty. He suctioned her and was surprised at the amount of secretions even after the two doses of atropine. Checking

Patty's pupils, he was pleased they were not dilated. In fact, he was surprised to find them pinpoint. With oxygenation remaining up, Jeffrey decided to hold off introducing any more drugs into Patty's system until after the baby was delivered. Briefly, he explained what had happened to the nurse anesthetist.

"You think it's a reaction to the Marcaine?" she asked.

"That's all I can think of," Jeffrey admitted.

In the next minute a silent, blue, flaccid baby was pulled from Patty's abdomen. After the cord was severed, the child was quickly handed to the waiting pediatrician. He rushed the newborn to the infant care unit, where the baby was surrounded by his own resuscitation team. The nurse anesthetist joined that group.

"I don't like this flat EKG," Jeffrey said to himself as he injected a bolus of epinephrine. He watched the EKG. No response. He then tried another dose of atropine. Nothing. Exasperated, he drew an arterial blood sample and sent it off to the lab for a stat reading.

Ted Overstreet, one of the cardiac surgeons who had recently finished a bypass case, came in and stood next to Jeffrey. After Jeffrey explained the situation, Overstreet suggested opening her UP.

The nurse anesthetist came back to report that the baby was not in good shape. "The Apgar is only three," she said. "He's breathing and his heart is beating, but not well. And his muscle tone is not good. In fact, it's weird."

"How so?" Jeffrey asked, fighting a wave of depression.

"His left leg moves okay, but not his right. The right one is completely flaccid. With his arms it's just the opposite."

Jeffrey shook his head. Obviously the child had been oxygen deprived in utero and was now brain damaged. The realization was crushing, but there was no time to wallow in regret. Just then his chief concern was Patty and how to get her heart started.

The stat lab work came back. Patty's pH was 7.28. bnder the circumstances,

Jeffrey thought, that was pretty good. Next he injected a dose of calcium chloride. Minutes dragged like hours as everyone watched the EKG, waiting for some sign of life, some response to treatment. But the monitor traced a frustratingly flat line.

The male nurse continued the chest compressions and the ventilator kept

Patty's lungs Ned with pure oxygen. Her pupils remained miotic, suggesting her brain was getting enough oxygen, but her heart stayed electrically and mechanically still. Jeffrey repeated all the textbook procedures but to no avail. He even had Patty shocked again with the defibrillator set at 400 joules.

Once the pediatrician had the newborn stabilized, he had the entire infant care unit vacate the OR along with its attendant clutch of residents and nurses. Little Mark was on his way to the neonatal intensive care unit.

Jeffrey watched them go. He felt heartsick. Shaking his head in sorrow, he turned back to Patty. What to do?

Jeffrey looked up at Ted, who was still standing next to him. He asked Ted what he thought they should do. Jeffrey was desperate.

64 Like I said, I think we should open her up and work on the heart directly. There's not much to lose at this point."

Jeffrey watched the flat EKG for another moment. Then he sighed. "Okay.

Let's try it," he said reluctantly. He had no other ideas, and he didn't want to give up. As Ted pointed out, they had nothing to lose. It was worth a try.

Ted,gowned and gloved in less than ten minutes. Once he was prepared, he had the nurse stop compressing the chest so that he could rapidly drape and slice into it. Within seconds he was holding Patty's naked heart.

Ted massaged the heart with his gloved hand and even injected epinephrine directly into the left ventricle. When that failed to have an effect, he tried to pace the heart by attaching internal leads to the cardiac wall.

That resulted in a complex on the EKG, but the heart itself did not respond.

Ted recommenced the internal cardiac massage. "No pun intended," he said after a couple of minutes, "but my heart is no longer in this. I'm afraid the ballgame is over unless you guys have a heart transplant waiting around here. This one is long gone."

Jeffrey knew that Ted didn't mean to sound callous and that his apparently flip attitude was more of a defense mechanism than a true lack of compassion, yet it cut Jeffrey to the quick. He had to restrain himself from lashing out verbally.

For as much as he'd given up, Ted continued the internal cardiac massage.

The only sound in the OR came from the monitor recording the pacemaker's discharge and the low hum of the pulse oximeter as it responded to Ted's internal massage.

Simarian was the one who broke the silence. "I agree," he said simply. He snapped off his gloves.

Ted looked across the rapidly erected ether screen at Jeffrey. Jeffrey nodded. Ted stopped massaging the heart and pulled his hand from within

Patty's chest. "Sorry," he said.

Jeffrey nodded again. He took a deep breath, then turned the ventilator off. He looked back at the sorry sight of Patty Owen with her abdomen and chest rudely sliced open. It was a terrible sight, one that would stay with

Jeffrey for the rest of his life. The floor was littered with drug containers and wrappers.

Jeffrey felt crushed and numb. This was the nadir of his professional career. He'd witnessed other tragedies, but this was the worst, and most unexpected. His eyes drifted to his anesthesia machine. It too was covered with debris. Beneath the debris was the incomplete anesthesia record. He'd have to bring it up to date. In the fevered attempt to save Patty he'd had no time to do so. He looked for the half-empty vial of Marcaine, feeling an irrational antipathy toward it. Although it seemed unreasonable in light of the test dose results, he couldn't help but feel an allergic reaction to the drug was the root of this tragedy. He wanted to dash the vial against the wall, just to vent his frustration. Of course he knew he wouldn't actually throw the vial; he was too controlled for that. But he couldn't find it among the mess.

"Sheila," Jeffrey called to the circulating nurse who was starting the clean-up process, "what happened to the Marcaine vial?"

Sheila stopped what she was doing to glare at Jeffrey. "If you don't know where you put it, I certainly don't," she said angrily.

Jeffrey nodded and then turned his attention to unhooking

Patty from the monitors. He could understand Sheila's anger. He was angry too. Patty didn't deserve this kind of fate. What Jeffrey didn't realize was that Sheila wasn't angry at fate. She was angry at Jeffrey. In fact, she was furious.

MONDAY,

MAY 15, 1989

11:15 A.M.

A shaft of golden morning sunlight filtered through a window high on the wall to Jeffrey's left and knifed down through the courtroom, hitting the paneled wall behind the judge's bench like a spotlight. Millions of tiny motes of dust sparkled and swirled in the intense beam of light. Ever since the beginning of this trial, Jeffrey had been struck by the theatric quality of the justice system. But this was no TV daytime drama. Jeffrey's career-his whole life-was on the line.

Jeffrey closed his eyes and leaned forward at the defendant's table, cradling * his head in his hands. With his elbows splayed on the table, he roughly rubbed his eyes. The tension was about to drive him crazy.

Taking a deep breath, he opened his eyes, half hoping the scene before him would have magically disappeared and he would wake up from the worst nightmare of his life. But of course it wasn't a bad dream he was suffering. Jeffrey was involved in his second trial for Patty Owen's untimely death eight months previously. Just then he was sitting in a courtroom in the center of Boston, waiting to hear the jury deliver his fate on criminal charges.

Jeffrey glanced over his lawyer's head to scan the crowd. There was an excited, low-pitched babble of voices, a murmur of expectancy. Jeffrey averted his gaze, knowing that all the talk centered on him. He wished he could hide. He felt utterly humiliated by the public spectacle so rapidly unfolding. His entire life had unraveled and disintegrated. His career was going down the drain. He felt overwhelmed, yet oddly numb.

Jeffrey sighed. Randolph Bingham, his lawyer, had urged him to appear calm and controlled. Easier said than done, especially now. After all the heartache, anxiety, and sleepless nights, it was

now down to the wire. The jury had reached its decision. The verdict was on its way.

Jeffrey studied Randolph's aristocratic profile. The man had become a father to him through these last eight harrowing months, even though he was only five years Jeffrey's senior. Sometimes Jeffrey had felt almost love for the man, other times something more akin to rage and hatred. But he'd always had confidence in his lawyer's skills, at least until this point.

Glancing at the prosecuting team, Jeffrey studied the district attorney. He had particular antipathy for this man, who seemed to have seized on the case as a vehicle for advancing his political career. Jeffrey could appreciate the man's native intelligence though he'd grown to despise him during the course of the fourday trial. But now, watching as the D.A. conversed animatedly with an assistant, Jeffrey realized he felt oddly devoid of emotion toward the man. For him, the whole business had been a job, no more, no less.

Jeffrey's eyes strayed beyond the district attorney toward the emptyjury box. During the trial the realization that these twelve strangers held his fate in their hands had paralyzed Jeffrey. Never before had he experienced such vulnerability. Up until this episode, Jeffrey had been living under the delusion that his fate was largely in his own hands. This trial showed him just how mistaken he was.

The jury had been deliberating for two anxious days and-for Jeffrey-two sleepless nights. Now they were waiting for the jury to return to the courtroom. Jeffrey again wondered if two days of deliberation was a good sip or a bad. Randolph, in his irritatingly conservative manner, would not speculate. Jeffrey felt the man could have lied just to give him a few hours of relative peace.

Despite his good intentions to refrain from fidgeting, Jeffrey began to stroke his mustache. When he realized what he was doing, he folded his hands and set them on the table in front of him.

He glanced over his left shoulder and caught sight of Carol, his soon io be ex-wife. Her head was down. She was reading. Jeffrey turned his gaze back to the judge's empty bench. He could have been irritated that she was relaxed enough to be able to read at this moment, but he wasn't. Instead,

Jeffrey felt thankful that she was there and that she'd shown as much support as she had. After all, even before this legal nightmare had

started, the two of them had come to the mutual conclusion that they had grown apart.

When they had first married eight years ago, it hadn't seemed important that Carol was extremely social and outgoing while he tended toward the opposite. It also hadn't bothered Jeffrey that Carol wanted to put off having a family while she advanced her career in banking, at least until

Jeffrey found out that her idea of postponement meant never. And now she wanted to head west, to Los Angeles. Jeffrey could have lived with the idea of moving to California, but he had trouble with the family issue. Over the years he'd come to want a child more and more. To see Carol's hopes and aspirations move in an entirely different direction saddened him, but he found he didn't hold it 4ainst her. Jeffrey had fought the idea of divorce at first, but had finally given in. Somehow, they just weren't meant to be.

But then, when Jeffrey's legal problems materialized, Carol had graciously offered to hold off on the domestic issue until Jeffrey's legal diffi- culties were resolved.

Jeffrey sighed again, more loudly than before. Randolph shot him a disapproving glare, but Jeffrey couldn't see that appearances mattered at this point. Whenever Jeffrey thought about the sequence of events, it had a dizzying effect on him. It had all happened so quickly. After the disastrous death of Patty Owen, the malpractice summons had arrived in short order. Under the current litigious climate, Jeffrey had not been sur- prised by the lawsuit, except perhaps by the speed.

From the start, Randolph had warned Jeffrey that it would be a tough case.

Jeffrey had had no idea how tough. That was right before Boston Memorial suspended him. At the time, such a move had seemed capricious and unreasonably vicious. It certainly wasn't the kind of support or vote of confidence Jeffrey had hoped for. Neither Jeffrey nor Randolph had had any inkling of the rationale for the suspension. Jeffrey had wanted to take action against Boston Memorial for this unwarranted act, but Randolph had advised him to sit tight. He thought that issue would be better resolved after the conclusion of the malpractice litigation.

But the suspension was only the harbinger of worse trouble to come. The malpractice plaintiff attorney was a young, aggressive fellow named Matthew

Davidson from a firm in St. Louis specializing in malpractice litigation.

He was also associated with a small general law firm in Massachusetts. He'd filed suit against Jeffrey, Simarian, Overstreet, the hospital, and even

Ar-

olen Pharmaceuticals, who'd manufactured the Marcaine. Jeffrey had never been the subject of a malpractice action before. Randolph had to explain that this was the "shotgun" approach. Litigators; sued everybody with "deep pockets" whether or not there was any evidence of direct involvement in the alleged incident of malpractice.

Being one among many had initially provided some solace to Jeffrey, but not for long. It quickly became clear that Jeffrey would stand alone. lie could remember the turning point as if it were yesterday. It had happened through the course of his own testimony in the early stages of the initial civil malpractice trial. He had been the first defendant to take the stand.

Davidson had been asking cursory background questions, when he suddenly became harder hitting.

"Doctor," Davidson said, turning his thin, handsome face toward Jeffrey and putting a pejorative cast to the title. He walked directly to the witness stand and placed his face within inches of Jeffrey's. He was dressed in an impeccably tailored, dark pinstriped suit with a light lavender shirt and a dark purple paisley tie. He smelled of expensive cologne. "Have you ever been addicted to any drug?"

"Objection!" Randolph called out, rising to his feet.

Jeffrey had felt as if he were watching a scene in some drama, not a chapter in his life. Randolph elaborated on his objection: "This question is immaterial to the issues at hand. The plaintiff attorney is trying to impugn my client."

"Not so," Davidson countered. "This issue is extremely germane to the current circumstances as will be brought out with the testimony of subsequent witnesses."

For a few moments silence reigned in the crowded courtroom. Publicity had brought notoriety to the case. People were standing along the back wall.

The judge was a heavyset black man named Wilson. He pushed his thick black-rimmed glasses higher on the bridge of his nose. Finally he cleared his throat. "If you're fooling with me, Mr. Davidson, there's going to be hell to pay."

"I certainly wouldn't choose to fool with you, Your Honor."

"Objection overruled," Judge Wilson said. He nodded toward Davidson. "You may proceed, Counselor."

"Thank you," Davidson said as he turned his attention back to Jeffrey.

"Would you like me to repeat the question, Doctor?" he asked.

"No," Jeffrey said. He remembered the question well enough.

He glanced at Randolph, but Randolph was busy writing on a yellow legal tablet. Jeffrey returned Davidson's steady glare. He had a premonition that trouble was ahead. "Yes, I had a mild drug problem once," he said in a subdued voice. This was an old secret that he'd never imagined would surface, especially not in a court of law. He had been reminded of it recently when he had to fill out the required form to renew his

Massachusetts medical license. Yet he thought that information was confiden- tial.

"Would you tell the jury what drug you were addicted to," Davidson asked, stepping away from Jeffrey as if he was too revolted to remain too close to him for any longer than necessary.

"Morphine," Jeffrey said with almost a defiant tone. "It was five years ago. I had trouble with back pain after a bad bicycle accident."

Out of the comer of his eye, Jeffrey saw Randolph scratching his right eyebrow. That was a previously arranged gesture to signal that he wanted

Jeffrey to confine himself to the question at hand and not offer any information. But Jeffrey ignored him. Jeffrey was angry that this irrelevant piece of his past was being dredged up. He felt the urge to explain and defend himself. He certainly wasn't a drug addict by any stretch of the imagination.

"How long were you addicted?" Davidson asked.

"Less than a month," Jeffrey snapped. "It was a situation where need and desire had imperceptibly merged."

"I see," Davidson said, lifting his eyebrows in a dramatic gesture of understanding. "That's how you explained it to yourself?"

"It was how my treatment counselor explained it to me," Jeffrey shot back.

He could see Randolph frantically scratching again, but Jeffrey continued to ignore him. "The bicycle accident occurred at a time of deepening domestic strain. I was prescribed the morphine by an orthopedic surgeon. I convinced myself that I needed it longer than I actually did. But I realized what was happening in a few weeks' time and I took sick leave from the hospital and volunteered for treatment. And also marriage counseling,

I might add."

"During those weeks, did you ever administer anesthesia while..."

Davidson paused as if he were trying to think how to word his question while you were under the influence?"

"Objection!" Randolph called. "This line of questioning is ab surd! It's nothing short,of calumny."

The judge bent his head down to look over the top of his

glasses, which had slid down his nose. "Mr. Davidson," he said patronizingly, "we're back to the same issue. I trust that you have some cogent reason for this apparent excursion."

"Absolutely, Your Honor," Davidson said. "We intend to show that this testimony has a direct bearing on the case at hand."

"Objection overruled," the judge said. "Proceed."

Davidson turned back to Jeffrey and repeated the question. He seemed to relish the phrase "under the influence."

Jeffrey glared back at the plaintiff attorney. The one thing in his life that he was absolutely sure of was his sense of professional responsibility, competence, and performance. The fact that this man was suggesting something else infuriated him. "I have never compromised a patient," Jeffrey snapped.

"That is not my question," Davidson said.

Randolph got to his feet and said, "Your Honor, I would like to approach the bench."

"As you wish," the judge said.

Both Randolph and Davidson went up to the judge. Randolph was obviously incensed. He began talking in a hoarse whisper. Even though Jeffrey was only ten feet away, he could not hear the conversation clearly although he did hear the word "recess" mentioned several times. Eventually, the judge leaned back and looked at him.

64 Dr. Rhodes," he said, "your counsel seems to think you need a rest. Is that true?"

"I don't need any rest," Jeffrey said angrily.

Randolph threw up his hands in frustration.

"Good," the judge said. "Then let's get on with this examination, Mr.

Davidson, so we can all get out for some lunch."

,.All right, Doctor," Davidson said. "Have you ever administered anesthesia under the influence of morphine?"

"There may have been one or two times..." Jeffrey began, "but--2'

"Yes or no, Doctor!" Davidson cut in. "A simple yes or no is all I want."

"Objection!" Randolph called. "The counselor is not letting the witness answer the question."

" Quite the contrary," Davidson said. "It's a simple question and I'm looking for a simple answer. Either yes or no."

"Overruled," the judge said. "The witness will have a chance to elaborate on cross-examination. Please answer the question, Dr. Rhodes."

"Yes," Jeffrey said. He could feel his blood boil. He wanted to reach out and strangle the plaintiff attorney.

"Since your treatment for your addiction to morphine..

Davidson began, walking away from Jeffrey. He emphasized the words

"addiction" and "morphine," then paused. He stopped near the jury box, turned, then added: have you ever taken morphine again?"

"No," Jeffrey said with forcefulness.

"Did you take morphine on the day you administered anesthesia to the unfortunate Patty Owen?"

"Absolutely not," Jeffrey said.

"Are you sure, Dr. Rhodes?"

"Yesl" Jeffrey shouted.

"No more questions," Davidson said, and he returned to his seat.

Randolph had done what he could on cross-examination, emphasizing that the addiction problem had been minor and shortlived, and that Jeffrey had never taken more than a therapeutic dose. Besides, Jeffrey had volunteered for treatment, had been certified "cured," and had not been subjected to any disciplinary action. But despite these assurances, Jeffrey and Randolph had both felt his case had been dealt a death blow.

Just then, Jeffrey was brought back to the present by the sudden appearance of a uniformed court officer at the door to the jury room. His pulse shot up. He thought the jury was about to be announced. But the court officer made his way over to the door to thejudge's chambers and disappeared.

Jeffrey's thoughts drifted back to the malpractice trial.

True to his word concerning its relevancy, Davidson brought the addiction issue back with further testimony that had been totally unexpected despite the discovery depositions. The first surprise came in the form of Regina

Vinson.

After the usual introductory questions, Davidson asked her if she had seen

Dr. Jeffrey Rhodes on the fateful day of Patty Owen's death.

"I did," Regina said, staring at Jeffrey.

Jeffrey knew Regina vaguely as one of the evening OR nurses. He didn't remember seeing her on the day that Patty died.

"Where was Dr. Rhodes when you saw him?" Davidson asked.

"He was in the anesthesia alcove for operating room eleven," Regina said, keeping her eyes directly on Jeffrey.

Again, Jeffrey had a premonition that something detrimental

to his case was c6ming, but he couldn't guess what it would be. He remembered working in room eleven for most of the day. Randolph leaned over and asked in a hushed voice, "What is she leading up to?"

"I haven't the foggiest," Jeffrey whispered, unable to break eye contact with the nurse. What disturbed him was that he could sense real hostility in the woman.

"Did Dr. Rhodes see you?" Davidson asked.

"Yes," Regina replied.

All at once, Jeffrey remembered. In his mind's eye he saw the image of her startled face as she pulled the drape aside. The fact that he was sick that fateful day was something besides his addiction problem that he had failed to tell Randolph. He'd considered it, but had been afraid to tell him. At the time he thought of his behavior as evidence of his dedication and self-sacrifice. After the fact, he'd not been so sure. So he'd never told anyone. He started to reach for Randolph's arm, but it was far too late.

Davidson was looking at the jurors, one after another, as he posed the next question: "Was there something strange about Dr. Rhodes being in the alcove of operating room eleven?"

"Yes," Regina answered. "The curtain was closed and operating room eleven was not in use."

Davidson kept his eyes on the jurors. Then he said, "Please tell the court what Dr. Rhodes was doing in the anesthesia alcove of the empty operating room with the drapes closed."

"He was shooting up," Regina said angrily. "He was injecting himself intravenously."

An excited murmur rippled through the courtroom. Randolph turned to Jeffrey with a shocked expression. Jeffrey shook his head guiltily. "I can explain," he said lamely.

Davidson went on. "What did you do after you saw Dr. Rhodes 'shooting up'T'

"I went to the supervisor, who called the chief of anesthesia," Regina said. "Unfortunately, the chief of anesthesia was not reached until after the tragedy."

Immediately after Regina's damaging testimony, Randolph had been able to get a recess. When he was alone with Jeffrey he demanded to know about this

"shooting-up" episode. Jeffrey confessed to having been ill that fateful day, and said that no one but he had been available for the delivery. He explained everything he'd done in order to keep working, including giving himself the IV and taking paregoric.

"What else haven't you told me?" Randolph demanded angrily.

"That's all," Jeffrey said.

"Why didn't you tell me this before?" Randolph snapped.

Jeffrey shook his head. In truth, he wasn't completely sure himself. "I don't know," he said. "I have never liked admitting when I'm sick even to myself, much less anyone else. Most doctors are like that. Maybe it's part of our defense about being around illness. We like to think we're invulnerable."

"I'm not asking for an editorial," Randolph practically shouted. "Save it for the New England Journal of Medicine. I want to know why you couldn't tell me, your lawyer, that you were seen 'shooting up' on the morning in question."

"I guess I was afraid to tell you," Jeffrey admitted. "I did everything possible for Patty Owen. Anyone can read the record and attest to that. The last thing I wanted to admit was that there could be a question of my having been in top form. Maybe I was afraid you wouldn't defend me with the same intensity if you thought I was even remotely culpable."

"Jesus Christl" Randolph exclaimed.

Later, back in the courtroom, during the cross-examination, Randolph did as much damage control as he could. He brought out the fact that Regina did not know if Jeffrey was injecting himself with a drug or merely starting an

IV to rehydrate himself.

But Davidson was not done yet. He brought Sheila Dodenhoff to the stand.

And just like Regina, she glared at Jeffrey while she testified.

"Miss Dodenhoff," Davidson intoned, "as the circulating nurse during Mrs.

Owen's tragedy, did you ever notice anything strange about the defendant,

Dr. Rhodes?"

"Yes, I did," Sheila said triumphantly.

"Would you please tell the court what you noticed," Davidson said, obviously relishing the moment.

"I noticed his pupils were pinpoint," Sheila said. "I noticed it because his eyes are so blue. In fact, I could barely see his pupils at all."

Davidson's next witness was a world-famous ophthalmologist from New York who'd written an exhaustive tome on the function of the pupil. After establishing his eminent credentials, Davidson asked the doctor to name the most common drug to cause pupils to contract to pinpoints-miosis, as the doctor preferred to call the condition.

"You mean a systemic drug or an eye drop?" the ophthalmologist asked.

:'A systemic drug," Davidson said.

'Morphine," the ophthalmologist said confidently. He then commenced an incomprehensible lecture about the EdingerWestphal nucleus, but Davidson cut him off and turned the witness over to Randolph.

As the trial dragged on, Randolph had tried to rectify the damage, proposing that Jeffrey had taken paregoric for diarrhea. Since paregoric is compounded with tincture of opium, and since opium contains morphine, he proposed that the paregoric had caused Jeffrey's constricted pupils. He also explained that Jeffrey had given himself an IV to treat flu symptoms, which are frequently caused by dehydration. But it was apparent that the jury did not buy these explanations, especially after Davidson brought a well-known and respected internist to the stand.

-Tell me, Doctor," Davidson said unctuously, "is it common for doctors to give themselves IVs as it has been suggested that Dr. Rhodes had done?"

"No," the internist said. "I've heard some scuttlebutt about gung-ho surgical residents doing such a thing, but even if such reports are true, it's certainly not a common practice."

The final blow in the trial came when Davidson called Marvin Hickleman to the stand. He was one of the OR orderlies.

"Mr. Hickleman," Davidson said. "Did you clean OR fifteen after the Patty

Owen case?"

'Yes, I did," Marvin said.

'I understand you found something in the biohazard disposal container on the side of the anesthesia machine. Could you tell the court what you found?"

Marvin cleared his throat. "I found an empty vial of Marcaine."

"What concentration was the vial?" Davidson asked.

.,It was.75%," Marvin said.

Jeffrey had leaned over and whispered to Randolph, "I used.5%. I'm sure of it."

As if he'd overheard, Davidson then asked Hickleman: "Did you find any.5% vials?"

"No," Marvin said, "I did not."

On cross-examination, Randolph tried to discredit Marvin's testimony, but only made things worse. "Mr. Hickleman, do you always go through the trash when you clean an operating room and check the concentration of the various drug containers?"

"Nopel"

"But you did on this particular case."

.,Yup!"

"Can you tell us why?"

"The nursing supervisor asked me to."

The final coup de grace was delivered by Dr. Leonard Simon from New York, a renowned anesthesiologist whim even Jeffrey recognized. Davidson got right to the point.

"Dr. Simon. Is.75% Marcaine recommended for obstetric epidural anesthesia?"

"Absolutely not," Dr. Simon said. "In fact it is contraindicated. The warning is clearly labeled in the package insert and in the PDR. Every anesthesiologist knows that."

"Can you tell us why it is contraindicated in obstetrics?"

"It was found to cause occasional serious reactions."

"What kind of reactions, Doctor?"

"Central nervous system toxicity."

"Does that mean seizures, Doctor?"

"Yes, it has been known to cause seizures."

"What else?"

"Cardiac toxicity."

"Meaning... T'

"Arrhythmias, cardiac arrest."

"And these reactions were occasionally fatal?"

"That's correct," Dr. Simon said, pounding in the final nail of Jeffrey's coffin.

The result had been that Jeffrey and Jeffrey alone was found guilty of malpractice. Simarian, Overstreet, the hospital, and the pharmaceutical company had been exonerated. The jury awarded the Patty Owen estate eleven million dollars: nine million more than Jeffrey's malpractice coverage.

At the end of the trial, Davidson had been openly disappointed that he'd done such a good job destroying Jeffrey. Since the other defendants and their deep pockets had been exculpated, there was little chance of collecting much above and beyond Jeffrey's insurance coverage even if

Jeffrey's income was attached for the rest of his life.

For Jeffrey, the result was devastating, personally no less than professionally. His whole image of himself and his self-worth had been predicated on his sense of dedication, commitment, and sacrifice. The trial and the finding by thejury destroyed that. He even came to doubt himself.

Maybe he had used the.75% Marcaine by accident.

Jeffrey could have become depressed, but he didn't have time to submit to depression. Between the widespread news reports of Jeffrey's having

"operated under the influence" and the fierce antidrug sentiment of the times, the district attorney had felt compelled to file criminal charges.

To Jeffrey's total disbelief, he now found himself charged with murder in the second degree. It was on this charge that Jeffrey was now awaiting the jury's verdict.

Jeffrey's musings were again interrupted by the uniformed court officer as he reappeared from the judge's chamber and slipped back into the jury room.

Why were they drawing it out like this? It was torture for Jeffrey. He was plagued by an allioo-real sense of d6jA vu, since the four-day criminal trial had not gone much differently than the previous civil trial. Only this time the stakes were higher.

Losing money, even if he didn't have it, was one thing. The specter of a criminal conviction and mandatory prison term was something else entirely.

Jeffrey truly did not think he could withstand life behind bars. Whether it was due to a rational fear or an irrational phobia, he didn't know.

Regardless, he'd told Carol he'd spend the rest of his life in another country rather than face a prison term.

Jeffrey raised his eyes to the empty judge's bench. Two days previously, the judge had charged the jury before they'd retired for their deliberations. Some of the judge's words reverberated in Jeffrey's mind and fanned his fears.

7

"Members of the jury," Judge Janice Maloney had said, "before you can find the defendant, Dr. Jeffrey Rhodes, guilty of second-degree murder, the

Commonwealth must have proved beyond a reasonable doubt that Patty Owen's death was caused by an act of the defendant which was imminently dangerous to another person and evinced a depraved mind, indifferent to human life.

An act is 'imminently dangerous' and 'evinces a depraved mind' if it is an act that a person of ordinary judgment would know is reasonably certain to kill or do serious bodily injury to another. It is also such an act if it comes from ill will, hatred, or harmful intent."

It seemed to Jeffrey that the outcome of the case hinged on whether the jury believed he had taken morphine or not. If they believed he had, then they would find he had acted with harmful intent. At least that was how

Jeffrey would find if he were one of the jurors. After all, giving anesthesia was always imminently

dangerous. The only thing that distinguished it from criminal battery was the informed consent.

But the judge's words to the jury that had most threatened Jeffrey involved the part about punishment. The judge had informed the jury that even a conviction of the lesser charge of manslaughter would require her to sentence Jeffrey to a minimum of three years in prison.

Three years! Jeffrey began to perspire and feel cold at the same moment. He wiped his brow and his fingers came away damp.

"All rise!" the court officer called out, having just stepped out of the jury room. Then he stood aside. Everyone in the courtroom scrambled to his feet. Many craned their necks, hoping to get a glimmer of the verdict from the jurors' expressions when they appeared.

Preoccupied with his thoughts, Jeffrey was caught off guard by the court officer's terse announcement. He overreacted, leaping to his feet. He felt momentarily dizzy and had to lean on the defendant's table a moment for support.

As the jurors filed in, none of them made eye contact with Jeffrey. Was that a good or bad sign? Jeffrey wanted to ask Randolph but he was afraid to.

"The Honorable Judge Janice Maloney," the court officer called out as the judge appeared from her chambers and took her seat at the bench. She arranged things on the desk in front of her, moving the water pitcher to the side. She was a thin woman with intense eyes.

"You may be seated," the court officer called. "Members of the jury, please remain standing."

Jeffrey took his seat, still watching the jury. Not one of them would look at him, a fact that progressively disturbed him. Jeffrey focused on the white-haired grandmotherly figure who stood on the far left in the front row. During the trial she had frequently looked in his direction. It had been Jeffrey's intuition she'd felt some special warmth toward him. But not now. Her hands were clasped in front of her, her eyes downcast.

The clerk of the court adjusted his glasses. He was sitting at a desk just below the bench and to the right. The court recorder was directly in front of him.

"Will the defendant please stand and face the jury," the clerk said.

Jeffrey stood up again. This time he did it slowly. Now all the jurors were staring at him. Still, their faces remained stony. Jeffrey felt his pulse hammering in his ears.

"Madam Foreperson," the clerk called out. The foreperson was a handsome woman in her late thirties who looked professional. "Has the jury agreed upon a verdict?"

:'Yes," the foreperson said.

'Bailiff, please get the verdict from the foreperson," the clerk directed.

The court officer stepped over to her and took a seemingly plain sheet of paper from her hands. Then he handed the sheet to the judge.

The judge read the note, tilting her head back to read through her bifocals. She took her time, nodded, then handed the paper to the clerk who had stood to receive it.

The clerk seemed to take his time, too. Jeffrey felt intense irritation at all this unnecessary delay as he stood facing the expressionless jurors.

The court was taunting him, mocking him with its archaic protocol. His heart was beating faster now, and his palms were sweating. There was a burning in his chest.

After clearing his throat, the clerk turned to face the jury. "What say you, Madam Foreperson, is the defendant guilty or not guilty of the alleged complaint of second-degree murder?"

Jeffrey felt his legs tremble. His left hand leaned on the edge of the defendant's table. He wasn't specifically religious, but he found himself praying: Please, God...

"Guilty!" the foreperson called out with a clear, resonant voice.

Jeffrey felt his legs sway as the image of the courtroom momentarily swam before him. He grappled for the table with his right hand to steady himself. He felt Randolph grip his right arm.

"This is only the first round," Randolph whispered in his ear. "We'll appeal, just like we did the malpractice judgment."

The clerk looked over toward Jeffrey and Randolph reprovingly, then turned back to the jury and said: "Madam Foreperson and members of the jury, harken to your verdict as recorded by the court. The jurors upon their oath do say that the defendant is guilty as charged in said complaint. So say you, Madam FoTeperson?"

:'Yes," the forelady said.

'So say you, members of the jury?" the clerk asked.

"Yes," the jurors replied in unison.

The clerk turned his attention back to his books while the judge began to discharge the jury. She thanked them for their

time and consideration of the case, praising their role in upholding a two-hundred-year tradition of justice.

Jeffrey sat down heavily, feeling numb and cold. Randolph was talking to him, reminding him that thejudge of the malpractice case should never have allowed the question of his drug problem to stand.

"Besides," Randolph said, bending down and looking Jeffrey directly in the eye, "all the evidence is circumstantial. There was not one piece of definitive evidence that you had taken morphine. Not one!"

But Jeffrey was not listening. The ramifications of this verdict were too overwhelming to consider. Deep down he realized that for all his fears, he'd really never believed he'd be convictedsimply because he was not guilty. He'd never been involved in the legal system before, and he'd always trusted that "truth would out" if he ever was wrongly accused. But that belief had been false. Now he'd be going to prison.

Prison! As if to underscore his fate, the court officer came over to handcuff him. Jeffrey could only look on, incredulous. He stared at the polished surface of the handcuffs. It was as if the manacles had transformed him into a criminal, a convict, even more than the jury's verdict.

Randolph was murmuring encouragement. The judge was still discharging the jury. Jeffrey heard none of it. He felt depression descend like a leaden blanket. Competing with the depression was a sense of panic from imminent claustrophobia. The idea of being locked in a small room evoked scary images of being caught beneath the blankets when he was a young child by his older brother, filling him with a fear of being smothered.

"Your Honor," the district attorney said as soon as the jury had filed out.

He got to his feet. "The Commonwealth moves for sentencing."

"Denied," the judge said. "The court will schedule penalty proceedings after a presentencing; investigation by the probation department. When is an appropriate time, Mr. Lewis?"

The clerk flipped through the scheduling book. "July 7 looks good. 19

"July 7 it is," the judge said.

"The Commonwealth respectfully requests denying bail or a significant increase in bail," the district attorney said. "It is the Commonwealth's position that at a minimum,- the bail should be raised from $50,000 to

$500,000."

"All right, Mr. District Attorney," the judge said, "let's hear your argument."

The district attorney stepped from behind the prosecution tablc to face the judge. "The serious nature of the complaint combined with the verdict demands a significant bail, more in keeping with the severity of the crime of which he has been convicted. There also have been rumors that Dr.

Jeffrey Rhodes would prefer to flee rather than face the punishment of the court."

The judge turned toward Randolph. Randolph stood up. "Your Honor," he began, "I would like to emphasize to the court that my client has significant ties to the community. He has always demonstrated responsible behavior. He has no previous criminal record. In fact, he has been an exemplary member of society, productive and law-abiding. He has every intention of appearing for sentencing. I feel that $50,000 is more than enough bail; $500,000 would be excessive."

..Has your client ever expressed an intention of avoiding punishment?" the judge asked, looking over the top of her glasses.

Randolph shot a glance at Jeffrey. Jeffrey's gaze fell to his hands.

Turning back to the judge, Randolph said: "I do not believe my client would think or say such a thing."

The judge looked slowly back and forth between Randolph and the district attorney. Finally she said, "Bail set at $500,000 cash surety." Then, looking directly at Jeffrey, she said, "Dr. Rhodes, as a convicted felon you are not to leave the Commonwealth of Massachusetts. Is that clear?"

Jeffrey meekly nodded.

"Your Honor... !" Randolph protested.

But the judge only pounded her gavel once and stood up, clearly dismissive.

"All rise!" the court officer barked.

With swirling robes like a dervish, Judge Janice Maloney swept from her court and disappeared into her chambers. The courtroom erupted in conversation.

"This way, Dr. Rhodes," the court officer standing next to Jeffrey said, motioning toward a side door. Jeffrey stood and stumbled forward. He cast a quick glance in Carol's direction. She was looking at him sadly.

Jeffrey's panic grew as he was taken to a holding room furnished with a plain table and spartan wooden chairs. He sat in the chair Randolph steered him to. Although he did his best to

maintain his composure, he couldn't keep his hands from trembling. He felt short of breath.

I Randolph did his best to calm him. He was indignant about the verdict and optimistic about the appeal. Just then, Carol was escorted into the narrow room. Randolph patted her on the back and said, "You talk to him. I'll go call the bail bondsman."

Carol nodded and looked down at Jeffrey. "I'm sorry," she said after

Randolph had left the room.

Jeffrey nodded. She had been good to stand by him. His eyes welled with tears. He bit his lip to keep from crying.

"It's so unfair," Carol said, sitting down next to him.

"I can't go to prison," was all Jeffrey could say. He shook his head. "I still can't believe this is happening."

"Randolph will appeal," Carol said. "It's not over yet."

"Appeal," Jeffrey said with disgust. "It will be just more of the same.

I've lost two cases..."

"It's not the same," Carol said. "Only experienced judges will be looking at the evidence, not an emotional jury."

Randolph came back from the phone to say that Michael Mosconi, the bail bondsman, was on his way over. Randolph and Carol began an animated conversation about the process of appeal. Jeffrey put his elbows on the table and despite the handcuffs, rested his head in his hands. He was thinking about his medical license, wondering what would happen to it as a consequence of the verdict. Unfortunately, he had a pretty good idea.

Michael Mosconi arrived in short order with his briefcase. His office was only a few steps from the courthouse, in the curved building facing

Government Center. He was not a big man, but his head was large and almost bald. What hair he had grew in a dark crescent that stretched around the back of his head from ear to ear. Some of the strands of dark hair were combed directly over the bald dome in a vain effort to provide a minimum of cover. He had intensely dark eyes that appeared to be all pupil. He was oddly dressed in a dark blue polyester suit with a black shirt and a white tie.

Mosconi set his briefcase on the table, snapped open the latches, and removed a file folder labeled with Jeffrey's name.

"Okay," he said, taking a seat at the table and opening the file. "How much is the increase in bail?" He had already put up the initial $50,000 bail, having collected $5,000 for his services.

"It's $450,000," Randolph said.

Mosconi whistled through his teeth, pausing in setting out the

papers. "Who do they think they got here, Public Enemy Number One?" Neither

Randolph nor Jeffrey felt they owed him the courtesy of an answer.

Mosconi's attention returned to his paperwork, unconcerned by his client's lack of response. He'd already done an O&E, an ownership and encumbrance check, on Jeffrey and Carol's Marblehead house when bail had initially been set, securing the first bond with a lien of $50,000 on the home. The house had a documented value of $800,000 with an existing mortgage ofjust over

$300,000. "Well, isn't that convenient," he said. "I'll be able to post bond with an additional $450,000 lien against your little castle in

Marblehead. How's that?"

Jeffrey nodded. Carol shrugged.

As Mosconi began filling out the papers, he said: "Then, of course, there is the little matter of my fee, which in this case will be $45,000. I'll want that in cash."

"I don't have that kind of cash," Jeffrey said.

Mosconi held up from completing the form.

"But I'm sure you can raise it," Randolph put in.

"I suppose," Jeffrey said. Depression was setting in.

"Either yes or no," Mosconi said. "I don't do this stuff for recreation."

"I'll raise it," Jeffrey said.

"Normally I require the fee up front," Mosconi added. "But since you are a doctor..." He laughed. "Let's just say I'm accustomed to dealing with a slightly different clientele. But for you, I'll take a check. But only if you can raise the money and have it in your account by, let's say, this time tomorrow. Is that possible?"

"I don't know," Jeffrey said.

"If you don't know, then you'll have to stay in custody until you got the money," Mosconi said.

"I'll raise it," Jeffrey said. The thought of even a few nights in jail was intolerable.

"Do you have a check with you?" Mos6oni asked.

Jeffrey nodded.

Mosconi went back to filling out the form. "I hope you understand, Doctor," he said, "that I'm doing you a big favor by taking a check. My company would take a dim view, so let's just keep it between us. Now you'll have that money in your account in twenty-four hours?"

"I'll take care of it this afternoon," Jeffrey said.

"Wonderful," Mosconi said. He pushed the papers toward

Jeffrey. "Now if you two will sign this note, I'll run down to the clerk's office and settle the score."

Jeffrey signed without reading what he was signing. Carol read it carefully, then signed. Carol got Jeffrey's checkbook out of his jacket pocket and held it while Jeffrey made out a check for $45,000. Mosconi took the check and put it in his briefcase. Then he got up and sauntered to the door. "I'll be back," he said with a sly smile.

"Charming fellow," Jeffrey said. "Does he have to dress that way?"

"He is doing you a favor," Randolph said. "But it's true, you're hardly one of the lowlifes he's accustomed to dealing with. Before he gets back, I think we should talk about the presentencing investigation and what it entails."

"When do we file the appeal?" Jeffrey asked.

"Immediately," Randolph said.

"And I'm on bail until the appeal is heard?"

"Most likely," Randolph said evasively.

"Thank God for small favors," Jeffrey said.

Randolph then explained the presentencing investigation and what Jeffrey might expect from the penalty proceedings. He didn't want to see Jeffrey any more demoralized than he already was, so he was careful to emphasize the more promising aspects of the appeal. But Jeffrey's spirits remained low.-

"I have to admit I don't have a lot of faith left in this legal system,"

Jeffrey said.

"You've got to think positively," Carol said.

Jeffrey looked at his wife and began to appreciate how angry he was. Carol telling him he should think positively under the circumstances was eminently annoying. Suddenly Jeffrey realized he was angry at the system, angry at fate, angry at Carol, even angry at his attorney. At least anger was probably healthier than being depressed.

"All is in order," Mosconi said as he slipped in the door. He was waving an official-looking document. "If you would?" he said, motioning for the court officer to unhandcuff Jeffrey.

Jeffrey rubbed his wrists with relief when they were free from the shackles. What he wanted most was to get out of the courthouse. He stood up.

"I'm sure I don't have to remind you about the $45,000," Mosconi said.

"Just remember, I'm putting my ass on the line for you."

"I appreciate it," Jeffrey said, trying to sound thankful.

They left the holding room together although Michael Mosconi hurried off in the opposite direction when they got to the hall.

Jeffrey had never been so consciously appreciative of the fresh, ocean-scented air as when he stepped from the courthouse onto the brick-paved plaza. It was a bright, midspring afternoon with puffy little white clouds scudding across a faraway blue sky. The sun was warm but the air crisp. It was amazing how the threat of prison had sharpened Jeffrey's perceptions.

Randolph took his leave on the wide plaza in front of the garishly modem

Boston City Hall. "I'm sorry it turned out like this. I tried my best."

"I know," Jeffrey said. "I also know I was a lousy client and made it extra hard for you."

"We'll get right on the appeal. I'll be talking with you in the morning.

Good-bye, Carol."

Carol waved, then she and Jeffrey watched Randolph stride off toward State

Street, where he and his partners occupied an entire floor of one of the newer Boston office towers. "I don't know whether to love him or hate him,"

Jeffrey said. "I don't even know if he did a good job or not, especially since I got convicted."

"I personally don't think he was forceful enough," Carol said. She started toward the parking garage.

"Aren't you going back to work?" Jeffrey called after her. Carol worked for an investment banking firm located in the financial area. That was in the opposite direction.

"I took the day off," she said over her shoulder. She stopped when she saw that Jeffrey wasn't walking after her. "I didn't know how long rendering the verdict would take. Come on, you can give me a ride to my car."

Jeffrey caught up to her and they walked together, skirting City Hall. "How are you going to raise $45,000 in twenty-four hours?" Carol'asked, tossing her head in her characteristic way. She had fine, straight, dirty-blond hair that she wore in a fashion that caused it to constantly blow in her face.

Jeffrey felt his irritation surface again. Finances had been one of the trouble points in their marriage. Carol liked to spend money, Jeffrey liked to save it. When they'd married, Jeffrey's salary was larger by far, so it was Jeffrey's salary Carol made it her business to spend. When Carol's salary began to climb, it all went into her investment portfolio while

Jeffrey's salary was still used to pay all the expenses. Carol's rationale had been

that if she didn't work, then they would be using Jeffrey's salary for all the expenses anyway.

Jeffrey didn't answer Carol's question immediately. He realized that in this instance his anger was misdirected. He wasn't angry with her. All their old financial disputes were water under the bridge, and wondering where $45,000 in cash was to come from was a legitimate concern. What angered him was the legal system and the lawyers who ran it. How could lawyers like the district attorney or the plaintiff attorney live with themselves when they lied so much? From the depositions Jeffrey knew they did not believe their own prosecution ploys. Each of Jeffrey's trials had been an amoral process in which the opposing attorneys had allowed ends to justify dishonest means.

Jeffrey got in behind the wheel of his car. He took a deep breath to control his anger, then turned to Carol. "I plan to increase the mortgage on the Marblehead house. In fact, we should stop at the bank on the way home."

"With the lien we just signed, I don't think the bank will up the mortgage," Carol said. She was something of an authority on the subject; this was her area of expertise.

"That's why I want to go right now," Jeffrey said. He started the car and drove out of the garage. "No one will be the wiser. It will take a day or two before that lien finds its way into their computers."

"Do you think you ought to do that?"

"Do you have any other ideas of how I can raise $45,000 by tomorrow afternoon?" Jeffrey asked.

"I guess not. "

Jeffrey knew she had that kind of money in her investment portfolio, but he'd be damned if he'd ask her for it.

"See you at the bank," Carol said as she got out in front of the garage where her car was parked.

As Jeffrey drove north over the Tobin Bridge, exhaustion settled over him.

It seemed that he had to make a conscious effort to breathe. He began to wonder why he was bothering with all this rigmarole. It wasn't worth it.

Especially now that he was sure to lose his medical license. Other than medicine, in fact other than anesthesia, he didn't know much about anything. Except for a menial job like bagging at a grocery store, he couldn't think of anything else he was qualified to do. He was a convicted, worthless forty-two-year-old, an unemployable middle-aged nothing.

When Jeffrey arrived at the bank, he parked but didn't get

out of the car. He slumped forward and let his forehead rest on the steering wheel. Maybe he should just forget everything, go home, and sleep.

When the passenger-side door opened, Jeffrey didn't even bother to look up.

"Are you all right?" Carol asked.

"I'm a little depressed," Jeffrey said.

"Well, that's understandable," Carol said. "But before you get too immobile, let's get this bank stuff out of the way."

"You're so understanding," Jeffrey said irritably.

"One of us has to be practical," Carol said. "And I don't want to see you going to jail. If you don't get that money in your checking account, that's where you'll end up."

"I have a terrible premonition that that's where I'm going to end up no matter what I do." With supreme effort, he got out of the car. He faced

Carol over the roof of the car. "The one thing I find interesting," he added, "is that I'm going to prison and you're going to L.A., but I don't know who's worse off."

"Very funny," Carol said, relieved that he was at least making a joke, even if she failed to find it amusing.

Dudley Farnsworth was the manager of the Marblehead branch of Jeffrey's bank. Years before, he'd happened to be the junior bank officer in the

Boston branch of the bank that had handled Jeffrey's first real estate purchase. Jeffrey had been a resident in anesthesia at the time. Fourteen years previously, Jeffrey had bought a Cambridge three-decker and Dudley had arranged the financing.

Dudley saw them as soon as he could, taking them back to his private office and seating them in leather chairs facing his desk.

"What can I do for you?" Dudley said pleasantly. He was Jeffrey's age but looked older with his silver-white hair.

"We'd like to increase the mortgage on our house," Jeffrey said.

"I'm sure that won't be a problem," Dudley said. He went to a file drawer and pulled out a folder. "What kind of money are you looking for?"

"Forty-five thousand dollars," Jeffrey said.

Dudley sat down and opened the folder. "No problem," he said, looking at the figures. "You could take even more if you wish."

"Forty-five thousand will be enough," Jeffrey said. "But I need it by tomorrow."

"Ouchl" Dudley said. "That's going to be tough."

"Perhaps you could arrange a home equity loan," Carol suggested. "Then when the mortgage comes through, you can use that to pay off the loan."

Dudley nodded with eyebrows arched. "That's an idea. But I tell you what, let's go ahead and fill out the forms for the mortgage. I'll see what I can do. If the mortgage doesn't come through, then I'll take Carol's suggestion. Can you come in tomorrow morning?"

"If I can get out of bed," Jeffrey said with a sigh.

Dudley shot a glance at Jeffrey. He intuited that something was wrong, but he was too much of a gentleman to inquire.

After the bank business was concluded, Jeffrey and Carol walked out to their cars.

"Why don't I stop at the store and get something good for dinner?" Carol suggested. "What would you like tonight? How about your favorite: grilled veal chops."

"I'm not hungry," Jeffrey said.

"Maybe you're not hungry now, but you will be later." I doubt it," Jeffrey said.

"I know you and you'll be hungry. I'm going to stop at the grocery for food for tonight. So what'll it be?"

"Get whatever you want," Jeffrey said. He climbed into his car. "With the way I feel, I can't imagine I'm going to want to eat.$'

When Jeffrey reached home, he pulled into the garage, then went directly to his room. He and Carol had been occupying separate rooms for the past year.

It had been Carol's idea, but Jeffrey. surprised himself by warming to the idea right away. That had been one of the first clear signs that their marriage was not all it should be.

Jeffrey closed the door behind him and locked it. His eyes wandered to his books and periodicals carefully shelved according to height. He wasn't going to need them for a while. He 'walked over to the bookcase and pulled out Bromage's Epidural Analgesia and threw it against the wall. It poked a small hole in the plaster, then crashed to the floor. The gesture didn't make him feel any better. In fact it made him feel guilty, and the effort exhausted him even more. He picked up the book, smoothed out a few of the bent pages, then slipped it back into its designated spot. By habit, he lined the spine up with the other volumes.

Sitting down heavily in the wing chair by the window, Jeffrey vacantly stared out at the dogwood, whose wilting spring blos-

soms were past their prime. He was gripped by overwhelming sadness. He knew he had to shake this self-pity if he was to accomplish anything. He heard

Carol's car pull up, then the door slam. A few minutes later there was a quiet knock at his door. He ignored it, thinking she'd guess he was asleep.

He wanted to be alone.

Jeffrey struggled with his deepening sense of guilt. Perhaps that was the worst part of having been convicted. By undermining his confidence, he again worried that maybe he had erred in administering the anesthesia that fateful day. Maybe he had used the wrong concentration. Maybe Patty Owen's death was his fault.

Hours slipped by as Jeffrey's preoccupied mind wrestled with a growing sense of his worthlessness. Everything that he'd ever done seemed stupid and pointless. He'd failed at everything from being an anesthesiologist to being a husband. He couldn't think of one thing that he'd succeeded at.

He'd even failed at making the basketball team in junior high school.

When the sun sagged down in the western sky and touched the horizon,

Jeffrey had the sense it was setting on his life. He thought that few people could realize the tremendous toll malpractice litigation took on a practicing physician's emotional and professional life, especially when there was no malpractice involved. Even if Jeffrey had won the case, he knew that his life would have been changed forever. The fact that he lost was that much more devastating. And it had nothing to do with money.

Jeffrey watched the sky change from warm reds to cold purple and silver, while the light ebbed and the day died. As he sat there in the gathering gloom, he suddenly had an idea. It wasn't entirely true that he was helpless. There was something he could do to affect his destiny. With the first sense of purpose in weeks, Jeffrey pushed himself out of the wing chair and went to the closet. From it he pulled his large black doctor's bag and put it on the bureau.

From the doctor's bag he retrieved two small bottles of Ringer's Lactate intravenous fluid as well as two infusion kits and one small scalp needle.

Then he took out two vials, one of succinyleholine, the other of morphine.

Using a syringe, he drew up 75 mg of the succinylcholine and squirted it into one of the Ringer's Lactate bottles. Then he drew up 75 mg of morphine, a walloping dose.

One of the benefits of being an anesthesiologist was that Jeffrey knew the most efficient way to commit suicide. Other doc-

tors didn't, though they tended to be more successful in their attempts than the general public. Some shot themselves, a messy method which, surprisingly enough, was not always effective. Others took overdoses, another method that often didn't yield the desired result. Too often the would-be suicides were caught in time to have their stomachs pumped. Other times the drugs injected were enough to bring on a coma but not death. Jeffrey shuddered at the haphazard consequences.

Jeffrey felt his depression lift slightly as he worked. It was heartening to have a goal. He took the painting that hung over the head of the bed down to use the hook to hang both IV bottles. He then sat down on the side of the bed and started the IV on the back of his left hand with the bottle containing only the Ringer's Lactate solution. He piggy-backed the bottle containing the succiny1choline onto the other, with only the thin blue stopcock separating him from its lethal contents.

Careful not to dislodge the IV, Jeffrey lay back on the bed. His plan was to inject the huge dose of morphine and then open the stopcock on the solution containing the succiny1choline. The morphine would send him to never-never-land long before the succiny1choline concentration paralyzed his respiratory system. Without a ventilator, he would die. It was as simple as that.

Gently, Jeffrey inserted the needle of the syringe containing the morphine into the IV port of the infusion line going into the vein on the back of his hand. Just as he was beginning to inject the narcotic, there was a soft knock on his door.

Jeffrey rolled his eyes. What a time for Carol to interrupt. He held off the injection but didn't respond to her knock, hoping she'd go away if she thought he was still asleep. Instead, she knocked louder, then louder still. "Jeffrey!" she called. "Jeffreyl I've made dinner."

There was a short silence that made Jeffrey think she'd given up. But then

Jeffrey heard the knob turn and the door rattle against the jamb.

"Jeffrey-are you all right?"

Jeffrey took a deep breath. He knew he had to say something or she might be concerned enough to force the door. The last thing he wanted was for her to come barging in and see the IV.

"I'm fine," Jeffrey called out at last.

"Then why didn't you answer me?" Carol demanded.

"I was asleep."

"Why is this door locked?" Carol asked.

"I guess I didn't want to be disturbed," Jeffrey replied with pointed irony.

"I've made dinner," Carol said.

"That's nice of you, but I'm still not hungry."

"I made veal chops, your favorite. I think you should eat."

"Please, Carol," Jeffrey said with exasperation. "I'm not hungry. 11

"Well, come eat for my sake. As a favor to me."

Fuming, Jeffrey set the syringe with the morphine on the night table and pulled out the IV. He went to the door and yanked it open, but not so far that Carol could see in. "Listen!" he snapped. "I told you earlier that I wasn't hungry then and I'm telling you that I'm not hungry now. I don't want to eat and I don't like you trying to make me feel guilty about it, understand?"

"Jeffrey, come on. I don't think you should be alone. Now I've gone to the trouble to shop for you and cook. The least you can do is come try it."

Jeffrey could see there would be no getting around her. When she'd made up her mind, she was not the type of person who could be easily dissuaded.

"All right," he said heavily. "All right."

"What's wrong with your hand?" Carol asked, noticing a drop of blood on the back of it.

"Nothing," Jeffrey said. "Nothing at all." He glanced at the back of his hand. Blood was oozing from the IV site. Frantically, he searched for an explanation.

"But it's bleeding."

"A paper cut," Jeffrey said. He was never good at fibbing. Then, with an irony only he could appreciate, he added, "I'll live. Believe me, I'll live. Look," he said, "I'll be down in a minute."

"Promise?" Carol said.

"I promise."

With Carol gone and the door relocked, Jeffrey removed the quarter-liter IV bottles and stored them in the back of his closet in his leather doctor's bag. He threw the wrappers from the infusion kits and the scalp needle into the wastebasket in the bathroom.

Carol had some sense of timing, he thought ruefully. Only as he packed away the medical paraphernalia did he realize how close he had come. He told himself he shouldn't give in to despair, at least not until all legal avenues had been exhausted. Until this recent turn of events, Jeffrey had never seriously enter tained thoughts of suicide. He was honestly baffled by the sui-

cides he knew of, though intellectually he could appreciate the depths of despair that might prompt it.

Oddly enough, or perhaps not so oddly, the only suicides he had known were other doctors who'd been pushed to the brink by motives not unlike

Jeffrey's. He recalled one friend in particular: Chris Everson. He couldn't remember exactly when Chris had died, but it had been within the last two years.

Chris had been a fellow anesthesiologist. Years before, he and Jeffrey had been residents together. Chris would have remembered the days when gung-ho residents warded off flu symptoms with Ringer's Lactate. What made thinking about Chris suddenly so poignant was the realization that he'd been sued for malpractice because one of his patients had had a terrible reaction to a local anesthetic during epidural anesthesia.

Jeffrey closed his eyes and tried to remember the details of the case. As best as he could recall, Chris's patient's heart had arrested as soon as

Chris put in the test dose of only 2 cc's. Although they had been able to get the heart beating again, the patient ended up quadriplegic and semicomatose. Within a week after the event, Chris had been sued along with

Valley Hospital and everyone else even remotely associated with the episode. The "deep pockets" strategy yet again.

But Chris never went to court. He committed suicide even before the discovery period had been completed. And even though the anesthesia procedure had been characterized as having been impeccable, the decision ultimately rendered found for the plaintiff. At the time, the settlement had been the largest award for malpractice in Massachusetts' history. But in the ensuing months, Jeffrey could think of -at least two awards that had topped it.

Jeffrey could distinctly remember his reaction when he'd heard of Chris's suicide. It had been one of complete disbelief. Back then, before Jeffrey's current involvement with the legal system, he'd had no idea what could have pushed Chris to do such an awful thing. Chris enjoyed a reputation as a superb anesthesiologist, a doctoes doctor, one of the best. He'd recently married a beautiful OR nurse who worked in Valley Hospital. He seemed to have everything going for him. And then the nightmare struck...

A soft knock brought Jeffrey back to the present. Carol was at the door again.

"Jeffrey!" she called. "Better come before it gets cold."

"I'm on my way."

Now that he knew too well what Chris had only begun to go through, Jeffrey wished he'd stayed in touch at the time. He could have been a better friend. And even after the man ended his life, all Jeffrey had done was attend the funeral. He had never even contacted Kelly, Chris's wife, even though at the funeral he'd promised himself he would do so.

Such behavior wasn't like Jeffrey, and he wondered why he'd acted so heartlessly. The only excuse he could think of was his need to repress the episode. The suicide of a colleague with whom Jeffrey could so easily identify was a fundamentally disturbing event. Perhaps facing it squarely would have been too great a challenge for him. It was the kind of personal examination that Jeffrey and doctors in general had been taught to avoid, labeling it "clinical detachment."

What a terrible waste, he thought as he remembered Chris the last time he'd seen him, before all the tragedy struck. And if Carol hadn't interrupted, mightn't there be others thinking the same thoughts with respect to him?

No, Jeffrey thought vehemently, suicide wasn't an option. Certainly not yet. Jeffrey hated to sound mawkish, but where there was life, there was hope. And what had happened in the aftermath of Chris's suicide? With Chris dead, there was no one to defend or clear his name. For all his despair and developing depression, Jeffrey still was enraged by a system and process that had managed to convict him when he had honestly done no wrong. Could he really rest until he'd done his best to clear his name?

Jeffrey got angry just thinking about his case. To the lawyers involved, even Randolph, all this might be business as usual, but not so to Jeffrey.

This was his life on the line. His career. Everything. The great irony was that the day of the Patty Owen tragedy, Jeffrey had done his utmost to do well by her. He'd only run the IV and taken the paregoric so he could perform the job for which he'd been trained. Dedication was what had motivated him, and this was how he'd been repaid.

If Jeffrey ever was able to return to medicine, he would be afraid of the long-lasting effects this case would have on any medical decisions he would ever make. What kind of care could people come to expect from doctors who were forced to work in the current malpractice milieu and who had to restrain their best instincts and second-guess their every step? How had such a system evolved? Jeffrey wondered. It certainly wasn't eliminating the few "bad" doctors, since they ironically rarely got sued.

What was happening was that a lot of good doctors were being destroyed.

As Jeffrey washed before descending to the kitchen, his mind dredged up another memory that he had unconsciously repressed. One of the best and most dedicated internists he'd ever met had killed himself five years ago on the same night he'd received a summons for malpractice. Shot himself through the mouth with a hunting rifle. He hadn't even waited for the discovery process to begin, much less the trial. At the time Jeffrey had been disturbingly mystified, since everyone, knew the suit had been baseless. In fact the doctor had, ironically, saved the man's life. Jeffrey now had some idea of the source of the man's despair.

Finished in the bathroom, Jeffrey returned to his bedroom and changed into clean slacks and shirt. Opening his door, he smelled the food Carol had prepared. He still wasn't hungry, but he'd make an effort. Pausing at the top of the stairs, he vowed to fight the depressive thoughts he was bound to experience until this current episode had run its course. With that commitment in mind he started for the kitchen.

TUESDAY,

MAY 16,1989

9:12 A.M.

Jeffrey woke up with a start and was amazed at the time. He'd first awakened around five A.M., surprised to find himself sitting in the wing chair by the window. Stiffly, he had removed his clothes and gotten into bed, thinking he would never be able to fall back asleep. But obviously he had.

He took a quick shower. Emerging from his room, he looked for Carol. Having recovered to an extent from the depressive depths of the previous day, he wanted some h1iman contact and a bit of sympathy. He hoped that Carol had not left for work without talking to him. He wanted to apologize for his lack of appreciation for her efforts the night before. It was a good thing, he now realized, that she'd interrupted him, and that she'd gotten him irritated. Unknowingly she'd saved him from committing suicide. For the first time in his life, getting angry had had a positive effect.

But Carol was long gone. A note was leaning against a shredded wheat box on the kitchen table. It said that she'd not wanted to disturb him since she was sure he needed rest. She had to get to work early. She hoped he'd understand.

Jeffrey filled a bowl with cereal and got the milk from the refrigerator.

He envied Carol her job. He wished he had a job to go to. It would keep his mind occupied if nothing else. He would have liked to have made himself useful. It might have helped his self-esteem. He'd never realized quite how much his work defined his persona.

Back in his room, Jeffrey disposed of the IV paraphernalia by wrapping it in old newspapers and carrying it out to the trash barrels in the garage.

He didn't want Carol to find it. He felt strange handling the material. It gave him a tremendous uneasiness to have been knowingly and voluntarily so close to death.

The idea of suicide had occurred to Jeffrey in the past, but always in a metaphorical context, and usually more as a retribution fantasy to get back at someone who he believed had wronged him in some emotional way, like when his girlfriend in the eighth grade had capriciously switched her affections to Jeffrey's best friend. But last night it had been different, and to think that he'd come within a hair's breadth of doing it made his legs feel weak.

Returning to the house, Jeffrey considered what effects his suicide would have had on his friends and family. It probably would have come as a relief to Carol. She wouldn't have had to go through with the divorce. He wondered if anyone would have missed him. Probably not...

"For Pete's sake," Jeffrey exclaimed, realizing the ridiculousness of this line of thought and remembering his vow to resist depressive thoughts.

Would his thinking thrive on his low selfesteem for the rest of his days?

But the subject of suicide was hard to shake from his mind. He wondered again about Chris Everson. Had his suicide been the product of an acute depression that had struck like a sudden storm, like Jeffrey had felt the night before? Or had he planned it for some time? Either way, his death was a terrible loss for everyone-his family, the public, even the profession of medicine.

Jeffrey stopped en route to his room and stared out the livingroom window with unseeing eyes. His situation was no less a waste. From the point of view of his productivity, the loss of his medical license and his going to prison was no less a waste than if he'd succeeded in committing suicide.

"Damn!" he shouted as he grabbed one of the pillows from the couch and punched it repeatedly with his fist. "Damn, damn, damn!"

Jeffrey quickly wore himself out and replaced the pillow. Then he sat himself down dejectedly with his knees jutting up in front of him. He interwound his fingers and rested his elbows on his knees and tried to think of himself in prison. It was a horrid thought. What a travesty of justice! The malpractice stuff had been more than enough to seriously disrupt and alter his life, but this criminal nonsense was a quantum leap worse, like throwing salt into a mortal wound.

Jeffrey thought about his colleagues at the hospital and other physician friends. They had all been supportive at first, at least until the criminal indictment had been handed down. Then they had avoided Jeffrey as if he'd had some kind of infectious dis-

ease. Jeffrey felt isolated and alone. And more than anything, he felt angry.

..It's just not fair!" he said through clenched teeth.

Completely out of character, Jeffrey snatched up a piece of Carol's crystal bric-a-brac from a side table and in a moment of sheer frustration threw it with deadly accuracy at the glassfronted sideboard that he could see through- the arch leading to the dining room. There was a resounding shatter of glass that made him wince.

'~Uh-ohl" Jeffrey said as he realized what he'd done. He got up and went for the dustpan and broom. By the time he'd picked up the mess, he'd come to a momentous conclusion: he wasn't going to prisonl No way. Screw the appeal process. He had as much confidence in the legal system as he did in fairy tales.

The decision was made with a suddenness and resolve that left Jeffrey feeling exhilarated. He checked his watch. The bank would be open soon.

Excitedly he went to his room and found his passport. He was lucky the court hadn't made him surrender it at the same time they'd increased his bail. Then he called Pan Am. He learned that he could shuttle to New York, bus to Kennedy, and then fly on to Rio. Considering all the carriers serving the market, he had a wide range of flights from which to choose, including one that left at 11:45 P.m. and made a few stops in exotic locations.

With his pulse racing in anticipation, Jeffrey called the bank and got

Dudley on the line. He did his best to sound controlled. He asked about the progress on the loan.

"No problem," Dudley said proudly. "Pulling a few strings, I got it approved like that." Jeffrey could hear the man snap his fingers for his benefit. "When will you be coming in?" Dudley continued. "I'd like to be sure I'm here."

"I'll be in shortly," Jeffrey said, planning his schedule. Timing would be key. "I have one other request. I'd like to have the money in cash."

"You're joking," Dudley said.

"I'm serious," Jeffrey insisted.

"It's a bit irregular," Dudley said hesitantly.

Jeffrey hadn't given this issue much thought, and he could sense Dudley's hesitance. He realized he'd have to explain if he hoped to get the money, and he definitely needed the money. He couldn't leave for South America with only pocket change.

"Dudley," Jeffrey began, "I'm in some unfortunate trouble."

"I don't like the sound of this," Dudley said.

"It's not what you're thinking. It's not gambling or anything like that.

The fact is, I have to pay it to a bail bondsman. Haven't you read about my troubles in the papers?"

"No, I haven't," Dudley said, warming up again.

"I got sued for malpractice and then indicted over a tragic anesthesia case. I won't burden you with the details at the moment. The problem is, I need the $45,000 to pay a bail bondsman who posted my bail. He said he wanted it in cash."

"I'm sure a cashier's check would be acceptable."

"Listen, Dudley," Jeffrey said. "The man told me cash. I promised him cash.

What can I say? Do me this one favor. Don't make it any harder on me than it already is."

There was a pause. Jeffrey thought he heard Dudley sigh.

"Are hundred-dollar bills okay?"

"Fine," Jeffrey said. "Hundreds would be perfect." He was wondering how much space four hundred and fifty hundreddollar bills would take.

"I'll have it ready," Dudley said. "I just hope you're not planning on carrying this around for any length of time."

"Just into Boston," Jeffrey said.

Jeffrey hung up the phone. He hoped that Dudley wouldn't call the police or try to check his story. Not that anything wouldn't have jibed. Jeffrey felt the fewer people thinking about him and asking questions, the better, at least until he was on the plane out of New York.

Sitting down with a writing tablet, Jeffrey started a note to Carol, telling her he was taking the $45,000 but that she could have everything else. But the letter sounded awkward. Besides, as he wrote he realized he didn't want to leave any evidence of his intentions in case he was delayed for some reason. He crumpled the paper, set a match to it, and tossed it in the fireplace. Instead of writing, he decided to call Carol from some foreign location and talk to her directly. It would be more personal than a letter. It would be safer, too.

The next issue was what he should take with him. He didn't want to be burdened with a lot of luggage. He settled on a small suitcase, which he loaded with basic casual clothes. He didn't imagine South America would be very formal. By the time he had packed everything he wanted, he had to sit on the suitcase to get it closed. Then he put some things in his briefcase, including his toiletries and clean underwear.

He was about to leave his closet when he eyed his doctor's bag. He hesitated for a moment, wondering what he would do

if something went horribly wrong. To be on the safe side, he opened the doctor's bag and took out an IV setup, a few syringes, a quarter liter of IV fluid, and a vial each of succiny1choline and morphine and packed them in his briefcase beneath the underwear. He didn't like to think he was still entertaining thoughts of suicide, so he told himself that the drugs were like an insurance policy. He hoped he wouldn't need them, but they were there just in case...

Jeffrey felt strange and a little sad glancing around the house for what was probably the last time, knowing he might never lay eyes on it again.

But walking from room to room, he was surprised not to be more upset. There was so much to remind him of past events, both good and bad. But more than anything else, Jeffrey realized that he associated the place with his failed marriage. And just like his malpractice case, he'd be better off leaving it behind. He felt energized for the first time in months. It felt like the first day of a new life.

With the suitcase in the trunk and his briefcase on the passenger seat beside him, Jeffrey drove out of the garage, beeped the door shut, and was on his way. He didn't look back. The first stop was the bank, and as he got closer, he began to get anxious. His new life was starting out in a unique fashion: he was deliberately planning to break the law by defying the court. He wondered if he would get away with it.

By the time he pulled into the bank's parking lot, he was very nervous. His mouth had gone dry. What if Dudley had called the police about his requesting the bail money in cash? It wouldn't take the intelligence of a rocket scientist to figure that Jeffrey might be planning on doing something else with the money rather than turn it over to the bail bondsman.

After sitting in his parked car for a moment to summon his courage, Jeffrey grabbed his briefcase and forced himself into the bank. In some respects he felt like a bank robber, even though the money he was seeking technically belonged to him. Taking a deep breath to steady himself, he went to the service desk and asked for Dudley.

Dudley came to meet him with smiles and small talk. He led Jeffrey back to his office and motioned to a chair. To judge by his demeanor, he didn't hold Jeffrey suspect. But Jeffrey's anxiety stayed razor sharp. He was trembling.

"Some coffee or a soft drink?" Dudley offered. Jeffrey decided he'd be better off without caffeine. He told Dudley some juice would be fine. He thought it best to give his hands something

to do. Dudley smiled and said, "Sure thing." The man was being so cordial,

Jeffrey was afraid it was a trap.

"I'll be right back with the cash," Dudley said after handing Jeffrey a glass of orange juice. He returned in a few minutes carrying a soiled canvas money bag. He dumped the contents onto his desk. There were nine packets of hundred-dollar bills, each containing fifty bills. Jeffrey had never seen so much money in one place. He felt increasingly uneasy.

"It took us a little doing to get this together so quickly," Dudley told him.

"I appreciate your effort," Jeffrey said.

"I suppose you'll want to count it," Dudley said, but Jeffrey declined.

Dudley had Jeffrey sign a receipt for the cash. "Are you sure you don't want a cashier's check?" Dudley asked as he took the signed paper from

Jeffrey. "It's not safe carrying this kind of cash around. You could call your bail bondsman and have him pick it up here. And you know, a cashier's check is as good as cash. He could then go into one of our Boston offices and get cash if that's what he's after. It would make it safer for you."

"He said cash, so I'm giving him cash," Jeffrey said. He was actually touched by Dudley's concern. "His office isn't far," he explained.

"And you're sure you don't want to count it?"

Jeffrey's tension was beginning to evoke irritation, but he forced a smile.

"No time. I was supposed to have this money in town before noon. I'm already late. Besides, I've been doing business long enougk with you." He packed the money into his briefcase and stood up.

"If I'd known you weren't going to count it, I would have taken a few bills from each packet." Dudley laughed.

Jeffrey hurried out to the car, tossed in the briefcase, and drove out of the parking lot with extra care. All he needed was a speeding ticket! He checked the rearview mirror to make sure he wasn't being followed. So far so good.

Jeffrey drove directly to the airport and parked on the roof of the central parking building. He left the parking stub in the car's ashtray. When he called Carol from wherever, he'd tell her to pick the car up.

With the briefcase in one hand and the suitcase in the other, Jeffrey walked to the Pan Am ticket counter. He tried to behave like any businessman going off on a trip, but his nerves were shot; his stomach was in agony. If anyone recognized him,

they'd know he was jumping bail. He'd been specifically told not to leave the state of Massachusetts.

Jeffrey's anxiety went up a notch every minute he waited in the ticket line. When his turn finally came, he bought a ticket for the New York to

Rio flight as well as one for the 1:30 P.m. shuttle. The agent tried to convince him it would be far easier to take one of their late afternoon flights directly to Kennedy. That way Jeffrey wouldn't have to take the bus from LaGuardia to Kennedy. But Jeffrey wanted to go on the shuttle. He felt the sooner he got out of Boston, the better he would feel.

Leaving the ticket area, Jeffrey approached security's X-ray machine. There was a uniformed state police officer casually lounging just beyond it. It was all Jeffrey could do not to turn around and run.

Right after he hoisted his briefcase and then the suitcase onto the conveyer belt and watched them disappear into the machine, Jeffrey had a sudden fright. What about the syringes and the ampule of morphine? What if they showed up on the X-ray, and he had to open the briefcase? Then they'd discover the stacks of moneyl What would they think of all that cash?

Jeffrey thought about trying to reach into the X-ray machine to yank his briefcase back, but it was too late. He glanced at the woman studying the screen. Her face was illuminated eerily by the light, but her eyes were glazed with boredom. Jeffrey felt himself being subtly urged on by the people waiting behind. He stepped through the metal detector, eyes on the policeman the whole time. The policeman caught his eye and smiled; Jeffrey managed a crooked smile in return. Jeffrey looked back at the woman studying the screen. Her blank face looked suddenly puzzled by something.

She had stopped the conveyor belt and was motioning for another woman to look at the screen.

Jeffrey's heart sank. The two were examining the contents of his briefcase as it appeared on the screen. The policeman hadn't noticed yet. Jeffrey caught him yawning.

Then the conveyor belt started again. The briefcase came out, but the second of the two women stepped over and put her hand on it.

"Is this yours?" she asked Jeffrey-

Jeffrey hesitated, but there was no denying it was his. His passport was in it.

:'Yes," he said weakly.

'Do you have a Dopp Kit in there with a small pair of scissors?"

Jeffrey nodded.

"Okay," she said, giving the briefcase a push toward him.

Stunned but relieved, Jeffrey quickly took his belongings to a far comer of the waiting area and sat down. He picked up a discarded newspaper and hid behind it. If he hadn't felt like a criminal when the jury handed down its verdict, he felt like one now.

As soon as his flight was called, Jeffrey pressed to get on. He couldn't wait to get on the plane. Once he was on, he couldn't wait to take his seat.

Jeffrey was in an aisle seat fairly close to the front of the plane. With his suitcase secured in the overhead compartment and his briefcase tucked under his feet, Jeffrey leaned back and closed his eyes. His heart was still racing but at least he could now try to relax. He had just about made it.

But it was difficult to calm down. Sitting there in that plane, the seriousness and irreversibility of what he was about to do finally began to sink in. So far, he hadn't broken any law. But as soon as the plane crossed from Massachusetts into another state, he would have. And there would be no turning back.

Jeffrey checked his watch. He began to perspire. It was one twenty-seven.

Only three minutes to go before the door would be sealed. Then takeoff. Was he doing the right thing? For the first time since he'd come to this decision that morning, Jeffrey felt real doubt. The experience of a lifetime argued against it. He'd always followed the law and respected authority.

Jeffrey began to shake all over. He'd never experienced such agonizing indecision and confusion. He looked at his watch again. It was twenty-nine after the hour. The cabin attendants were busy slamming all the overhead compartments, and the crashing noise threatened to drive him mad. The door to the cockpit was closed with a resounding click. A gate agent came onto the plane and gave a final manifest. All the passengers were in their seats. In a way he was ending the life he had always known, as surely as if he'd released the stopcock the night before.

He wondered how running away would affect his appeal. Wouldn't it make him appear the guiltier? And if be was ever brought to justice, would he have to serve extra time for fleeing? Just what did he plan to do in South

America? He didn't even speak Spanish or Portuguese. In a flash, the full horror of his action hit home. He just couldn't go through with it.

"Waitf" Jeffrey shouted as he heard the sounds of the plane's

door closing. All eyes turned on him. "Wait! I have to get off!" He undid the seat belt, then tried to pull his briefcase from under the seat. It opened and some of the contents, including a stack of hundred-dollar bills, fell out. Hastily, he jammed the things back inside, then got his suitcase from the overhead compartment. No one spoke. Everyone was watching Jeffrey's panic with stunned curiosity.

Jeffrey rushed forward and confronted the cabin attendant. "I have to get off!" he repeated. Perspiration was running down his forehead, blurring his vision. He looked crazed. "I'm a doctor," he added, as if to explain. "It's an emergency."

"Okay, okay," the cabin attendant said calmly. She pounded on the door, then made a gesture through the window at the gate agent who was still standing on the jetway on the other side. The door was opened, too slowly for Jeffrey's taste.

As soon as the passage was clear, Jeffrey rushed from the plane. Luckily, no one confronted him to ask for his reasons for deplaning. He ran up the jetway. The door to the terminal was closed, but it was unlocked. He started across the boarding area, but he didn't get far. The gate agent called him over to the boarding podium.

"Your name, please?" he asked with no expression.

Jeffrey hesitated. He hated to say. He didn't want to have to explain himself to the authorities.

"I can't give you your ticket back unless you give me your name," the agent said, slightly irritated.

Jeffrey relented, and the gate agent returned his ticket. Pushing it hastily into his pocket, he then walked past the security check and went into the men's room. He had to calm down. He was a nervous wreck. He put down his hand luggage and leaned on the edge of the sink. He hated himself for vacillating, first with suicide, now with fleeing. In both cases

Jeffrey still felt he made the right choice, but now what were his options?

He felt depression threaten to return but he fought against it.

At least Chris Everson had had the fortitude to follow through with his decision, albeit a misguided one. Jeffrey cursed himself again for not having been a better friend. If only he knew then what he knew now, he might have been able to save the man. Only now did Jeffrey have an appreciation of what Chris had been going through. Jeffrey hated himself for not having called the man, and for compounding the oversight by failing to call his young widow, Kelly.

Jeffrey splashed his face with cold water. When he'd regained

some semblance of composure, he picked up his belongings and emerged from the rest room. Despite the bustle of the airport, he felt horribly alone and isolated. The thought of going home to an empty house was oppressive. But he didn't know where else to go. Directionless, he headed for the parking garage.

Reaching his car, Jeffrey put the suitcase in the trunk and the briefcase on the passcngcr-sidc seat. He got in behind the wheel and sat, blankly staring ahead, waiting for inspiration.

For several hours he sat there running through all his failings. Never had he been so low. Obsessed about Chris Everson, he eventually began to wonder what had happened to Kelly Everson. He'd met her on three or four social occasions prior to Chris's death. He could even remember having made some complimentary remarks about her to Carol. Carol hadn't been pleased to hear them at the time.

Jeffrey wondered if Kelly still worked at Valley Hospital, or, for that matter, if she still lived in the Boston vicinity. He remembered her as being about five-four or five, with a slim, athletic build. Her hair had been brown with highlights of red and gold, which she'd wear long, clasped with a single barrette. He recalled her face as being broad with dark brown eyes and small, full features that frequently broke into a bright smile.

But what he remembered most was her aura. She'd had a playfulness that had melded wonderfully with a feminine warmth and sincerity that made people like her instantly.

As Jeffrey's thoughts switched from Chris to Kelly, he found himself thinking that she, more than anyone else, would have some insight into what

Jeffrey was now going through. Having lost a husband through the emotional devastation caused by a malpractice case, she'd probably be acutely sensitive to Jeffrey's emotional plight. She might even have some suggestions for dealing with it. At the very least she might provide some much needed sympathy. And if nothing else, at least his conscience would be assuaged by finally making a call he'd been vaguely meaning to make.

Jeffrey returned to the terminal. At the first bank of phones he came to, he used a directory to look up Kelly Everson. He held his breath as his index finger trailed down the names. He stopped on K. C. Everson in

Brookline. That was promising. He put in his coin and dialed. The phone rang once, twice, then a third time. He was about to hang up when someone at the other end picked up. A cheerful voice came through the receiver.

Jeffrey realized he hadn't given a thought as to how to begin.

Abruptly, he said hello and gave his name. He was so unsure of himself, he was afraid she wouldn't remember him, but before he could offer something to jog her memory, he heard her ebullient "Hello, Jeffrey!" She sounded genuinely glad to hear from him and didn't sound at all surprised.

"I'm so pleased you called," she said. "I'd thought about calling you when

I read about your legal problems, but I just couldn't get myself to do it.

I was afraid you might not even remember me."

Afraid that he wouldn't remember her! Jeffrey assured her that wouldn't have been the case. Taking her lead, he apologized profusely for not having called her sooner as he'd promised.

"You don't have to apologize," she said. "I know tragedies intimidate people, the way cancer does, or used to. And I know that doctors have a hard time dealing with a suicide of a colleague. I didn't expect you to call, but I was moved you'd taken the time to come to the funeral. Chris would have been pleased to know you cared. He really respected you. He once told me that he thought you were the best anesthesiologist he knew. So I was honored you were there. A few of his other friends didn't come. But I understood."

Jeffrey didn't know what to say. Here Kelly was forgiving him completely, even complimenting him. Yet the more she said, the more he felt like a heel. Not knowing how to respond, he changed the subject. He said he was glad to find her home.

"This is a good time to catch me. I just got home from work. I guess you know I don't work at the Valley anymore."

"No, I didn't know that."

"After Chris's death I thought it would be healthy for me to go elsewhere,"

Kelly said. "So I moved into town. I'm working at St. Joe's now. In the intensive care unit. I like it better than recovery. I guess you're still at Boston Memorial?"

"Sort of," Jeffrey said evasively. He felt awkward and indecisive. He was afraid she'd refuse to see him. After all, what did she owe him? She had a life of her own. But he'd gotten this far; he had to try. "Kelly," he said at last, "I was wondering if I could drop by and talk with you for a moment."

"When did you have in mind?" Kelly asked without missing a beat.

"Whenever's good for you. I... I could come by now if you're not too busy."

"Well, sure," Kelly said.

"If it's inconvenient, I could..

"No, no! It's fine. Come on over," Kelly said before Jeffrey had a chance to finish. Then she gave him directions to her house.

Michael Mosconi had Jeffrey's check on his blotter in front of him when he placed the call to Owen Shatterly at the Boston National Bank. He didn't think he'd be nervous, but his stomach filled with butterflies the instant he dialed. He had taken a personal check only once before in his bail bondsman career. That transaction had turned out fine. He hadn't been burned. But Michael had heard horror stories from colleagues. Of course if anything did go wrong, Mosconi's biggest problem was that his underwriting company forbade him to take checks in the first place. As Michael had explained it to Jeffrey, he was putting his ass on the line. He didn't know why he was getting to be- such a soft touch. Then again, it was a unique case. The guy was a doctor, for chrissake. Also, a $45,000 fee came along only once in a blue moon. Michael had not wanted to lose the case to his competition. So, in his way, he'd offered better terms. It had been an executive decision.

Someone at the bank answered, then put Michael on hold. Muzak floated out of the receiver. Michael drummed his fingers on the desk top. It was close to four in the afternoon. All he wanted to do was make sure the doc's check would clear before he deposited it. Shatterly had been a friend for a long time; Michael knew there would be no problem finding out from him.

When Shatterly came on the line, Michael explained the information he needed. He didn't have to say more. Shatterly only said, "Just a sec."

Michael could hear him tapping his computer keys.

"How much is the check?" Shatterly asked.

"Forty-five grand," Michael said.

Shatterly laughed. "The account only has twenty-three dollars and change."

There was a pause. Michael stopped his drumming. He got a sinking feeling in the pit of his stomach. "You sure there's been no deposits today?" he asked.

"Nothing like $45,000," Shatterly said.

Michael hung up the phone.

"Trouble?" Devlin O'Shea asked, peering over the top of an old Penthouse magazine. Devlin was a big man who looked more like a sixties-style biker than a former Boston policeman. Dangling from his left earlobe was a small, gold Maltese cross ear-

ring. He even wore his hair in a neat little ponytail. Besides helping with his work, his appearance was his small way of thumbing his nose at authority now that he didn't have to trouble himself with rules like dress codes anymore. O'Shea had been dropped from the force after a bribery conviction.

Devlin was making himself comfortable on a vinyl couch facing Michael's desk. He was dressed in the clothes that had pretty much become his uniform since his leaving the force: a denim jacket, acid-washed jeans, and black cowboy boots.

Michael didn't say anything, which was enough of an answer for Devlin.

"Anything I can help with?" Devlin asked.

Michael studied Devlin, taking in the man's massive forearms and their lattice of tattoos. One of Devlin's front teeth was gone, giving him the look of the barroom brawler he occasionally was.

"Maybe," Michael said. He was beginning to form a plan.

Devlin had dropped by Mosconi's office that afternoon bdcause he was between jobs. He'd just brought back a killer who'd jumped bail and fled to

Canada. Devlin was one of the bounty hunters that Michael used when the need arose.

Michael felt that Devlin was just the man to send to remind Jeffrey about his obligation. Michael thought that Devlin would be far more persuasive than he could be.

Leaning back in his desk chair, Michael explained the situation. Devlin tossed the Penthouse aside and stood up. He was six-foot-five and weighed two hundred and sixty-eight pounds. His rotund belly spilled over the large silver buckle of his belt. But underneath the layer of fat was a lot of muscle.

:'Sure, I can talk to him," Devlin said.

'Be nice," Michael said. "Just be persuasive. Remember, he's a doctor. I just don't want him to forget about me."

"I'm always nice," Devlin said. "Considerate, well-groomed, well-mannered.

That's my charm."

Devlin left the office, glad to have something to do. He hated just sitting around. The only problem was that he wished the task was a bit more lucrative. But he looked forward to the ride out to Marblehead. Maybe he'd hit that Italian restaurant up there and then go and have a few beers at his favorite harbor bar.

Kelly's house was a charming two-story colonial with mullioned windows. It was painted white with black shutters. The two chimneys on either end were surfaced with old brick. A two-car

garage was to the right of the house, a screened porch off the left.

Jeffrey stopped in the street across from the house and pulled up to the curb. He studied the house through the car window, hoping to nerve up enough to cross the street and ring the bell. He was surprised to see so many trees so close to downtown Boston. The house was nestled in a cozy stand of maples, oaks, and birches.

As he sat there, Jeffrey tried to think of what he would say. Never before had he gone to someone's house looking for "sympathy and understanding."

And there was always the concern of rejection despite her warmth on the phone. If he didn't know she was waiting for him, he wouldn't have been able to go through with it.

Marshaling his courage, he put the car in gear and turned into Kelly's driveway. He went up to the front door, briefcase in hand. He felt ridiculous holding it-as a doctor, he wasn't even used to carrying one-but he was afraid to leave so much cash in the car.

Kelly opened the door before he had a chance to ring the bell. She was dressed in black tights with a pink leotard and pink headband and warm-up leggings. "I go to an aerobics class most afternoons," she explained, blushing slightly. Then she gave Jeffrey a big hug. Tears almost came to his eyes when he realized he couldn't remember the last time someone had hugged him. It took him a moment to catch his balance and hug her back.

Still holding his arms, she leaned back so she could look up into his eyes.

Jeffrey was a good six inches taller than she was. "I'm so glad you came over," she said. She held his gaze for a beat, then added: "Come in, come in!" She took him by the hand and led him inside, giving the door a kick closed with her stockinged foot.

Jeffrey found himself in a wide foyer with archways into a dining room on the right and a living room on the left. There was a small table supporting a silver tea service. At the end of the foyer, toward the back of the house, an elegant staircase curved up to the second floor.

"How about some tea?" Kelly offered.

"I don't want to be a bother," Jeffrey said.

Kelly clucked her tongue. "What do you mean, bother?" She led him, still holding his hand, through the dining room and into the kitchen. Extending off the back of the house and open to the kitchen was a comfortable family room. It seemed to, be part

of an addition. There was a garden outside the broad bow window. The garden appeared as if it could use a little attention. Inside, the house was spotless.

Kelly sat Jeffrey on a gingham couch. Jeffrey put down his briefcase. -

"What's with the briefcase?" Kelly asked as she went over to put some water on to boil. "I thought doctors carried little black bags when they made house calls. It makes you look more like an insurance salesman." She laughed a crystalline laugh as she went to the refrigerator and pulled a cheesecake from the freezer.

"If I showed you what was in this briefcase you wouldn't believe it,"

Jeffrey said.

"What makes you say that?"

Jeffrey didn't answer, but she graciously let it pass. She pulled a knife from a rack above the sink and cut two pieces of cheesecake.

"I'm glad you decided to come over," she said, licking the knife. "I only bring out the cheesecake when I have company." She put a large tea bag in the teapot and got out cups.

The kettle began to whistle fiercely. Kelly pulled it off the range and poured the boiling water into the teapot. She put everything on a tray and carried it to a coffee table in front of the family room couch.

"There!" she said, setting it down. "Did I forget anything?" Kelly surveyed the tray. "Napkins!" she cried, and returned to the kitchen area. When she returned, she sat down. She smiled at Jeffrey. "Really," she said, pouring the tea. "I'm glad you came over, and not just because of the cheesecake."

Jeffrey realized he'd not eaten since the shredded wheat that morning. The cheesecake was a delight.

"Was there something in particular that you wanted to talk about?" Kelly asked, setting her teacup down.

Jeffrey admired her frankness. It made it easier for him.

"For starters, I guess I want to apologize for not having been much of a friend to Chris," Jeffrey said. "After what I've been through in the past few months, I have an appreciation of what Chris went through. At the time,

I had no idea."

"I guess no one did," Kelly said sadly. "Even I didn't."

"I don't mean to dredge up painful memories for you," Jeffrey said when he saw the change in Kelly's expression.

"Don't worry. I've finally come to terms with it," she said.

"But that's all the more reason I should have called you. How are you holding up?"

Jeffrey hadn't expected the conversation to shift to his troubles so quickly. How was he holding up? In the last twenty-four hours he'd attempted suicide and, failing that, had tried to leave the country. "It's been difficult," was all he managed.

Kelly reached over and squeezed his hand. "I don't think people have any idea of the toll malpractice takes and I'm not talking about money."

"You know better than most," Jeffrey said. "You and Chris paid the highest price."

"Is it true you are going to prison?" Kelly asked.

Jeffrey sighed. "It looks that way."

"That's absurd!" Kelly said with a vehemence that surprised Jeffrey.

"We're filing an appeal," he said, "but I don't have much faith in the process. Not anymore."

"How did you become the scapegoat?" Kelly asked. "What happened to the other doctors and the hospital? Weren't they sued?"

"They were all dropped from the case," Jeffrey explained. "I had a brief problem with morphine a few years back. Standard story: it was prescribed for a back injury I suffered in a bike accident. During the trial, they suggested that I'd mainlined some morphine shortly before I came on the case. Then someone found an empty via] of.75% Marcaine in the disposal of the anesthesia machine I was using-.75% Marcaine is contraindicated for obstetric anesthesia. No one found the.5% vial."

"But you didn't use.75%, did you?" Kelly asked.

"I always check the label of any medication," Jeffrey said. "But it's that type of reflex behavior that's hard to specifically remember. I can't believe I used.75%. But what can I say? They found what they found."

"Hey," Kelly said. "Don't start to doubt yourself. That's what Chris started to do."

"Easier said than done."

"What is.75% Marcaine used for?" Kelly asked.

"Quite a few things," Jeffrey said. "Whenever you want a particularly long-acting block with little volume. It's used a lot in eye surgery."

"Had there been any eye cases in the OR where your accident occurred or any operations that might have required.75% Marcaine?"

Jeffrey thought for a moment. He shook his head. "I don't think so, but I don't know for sure."

"It might be worth looking into," Kelly said. "It wouldn't have much legal import, but if you could explain the.75% Marcaine, at least to yourself, it would go a long way in helping rebuild your confidence. I really think that where malpractice is concerned, doctors need to be as diligent in guarding their selfesteem as thef are in preparing their court cases."

"You're right about that," Jeffrey said, but he was still thinking about

Kelly's questions regarding the.75% Marcaine. He couldn't believe that no one had thought to ask about cases prior to Patty Owen's in the same OR. He sure hadn't thought of it. He wondered how he'd go about inquiring now that he didn't enjoy the access to the hospital he once had.

"Speaking of self-esteem, how's yours?" Kelly smiled, but Jeffrey could tell that despite her apparent lightheartedness, she was dead serious.

"I have the feeling I'm talking to an expert," Jeffrey said. "Have you been reading a bit of psychiatry on the side?"

"Hardly," Kelly said. "Unfortunately, I learned about the importance of self-esteem the hard way, by experience." She took a sip of tea. For a moment she was lost in her own sorrowful reverie, staring out the bay window at the overgrown garden. Then, just as abruptly, she snapped out of her momentary trance. She looked at Jeffrey, without her smile. "I'm convinced it was through low self-esteem that Chris committed suicide. He couldn't have done what he did if he felt better about himself. I just know it. It wasn't the fact of the tragedy that pushed him over the edge. It certainly wasn't guilt. Chris was like you, in that he had nothing to feel guilty about. It was the sudden erosion of confidence, the damage done to how he thought about himself, that made Chris take his life. People have no idea how sensitive even the most accomplished doctors are to the impact of being sued. In fact, the better the doctor the more it hurts. The fact that the suit is baseless has nothing to do with it."

"You're so right," Jeffrey said. "Back when I heard that Chris had killed himself, I was astounded. I knew what kind of man he was, what kind of doctor he was. Now his suicide doesn't astound me at all. In fact, from where I sit now, I'm surprised more doctors sued for malpractice aren't drawn to it. In fact, I tried it last night."

"Tried what?" Kelly asked sharply. She knew what Jeffrey meant but she didn't want to believe it.

Jeffrey sighed. He couldn't look at her. "Last night I tried to commit suicide," he said simply. "I came within an inch of doing the same thing that Chris did. You know, the succiny1choline and morphine trick. I had the

IV running and everything."

Kelly dropped her cup of tea. She lunged forward and, grabbing Jeffrey by his shoulders, she shook him. The Miove startled him. She caught him completely unaware.

"Don't you dare do such a thing. Don't even think about it!"

Kelly was glaring at him, still clutching his shoulders. Finally Jeffrey mumbled that she needn't worry, since he'd lacked the courage to go through with it.

Kelly shook him again, reacting to his comments.

Jeffrey didn't know what to do, much less say.

Kelly kept shaking him, her passions inflamed. "Suicide is not courageous," she said angrily. "It is the opposite. It's the cowardly thing to do. And it's selfish. It hurts everyone you leave behind, everyone who loves you.

I want you to promise me that if you ever have thoughts of suicide again, you'll call me immediately, no matter what time of day or night. Think of your wife. Chris's suicide filled me with such guilt, you have no idea. I was crushed. I felt that somehow I had failed him. I know that's not true now, but his death is something I'll probably never get over completely."

"Carol and I are getting a divorce," Jeffrey blurted.

Kelly's expression softened. "Because of the malpractice suit?"

Jeffrey shook his head. "We'd planned it before all this started. Carol was just nice enough to put it off for the time being.,,

"You poor man," Kelly said. "I can't imagine trying to deal with being sued for malpractice and a breakup of a marriage at the same time."

"My marital problems are the least of my worries," Jeffrey said.

"I'm serious about your promising me you'll call before you do anything foolish," Kelly said.

"I'm not thinking..."

"Promise!" Kelly insisted.

"All right, I promise," Jeffrey said.

Satisfied, Kelly got up and cleaned up the mess that she'd made when she'd dropped her teacup. As she picked up the pieces of broken china, she said:

"I wish more than anything that I'd had the slightest indication of what

Chris had been plan-

ning. One minute it seemed that he'd been full of fight, talking about the anesthetic complication being secondary to a contaminant in the local, the next minute he was dead."

Jeffrey watched Kelly as she threw the shards of china away. It took a few moments for her last words to sink in. When she returned and took her seat again, Jeffrey asked, "What made Chris think of a contaminant in the local anesthetic?"

Kelly shrugged. "I haven't the faintest idea. But he seemed to be genuinely excited about the possibility. I encouraged him. Just before that he'd been depressed. Very depressed. The idea of a contaminant gave him a real boost.

He spent several days poring over pharmacology and physiology textbooks. He made lots of notes. He was working on it the night he... I'd gone to bed.

I found him the next morning with an IV in place, the bottle empty."

"How awful," Jeffrey said.

"It was the worst experience of my life," Kelly admitted.

For an instant, Jeffrey envied Chris, not because he'd succeeded where

Jeffrey had failed, but because he'd left behind someone who obviously loved him so deeply. If Jeffrey had followed through, would anyone be that sorry about it? Jeffrey tried to shake the thought. Instead, he considered the notion of a contaminant in the local anesthetic. It was a curious thought.

"What kind of contaminant was Chris thinking about?" Jeffrey asked.

"I really don't know," Kelly answered. "It was two years ago, and Chris never did go into much detail about if. At least not with me."

"Did you mention his theory to anybody at the time?"

"I told the lawyers. Why?"

"It's an intriguing idea," Jeffrey said.

"I still have Chris's notes," Kelly said. "You're welcome to see them if you'd like."

"I would," Jeffrey said.

Kelly stood up and led Jeffrey back through the kitchen and dining room, across the foyer and through the living room. She stopped at a closed door.

"I think I'd better explain," she said. "This was Chris's study. I know it probably wasn't all that healthy, but after Chris's death I just closed the door to this room and left everything the way it was. Don't ask me why. At the time it made me feel better, as if some part of him was still here. So be prepared. It might

be a little on the dusty side." She opened the door and stepped aside.

Jeffrey walked into the study. In contrast to the rest of the house, it was disheveled and musty. A thick layer of dust coated everything. There were even a few cobwebs hanging from the ceiling. The blinds were closed tight.

On one wall was a floorto-ceiling bookcase filled with volumes that Jeffrey recognized immediately. Most of them were standard texts for anesthesia.

The others dealt with more general medical topics.

In the center of the room stood an old partners' desk, heaped with papers and books. In the comer of the room was an Eames chair upholstered in black leather that had dried and cracked. Next to the chair was a tall stack of books.

Kelly was leaning against the doodamb with her arms folded as if she was reluctant to enter. "Quite a mess," she said.

"You don't mind if I look around?" Jeffrey asked. He felt a certain kinship with his dead colleague but did not want to trespass on Kelly's feelings.

"Be my guest," she said. "As I told you, I've finally come to terms with

Chris's passing. I've been meaning to clean this room for some time. I just haven't gotten around to it."

Jeffrey circled the desk. There was a lamp on it, which he turned on. He wasn't superstitious; he did not believe in the supernatural. Yet somehow he felt Chris was trying to tell him something.

Open on the desk's blotter was a familiar textbook: Goodman and Gillman's

Pharmacological Basis of Therapeutics. Next to it was Clinical Toxicology.

Beside both books was a pile of handwritten notes. Bending over the desk,

Jeffrey noted that the Goodman and Gillman was open to the section on

Marcaine. The potential adverse side effects were heavily underlined.

"Did Chris's case involve Marcaine as well?" Jeffrey asked.

"Yes," Kelly said. "I thought you knew that."

"Not really," Jeffrey said. He'd not heard which of the local anesthetics

Chris had used. Occasional complications were seen with all of them.

Jeffrey picked up the stack of notes. Almost immediately he felt a tickle in his nose. He sneezed.

Kelly put the back of her hand to her lips to hide her smile. "I warned you it might be dusty."

Jeffrey sneezed again.

"Why don't you get what you want and we can retreat to the family room,"

Kelly suggested.

Through watery eyes, Jeffrey picked up the pharmacology and toxicology books, along with the notes, and carried them out with him. He sneezed a third time before Kelly shut the study door.

When they got back to the kitchen, Kelly offered a suggestion. "Why don't you stay for an early dinner? I can whip us up something. It won't be gourmet, but it'll be healthy."

"I thought you were off to an aerobics class," Jeffrey said. He was delighted by her offer, but didn't want to inconvenience her any more than he already had.

"I can work out any day," Kelly said. "Besides, I think you need a little

TLC."

"Well, if it wouldn't be a bother," Jeffrey said. He was amazed by her kindness.

"I'll enjoy it," Kelly said. "Now you make yourself comfortable on the couch. Take your shoes off if you like."

Jeffrey took her at her word. He sat down and laid the books on the coffee table. He watched her for a moment as she bustled about the kitchen, looking in the refrigerator and various cabinets. Then he kicked off his shoes and settled back to shuffle through Chris's notes. The first thing he came across was a handwritten summary of the anesthetic complication in

Chris's tragic case.

'.I'm going to run to the store," Kelly said. "You just stay put.,,

"I don't want you going to any trouble," Jeffrey said, making a motion as if to get up. But it wasn't true. He loved the fact that Kelly was willing to make such an effort for him.

"Nonsense," Kelly said. "I'll be back in a flash."

Jeffrey wasn't sure if Kelly had said nonsense because she saw through his fib or because to her it was no trouble. She was gone in the blink of an eye. Jeffrey heard her start her car in the garage, pull out, and accelerate down the street.

He glanced around at the comfortable family room and kitchen, pleased that he'd made the decision to call Kelly. Aside from deciding not to kill himself and not to fly away, in the last twenty-four hours it was the best decision he'd made.

Settling back again, Jeffrey turned his attention to the summary of Chris's anesthetic complication:

Henry Noble, a fifty-seven-year-old white male, entered the Valley

Hospital to undergo a total prostatectomy for cancer. The request from

Dr. Wallenstern was for continuous epidural anesthesia. I visited the man the evening before his surgery. He was mildly apprehensive. His health was good. Cardiac status was normal with a normal

EKG. Blood pressure was normal. Neurological exam was normal. He had no allergies. Specifically, he had no drug allergies. He'd had general anesthesia for a hernia operation in 1977 with no problems. He'd had local anesthesia for multiple dental procedures with no problems. Because of his apprehension I wrote an order for 10 mg of diazeparn to be given by mouth one hour prior to coming to surgery. The following morning he arrived in good spirits. The diazepam had had good effect. The patient was mildly sleepy but could be roused. He was taken to the anesthesia room and placed in a right lateral position. An epidural puncture was made with an 18-gauge

Touhey needle without problems. There was no reaction to 2 cc's of Lido- caine utilized to facilitate the epidural stick. Confirmation of the epidural location was made with 2 cc's of sterile water with epinephrine.

A small-bore epidural catheter was threaded through the Touhey needle. The patient was returned to a supine position. A test dose of.5% Marcaine with a small amount of epinephrine was then prepared from a 30 ml vial. This test dose was injected. As soon as the test dose was injected the patient complained of what he )described as dizziness, followed by severe intestinal cramping. The heart rate began to increase but not to the extent expected if the test dose had inadvertently been injected intravenously.

Generalized muscular fasciculations then appeared, suggesting a hyperesthesia state. Massive salivation intervened, suggesting a parasympathetic reaction. Atropine was given intravenously. Miotic pupils were noted. The patient then had a grand mal seizure which was treated with succiny1choline and Valium intravenously. The patient was intubated and maintained on oxygen. The patient then had a cardiac arrest. The heart proved to be extremely resistant to drugs, but finally a sinus rhythm was achieved. The patient was stabilized but did not return to consciousness.

The patient was moved to the surgical intensive care unit, where he remained comatose for one week, suffering multiple cardiac arrests. It was also documented that the patient had a total paralysis following his anesthetic complication that involved not only the spinal cord but cranial nerves as well. At the end of the week, the patient had a final cardiac arrest from which the heart could not be started.

Jeffrey looked up from the notes. Reading Chris's terse history of his complication recreated the terror that Jeffrey had felt when he'd desperately fought to save Patty Owen. The memory was so poignant that it brought perspiration to Jeffrey's hands. What made it so poignant were the striking similarities in the two cases, and it wasn't just -the dramatic seizures and cardiac

arrests. Jeffrey could remember with startling clarity the moment he'd seen salivation and lacrimation that Patty had had. And besides that there was the abdominal pain and the small pupils. None of these responses were usual side effects of local anesthetics, although local anesthetics were capable of causing an extraordinarily wide range of adverse neurological and cardiac effects in a few unfortunate individuals.

Jeffrey studied the next page of the notes. There were a number of words printed in bold letters. Two of them were "muscarinic" and "nicotinic."

Jeffrey recognized them, mostly from his medical school days. They had to do with autonomic nervous system function. Then there was the phrase

"irreversible high spinal blockade with cranial nerve involvement," followed by a series of exclamation points.

Jeffrey heard Kelly's car pull up the drive and enter the garage. He glanced at his watch. She was a fast shopper.

The next item in Chris's pile was an NMR-nuclear magnetic resonance-report on Henry Noble during the time he was paralyzed and comatose. The results recorded were normal.

"Hi," Kelly called brightly as she came through the door. "Miss me?" She laughed as she dumped a parcel on the kitchen countertop. Then she stepped up to the back of the couch and looked over Jeffrey's shoulder. "What does all this stuff mean?" She pointed to the words and phrases Jeffrey had been reading.

"I don't know," Jeffrey admitted. "But these notes are fascinating. There are so- many similarities between Chris's case and mine. I don't know what to make of it."

"Well, I'm glad someone's getting some use out of that stuff," Kelly said as she went back into the kitchen. "It makes me feel less weird for having saved it all."

'.1 don't think your saving it was weird at all," Jeffrey said, turning to the next page. It was a typed summary of Henry Noble's autopsy, which had been performed by the medical examiner. Chris had underlined the phrase

"axonal degeneration seen on microscopic sections" and had followed it up with a series of question marks. Then he'd underlined the phrase "toxi- cology negative" and capped it off by an emphatic exclamation point.

Jeffrey was mystified.

The rest of the notes were outlines of articles taken mostly from the

Goodman and Gillman book on pharmacology. A quick glance suggested to

Jeffrey that they chiefly dealt with the function of the autonomic nervous system. He decided to look

at the material later. He stacked the papers and set them on the table with the two medical volumes serving to anchor them.

Jeffrey joined Kelly by the kitchen sink. "What can I do?" he asked her.

"You're supposed to be relaxing," Kelly said as she rinsed the lettuce.

"I'd prefer to help," Jeffrey said.

"Suit yourself. How about firing up the barbie on the back porch? The matches are in that drawer." Kelly pointed with a lettuce leaf

Jeffrey grabbed a book of matches and went outside. The barbecue was one of those domed types powered by a cylinder of propane. He quickly figured out how the valve worked and lit it, then closed the dome.

Before going back inside, Jeffrey looked around the untended yard. The tall grass was a fresh spring green. There had been a lot of rain that spring, so all the vegetation was particularly healthy and lush. Lacy fern fronds could be seen within the thicket of trees.

Jeffrey shook his head in disbelief. It seemed almost inconceivable that only last night he had come so close to committing suicide. And only that afternoon he'd tried to flee to South America for good. And now here he was standing on a porch in Brookline getting ready to have a barbecue with an attractive, sensitive, disarmingly demonstrative woman. It almost seemed too good to be true. Then Jeffrey realized with a shock that it was; before too long he'd probably be confined to prison.

Jeffrey took in a deep breath of the cool, late-afternoon air, enjoying its purity. He watched a robin yank a worm from the moist soil. Then he went back inside to see what else he could do to help.

The dinner was delicious and a great success. In spite of the rather dire circumstances, Jeffrey managed to enjoy himself immensely. Conversation with Kelly was natural and easy. They dined on marinated tuna steaks, rice pilaf, and a mixed green salad. Kelly had a bottle of chardonnay hidden in the back of her refrigerator. It was cold and crisp. Jeffrey found himself laughing for the first time in months. That in itself was a major accomplishment.

With coffee and more of the frozen cheesecake, they retired to the gingham couch. Chris's notes and the textbooks brought Jeffrey's mind back to more serious thoughts.

"I hate to revert to unpleasant subjects," Jeffrey said after a

pause in the conversation, "but what was the outcome of Chris's malpractice case?"

"The jury found for the plaintiffs estate," Kelly said. "Payment of the settlement was divided between the hospital, Chris, and the surgeon according to some complicated plan. I think that Chris's insurance paid most of it, but I don't know for sure. Fortunately this house was in my name only, so they couldn't count that among his available assets."

"I read a summary that Chris had written," Jeffrey said. "There certainly wasn't any malpractice involved."

"With that kind of emotionally charged case," Kelly said, "whether there was actual malpractice or not isn't all that important. A good plaintiff attorney can always get the jury to identify with the patient."

Jeffrey nodded. Unfortunately, it was true. "I have a favor to ask,"

Jeffrey said after a pause. "Would you mind terribly if I borrowed these notes?" He patted the pile.

"Heavens no," Kelly said. "Be my guest. May I ask why you're so interested in them?"

"They remind me of questions I'd had about my own case," Jeffrey said.

"There were some mild inconsistencies that I could never explain. I'm surprised to see that the same inconsistencies appeared in Chris's case.

The thought of a contaminant hadn't occurred to me. I'd like to go over his notes a few more times. It's not immediately apparent what he was thinking.

Besides," Jeffrey added with a smile, "borrowing them will give me a good excuse for coming back."

"You hardly need an excuse," Kelly said. "You're welcome here anytime."

Jeffrey left soon after they finished their dessert. Kelly walked him out to his car. They had eaten so early that it was still daylight outside.

Jeffrey thanked her effusively for her spontaneous hospitality. "You have no idea how much I've enjoyed this visit," he said with sincerity.

After Jeffrey had climbed into his car, along with his briefcase, which now contained Chris's notes, Kelly stuck her head in through the open window.

"Remember your promise!" she warned. "If you start thinking foolish thoughts, you have to get in touch with me."

"I'll remember," Jeffrey assured her. He drove home in quiet contentment.

Spending a few hours with Kelly had done much to elevate his mood. Under the circumstances it amazed him that he'd been able to respond in such a normal fashion. But

he knew it had more to do with Kelly's psyche than his. Making the final turn onto his street, Jeffrey reached out to steady his briefcase, which threatened to fall from the seat. With his hand on it, he thought of its strange contents. Toiletries, underwear, $45,000 in cash, and a pile of notes written by a suicide victim.

Although he didn't expect to find anything absolving in the notes, just having them in his possession gave him a feeling of hope. Maybe he could learn something from Chris's experience that he hadn't been able to see himself.

And although he'd been sorry to say good-bye to Kelly, Jeffrey was glad to be getting home so early. He planned to go through Chris's notes more thoroughly and pull out a few books of his own for some serious reading.

TUESDAY,

MAY 16,1989

7:49 P.M.

Jeffrey stopped just short of the garage door, got out of the car, and stretched. He could smell the ocean. As a peninsula that jutted into the

Atlantic Ocean, all of Marblehead was near to the water. Bending back into the car, Jeffrey dragged his briefcase toward him and hefted it into the air. He slammed the car door and started up the front steps.

As he walked he noted the beauty that was all around him. Songbirds were going crazy in the evergreen tree in the front lawn and a sea gull shrieked in the distance. A bank of rhododendrons was in full bloom in a riot of color along the front of the house. Having been preoccupied by his problems during the last months, Jeffrey had completely missed the enchanting tran- sition from bleak New England winter to glorious springtime. He was appreciating it now for the first time that year. The effect of having visited Kelly was still very much on his mind.

Reaching the front door, Jeffrey remembered his suitcase. He hesitated a moment, then decided he could get it later. He put his key in the front door and went inside.

Carol was standing in the entranceway, her hands on her hips. He could tell by her expression that she was angry. Welcome home, thought Jeffrey. And how was your day? He put his briefcase down.

"It's almost eight o'clock," Carol said with undisguised impatience.

"I'm quite aware of the time."

"Where have you been?"

Jeffrey hung up his jacket. Carol's inquisitional attitude irked him. Maybe he should have called. In the old days, he would have, but these weren't normal times by any stretch of the imagination.

"I don't ask you where you've been," Jeffrey said.

"If I'm going to be delayed until almost eight at night I always call,"

Carol said. "It's just common courtesy."

"I suppose I'm not a courteous person," Jeffrey said. He was too tired to argue the point. He picked up his briefcase, intending to go directly to his room. He wasn't interested in fighting with Carol. But then he stopped.

A large man had appeared, leaning casually against the doodamb leading into the kitchen. Jeffrey's eyes immediately took in the ponytail, the denim clothes, the cowboy boots, and the tattoos. He had a gold earring in one ear and was holding a bottle of Kronenbourg in his hand.

Jeffrey gave Carol a questioning look.

"While you are out doing God knows what," Carol snapped, 'I've been here putting up with this pig of a man. And all because of you. Where have you been?"

Jeffrey's eyes went from Carol to the stranger and back again. He had no idea what was going on. The stranger winked and smiled at Carol's unflattering reference as if it had been a compliment.

"I'd also like to know where you've been, sport," the thug said. "I already know where you haven't been." He took a pull on the beer and smiled. He acted as if he were enjoying himself.

"Who is this man?" Jeffrey asked Carol.

"Devlin O'Shea," the stranger offered. He pushed off the doorjamb and stepped beside Carol. "Me and the cute little missus here have been waiting for you for hours." He reached out to pinch Carol's cheek, but she batted his hand away. "Feisty little thing." He laughed.

"I want to know what's going on here," Jeffrey demanded.

"Mr. O'Shea is the charming emissary of Mr. Michael Mosconi," Carol said angrily.

"Emissary?" Devlin questioned. "Ooh, I like that. Sounds sexy.,,

"Did you go to the bank to see Dudley?" Carol demanded, ignoring Devlin.

"Of course," Jeffrey said. Suddenly he realized why Devlin was there.

"And what happened?" Carol demanded.

"Yeah, what happened?" Devlin chimed in. "Our sources report that there was no deposit like was promised. That's unfortunate."

"There was a problem...'9 Jeffrey stammered. He'd not been prepared for this interrogation.

"What kind of a problem?" Devlin asked, stepping forward and poking Jeffrey repeatedly in the chest with his index finger, keeping the pressure on. He felt Jeffrey wasn't coming clean.

"Paperwork," Jeffrey said, trying to fend off Devlin's jabs. "The kind of red tape you always get at a bank."

"What if I don't believe you?" Devlin said. He smacked Jeffrey on the side of the head with an open palm.

Jeffrey's hand went to his ear. The blow stung him and startled him. His ear was ringing.

"You can't come in here and push me around," Jeffrey said; trying to be authoritative.

"Oh, no?" Devlin said in an artificially high voice. He switched the beer to his right hand and then with his left he smacked Jeffrey on the other side of the head. His movement was so swift, Jeffrey had no time to react.

He stumbled back against the wall, cowering in front of this behemoth.

"Let me remind you of something," Devlin said, staring down at Jeffrey.

"You are a convicted felon, my friend, and the only reason you're not rotting in prison at this moment is because of the generosity of Mr.

Mosconi."

"Carol!" Jeffrey yelled. He felt a mixture of terror and anger. "Call the police!"

"Ha!" Devlin laughed, throwing his head back. " 'Call the police!' You're too much, Doc. You really are. I'm the one with the law behind me-not you.

I'm just here as an..." Devlin paused, then looked back at Carol. "Hey,

&arie, what was that you called me?"

"An emissary," Carol said, hoping to appease the man. She was appalled at this scene but had no idea what to do.

"Like she said, I'm an emissary," Devlin repeated, turning back to Jeffrey.

"I'm an emissary to remind you about your deal with Mr. Mosconi. He was a little disappointed this afternoon when he called the bank. What happened to the money that was supposed to be in your checking account?"

"It was the bank's fault," Jeffrey repeated. He hoped to God this giant didn't look in his briefcase, which he was still holding. If he saw the cash, he'd guess that Jeffrey had been planning to flee. "It was some minor bureaucratic holdup, but the money will be in the account in the morning.

All the paperwork is done."

"You wouldn't be jerking me around, would you?" Devlin asked. He flicked the end of Jeffrey's nose with the nail of his

index finger. Jeffrey winced. His nose felt like it had been stung by a bee.

"They assured me there would be no further problems," Jeffrey said. He touched the tip of his nose and looked at his finger. He expected to see blood but there wasn't any.

"So the money will be there tomorrow morning?"

"Absolutely."

"Well, in that case I guess I'll be going," Devlin said. "Needless to say, if the money doesn't appear, I'll be back." Devlin turned from Jeffrey and stepped over to Carol. He extended the beer. "Thanks for the brew, honey."

She took the bottle. Devlin again made a motion to pinch her cheek. Carol tried to slap him, but he caught her arm. "You certainly are feisty," he said with a laugh. She yanked her arm free.

"I'm sure you're both sorry to see me go," Devlin said at the door. "I'd love to stay for dinner but I'm supposed to meet a group of nuns over at

Rosalie's." He laughed a hoarse laugh as he pulled the door closed behind himself.

For a few moments neither Jeffrey nor Carol moved. They could hear a car start out in the street, then pull away. Carol was the one to break the silence: "What happened at the bank?" she demanded. She was furious. "Why didn't they have the money for you?"

Jeffrey didn't answer. He just looked at his wife dumbly. He was shaking from his reaction to Devlin. The balance between anger and terror had tilted to terror. Devlin was the embodiment of Jeffrey's worst fears, especially since he understood he had no defense against him and no protection from the law. Devlin was just the kind of person Jeffrey imagined populated the prisons. Jeffrey was surprised the man hadn't threatened to break his kneecaps. Despite his Irish name, he seemed like a character straight from the Mafia.

"Answer me!" Carol demanded. "Where have you been?"

With his briefcase still in hand, Jeffrey started for his room. He wanted to be alone. The nightmare vision of a prison filled with inmates all like

Devlin came to him in a dizzying rush.

Carol grabbed his arm. "I'm talking to you!" she snapped.

Jeffrey stopped and looked down at Carol's hand gripping his arm. "Let go of me," he said in a controlled voice.

"Not until you talk to me and tell me where you've been."

"Let go of me," Jeffrey said menacingly.

Thinking better of it, Carol let go of his arm. Again he started for his room. She quickly fell in behind him. "You are not the

only one around here who has been under strain," she yelled after him. "I think I deserve some kind of explanation. I had to entertain that animal for hours."

Jeffrey stopped at his door. "I'm sorry," he said. He owed her that. Carol was right behind him.

"I think I've been pretty understanding through all this," Carol said. "Now

I want to know what happened at the bank. Dudley said yesterday there would be no problems."

"I'll talk to you about it later." He needed a few minutes to calm down.

"I want to talk about it now," Carol persisted.

Jeffrey opened his door and stepped into the room. Carol tried to push through after him, but Jeffrey blocked her way. "Later!" he said, louder than he'd meant to. He closed the door on her. Carol heard the lock click into place.

She pounded on the door in frustration and began to cry. "You're impossible! I don't know why I was willing to wait on the divorce. This is the thanks I get." Sobbing, she gave the door a kick, then ran down the hall to her own room.

Jeffrey slammed the briefcase down on his bed, then sat down next to it. He didn't mean to aggravate Carol like that, but he couldn't help it. How could he explain what he was going through when there hadn't been any real communication between them for years? He knew he owed her an explanation, but he didn't want to confide in her until he'd decided what to do. If he told her he had the cash in hand, she'd make him take it to the bank first thing. But Jeffrey needed time to think first. For what felt like the fortieth time that day alone, he wasn't sure what he would do.

For the moment, he got up and went into the bathroom. He filled a glass with water and held it with both hands as he drank. He was still shaking from a whirlpool of emotions. He looked at himself in the mirror. There was a scratch on the end of his nose where Devlin had flicked him. Both his ears were bright red. He shuddered when he recalled how defenseless he'd felt in front of the man.

Jeffrey returned to the bedroom and eyed the briefcase. Flipping open the latches, he lifted the lid and pushed aside Chris Everson's notes. He looked at the neat packets of hundred-dollar bills and found himself wishing that he'd stayed on the plane that afternoon. If he had, he'd now be well on his way to Rio and some sort of new life. Anything had to be better than what

he was going through now. The warm moments with Kelly, that great dinner, seemed to have happened to him in another life.

Glancing at his watch, Jeffrey noticed it was a little after eight. The last Pan Am shuttle was at nine-thirty. He could make it if he left soon.

He remembered how awful he'd felt on the plane that afternoon. Could he really go through with it? Jeffrey went back into the bathroom and again examined his inflamed ears and scratched nose. What else was a man like

Devlin capable of if they were locked in the same room day in, day out?

Jeffrey turned and went back to the briefcase. He closed the lid and locked it up. He was going to Brazil.

When Devlin left the Rhodes's house, he fully intended to follow his original plan of Italian food, followed by beers at the harbor. But when he got about three blocks away, intuition made him pull over to the side of the road. In his mind's eye, he replayed the conversation he'd had with the good doctor. From the moment Jeffrey had blamed the bank for not coming through with the money, Devlin knew he'd been lying. Now he started wondering why.

"Doctors!" Devlin said. "They always think they're smarter than everybody else."

Doing a U-turn, Devlin drove back the way he'd come and cruised by the

Rhodes's house, trying to decide how to proceed. About a block beyond it, he made a second U-turn and passed the house again. This time he slowed down. He found a parking place and pulled in.

The way he saw it, he had two choices. Either he could go back inside the

Rhodes's house and ask the doc why he was lying, or he could sit tight and wait awhile. He knew he'd put the, fear of God into the man. That had been his intention. Often people who felt guilty about something reacted to confrontation by hastily committing some telltale act. Devlin decided to wait Rhodes out. If nothing happened in an hour or so, then he'd go get some food and come back for a visit afterward.

Turning off the motor, Devlin scrunched down as best he could behind the steering wheel. He thought about Jeffrey Rhodes, wondering what the guy had been convicted of Mosconi hadn't told him that. To Devlin, Rhodes didn't seem like the criminal type, even the white-collar variety.

A few mosquitoes disturbed Devlin's reverie. After rolling up the windows, the temperature inside the car climbed. Devlin began to rethink his plans.

Just as he was about to start the car,

he saw movement at the far edge of the garage. "Now what have we here?" he said, hunching low in his seat.

At first Devlin couldn't tell who it was, the Mr. or the Mrs. Then Jeffrey stepped around the edge of the garage, making a beeline for his car. He was carrying his briefcase, and he ran kind of hunched over, as if he didn't want to be seen by anyone inside the house.

"This is getting interesting," Devlin whispered. If Devlin could prove

Jeffrey was trying to jump bail and caught him, and dragged him to jail, some big money would be coming his way.

Without closing the car door for fear that Carol might hear it, Jeffrey released the emergency brake and let the auto slip silently down the driveway and out into the street. Only then did he start the motor and drive off. He craned his neck for a view of the house for as long as he could, but

Carol never appeared. A block away he slammed the door properly and put on his seat belt. It had been easier to get away than he'd thought.

By the time Jeffrey got to the congested Lynn Way with its used-car lots and gaudy neon signs, he began to calm down. He was still somewhat shaky from Devlin's visit, but it was a relief to know that he would soon be putting the man and the threat of prison far behind him.

As he got closer to Logan International Airport, he began to feel the same misgivings he had had that morning. But all he had to do was touch his tender ears to rekindle his resolve. This time he was committed to following through, no matter his qualms, no matter how high his anxiety.

Jeffrey had a few minutes' leeway, so he went to the ticket counter to have the agent change his Rio de Janeiro ticket. He knew the shuttle ticket was still fine. As it turned out, the night flight to Rio was cheaper than the afternoon flight, and Jeffrey got a considerable refund.

Holding his ticket in his mouth, the suitcase in one hand, and the briefcase in the other, he hurried toward security. It had taken longer than he'd expected to exchange the ticket. That was one flight he didn't want to miss.

Jeffrey went directly to the X-ray machine and hoisted the suitcase onto the conveyor belt. He was about to do the same with his briefcase when someone grabbed his collar from behind.

"Going on vacation, Doctor?" Devlin asked with a wry smile. He snatched the airline ticket from Jeffrey's mouth.

Holding on to Jeffrey's collar with his left hand, Devlin

flipped open the ticket folder and read the destination. When he saw Rio de

Janeiro, he said "Bingo!" with a broad smile. He could already see himself at one of the gaming tables in Vegas. He was in the money now.

Stuffing Jeffrey's ticket into his denim jacket pocket, Devlin reached around to his back pocket and pulled out his handcuffs. A few people who had backed up behind Jeffrey to get at the X-ray machine stood gawking in open-mouthed disbelief.

The familiar sight of handcuffs jolted Jeffrey from his paralysis. With a sudden, unexpected move, he swung his briefcase in a violent arc aimed at

Devlin. Devlin, concentrating on opening the handcuffs with his free hand, didn't see the blow coming.

The briefcase hit Devlin on the left temple, just above the ear, sending him crashing into the side of the X-ray machine. The handcuffs clattered to the floor.

The female attendant behind the X-ray machine screamed. A uniformed state police officer looked up from the sports page of the Herald. Jeffrey took off like a rabbit, sprinting back toward the terminal and ticket counters.

Devlin put a hand to his head, and it came away with blood on it.

For Jeffrey it was like broken-field running as he tried to skirt passengers, missing some, colliding into others. As he came to the junction of the concourse with the terminal proper, he glanced back at the security area. He could see Devlin pointing in his direction with the uniformed policeman at his side. Other people were looking in Jeffrey's direction as well, mainly those he'd run into.

In front of Jeffrey was an escalator bringing people up from the floor below. Jeffrey ran for it and charged down, pushing irate passengers out of his way along with their luggage. On the arrival floor below there was a crowd milling about, since several flights had recently landed. Worming his way through the newly arrived, Jeffrey skirted the baggage area as fast as he could and ran out through the electronic doors to the street.

Gasping for breath, he paused at the curb, trying to decide where to go next. He knew he had to get out of the airport immediately. The question was how. There were a few taxis lined up, but there was also a long line of people waiting for them. Jeffrey didn't have much time. He could run over to the parking garage and get his car, but something told him that would be a dead end. For starters, Devlin probably knew where it was. He'd probably trailed Jeffrey to the airport. How else would he have known where to find him?

As Jeffrey weighed his alternatives, the intraterminal bus came lumbering along the roadway. Without a second's hesitation, Jeffrey rushed into the street and stood directly in its path, flailing his arms wildly.

The bus screeched to a halt. The driver opened the door. As Jeffrey jumped on, the driver said, "Man, you are either stupid or crazy and I hope it's stupid 'cause I'd hate to have a nut on board." He shook his head in disbelief, put the bus in gear, and hit the gas pedal.

Steadying himself by clutching the overhead rack, Jeffrey stooped to get a look out the window. He caught sight of Devlin and the policeman threading their way through the crowds at the baggage carousel. Jeffrey couldn't believe his luck. They hadn't seen him.

Jeffrey took a seat and set his briefcase on his lap. He still had to catch his breath. The next stop was the central terminal, serving Delta, United, and TWA. That's where Jeffrey got off. Dodging traffic, he ran over to the taxi line. As before, there was a considerable number of people waiting.

Jeffrey hesitated for a moment, running through his alternatives.

Marshaling his courage, he walked directly to the taxi dispatcher..

"I'm a doctor and I need a cab immediately," he said with as much authority as he could muster. Even in emergency situations, Jeffrey was loath to take advantage of his professional status.

Holding a clipboard and a stub of a pencil, the man looked Jeffrey up and down. Without saying a word, he pointed to the next cab in line. As Jeffrey hustled in, some of the people queued up grumbled.

Jeffrey slammed the taxi's door. The driver looked at him through his rearview miffor. He was ' a young fellow with long, stringy hair. "Where to?" he asked.

Hunching low, Jeffrey told him just to drive out of the airport. The cabbie turned around to look Jeffrey in the eye.

'I need a destination, man!" he said.

'All right-downtown."

"Where downtown?" the cabbie asked irritably.

"I'll decide when we get there," Jeffrey said, turning around to peek out the rear window. "Just go!"

"Jesusl" the driver murmured, shaking his head in disbelief. He was doubly irritated to get such a short fare. He'd been waiting in the pool for half an hour and had hopes for a run to some-

place like Weston. And on top of the short fare, his passenger was a weirdo or maybe worse. When they drove past a police car at the far end of the terminal, the guy lay flat across the backseat. Just what he needed: a weirdo on the lam.

Jeffrey lifted his head slowly, even though the cab had to be well beyond the squad car. He turned and peered out the rear window. No one seemed to be following. There were certainly no sirens or flashing lights. He turned around and faced forward. Night had finally fallen. Ahead lay a sea of bobbing taillights. Jeffrey tried to clear his head enough to think.

Had he done the right thing? His reflex had been to flee. He was understandably terrified of Devlin, but should he have run, especially with the policeman there?

With a shock, Jeffrey remembered that Devlin had seized his ticket, proof he had intended to jump bail. That was reason enough to toss him in jail.

What effect would his attempt to flee have on the appeal process? Jeffrey didn't want to be around when Randolph found out.

Jeffrey didn't know much about the finer points of the law, but this much he did know: with his bumbling, indecisive behavior he had managed to turn himself into a true fugitive. Now he would have to face an entirely separate charge, maybe a separate set of charges.

The cab plunged into the Sumner Tunnel. Traffic was relatively light, so they moved ahead swiftly. Jeffrey wondered if he should go directly to the police. Would it be better to own up and turn himself in? Maybe he should go to the bus station and get out of town. He thought about renting a car, since he'd have more independence that way. But the trouble with that idea was that the only car rental places open at that time of the night were at the airport.

Jeffrey was at a loss. He had no idea what he should do. Every plan of action he could think of had disadvantages. And every time he thought he'd reached rock bottom, he managed to find an even deeper quagmire.

TUESDAY,

MAY 16,1989

9:42 P.M.

"I got good news and I got bad news," Devlin said to Michael Mosconi. "Which do you want to hear first?" Devlin was calling from one of the airport phones in the baggage section beneath the Pan Am departure gates. He had combed the terminal searching for Jeffrey, with no luck. The policeman had gone off to alert the other officers at the airport. Devlin was calling Mi- chael Mosconi for additional backup. Devlin was surprised that the doc was lucky enough to have slipped away.

"I'm not in any mood to be playing games," Mosconi said irritably. "Just tell me what you have to tell me and be done with it."

"Come on, lighten up. Good news or bad?" Devlin enjoyed teasing Mosconi because Mosconi was such an easy target.

"I'll take the good news," Mosconi fumed, swearing under his breath. "And it better be good."

"Depends on your point of view," Devlin said cheerfully. -The good news is that you owe me a few bucks. Minutes ago I stopped the good doctor from boarding a plane for Rio de Janeiro."

"No shit?" Mosconi said.

"No shit-and I have the ticket to prove it!"

"That's great, Dev!" Mosconi said excitedly. "My God, the man's bail is five hundred thousand dollars! That would have ruined me. How the hell did you do it? I mean, how did you know he was going to try to jump? I got to hand it to you. You're amazing, Dev!"

"It's so nice to be loved," Devlin said. "But you're forgetting the bad news." Devlin smiled into the receiver mischievously, knowing what

Mosconi's reaction was soon to be.

There was a brief pause before Mosconi said with a groan, "All right, give me the bad news!"

"At the moment, I don't know where the good doc is. He's on the loose in

Boston someplace. I got ahold of him, but the skinny bastard hit me with his briefcase before I could 'cuff him. I never expected it, him being a doctor and all that."

"You got to find him!" Mosconi shouted. "Why the hell did I trust him? I should have my head examined."

"I've explained the situation to the airport police," Devlin said. "So they'll be on the lookout for him. My hunch is, he won't try to fly away again. At least not from Logan. Oh, and I had his car impounded."

"I want that guy found!" Mosconi said menacingly. "I want him delivered to the jail. Pronto. You hear me, Devlin?"

"I hear you, man, but I don't hear any numbers. What are you offering me to bring in this dangerous criminal?"

"Quit joking around, Dev!"

"Hey, I'm not joking. The doctor might not be all that dangerous, but I want to know how serious you are about this guy. The best way you can tell me is what kind of reward I'll be getting."

"Get him, then we'll talk numbers."

"Michael, what do you take me for, a fool?"

There was a strained silence. Devlin broke it. "Well, maybe I'll go have some dinner, then take in a show. See you around, sport.,,

"Wait!" Michael said. "All right-I'll split the fee. Twentyfive thousand."

"Split the fee?" Devlin said. "That's not the usual rate, my friend."

"Yeah, but this guy is hardly the cold-blooded, armed killer that you usually have to deal with."

"I don't see where that makes any difference," Devlin said. "If you call in anybody else, they'll demand the whole ten percent. That's fifty grand. But

I tell you what. Since we go back a long way, I'll do it for forty grand and you can keep ten for filling out those papers."

Mosconi hated to give in, but he was in no position to bargain. "All right, you bastard," he said. "But I want the doctor in the slammer ASAP, before they forfeit the bond. Understand?"

"I'll give the matter my undivided attention," Devlin said. "Especially now that you have insisted on being so generous. In the meantime, we got to block the usual exits from the city.

The airport is already covered, but that leaves the bus station, the railroads, and the car rental agencies."

"I'll call the duty police sergeant," Mosconi said. "Tonight it should be

Albert Norstadt, so there won't be any problem there. What are you going to do?"

"I'll stake out the doc's house," Devlin said. "My guess is that he will either show up there or call his wife. If he calls his wife, then she'll probably go to wherever he is."

"When you get to him, treat him like he's murdered twelve people," Mosconi said. "Don't go soft on him. And Dev, I mean business on this. At this point I really don't much care whether you bring him in alive or dead."

"So long as you make sure he stays in town, I'll get him. If you have any problems with the police, you can reach me on the car phone."

Jeffrey's cabbie's mood improved as the fare mounted on the meter. Unable to decide where to go, Jeffrey had the man drive aimlessly around Boston. As they cruised the periphery of the Boston Garden for the third time, the meter hit thirty dollars.

Jeffrey was afraid to go home. His house was sure to be the first place

Devlin would go to look for him. In fact, Jeffrey was afraid to go anyplace. He was afraid of going to the bus or train station for fear the authorities had already been put on some alert. For all he knew, every policeman in Boston could be looking for him.

Jeffrey thought he'd try to call Randolph to see what the lawyer could do-if anything-to turn things back to the preairport status quo. Jeffrey wasn't optimistic but the possibility was worth pursuing. At the same time, he decided he'd do well to check into a hotel, though not one of the better ones. The good hotels would probably be the second place Devlin would look for him.

Scooting forward against the Plexiglas divider, Jeffrey asked the cabbie if he knew of any cheap hotels. The cabbie thought for a moment. "Well," he said, "there's the Plymouth Hotel."

The Plymouth was a large motor inn. "Something less wellknown. I don't care if it's a little on the seedy side. I'm looking for something out-of-the-way, nondescript."

"There's the Essex," the cabbie said.

"Where's that?" Jeffrey asked.

"Other side of the combat zone," the driver said. He eyed Jeffrey in the rearview mirror to see if he registered a flicker of rec-

ognition. The Essex was a dump, more of a flophouse than a hotel. It was frequented by many of the zone's call girls.

"So it's kind of low-key?" Jeffrey asked.

"About as low as I'd care to sink."

"Sounds perfect," Jeffrey said. "Let's go there." He slid back in the seat.

The fact that he'd never heard of the Essex sounded promising, since he'd been in the Boston area for almost twenty years, right from the beginning of medical school.

The driver took a left off Arlington Street onto Boylston, then made his way downtown. There, the neighborhood took a nosedive. In contrast to the genteel areas around the Boston Garden, there were abandoned buildings, porn shops, and garbagestrewn streets. The homeless were scattered in alleyways and huddled on tenement steps. When the cab was stopped waiting for a light to change, a pimply-faced girl in an obscenely short skirt raised her eyebrows at Jeffrey suggestively. She looked like she couldn't have been more than fifteen.

The red neon sign in front of the Essex Hotel had aptly been amended to SEX

EL; the other letters were out. Seeing how decrepit the place seemed,

Jeffrey felt a moment's hesitation. Peering out the window from the safety of his cab, he warily surveyed the hotel's dirty brick fagade. Seedy was too kind an adjective. A drunk, still clutching his brown-paper-bag-wrapped bottle, was passed out to the right of the front steps.

"You wanted cheap," the cabbie said. "Cheap it is."

Jeffrey handed him a hundred-dollar bill from the briefcase.

"You don't have anything smaller?" the cabbie complained.

Jeffrey shook his head. "I don't have forty-two dollars."

The cabbie sighed and made an elaborate passive-aggressive ritual of giving

Jeffrey his change. Deciding he'd be better off not leaving an angry cabbie in his wake, Jeffrey gave him an extra ten. The driver even said thanks and have a nice night before driving off.

Jeffrey studied the hotel again. On the right was an empty building whose windows except for the ground floor were covered with plywood. On the ground floor there was a pawnshop and an X-rated video store. On the left was an office building in equal disrepair to the Essex Hotel. Beyond the office building was a liquor store, whose windows were barred like a fortress. Beyond the liquor store was an empty lot that was strewn with litter and broken bricks.

With his briefcase in hand and looking distinctly out of place, Jeffrey climbed the steps and entered the Essex Hotel.

The hotel's interior was about as classy as the exterior. The lobby furnishings consisted of a single threadbare couch and a half-dozen folding metal chairs. A bare pay phone was the wall's sole decoration. There was an elevator but the sign across its doors said OUT OF ORDER. Next to the elevator was a heavy door with a wire-embedded window leading to a stairwell. With a sinking feeling in his stomach, Jeffrey stepped up to the reception desk.

Behind the desk, a shabbily dressed man in his early sixties eyed Jeffrey suspiciously. Only drug dealers came to the Essex with briefcases. The clerk had been watching a small-screen black-and-white TV complete with old-fashioned rabbit-ear an' He had unkempt hair and sported a three-day-old beard. tennae.

He had on a tie, but it was loosened at the collar and had a line of gravy stains across the lower third.

"Can I help you?" he asked, giving Jeffrey the once-over. Helping seemed the last thing he was inclined to do.

Jeffrey nodded. "I'd like a room."

"You got a reservation?" the man asked.

Jeffrey couldn't believe the man was serious. Reservations in a flophouse like this? But he didn't want to offend him. Jeffrey decided to play along.

"No reservation," he told him.

"Rates are ten dollars an hour or twenty-five a night," the man said.

"How about two nights?" Jeffrey said.

The man shrugged. "Fifty dollars plus tax, in advance," he said.

Jeffrey signed "Richard Bard." He gave the clerk the change he'd gotten from the taxi driver and added a five and a few singles from his wallet.

The man gave him a key with an attached chain and a metal plaque that had

5F etched into its surface.

The staircase provided the first and only hint that the building had once been almost elegant. The treads and risers were white marble, now long since stained and marred. The ornate balustrade was wrought iron festooned with decorative swirls and curlicues.

The room Jeffrey had been given faced the street. When he opened the door, the room's only illumination came from the blood-red glow of the dilapidated neon sign over the entrance four stories below. Switching on the light, Jeffrey surveyed his new home. The walls hadn't been painted for ages. What paint remained was scarred and peeling. It was difficult to determine

what the original color had been; it seemed to be somewhere between gray and green. The sparse furnishings consisted of a single bed, a nightstand with a lamp minus the shade, a card table, and a single wooden chair. The bedspread was chenille with several greenish stains. A thin-paneled door led to a bathroom.

For a moment, Jeffrey hesitated to enter, but what was his choice? He decided to try to make the best of his predicament, or at least make do.

Stepping over the threshold, he closed and locked his door. He felt terribly alone and isolated. He truly could not sink any deeper than this.

Jeffrey sat on the bed, then lay down across it, keeping both feet firmly planted on the floor. He didn't realize how exhausted he was until his back hit the mattress. He would have loved to curl up for a few hours, as much to escape as to rest, but he knew this was no time for napping. He had to come up with a strategy, some plan. But first he had to make a few phone calls.

Since there was no phone in the shabby hotel room, Jeffrey had to go to the lobby to place the calls. He took his briefcase with him, afraid to leave it unattended even for a minute or two.

Downstairs, the clerk reluctantly left his Red Sox game to make change so

Jeffrey could use the phone.

His first call was to Randolph Bingham. Jeffrey didn't have to be a lawyer to know he desperately needed sound legal advice. While Jeffrey waited for the call to go through, the same pimplyfaced girl he'd seen through the cab window entered the front door. She had a nervous-appearing, baldheaded man with her who had a sticker attached to his lapel that said: Hil I'm Harry.

He was obviously a conventioneer who was seeking the thrill of putting his life in jeopardy. Jeffrey turned his back on the transaction at the front desk. Randolph answered the phone with his familiar aristocratic accent.

6'I've got a problem," Jeffrey said without even saying who he was. But

Randolph recognized his voice immediately. In a few simple sentences,

Jeffrey brought Randolph up to date. He left nothing out, including his striking Devlin with the briefcase in full view of a policeman and the subsequent chase through the airport terminal.

"My good God," was all Randolph could say by the time Jeffrey had finished.

Then, almost angrily, he added, "You know, this is not going to help your appeal. And when it comes to sentencing, it is certainly going to have an influence."

"I know," Jeffrey said. "I could have guessed as much. But

1 didn't call you to tell me I'm in trouble. I had that figured without benefit of counsel. I need to know what you can do to help."

"Well, before I do anything, you have to turn yourself in."

"But..."

"No buts. You've already put yourself in an extremely precarious position with regard to the court."

"And if I do turn myself in, won't the court be likely to deny bail entirely?"

"Jeffrey, you have no choice. In light of your attempt to flee the country, you haven't exactly done much to encourage its trust. "

Randolph started to say more, but Jeffrey cut him off. "I'm sorry, but I'm not prepared to go to jail. Under any circumstances. Please do whatever you can from your end. I'll get back to you." Jeffrey slammed the receiver down. He couldn't blame Randolph for the advice he had given. In some respects it was just like medicine: sometimes the patient just didn't want to hear the doctor's proposed therapy.

With his hand still resting on the receiver, Jeffrey turned back into the reception area to see if anyone had overheard his conversation. The young miniskirted girl and her john had disappeared upstairs, and the clerk was again glued to his tiny TV set. Another man, who looked to be in his seventies, had appeared and was sitting on the tattered couch, thumbing through a magazine.

Dropping another coin into the phone, Jeffrey called home.

"Where are you?" Carol demanded as soon as Jeffrey muttered a dull hello.

"I'm in Boston," he told her. He wasn't about to tell her anything more specific, but he felt he owed her that much. He knew she would be furious that he had left without a word, but he wanted to warn her in case Devlin headed back. And he wanted her to pick up the car. Beyond that, he didn't expect anything along the lines of sympathy. An earful of fury was what he got.

"Why didn't you tell me you were leaving the house?" Carol snarled. "Here

I've been patient, standing by you all these months, and this is the thanks

I get. I looked all over the house before I realized your car was gone."

"It's the car I need to talk to you about," Jeffrey said.

"I'm not interested in your car," Carol snapped.

"Carol, listen to me!" Jeffrey yelled. When he heard that she was going to give him a chance to speak, he lowered his voice,

cupping a hand around the receiver. "My car is at the airport at central parking. The ticket stub is in the ashtray."

"Are you planning on forfeiting bail?" Carol asked incredulously. "We'll lose the house! I signed that lien in good faith... 11

"There are some things more important than the house!" Jeffrey snapped in spite of himself. He lowered his voice again. "Besides, the house on the

Cape has no mortgage. You can have that if money's your worry."

"You still haven't answered me," Carol said. "Are you planning to forfeit the bail?"

"I don't know," Jeffrey sighed. He really didn't. It was the truth. He still hadn't had time to think things through. "Look, the car's there on the second level. If you want it, fine. If not, that's fine too."

"I want to talk to you about our divorce," Carol said. "It's been on hold long enough. As much as I sympathize with your problems, and I do, I have to get on with my life."

"I'll have to get back to you," Jeffrey said irritably. Then he hung up on her as well.

He shook his head sadly. He couldn't even remember a time when there had been warmth between Carol and him. Dying relationships were so ugly. Here he was on the run and all she could worry about was property and the divorce. Well, she had her life to get on with, he supposed. One way or the other, it wouldn't be much longer. She'd be rid of him for good.

He looked at the phone. What he wanted to do was call Kelly. But what would he say? Would he admit to having tried to flee and failed? Jeffrey was filled with indecision and confusion.

Picking up his briefcase, he strode across the lobby, consciously avoiding looking at the two men.

Feeling even more alone than he had before, he climbed the four flights of twisting, filthy stairs, and returned to his depressing room. He stood at the window, bathed in the red neon glow, wondering what he should do. Oh, how he wanted to call Kelly, but he couldn't. He was too embarrassed.

Stepping over to the bed, he wondered if he could sleep. He had to do something. He eyed his briefcase.

TUESDAY,

MAY 16,1989

10:51 P.M.

The only light in the room came from the television set. A fortyfive-caliber pistol and a half-dozen vials of Marcaine on a bureau by the TV glimmered in the soft light. On the screen, three Jamaican men stood in a cramped hotel room and all three were visibly edgy. Each one was carrying an AK-47 assault rifle. The burliest of the three kept glancing at his watch. Perspiration stood on their foreheads. The obvious tension of the Jamaicans stood in sharp contrast to the sonorous reggae rhythm that pealed from a radio on the nightstand. Then the door burst open.

Crockett entered first, clutching a nine-millimeter automatic with the barrel pointed to the ceiling. With one swift, catlike move, he put the barrel against the first Jamaican's chest and pumped one silent, deadly bullet into him. Crockett had his second bullet into the second man by the time Tubbs cleared the doorway in time to take care of the third. It was all over in the blink of an eye.

Crockett shook his head. He was dressed in his usual: an expensive linen jacket by Armani over a casual cotton T-shirt. "Good timing, Tubbs," he said. "I would have had trouble nailing the third dude."

As the closing credits came onto the TV screen, Trent Harding high-fived an imaginary companion. "All right!" he exclaimed in triumph. TV violence had a stimulating effect on Trent. It charged him with aggressive energy that demanded expression. He lived to picture himself pumping bullets into chests the way Don Johnson did so regularly. Sometimes Trent thought he should have gone into law enforcement. If only he'd elected to join the military police when he enlisted in the Navy. Instead, Trent had decided to become a Navy corpsman. He'd liked it okay. It had been a challenge and he'd learned some far-

out stuff. He'd never thought about being a corpsman before going into the

Navy. The first time he thought of it had been when he'd heard a talk during basic training. He found the idea of performing physicals oddly appealing, and he liked the idea of guys coming to him for help so that he could tell them what to do.

Trent got up from the living room couch and vialked into his kitchen. It was a comfortable apartment with one bedroom and two baths. Trent could afford better, but he liked it fine where he was. He lived on the top floor of a five-story building on the back side of Beacon Hill. The bedroom and the living room windows looked out onto Garden Street. The kitchen and the larger of the two bathrooms faced an inner courtyard.

Pulling an Amstel Light from the refrigerator, Trent popped the top and took a long, satisfying gulp. He thought the beer might calm him down some.

He was anxious and edgy from the hour of Miami Vice. Even reruns got him riled up enough to want to hit one of the local bars to see if he could scare up some trouble. He could usually find a homo or two along Cambridge

Street to rough up.

Trent looked like a man who was looking for trouble. He also looked like he'd found it more than a couple of times. A stocky, muscular man of twenty-eight, Trent wore his bleach-blond hair in the severe, flat-topped hairstyle popularly known as a fade. His eyes were a piercing crystal blue.

He had a scar below his left eye that ran back to his ear. He'd gotten it from being on the wrong end of a broken beer bottle in a barroom scuffle in

San Diego. It had taken a few stitches but the other guy had had to have his entire face rearranged. The guy had made the mistake of telling Trent that he thought he had a cute ass. Trent still got hot every time he thought of the episode. What a creep, that goddamned fag.

Trent went back to his bedroom and set his beer down on top of the TV. He picked up the military-issue.45 pistol that he'd "cumshawed" from a Marine for amphetamines. It felt comfortable in his large hand. Gripping the pistol with both hands, Trent leveled the barrel straight at the TV screen with arms stiff and elbows locked. He spun around to point the gun out the open window.

Across the street a woman was opening her bedroom window. "Tough luck, baby," Trent whispered. He aimed the pistol carefully, lowering the barrel until the front and rear sights lined

up perfectly, targeting the woman's torso. Slowly, deliberately, Trent pulled the cold steel of the trigger.

As the firing mechanism clicked, Trent called out "Pow!" as he pretended the gun kicked in the air from its recoil. He smiled. He could have drilled the woman if he'd put in the clip. In his mind's eye he saw her hurled back into her apartment, a neat hole through her chest and blood squirting out.

Laying the pistol on the TV next to his beer bottle, Trent grabbed one of the vials of Marcaine from the bureau. Tossing it in the air, he caught it with his other hand behind his back. He calmly sauntered back to the kitchen to retrieve the necessary paraphernalia from its hiding place.

First he had to remove the glasses from the shelf of one of his kitchen cabinets next to the refrigerator. Then he gently lifted the plywood square that led to his secret cache: a small vault of space between the cabinet's back and the exterior wall. Trent brought out a single vial filled with yellow fluid and an array of 18-gauge syringes. He'd picked up the vial from a Colombian in Miami. The syringes easily came into his possession through his hospital job. He carried both vials and the syringes back to his bedroom along with a propane torch he kept under the kitchen sink.

Trent reached for his bottle and took another swig of beer. He set the propane torch on a small tripod he kept folded under his bed. Taking a cigarette from the pack by the television set, he lit it with a match.

Trent took a long drag, then lit the propane torch with the cigarette.

Next, he took one of the 18-gauge needles. After drawing up a tiny amount of the yellow fluid, he heated the tip of the needle until it glowed red hot. Keeping the needle in the flame, he picked up the vial of Marcaine and heated its top until it too started to become red. With deft, practiced moves, he pushed the hot needle through the molten glass and deposited a drop of the yellow fluid. Next was the trickiest part. After disposing of the needle, Trent began to twirl the vial, slipping it back into the hottest part of the flame. He kept it there for a few seconds, long enough for the puncture site to fuse closed.

He continued to twirl the vial even after.he pulled it from the flame. He didn't stop until the glass had cooled considerably.

"Shit!" Trent said as he watched the very end of the vial suddenly dimple into an unwanted depression. Though virtually unnoticeable, Trent couldn't risk the blemish. If someone was careful enough to notice, they'd discard the vial as a defect. Or

worse, someone on the ball might get suspicious. Disgusted, Trent tossed the vial into the trash.

"Dammit," he thought as he grabbed another vial of Marcaine. He'd have to try again. As he repeated the process, he became more and more intense, angrily cursing when even the third attempt ended in failure. Finally, on the fourth try, the puncture site sealed properly; the curved tip maintained its smooth hemispherical contour.

Holding the ampule up to the light, he inspected it carefully. It was close to perfect. He could still tell that the tube had been punctured, but he had to look carefully. He thought it might have been the best one he'd ever done. It gave him great satisfaction to have mastered such a difficult process. When he'd first thought of it a number of years ago, he'd had no idea if it would work. It used to take him hours to do what he could now do in minutes.

Once he had accomplished what he'd set out to do, Trent returned the vial of yellow fluid, the.45 pistol, and the remaining vials of Marcaine to the hiding place. He replaced the false back of the cabinet and put the glasses back.

Picking up the doctored Marcaine vial, he gave it a good shake. The drop of yellow fluid had long since dissolved. He turned the ampule upside down, checking to see if there was a leak. But the puncture site was as he expected it to be: airtight.

Trent gleefully considered the effect his vial would soon have in St.

Joseph's OR. He thought particularly about the high-andmighty doctors, the havoc he would wreak in that lofty quarter. In his wildest dreams, Trent couldn't have settled on a better career.

Trent hated doctors. They always acted as if they knew everything, when in reality many didn't know their ass from a hole in the wall, especially in the Navy. Most of the time Trent knew twice as much as the doctor did, yet he had to do their bidding. In particular, Trent loathed that true pig of a Navy doctor who'd turned him in for pocketing a few amphetamines. What a hypocrite. Everybody knew the doctors had been making off with drugs and instruments and all sorts of other loot for years. Then there was that real pervert doctor who complained to Trent's commanding officer about Trent's alleged homosexual behavior. That had been the straw that broke t he camel's back. Instead of going through some stupid court-martial or whatever the hell they were planning to do, Trent had resigned.

At least by the time he got out, he was properly trained. He

had no trouble getting nursing jobs. With nursing shortages widespread, he found he could work anywhere he pleased. Every hospital wanted him, especially since he liked working in the OR and had experience in that area from his stint in the Navy.

The only trouble with working in a civilian hospital, aside from the doctors, was the rest of the nursing staff. Some of them were as bad as the doctors, particularly the supervisors. They were always trying to tell him something he already knew. But Trent didn't find them as irritating as the doctors. After all, it was the doctors who conspired to limit the autonomy

Trent had had to practice routine medicine in the Navy.

Trent put the doctored ampule of Marcaine in the pocket of his white hospital coat, which hung in the front closet. Thinking about doctors reminded him of Dr. Doherty. He clenched his teeth at the thought of the man. But it wasn't enough. Trent couldn't contain himself. He slammed the closet door with such force it seemed to jar the whole building. Just that day, Doherty, one of the anesthesiologists, had had the nerve to criticize

Trent in front of several nurses. Doherty had chastised him for what he referred to as sloppy sterile technique. And this was coming from the moron who didn't put on his scrub hat or surgical mask properly! Half the time

Doherty didn't even have his nose covered. Trent was enraged.

"I hope Doherty gets the vial," Trent snarled. Unfortunately, there wasn't any way he could ensure Doherty's getting it. The chances were about one in twenty unless he waited until Doherty was scheduled for an epidural. "Ah, who cares," Trent said with a wave of dismissal. It would be entertaining no matter who got the vial.

Although Jeffrey's new fugitive status heightened his indecision and confusion, he no longer had the slightest inclination toward suicide. He didn't know if he was acting courageously or cow ardly, but he wasn't about to agonize further. Yet with all that had happened, he was understandably concerned about the pos sibility of a new round of depression. Thinking it better to throw temptation away, he t ' ook the step of getting the morphine vial from the briefcase, popping its lid, and flushing the contents down the toilet.

Having at least made a decision about one issue, Jeffrey felt slightly more in control. To make himself feel even more organized, he occupied himself by rearranging the contents of his briefcase. He stacked the money carefully, in the base, covering

it with the underwear. He then rearranged the contents of the accordion-style file area under the lid to make room for Chris Everson's notes. Turning his attention to the notes, he organized them according to size. Some of them were on Chris's notepaper, which had From the Desk of

Christopher Everson printed on top. Others were written on sheets of yellow legal paper.

Jeffrey began to scan the notes, almost without meaning to. He was glad for anything that took his mind away from his current predicament. Henry

Noble's case history was especially fascinating the second time around.

Once again, Jeffrey was struck by the similarities between Chris's unhappy experience with the man and his own with Patty Owen, particularly with respect to each patient's initial symptoms. The major difference between the two cases was that Patty's had been more fulminating and overwhelming.

Since Marcaine had been involved in both cases, the fact that the symptoms were similar was not surprising. What seemed extraordinary was that in both situations the initial symptoms were not what was expected in an adverse reaction to a local anesthetic.

Having been a practicing anesthesiologist for some years, Jeffrey was familiar with the kinds of symptoms that could occur when a patient had an adverse reaction to a local anesthetic. Trouble invariably arose due to an overdose reaching the bloodstream, where it could affect either the heart or the nervous system. Considering the nervous system, it was usually the central or the autonomic system that caused problems, either through stimulation or depression, or a combination of the two.

All this covered a lot of territory, but of all the reactions Jeffrey had studied, heard about, or witnessed, none had been anything like Patty

Owen's, not with the excessive salivation, the tearing, the sudden perspiration, the abdominal pain, and the constricted, or miotic, pupils.

Some of these responses might occur in an allergic reaction, but not from an overdose, and Jeffrey had reason to believe that Patty Owen had not been allergic to Marcaine.

Obviously, tojudge by his notes, Chris Everson had been comparably troubled. Chris noted that Henry Noble's symptoms were more muscarinic than anything else, meaning the kind that were expected when parts of the parasympathetic nervous system were stimulated. They were called muscarinic because they mirrored- the effect of a drug called muscarine, which came from a type of mushroom. But parasympathetic stimulation was not

expected with a local anesthetic like Marcaine. If not, then why the muscarine symptoms? It was puzzling.

Jeffrey closed his eyes. It was all very complicated, and, unfortunately, although he knew the basics, much of the physiological details were not fresh in his mind. But he remembered enough to know that the sympathetic division of the autonomic nervous system was the part affected by local anesthetics, not the parasympathetic part apparently affected in the Noble and Owen cases. There was no immediate explanation for it.

Jeffrey's deep concentration was interrupted by a thump against the wall, then some exaggerated moaning of feigned ecstasy coming from the neighboring room. He had an unwelcome image of the pimply-faced girl and the bald man. The moaning reached a crescendo of sorts and then diminished.

Jeffrey stepped over to the window to stretch. He was again bathed in the red neon light. A group of homeless people was milling around to the right of the Essex's stoop, presumably in front of the liquor store. Several young hookers were working the street. Off to the side were young toughs who seemed to take a proprietary interest in the goings-on of the area.

Whether they were pimps or drug dealers, Jeffrey couldn't say. What a neighborhood, he thought.

He turned away from the window. Jeffrey had seen enough. Chris's notes were sprawled across the bed. The moans from next door had stopped. Jeffrey tried to review the list of possibilities for the Noble and Owen mishaps.

Once more he focused on the notion that had so consumed Chris through the course of his last days: the possibility of a contaminant in the Marcaine.

Assuming that neither he nor Chris had made a gross medical error-in the

Owen case, for example, that he had not used the.75% Marcaine that had been found in his disposal-and in view of the fact that both patients had had unexpected parasympathetic symptoms without allergic or anaphylactic reactions, then Chris's theory of a contaminant had considerable validity.

Returning to the window, Jeffrey thought about the implications of a contaminant being in the Marcaine. If he could prove such a theory, it would go a long way toward absolving him from blame in the Owen case.

Culpability would fall to the pharmaceutical company that had manufactured it. Jeffrey wasn't sure about how the legal machinery would work once such a theory was proven. Given his recent brushes with the judicial system, he knew the gears would turn slowly, but turn they would. Maybe old Randolph would be able to figure a way to get the

wheels to turn faster. Jeffrey smiled at a wonderful thought: maybe his life and career could be salvaged. But how would he go about proving there had been a contaminant in a vial that had been used nine months earlier?

Suddenly, Jeffrey had a thought. He rushed back to Chris's notes to read

Henry Noble's case summary. Jeffrey was particularly interested in the initial sequence of events, when Chris was first administering the epidural anesthesia.

Chris had taken 2 cc's of Marcaine from a 30 cc ampule for his test dose, adding his own 1:200,000 epinephrine. It had been immediately after that test dose that Henry Noble's reaction began. With Patty Owen, Jeffrey had used a fresh 30 cc ampule of Marcaine in the OR. It was after this Marcaine was introduced into her system that her adverse reaction began. For the test dose, Jeffrey had used a separate 2 cc vial of spinal grade Marcaine, as was his custom. If a contaminant had been in the Marcaine, it had to have been in the 30 cc ampule in both situations. That would mean that

Patty had gotten a substantially larger dose than Henry Noble-a full therapeutic dose as opposed to a test dose of 2 cc's. That would explain why Patty's reaction was so much more severe than Henry Noble's and why

Noble had managed to live for a week.

For the first time in months, Jeffrey felt a glimmer of hope that his old life was still within reach. He could have it back again. During his defense, he'd never considered the possibility of a contaminant. Now, suddenly it seemed like a real possibility. But it would take time and some serious effort to investigate, much less prove. What was his first step?

First of all, he needed more information. That meant he'd have to bone up on the pharmakinetics of local anesthetics as well as the physiology of the autonomous nervous system. But that would be relatively easy. All he needed was books. The hard part would be looking into the idea of a contaminant.

He'd need access to the full pathology report on Patty Owen. He'd seen only parts of it during the discovery process. Plus, there was the question

Kelly had raised: what about an explanation for the.75% Marcaine vial found in the disposal container on the anesthesia machine? How could it have gotten there?

Investigating these issues would have been difficult under the best of circumstances. Now that he was a convict and a fugitive, it would be all but impossible. He would have to get into Boston Memorial. Could he do that?

Jeffrey went into the bathroom. Standing in front of the mirror, he evaluated his features in the raw fluorescent light. Could he change his appearance enough not to be recognized? He'd been associated with Boston

Memorial since his clinical clerkships in medical school. Hundreds of people knew him by sight.

Jeffrey put a hand to his forehead and slicked back his light brown hair.

He combed his hair to the side, parting it on the right. Holding it back made his forehead appear broader. He'd never worn glasses. Maybe he could get a pair now. And for most all of the years he'd been working at Boston

Memorial, he'd had a mustache. He could shave it off.

Caught up with this intriguing thought, Jeffrey went to the other room to retrieve his Dopp Kit. He went back to the bathroom miffor. Soaping up, he quickly shaved off his mustache. It felt strange to run his tongue across a bare upper lip. Wetting his hair, he combed it straight back from his forehead. He was encouraged; already he was beginning to look like a new man.

Next, Jeffrey shaved off his moderate sideburns. The difference wasn't much but he figured everything helped. Could he pass for another M.D.? He had the know-how; what he needed was an ID. Security at Boston Memorial had been beefed up considerably, a sign of the times. If he was challenged and couldn't produce an ID, he would be caught. Yet he needed the access, and it was the doctors who had access to all areas of the hospital.

Jeffrey kept thinking. He wouldn't despair. There was another group in the hospital that had wide access: housekeeping. No one questioned housekeeping. Having spent many nights on call in the hospital, Jeffrey could recall seeing housekeeping staff everywhere. No one ever wondered about them. He also knew there was a housekeeping graveyard shift from eleven P.m. to seven A.M., which they always had a hard time filling. The graveyard shift would be perfect, Jeffrey figured. He'd be less likely to bump into people who knew him. For the past few years, he'd worked mainly during the day.

Energized by this new crusade, Jeffrey yearned to start immediately. That meant a trip to the library. If he left right away, he would have about an hour before closing. Before he had time for second thoughts, he slipped

Chris's notes into the spot he'd prepared for them in his briefcase and closed and latched the lid.

For what it was worth, Jeffrey locked the door behind him. As he made his way down the stairs, he hesitated. The musty,

sour smell reminded him of Devlin. Jeffrey had gotten a whiff of his breath when Devlin nabbed him at the airport.

In considering his plan of action, Jeffrey neglected to factor in Devlin.

Jeffrey knew something about bounty hunters, and that's what Devlin undoubtedly was. Jeffrey harbored no illusions of what would happen if

Devlin caught him again, especially after the episode at the airport. After a moment's indecision, Jeffrey resignedly continued down the stairs. If he wanted to do any investigating, he'd have to take some chances, but it still behooved him to remain constantly alert. In addition, he'd have to think ahead so that if he was unlucky enough to confront Devlin, he'd have some sort of plan. Downstairs, the man with the magazine was gone, but the clerk was still watching the Red Sox game. Jeffrey slipped out without being noticed. A good sign, he joked to himself His first try at not being seen was a success. At least he still had a sense of humor.

Any lightheartedness that Jeffrey had been able to call up faded as he surveyed the street scene in front of him. He felt a wave of acute paranoia as he reminded himself of the double reality of being a fugitive and carrying around $45,000 in cash. Directly across from Jeffrey, in the shadows of a doorway of a deserted building, the two men he'd seen from the window were smoking crack.

Clutching his briefcase, Jeffrey descended the Essex's front steps. He avoided stepping on the poor man who was still lolling on the pavement with his brown-bagged bottle. Jeffrey turned to the right. He planned to walk the five or six blocks to the Lafayette Center, which included a good hotel. There he'd find a cab.

Jeffrey was abreast of the liquor store when he spotted a police car heading in his direction. Without a moment's hesitation, he ducked into the store. The jangle of bells attached to the door wore on Jeffrey's nerves.

As crazy as it seemed, he didn't know whom he was more afraid of, the street people or the police.

"Can I help you?" a bearded man asked from behind a counter. The police car slowed, then went past. Jeffrey took a breath. This wasn't going to be easy.

"Can I help you?" the clerk repeated.

Jeffrey bought a pint-sized bottle of vodka. If the police cruised back, he wanted his visit to the store to appear legitimate. But it wasn't necessary. When he emerged from the store, the police car was nowhere in sight. Relieved, Jeffrey turned to the right, intending to hurry. But he pulled up short, practically

colliding with one of the homeless men he'd seen earlier. Startled, Jeffrey raised his free hand to protect himself.

"Got any spare change, buddy?" the man asked unsteadily. He was obviously drunk. He had a fresh cut just by his temple. One of the lenses of his black-rimmed glasses was cracked.

Jeffrey recoiled from the man. He was about Jeffrey's height but with dark, almost black hair. His face was covered with a heavy stubble, suggesting he'd not shaved for a month. But what caught Jeffrey's attention was the man's clothes. He was dressed in a tattered suit complete with a button-down blue oxford shirt that was soiled and missing a few buttons. He had on a regimental striped tie that was loosened at the collar and spotted with green stains. Jeffrey's impression was that the man had dressed for work one day, then never gone home.

"What's the matter?" the man asked in a wavering, drunken voice. "Don't you speak English?"

Jeffrey dug into his trouser pocket for the change he'd received from his purchase of vodka. As he dropped the money in the man's palm, Jeffrey studied his face. His eyes, though glassy, looked kind. Jeffrey wondered what had driven the man to such desperate circumstances. He felt an odd kinship with this homeless person and his unknown plight. He shuddered to think of how fine a line separated him from a similar fate. The identification was made easier since the man appeared to be close to

Jeffrey's age.

As he'd expected, Jeffrey hailed a taxi easily at the nearby luxury hotel.

From there it took only fifteen minutes to get out to Harvard's medical area. It was just a little after eleven when Jeffrey walked into the

Countway Medical Library.

Among the books and narrow study cubicles, Jeffrey felt at home. He used one of the computer terminals to get the call numbers for several books on the physiology of the autonomic nervous system and the pharmacology of local anesthetics. With these books in hand he went into one of the carrels facing the inner court and closed the door. Within minutes he was lost in the intricacies of nerve impulse conduction.

It wasn't long before Jeffrey understood why Chris had highlighted the word

"nicotinic." Although most people thought of nicotine as an active ingredient in cigarettes, it was actually a drug, more specifically a poison, which caused a stimulation and then blockade of autonomic ganglia.

Many of the symptoms associated with nicotine were the same as those caused by muscarine: salivation, sweating, abdominal pain, and lacrimation-the

very same symptoms that had appeared in Patty Owen and Henry Noble. It even caused death in surprisingly low concentrations.

All this meant to Jeffrey that if he was thinking of a contaminant, it would have to have been a compound that mirrored local anesthetics to an extent, something like nicotine. But it couldn't have been nicotine, thought Jeffrey. The toxicology report on Henry Noble had been negative; something like nicotine would have shown up.

If there had been a contaminant it would also have to have been in an extremely small, nanomolar amount. Therefore it would have to have been something extraordinarily potent. As to what that could have been, Jeffrey hadn't a clue. But in his reading Jeffrey stumbled across something he'd remembered from medical school, but had not thought of since. Botulinum toxin, one of the most toxic substances known to man, mirrored local anesthetics in its ability to "freeze" neural cell membranes at the synapse. Yet Jeffrey knew he was not seeing botulinum poisoning. Its symptoms were totally different; muscarinic effects were blocked, not stimulated.

Never had time passed so quickly. Before Jeffrey knew it, the library was about to close for the night. Reluctantly, he gathered up Chris Everson's notes as well as his own that he'd just made. Carrying the books in one hand and his briefcase in the other, he descended to the first floor. He left the books on the counter to be reshelved and started for the door. He stopped abruptly.

Ahead people were being stopped by an attendant to open their parcels, knapsacks, and, of course, briefcases. It was standard practice to keep the loss of books to a minimum, but it was a practice Jeffrey had forgotten about. He hated to think what the reaction might be if the library guard got a look at his stacks of hundred-dollar bills. So much for staying low profile.

Jeffrey doubled back to the periodical section and ducked behind a shoulder-high display case. He opened his briefcase and began tojam the packets of paper money in his pockets. To make room, he pulled the pint of vodka from his jacket side pocket and packed it in the briefcase. Better to let the guard think he was a tippler than a drug dealer or thief.

Jeffrey was able to leave the library without incident. He felt a little conspicuous with all his pockets bulging, but there was nothing to be done about it just then.

There were practically no cabs on Huntington Avenue at that time of night.

After he tried for ten minutes to no avail, the

Green Line trolley came along. Jeffrey got on, feeling it was more prudent to keep moving.

Jeffrey took one of the seats oriented parallel to the car and balanced the briefcase on his knees. He could feel all of the packets of money that were in his pants, particularly the ones he was sitting on. As the trolley lurched forward, Jeffrey allowed his eyes to roam around the car.

Consistent with his experience on Boston subways, no one said a word.

Everyone stared ahead expressionlessly as if in a trance. Jeffrey's eyes met those of the other travelers who were sitting across from him. The people who sullenly returned his state made him feel transparent. He was amazed at how many of them in his mind looked as if they were criminals.

Closing his eyes, Jeffrey went over some of the material he'd just read, considering it in light of the experience he'd had with Patty Owen and

Chris's with Henry Noble. He'd been surprised by one piece of information about local anesthetics. Under a section marked "adverse reactions," he'd read that occasionally miotic or constricted pupils were seen. That was new to Jeffrey. Except for Patty Owen and Henry Noble, he'd never seen it clin- ically or read it before. There was no explanation of the physiological mechanism, and Jeffrey couldn't explain it. Then in the same article it was written that usually mydriasis, or enlargement, of the pupils was seen. At that point Jeffrey gave up the issue of pupillary size. It all didn't make much sense to him and only added to his confusion.

When the trolley suddenly plunged underground, the sound startled Jeffrey.

He opened his eyes in terror and let out a little gasp. He hadn't realized how jumpy he was. He began to take deep, steady breaths in order to calm himself

After a minute or two, Jeffrey's thoughts returned to the cases. He realized there was another similarity between the Noble and Owen cases that he'd not considered. Henry Noble had been paralyzed for the week he'd lived. It was as if he'd had total irreversible spinal anesthesia. Since

Patty had died, Jeffrey had no idea if she would have suffered paralysis had she lived. But her baby had survived and did display marked residual paralysis. It had been assumed that the baby's paralysis stemmed from a lack of oxygen to his brain, but now Jeffrey wasn't so sure. The strange, asymmetric distribution had always troubled him. Maybe this paralysis was an additional clue, one that might be of use in identifying a contaminant.

Jeffrey got off the subway at Park Street and climbed the

stairs. Giving wide berth to several policemen, he hurried down Winter

Street, leaving the crowded Park Street area behind. As he walked, he thought more seriously about getting back into Boston Memorial Hospital now that he'd done his reading.

The idea of becoming part of the housekeeping staff had a lot of merit except for one problem: to apply for a job he'd need to provide some sort of identification as well as a valid social security number. In this day of computers, Jeffrey knew he couldn't expect to get by by making one up.

He was wrestling with the problem of identification when he turned onto the street where the Essex Hotel stood. Half a block away from the liquor store, which was still open, he paused. A vision of the man in the tattered suit came back to him. The two of them had been about the same height and age.

Crossing the street, Jeffrey approached the empty lot next to the liquor store. A strategically placed streetlamp threw a good deal of light into the area. About a quarter of the way into the lot there was a concrete overhang sticking out of one of the bordering buildings that looked like it could have been an old loading dock. Beneath it Jeffrey could make out a number of figures, some sitting, some passed out on the ground.

Stopping and listening, Jeffrey could hear conversation. Overpowering any misgivings, he started toward the group. Stepping gingerly on a bed of broken bricks, Jeffrey approached the overhang. A fetid odor of unwashed humans assaulted his senses. The conversation stopped. A number of rheumy eyes regarded him suspiciously in the semidarkness.

Jeffrey felt he was an intruder in another world. With rising anxiety, he searched for the man in the tattered suit, moving his eyes quickly from one dark figure to the next. What would he do if these men suddenly sprang at him?

Jeffrey saw the man he was looking for. He was one of the men sitting in the semicircle. Forcing himself forward, Jeffrey approached closer. No one spoke. There was an electric charge of expectation in the air as if a spark could cause an explosion. Every eye was now following Jeffrey. Even some of the people who'd been lying down were now sitting up, staring at him.

"Hello," Jeffrey said limply when he was in front of the man. The man didn't move. Nor did anyone else. "Remember me?" Jeffrey asked. He felt foolish, but he couldn't think of what else to say. "I gave you some change an hour or so ago. Back there, in front of the liquor store." Jeffrey pointed over his shoulder.

The man didn't respond.

"I thought maybe you could use a little more," Jeffrey said. He reached into his pocket, and pushing away the packet of hundred-dollar bills, pulled out some change and several smaller bills. He extended the change.

The man reached forward and took the coins.

"Thanks, buddy," he managed, trying to see the coins in the darkness.

"I've got more," Jeffrey said. "In fact, I've got a five-dollar bill here, and I'm willing to bet that you're so drunk, you can't remember your social security number."

"Whaddya mean?" the man mumbled as he struggled to his feet. Two of the other men followed suit. The man Jeffrey was interested in swayed as if he were about to fall, but caught himself. He appeared drunker than he'd been earlier. "It's 139-321560. That's my social security number."

"Oh, sure!" Jeffrey said with a wave of dismissal. "You just made that up."

"The hell I did!" the man said indignantly. With a sweeping gesture that almost knocked him off his feet, he reached for his wallet. He staggered again, struggling to lift the wallet from his trouser pocket. After he got it out, he fumbled to remove not a Social Security card, but his driver's license. He dropped the wallet in the process. Jeffrey bent down to pick it up. He noticed there was no money in it.

"Lookit right here!" the man said. "Just like I said."

Jeffrey handed him the wallet and took the license. He couldn't see the number but that wasn't the point. "My word, I guess you were right," he said after he pretended to study it. He handed over the five-dollar bill, which the man grabbed eagerly. But one of the other men grabbed it out of his hand.

"Gimme that back!" the man yelled.

Another of the men had advanced behind Jeffrey. Jeffrey reached into his pocket and pulled out more coins. "There's some for everybody," he said as he tossed them on the ground. They clinked against the broken brick. There was a rush as everyone but Jeffrey dropped to his hands and knees in the darkness. Jeffrey took advantage of the diversion to turn and run as quickly as he dared across the rubble-strewn lot toward the street.

Back in his hotel room, he propped the license up on the edge of the sink and compared his image to that of the photo on the license. The nose was completely different. Nothing could be done about that. Yet if he darkened his hair and combed it

straight back with some gel the way he'd thought he would, and if he added some black-framed glasses, maybe it would work. But at the very least, he had a valid social security number associated with a real name and address: Frank Amendola, of 1617 Sparrow Lane, Framingham, Massachusetts.

WEDNESDAY,

MAY 17, 1989

6:15 A.M.

Trent Harding wasn't due to start work until seven, but at sixfifteen he was already pulling off his street clothes in the locker room off the surgical lounge of St. Joseph's Hospital. From where he was standing, he had a straight shot to the sinks and he could see himself in the over-the-basin mirrors. He flexed his arm and neck muscles so that they bulged. He hunched over slightly to check their definition. Trent liked what he saw.

Trent went to his health club at least four times a week to use the

Nautilus equipment to the point of exhaustion. His body was like a piece of sculpture. People noticed and admired it, Trent was sure. Yet he wasn't satisfied. He thought he could stand to beef up his biceps a bit more. On his legs, his quads could use tightening. He planned to concentrate on both in the coming weeks.

Trent was in the habit of arriving early, but on this particular morning, he was earlier than usual. In his excitement he'd awakened before his alarm and could not go back to sleep, so he'd decided to get to work early.

Besides, he liked to take his time. There was something unbelievably exhilarating about placing one of his doctored Marcaine ampules in the

Marcaine supply. It gave him shivers of pleasure-like planting a time bomb.

He was the only one who knew about the imminent danger. He was the one who controlled it.

After he'd gotten into his scrub outfit, Trent glanced around him. A few people who were going off shift had come into the locker room. One was in the shower singing a Stevie Wonder tune; another was in one of the toilet stalls; and a third was at his locker well out of sight.

Trent reached into the pocket of his white hospital jacket and pulled out the doctored ampule of Marcaine. Palming it in case

someone unexpectedly appeared, Trent slipped it into his briefs. It felt cold and uncomfortable at first; he grimaced as he adjusted it. Then he closed his locker and started walking toward the lounge area.

In the surgical lounge, fresh coffee was softly perking, filling the room with its pleasant aroma. Nurses, nurse anesthetists, a few doctors, and orderlies were gathered there. Soon they'd be going off shift. There were no emergency cases in progress, and all the preparations for the day's schedule for which the night shift was responsible were complete. The room rang with happy conversation.

No one acknowledged Trent, nor did he try to say hello to anyone. Most of the staff didn't recognize him since he was not a member of the night shift. Trent passed through the lounge and entered the OR area itself. No one was at the main scheduling desk. The huge blackboard was already chalked with the upcoming day's schedule. Trent paused briefly, scanning the big board for two things: to see which room he was assigned to for the day and to see if there were any spinal or epidural cases scheduled. To his delight there was a handful. Another shiver of excitement went down his spine. Having a number of such cases meant there was a good chance his

Marcaine would be used that very day.

Trent continued down the main OR corridor and turned into Central Supply, which was conveniently located in the middle of the OR area. The operating room complex at St. Joe's was shaped like the letter U with the ORs lining the outside of the U and Central Supply occupying the interior.

Moving with a sense of purpose, as if he were heading into Central Supply to get a setup pack for one of the ORs, Trent took a loop around the whole area. As usual, no one was there. There was always a hiatus between six-fifteen and six forty-five when Central Supply was unoccupied.

Satisfied, Trent went directly into the section that housed the IV fluids and the nonnarcotic and uncontrolled drugs. He did not have to search for the local anesthetics. He'd scouted them out long ago.

With one more quick glance around, Trent reached for an open pack of 30 cc.5% Marcaine. Deftly he raised the lid. There were three ampules remaining in the box where there originally had been five. Trent exchanged one of the good ampules for the one in his briefs. He winced again. It was surprising how cold room temperature glass could feel. He closed the lid of the Marcaine box and carefully slid it back into its original position.

Again Trent glanced around Central Supply. No one had appeared. He looked back at the box of Marcaine. Once more an almost sensual excitement rippled through his body. He'd done it again, and no one would ever have a clue. It was so damned easy, and depending on the OR schedule and a little luck, the vial would be used soon, maybe even that morning.

For a brief moment, Trent thought about removing the other two good vials from the box just to speed things up. Now that the vial was placed, he was impatient to enjoy the chaos it would cause. But he decided against removing the other vials. He'd never taken any chances in the past, and it wasn't a good time to start. What if someone was keeping track of how many vials of Marcaine were on hand?

Trent emerged from Central Supply and headed back to his locker to tuck away the ampule that was now in his briefs. Then he'd get himself a nice cup of coffee. Later that afternoon, if nothing had happened, he'd return to Central Supply to see if the doctored vial had been taken. If it was used that day, he'd know about it soon enough. News of a major complication spread like wildfire in the OR suite.

In his mind's eye, Trent could see the vial resting so innocently in the box. It was a kind of Russian roulette. He felt a stirring of sexual excitement. He hurried into the locker room, trying to contain himself. If only it could be Doherty who'd get it, thought Trent. That would make it perfect.

Trent's jaw tightened as he thought of the anesthesiologist. The man's name re-ignited his anger from the previous day's humiliation. Arriving at his locker, Trent gave it a resounding thump with his open palm. A few people looked in his direction. Trent ignored them. The irony was that before the humiliating episode, Trent had liked Doherty. He'd even been nice to the jerk.

Angrily, Trent twirled his combination lock and got his locker door open.

Pressing in against it, he slipped the ampule of Marcaine from his shorts and eased it into the pocket of his white jacket hanging within the locker.

Maybe he'd have to make some special arrangements for Doherty.

Breathing a sigh of relief, Jeffrey closed the door to his room at the Essex

Hotel. It Was just after eleven in the morning. He'd been on the go since nine-thirty when he left the hotel to do some shopping. Every moment he'd been terrified of being discovered by an acquaintance, Devlin, or the police. He'd seen several po-

lice officers, but he'd avoided any direct confrontation. Even so, it had been a nerve-racking venture.

Jeffrey put his packages and his briefcase on the bed and opened the smallest bag. Among its contents was a hair rinse. The color was called

Midnight Black. Taking off his clothes, Jeffrey went directly into the bathroom and followed the directions on the box. By the time he put the styling gel in his hair and brushed it straight back from his forehead, he looked like a different person. He thought he looked like a used car salesman or like someone out of a 1930s movie. Comparing his image with the small photo on the license, he thought he could pass for Frank Amendola if no one looked too closely. And he still wasn't finished.

Back in the bedroom, Jeffrey opened the larger of the packages and took out a new dark blue polyester suit he'd bought in Filene's Basement and had altered at Pacifici of Boston. Mike, the head tailor, had been happy to do the alterations while Jeffrey waited. Jeffrey didn't have much done to the suit because he didn't want it to fit too well. In fact, he had to resist some of Mike's suggestions.

Going back to his parcels, Jeffrey pulled out several white shirts and a couple of unattractive ties. He put on one of the shirts and a tie, then slipped on the suit. Finally he searched through the bags until he found a pair of dark-rimmed protective glasses. After he put them on, he returned to the bathroom mirror. Again he compared his image with the photo on the license. In spite of himself, he had to smile. From a general point of view, he looked terrible. In terms of looking like Frank Amendola, he looked reasonably good. It surprised him how little facial features mattered in generating an overall impression.

One of the other parcels contained a new duffel bag with a shoulder strap and a half-dozen compartments. Jeffrey transferred the packets of money to these. He'd felt conspicuous carrying the briefcase with him and was afraid it might be a way for the police to recognize him. He even guessed it might be mentioned as part of his description.

Going back to the briefcase, Jeffrey took out a syringe and the vial of succinylcholine. Having worried all morning about Devlin suddenly appearing as he had at the airport, Jeffrey had come up with an idea. He carefully drew up 40 mg of succinylcholine in the syringe, then capped it. He put the syringe in the side pocket of his jacket. He wasn't sure how he would use the

succinylcholine, but it was there just in case. It was more of a psychological support than anything else.

With his plano glasses on and his duffel bag over his shoulder, Jeffrey took one last glance around his room, wondering if he was forgetting anything. He was hesitant to leave because he knew the moment he stepped out of the room, the anxiety of being recognized would return. But he wanted to get into Boston Memorial Hospital, and the only way that was going to happen was if he went over there and applied for a housekeeping job.

Devlin rudely shoved his way out of the elevator on his way to Michael

Mosconi's office without giving the other passengers time to get out of his way. He got perverse pleasure out of provoking the people, especially men in business suits, and he half hoped one of them would try to be a gallant hero.

Devlin was in a foul mood. He'd been awake for most of the night, uncomfortably propped up in the front seat of his car watching the Rhodes's house. He'd fully expected Jeffrey to come sneaking home in the middle of the night. Or at the very least, he expected Carol to leave suddenly. But nothing happened until just after eight in the morning, when Carol came out of the garage like the Green Hornet in her Mazda RX7 and left a patch of rubber in the middle of the street.

With great difficulty and not very high hopes, Devlin had followed Carol through the morning traffic. She drove like an Indy 500 driver, the way she weaved in and out of the traffic. She led him all the way downtown, but she'd merely gone to her office on the twenty-second floor of one of the newer office buildings. Devlin decided to give up on her for the time being. He needed more information on Jeffrey to decide what to do next.

"Well?" Michael asked expectantly as Devlin came through the door.

Devlin didn't answer immediately, which he knew would drive Michael crazy.

The guy was always so wound up. Devlin dropped onto the vinyl couch that faced Michael's desk and put his cowboy boots on top of the small coffee table. "Well what?" he said irritably.

"Where's the doctor?" He thought Devlin was about to tell him he'd already delivered Rhodes to the jailhouse.

:'Beats me," Devlin said.

'What does that mean?" There was still a chance Devlin was teasing him.

"I think it's pretty clear," Devlin said.

"It might be clear for you, but it's not clear to me," Michael said..

"I don't know where the little bastard is," Devlin finally admitted.

"For chrissake!" Michael said, throwing up his hands in disgust. "You told me you'd get the guy, no problem. You gotta find him! This is no longer a joke."

"He never showed up at home," Devlin said.

"Damn, damn, damn!" Michael said with progressive panic. His swivel chair squeaked as he tipped forward and stood up. "I'm going to be out of business."

Devlin frowned. Michael was more wound up than usual. This missing doctor was really getting to him. "Don't worry," he told Michael. "I'll find him.

What else do you know about him?"

"Nothing!" Michael yelled. "I told you everything I know."

"You haven't told me squat," Devlin said. "What about other family, things like that? What about friends?"

"I'm telling you, I don't know anything about the guy," Michael admitted.

"All I did was an 0 and.E on his house. And you know something else? The bastard screwed me there too. This morning I got a call from Owen Shatterly at the bank, telling me he just learned Jeffrey Rhodes had upped his mortgage before my lien was filed. Now even the collateral doesn't cover the bond."

Devlin laughed.

"What the hell's so funny?" Michael demanded.

Devlin shook his head. "It tickles me that this little piss-ant doctor is causing so much trouble."

"I fail to find anything about this funny," Michael said. "Owen also told me that the doctor took the forty-five thousand he'd upped his mortgage in cash."

"Geez, no wonder the guy's briefcase hurt," Devlin said with a smile. "I've never been hit with that kind of dough."

"Very funny," Michael snapped. "The trouble is that the situation is going from bad to worse. Thank God for my friend Albert Norstadt down at police headquarters. The police weren't going to do a goddamn thing until he got involved."

"They think Rhodes is still in town?" Devlin questioned.

"As far as I know," Michael said. "They haven't been doing much, but at least they've been covering the airport, bus and train stations, rent-a-car agencies, and even taxi companies."

"That's plenty," Devlin, said. He certainly didn't want the police to catch Jeffrey. "If he's in town, I'll find him in the next day or so. If he's skipped, it will take a little longer, but I'll get him. Relax."

"I want him found today!" Michael said, working himself up into a renewed frenzy. He started to pace behind his desk. "If you can't find the bastard,

I'll bring in some other talent."

"Now hold on," Devlin said, bringing his legs off the coffee table and sitting up. He didn't want anybody else homing in on this job. "I'm doing the best anybody could do. I'll find the guy, no sweat."

"I want him now, not next year," Michael said.

"Relax. It's only been twelve hours," Devlin said.

"What the hell are you sitting around here for?" Michael snapped. "With forty-five grand in his pocket, he's not going to hang around forever. I want you to go back to the airport and see if you can pick up his trail from there. He had to get into town somehow. He sure as hell didn't walk.

Get your ass out there and talk to the MBTA people. Maybe somebody will re- member a skinny guy with a mustache and a briefcase."

"I think it's better to cover the wife," Devlin said.

"They didn't strike me as being so lovey-dovey," Michael said. "I want you to try the airport. If you don't, I'll send someone else."

"All right, all right!" Devlin said, getting to his feet. "If you want me to try the airport, I'll try the airport."

"Good," Michael said. "And keep me informed."

Devlin let himself out of Michael's office. His mood had not improved.

Normally he'd never let someone like Michael tell him how to do his job, but in this instance, he thought he'd better humor the man. The last thing he wanted was competition. Especially on this job. The only trouble was that now that he had to go to the airport, he'd have to hire someone to follow the wife and watch the house. As Devlin waited for the elevator, he thought about whom he could call.

Jeffrey paused on the broad steps of Boston Memorial's entrance to marshal his courage. Despite his efforts at disguise, he was apprehensive now that he had reached the hospital's threshold. He was worried he'd be recognized by the first person who knew him.

He could even imagine their words: "Jeffrey Rhodes, is that you? What are you doing, going to a masquerade ball? We heard the police are looking for you, is that true? Sorry about your

being convicted of second-degree murder. Sure does prove it's getting harder and harder to practice medicine in Massachusetts."

Taking a step back and switching his duffel bag to the other shoulder,

Jeffrey tipped his head to look up at the Gothic details over the lintel of the front entrance. There was a plaque that read: THE BOSTON MEMORIAL

HOSPITAL ERECTED AS A HOUSE OF REFUGE FOR THE SICK, INFIRM, AND TROUBLED.

He wasn't sick or infirm, but he was certainly troubled. The longer he hesitated, the harder it was to go inside. He was locked in indecision when he spotted Mark Wilson.

Mark was a fellow anesthesiologist whom Jeffrey knew well. They'd trained together at the Memorial. Jeffrey had been a year ahead. Mark was a large black man whose own mustache had always made Jeffrey's appear sparse by comparison; it had always been a point of humor between them. Mark seemed to be enjoying the brisk spring day. He was approaching from Beacon Street, heading for the front entrance-and straight for Jeffrey.

It was the kick Jeffrey needed. In a panic, he went through the revolving door and into the main lobby. He was immediately swept up in a sea of people. The lobby served not only as an entrance but as the confluence of three main corridors that led to the hospital's three towers.

Fearing that Mark was on his heels, Jeffrey hurried around the circular information booth in the center of the domed lobby and walked down the central corridor. He figured Mark would be heading left to the bank of elevators that led to the OR complex.

Tense with fear of discovery, Jeffrey walked down the hall trying to appear casual. When he finally turned to glance behind him, Mark was nowhere in sight.

Although he'd been affiliated with the hospital for almost twenty years,

Jeffrey was not acquainted with anyone in personriel. Even so, he was wary when he entered the employment office and took the application a friendly clerk handed him. Just because he wasn't familiar with personnel staff didn't mean they weren't familiar with him.

He filled out the application, using Frank Amendola's name, social security number, and his Framingham address. In the section asking for work preference, Jeffrey indicated housekeeping. In the section asking for shift preference if applicable, he wrote "night." For references, JelTrey listed several hospitals where he'd visited for anesthesia meetings. It was his hope that it would

take time for personnel to follow up on the references, if followups were done at all. Between the high demand for hospital workers and the low wages offered, Jeffrey figured it was an applicant's market. He didn't think that his employment in a position in housekeeping would be predicated on a reference check.

After he handed in his completed application, Jeffrey was offered the choice of being interviewed immediately or having an interview scheduled for a future date. He said he'd be pleased to be interviewed at personnel's earliest convenience.

After a brief wait, he was ushered into Carl Bodanski's windowless office.

Bodanski was one of the Memorial's personnel officers. One wall of his small room was dominated by a huge board with hundreds of name tags hanging from small hooks. A calendar was on another wall. Double doors filled the third. It was all very neat and utilitarian.

Carl Bodanski was in his mid to late thirties. He had dark hair, a handsome face, and was neatly if not too stylishly dressed in a dull business suit.

Jeffrey realized he'd seen the man many times in the hospital cafeteria, but the two had never spoken. When Jeffrey entered, Bodanski was hunched over his desk.

"Please sit down," Bodanski said warmly, not yet looking up. Jeffrey could see that he was going over his application. When Bodanski finally turned his attention to Jeffrey, Jeffrey held his breath. He was afraid he'd see some sudden evidence of recognition. But he didn't. Instead, Bodanski asked

Jeffrey if he would care for anything to drink, coffee, maybe a Coke.

Jeffrey nervously declined. He studied Bodanski's face. Bodanski smiled in return.

"So you've worked in hospitals?"

"Oh, yes," Jeffrey answered. "Quite a bit." Jeffrey smiled weakly. He was starting to relax.

"And. you want to work the night shift in housekeeping?" Bodanski wanted to make sure there hadn't been a mistake. As far as he was concerned, this was too good to be true: an applicant for housekeeping's night shift who didn't look like a criminal or an illegal alien, and who spoke English.

"That's what I'd prefer," Jeffrey said. He realized it was a bit unexpected. On the spur of the moment he presented an explanation: "I'm planning on taking a few courses at Suffolk University during the day or perhaps evening. Have to support myself."

"What kind of courses?" Bodanski asked.

"Law," Jeffrey responded. It was the first subject that came to mind.

"Very ambitious. So you'll be going to law school for a number of years?"

"I hope to," Jeffrey said enthusiastically. He could see Bodanski's eyes had brightened. Besides recruitment, housekeeping had a problem of a high turnover rate, especially on the night shift. If Bodanski thought Jeffrey would stay for several years on nights, he'd think it was his lucky day.

"When would you be interested in starting?" Bodanski asked.

"As soon as possible," Jeffrey said. "As early as tonight."

"Tonight?" Bodanski repeated with disbelief. This was really too good to be true.

Jeffrey shrugged his shoulders. "I've just come to town and I need work.

Gotta eat."

"From Framingham?" Bodanski asked, glancing at the application.

"That's correct," Jeffrey said. He didn't want to get into any discussion about where he'd never been, so he said: "If Boston Memorial can't use me,

I can head over to St. Joseph's or Boston City."

"Oh, no. No need for that," Bodanski said quickly. "It's just that things take a little time. I'm sure you understand. You'll have to have a uniform and an ID card. Also there's some paperwork that has to be done before you can start."

"Well, here I am," Jeffrey said. "Why can't we just get it all over with right away?"

Bodanski paused for a beat, then said, "Just one moment." He got up from behind his desk and left the office.

Jeffrey stayed in his seat. He hoped he hadn't been too eager about starting so soon. He looked around Bodanski's office to pass the time.

There was a silver-framed photo on the desk: a woman standing behind two rosy-cheeked children. It was the only personal touch in the whole room, but a nice one, Jeffrey thought.

Bodanski returned with a short man with shiny black hair and a friendly smile. He was dressed in a dark green housekeeping uniform. Bodanski introduced him as Jose Martinez. Jeffrey stood up and shook the man's hand.

He'd seen Martinez many times. He watched the man's face as he had with

Bodanski, but could detect no sign of recognition.

"Jose is our head of housekeeping," Bodanski said, with a hand on

Martinez's shoulder. "I've explained to Jose your wish to get to work right away. Jose is willing to expedite the process, so I'll turn you over to him."

Content

Cook Robin Harmful Intent