10. Thursday, 7:25 a.m., March 21, 1996

   As a man of habit, Jack arrived in the vicinity of the medical examiner’s office at the same time each day, give or take five minutes. This particular morning he was ten minutes late since he’d awakened with a slight hangover. He’d not had a hangover in so long, he’d completely forgotten how miserable it made him feel. Consequently he’d stayed in the shower a few minutes longer than usual, and on the slalom down Second Avenue, he’d kept his speed to a more reasonable level.
   Crossing First Avenue, Jack saw something he’d never seen before at that time of day. There was a TV truck with its main antennae extended sitting in front of the medical examiner’s building.
   Changing his direction a little, he cruised around the truck. No one was in it. Looking up at the front door to the ME’s office, he saw a group of newspeople clustered just over the threshold.
   Curious as to what was going on, Jack hustled around to the entrance bay, stashed his bike in the usual place, and went up to the ID room.
   As usual Laurie and Vinnie were in their respective seats. Jack said hello but continued through the room to peek out into the lobby area. It was as crowded as he’d ever seen it.
   “What the hell’s going on?” Jack asked, turning back to Laurie.
   “You of all people should know,” she said. She was busy making up the day’s autopsy schedule. “It’s all about the plague epidemic!”
   “Epidemic?” Jack questioned. “Have there been more cases?”
   “You haven’t heard?” Laurie questioned. “Don’t you watch morning TV?”
   “I don’t have a TV,” Jack admitted. “In my neighborhood owning one is just inviting trouble.”
   “Well, two victims came in to us during the night,” Laurie said. “One is for sure plague, or at least presumptive since the hospital did its own fluorescein antibody and it was positive. The other is suspected, since clinically it seemed to be plague despite a negative fluorescein antibody. In addition to that, as I understand it, there are several febrile patients who have been quarantined.”
   “This is all happening at the Manhattan General?” Jack asked.
   “Apparently,” Laurie said.
   “Were these cases direct contacts with Nodelman?” Jack asked.
   “I haven’t had time to look into that,” Laurie said. “Are you interested? If you are, I’ll assign them to you.”
   “Of course,” Jack said. “Which one is the presumptive plague?”
   “Katherine Mueller,” Laurie said. She pushed the patient’s folder toward Jack.
   Sitting on the edge of the desk where Laurie was working, Jack opened the folder. He leafed through the papers until he found the investigative report. He pulled it out and began reading. He learned the woman had been brought into the Manhattan General emergency room at four o’clock in the afternoon acutely ill with what was diagnosed to be a fulminant case of plague. She’d died nine hours later despite massive antibiotics.
   Jack checked on the woman’s place of employment and wasn’t surprised with what he learned. The woman worked at the Manhattan General. Jack assumed she had to have been a direct contact of Nodelman. Unfortunately the report did not indicate in what department she worked. Jack guessed either nursing or lab.
   Reading on in the report, Jack silently complimented Janice Jaeger’s work. After the conversation he’d had with her the day before by phone, she added information about travel, pets, and visitors. In the case of Mueller it was all negative.
   “Where’s the suspected plague?” Jack asked Laurie.
   Laurie pushed a second folder toward him.
   Jack opened the second file and was immediately surprised. The victim neither worked at the Manhattan General nor had obvious contact with Nodelman. Her name was Susanne Hard. Like Nodelman, she’d been a patient in the General, but not on the same ward as Nodelman. Hard had been on the OB-GYN ward after giving birth! Jack was mystified.
   Reading further, Jack learned that Hard had been in the hospital for twenty-four hours when she’d experienced sudden high fever, myalgia, headache, overwhelming malaise, and progressive cough. These symptoms had come on about eighteen hours after undergoing a cesarean section during which she delivered a healthy child. Eight hours after the symptoms appeared, the patient was dead.
   Out of curiosity Jack looked up Hard’s address, remembering that Nodelman had lived in the Bronx. But Hard had not lived in the Bronx. She had lived in Manhattan on Sutton Place South, hardly a ghetto neighborhood.
   Reading on, Jack learned that Hard had not traveled since she’d become pregnant. As far as pets were concerned, she owned an elderly but healthy poodle. Concerning visitors, she had entertained a business associate of her husband’s from India three weeks previously who was described as being healthy and well.
   “Is Janice Jaeger still here this morning?” Jack asked Laurie.
   “She was about fifteen minutes ago when I passed her office,” Laurie said.
   Jack found Janice where she’d been the previous morning.
   “You are a dedicated civil servant,” Jack called out from the threshold.
   Janice looked up from her work. Her eyes were red from fatigue. “Too many people dying lately. I’m swamped. But tell me: Did I ask the right questions on the infectious cases last night?”
   “Absolutely,” Jack said. “I was impressed. But I do have a couple more.”
   “Shoot,” Janice said.
   “Where’s the OB-GYN ward in relation to the medical ward?”
   “They’re right next to each other,” Janice said. “Both are on the seventh floor.”
   “No kidding,” Jack said.
   “Is that significant?” Janice asked.
   “I haven’t the slightest idea,” Jack admitted. “Do patients from the OB ward mix with those on the medical ward?”
   “You got me there,” Janice admitted. “I don’t know, but I wouldn’t imagine so.”
   “Nor would I,” Jack said. But if they didn’t, then how did Susanne Hard manage to get sick? Something seemed screwy about this plague outbreak. Facetiously he wondered if a bunch of infected rats could be living in the ventilation system on the seventh floor.
   “Any other questions?” Janice asked. “I want to get out of here, and I have this last report to finish.”
   “One more,” Jack said. “You indicated that Katherine Mueller was employed by the General but you didn’t say for what department. Do you know if she worked for nursing or for the lab?”
   Janice leafed through her night’s notes and came up with the sheet on which she’d recorded Mueller’s information. She quickly glanced through it and then looked back up at Jack. “Neither,” she said. “She worked in central supply.”
   “Oh, come on!” Jack said. He sounded disappointed.
   “I’m sorry,” Janice said. “That’s what I was told.”
   “I’m not blaming you,” Jack said with a wave of his hand. “It’s just that I’d like there to be some sort of logic to all this. How would a woman in central supply get into contact with a sick patient on the seventh floor? Where’s central supply?”
   “I believe it’s on the same floor with the operating rooms,” Janice said. “That would be the third floor.”
   “Okay, thanks,” Jack said. “Now get out of here and get some sleep.”
   “I intend to,” Janice said.
   Jack wandered back toward the ID room, thinking that nothing seemed to be making much sense. Usually the course of a contagious illness could be easily plotted sequentially through a family or a community. There was the index case, and the subsequent cases extended from it by contact, either directly or through a vector like an insect. There wasn’t a lot of mystery. That wasn’t the case so far with this plague outbreak. The only unifying factor was that they all involved the Manhattan General.
   Jack absently waved to Sergeant Murphy, who’d apparently just arrived in his cubbyhole office off the communications room. The ebullient Irish policeman waved back with great enthusiasm.
   Jack slowed his walk while his mind churned. Susanne Hard had come down with symptoms after only being in the hospital for a day. Since the incubation period for plague was generally thought to be two days at a minimum, she would have been exposed prior to coming into the hospital. Jack went back to Janice’s office.
   “One more question,” Jack called out to her. “Do you happen to know whether the Hard woman visited the hospital in the days prior to her admission?”
   “Her husband said no,” Janice said. “I asked that question specifically. Apparently she hated the hospital and only came in at the very last minute.”
   Jack nodded. “Thanks,” he said, even more preoccupied. He turned and started back toward the ID room. That information made the situation more baffling, requiring him to postulate that the outbreak had occurred almost simultaneously in two, maybe three locations. That wasn’t probable. The other possibility was that the incubation period was extremely short, less than twenty-four hours. That would mean Hard’s illness was a nosocomial infection, as he suspected Nodelman’s was as well as Mueller’s. The problem with that idea was that it would suggest a huge, overwhelming infecting dose, which also seemed unlikely. After all, how many sick rats could be in a ventilation duct all coughing at the same time?
   In the ID room Jack wrestled the sports page of the Daily News away from a reluctant Vinnie and dragged him down to the pit to begin the day.
   “How come you always start so early?” Vinnie complained. “You’re the only one. Don’t you have a life?”
   Jack swatted him in the chest with Katherine Mueller’s folder. “Remember the saying ‘The early bird gets the worm’?”
   “Oh, barf,” Vinnie said. He took the folder from Jack and opened it. “Is this the one we’re doing first?” he asked.
   “Might as well move from the known to the unknown,” Jack said. “This one had a positive fluorescein antibody test to plague, so zip up tight in your moon suit.”
   Fifteen minutes later Jack began the autopsy. He spent a good deal of time on the external exam, looking for any signs of insect bites. It wasn’t an easy job, since Katherine Mueller was an overweight forty-four-year-old with hundreds of moles, freckles, and other minor skin blemishes. Jack found nothing he was sure was a bite, although a few lesions looked mildly suspicious. To be on the safe side he photographed them.
   “No gangrene on this body,” Vinnie commented.
   “Nor purpura,” Jack said.
   By the time Jack started on the internal exam, a number of the other staff had arrived in the autopsy room and half of the tables were in use. There were a few comments about Jack becoming the local plague expert, but Jack ignored them. He was too engrossed.
   Mueller’s lungs appeared quite similar to Nodelman’s, with extensive lobar pneumonia, consolidation, and early stages of tissue death. The woman’s cervical lymphatics were also generally involved, as were the lymph nodes along the bronchial tree.
   “This is just as bad or worse than Nodelman,” Jack said. “It’s frightening.”
   “You don’t have to tell me,” Vinnie said. “These infectious cases are the kind that make me wish I’d gone into gardening.”
   Jack was nearing the end of the internal exam when Calvin came through the door. There was no mistaking his huge silhouette. He was accompanied by another figure who was half his size. Calvin came directly to Jack’s table.
   “Anything out of the ordinary?” Calvin asked, while peering into the pan of internal organs.
   “Internally this case is a repeat of yesterday’s,” Jack said.
   “Good,” Calvin said, straightening up. He then introduced Jack to his guest. It was Clint Abelard, the city epidemiologist.
   Jack could make out the man’s prominent jaw, but because of the reflection off the plastic face mask, he couldn’t see the fellow’s squirrelly eyes. He wondered if he was still as cantankerous as he’d been the day before.
   “According to Dr. Bingham you two have already met,” Calvin said.
   “Indeed,” Jack said. The epidemiologist did not respond.
   “Dr. Abelard is trying to discern the origin of this plague outbreak,” Calvin explained.
   “Commendable,” Jack said.
   “He’s come to us to see if we can add any significant information,” Calvin said. “Perhaps you could run through your positive findings.”
   “My pleasure,” Jack said. He started with the external exam, indicating skin abnormalities he thought could have been insect bites. Then he showed all the gross internal pathology, concentrating on the lungs, lymphatics, liver, and spleen. Throughout the entire discourse, Clint Abelard stayed silent.
   “There you have it,” Jack said as he finished. He put the liver back into the pan. “As you can see it’s a severe case, as was Nodelman’s, and it’s no wonder both patients died so quickly.”
   “What about Hard?” Clint asked.
   “She’s next,” Jack said.
   “Mind if I watch?” Clint asked.
   Jack shrugged. “That’s up to Dr. Washington,” he said.
   “No problem,” Calvin said.
   “If I may ask,” Jack said, “have you come up with a theory where this plague came from?”
   “Not really,” Clint said gruffly. “Not yet.”
   “Any ideas?” Jack asked, trying to keep sarcasm out of his voice. It seemed Clint was in no better humor than he had been the day before.
   “We’re looking for plague in the area’s rodent population,” Clint said condescendingly.
   “Splendid idea,” Jack said. “And just how are you doing that?”
   Clint paused as if he didn’t want to divulge any state secrets.
   “The CDC is helping,” he said finally. “They sent someone up here from their plague division. He’s in charge of the trapping and analysis.”
   “Any luck so far?” Jack asked.
   “Some of the rats caught last night were ill,” Clint said. “But none with plague.”
   “What about the hospital?” Jack asked. He persisted despite Clint’s apparent reluctance to talk. “This woman we’ve just autopsied worked in central supply. Seems likely her illness was nosocomial like Nodelman’s. Do you think she got it from some primary source in and around the hospital, or do you think she got it from Nodelman?”
   “We don’t know,” Clint admitted.
   “If she got it from Nodelman,” Jack asked, “any ideas of a possible route of transmission?”
   “We’ve checked the hospital’s ventilation and air-conditioning system carefully,” Clint said. “All the HEPA filters were in place and had been changed appropriately.”
   “What about the lab situation?” Jack asked.
   “What do you mean?” Clint said.
   “Did you know that the chief tech in micro actually suggested plague to the director of the lab purely from his clinical impression, but the director talked him out of following up on it?”
   “I didn’t know that,” Clint mumbled.
   “If the chief tech had followed up on it he would have made the diagnosis and appropriate therapy could have been started,” Jack said. “Who knows; it could have saved a life. The problem is that the lab has been downsizing because of pressure from AmeriCare to save a few bucks, and they don’t have a microbiology supervisor position. It got eliminated.”
   “I don’t know anything about all that,” Clint said. “Besides, the case of plague still would have occurred.”
   “You’re right,” Jack said. “One way or the other you still have to come up with the origin. Unfortunately, you don’t know any more than you did yesterday.” Jack smiled inside his mask. He was getting a bit of perverse pleasure out of putting the epidemiologist on the spot.
   “I wouldn’t go that far,” Clint muttered.
   “Any sign of illness in the hospital staff?” Jack asked.
   “There are several nurses who are febrile and who are quarantined,” Clint said. “As of yet there is no confirmation of them having plague, but it is suspected. They were directly exposed to Nodelman.”
   “When will you be doing Hard?” Calvin asked.
   “In about twenty minutes,” Jack said. “As soon as Vinnie gets things turned around.”
   “I’m going around to check on some other cases,” Calvin said to Clint. “You want to stay here with Dr. Stapleton or do you want to come with me?”
   “I think I’ll go with you, if you don’t mind,” Clint said.
   “By the way, Jack,” Calvin said before leaving. “There’s a bevy of media people upstairs crawling all over the outer office like bloodhounds. I don’t want you giving any unauthorized press conferences. Any information coming from the ME’s office comes from Mrs. Donnatello and her PR assistant.”
   “I wouldn’t dream of talking to the press,” Jack assured him.
   Calvin wandered to the next table. Clint stayed at his heels.
   “It didn’t sound as if that guy wanted to talk with you,” Vinnie said to Jack when Calvin and Clint were far enough away. “Not that I can blame him.”
   “That little mouse has been spleeny since I first met him,” Jack said. “I don’t know what his problem is. He’s kinda a weird duck, if you ask me.”
   “Now there’s the pot calling the kettle black,” Vinnie said.

11. Thursday, 9:30 a.m., March 21, 1996
New York City

   “Mr. Lagenthorpe, can you hear me?” Dr. Doyle called to his patient. Donald Lagenthorpe was a thirty-eight-year-old African-American oil engineer who had a chronic problem with asthma. That morning, just after three A.M., he’d awakened with progressive difficulty breathing. His prescribed home remedies had not interrupted the attack, and he’d come into the emergency room of the Manhattan General at four. Dr. Doyle had been called at quarter to five after the usual emergency medications had had no effect.
   Donald’s eyes blinked open. He hadn’t been sleeping, just trying to rest. The ordeal had been exhausting and frightening. The feeling of not being able to catch his breath was torture, and this episode had been the worst he’d ever experienced.
   “How are you doing?” Dr. Doyle inquired. “I know what you have been through. You must be very tired.” Dr. Doyle was one of those rare physicians who were able to empathize with all his patients with a depth of understanding suggesting he suffered from all the same conditions.
   Donald nodded his head, indicating that he was okay. He was breathing through a face mask that made conversation difficult.
   “I want you to stay in the hospital for a few days,” Dr. Doyle said. “This was a difficult attack to break.”
   Donald nodded again. No one had to tell him that.
   “I want to keep you on the IV steroids for a little while longer,” Dr. Doyle explained.
   Donald lifted the face mask off his face. “Couldn’t I get the steroids at home?” he suggested. As thankful as he was about the hospital’s having been there in his hour of need, he much preferred the idea of going home now that his breathing had returned to normal. At home he knew he could at least get some work done. As was always the case, this asthma attack had come at a particularly inconvenient time. He was supposed to go back to Texas the following week for more fieldwork.
   “I know you don’t want to be in the hospital,” Dr. Doyle said. “I’d feel the same way. But I think it is best under the circumstances. We’ll get you out just as soon as possible. Not only do I want to continue giving you IV steroids, but I want you breathing humidified, clean, nonirritating air. I also want to follow your peak expiratory flow rate carefully. As I explained to you earlier, it is still not completely back to normal.”
   “How many days do you estimate I’ll have to be in here?” Donald asked.
   “I’m sure it will only be a couple,” Dr. Doyle said.
   “I’ve got to go back to Texas,” Donald explained.
   “Oh?” Dr. Doyle said. “When were you there last?”
   “Just last week,” Donald said.
   “Hmm,” Dr. Doyle said while he thought. “Were you exposed to anything abnormal while you were there?”
   “Just Tex-Mex cuisine,” Donald said, managing a smile.
   “You haven’t gotten any new pets or anything like that, have you?” Dr. Doyle asked. One of the difficulties of managing someone with chronic asthma was determining the factors responsible for triggering attacks. Frequently it was allergenic.
   “My girlfriend got a new cat,” Donald said. “It has made me itch a bit the last few times I’ve been over there.”
   “When was the last time?” Dr. Doyle asked.
   “Last night,” Donald admitted. “But I was home just a little after eleven, and I felt fine. I didn’t have any trouble falling asleep.”
   “We’ll have to look into it,” Dr. Doyle said. “Meanwhile I want you in the hospital. What do you say?”
   “You’re the doctor,” Donald said reluctantly.
   “Thank you,” Dr. Doyle said.

12. Thursday, 9:45 a.m., March 21, 1996

   “For chrissake!” Jack murmured under his breath as he was about to start the autopsy on Susanne Hard. Clint Abelard was hovering behind him like a gnat, constantly switching his weight from one leg to the other.
   “Clint, why don’t you step around the table and stand on the other side,” Jack suggested. “You’ll be able to see much better.”
   Clint took the suggestion and stood with his arms behind his back opposite from Jack.
   “Now don’t move,” Jack mumbled to himself. Jack didn’t like Clint hanging around, but he had no choice.
   “It’s sad when you see a young woman like this,” Clint said suddenly.
   Jack looked up. He hadn’t expected such a comment from Clint. It seemed too human. He had struck Jack as an unfeeling, moody bureaucrat.
   “How old is she?” Clint asked.
   “Twenty-eight,” Vinnie said from the head of the table.
   “From the looks of her spine she didn’t have an easy life,” Clint said.
   “She had several major back surgeries,” Jack said.
   “It’s a double tragedy since she’d just given birth,” Clint said. “Now the child is motherless.”
   “It was her second child,” Vinnie said.
   “I suppose I shouldn’t forget her husband,” Clint said. “It must be upsetting to lose your spouse.”
   A knifelike stab of emotion went down Jack’s spine. He had to fight to keep from reaching across the table and yanking Clint off his feet. Abruptly he left the table and exited to the washroom. He heard Vinnie call after him, but he ignored him. Instead Jack leaned on the edge of the sink and tried to calm himself. He knew that getting angry with Clint was an unreasonable reaction; it was nothing but pure, unadulterated transference. But understanding the origin did not lessen the irritation. It always irked Jack when he heard such clichés from people who truly had no idea.
   “Is there a problem?” Vinnie asked. He’d stuck his head through the door.
   “I’ll be there in a second,” Jack said.
   Vinnie let the door close.
   As long as he was there, Jack washed and regloved his hands. When he was finished he returned to the table.
   “Let’s get this show on the road,” he said.
   “I’ve looked the body over,” Clint said. “I don’t see anything that looks like an insect bite, do you?”
   Jack had to restrain himself from subjecting Clint to a lecture like the one Clint had given to him. Instead, he merely proceeded with his external exam. Only after he’d finished did he speak.
   “No gangrene, no purpura, and no insect bites as far as I can see,” Jack said. “But by just looking at her I can see some of her cervical lymph nodes are swollen.”
   Jack pointed out the finding to Clint, who then nodded in agreement.
   “That’s certainly consistent with plague,” Clint said.
   Jack didn’t answer. Instead he took a scalpel from Vinnie and quickly made the typical Y-shaped autopsy incision. The bold cruelty of the move jolted Clint. He took a step back.
   Jack worked quickly but with great care. He knew that the less the internal organs were disturbed, the less chance that any of the infecting microbes would be aerosolized.
   When Jack had the organs out, he turned his attention first to the lungs. Calvin had drifted over at this point and towered behind Jack as he made his initial cuts into the obviously diseased organ. Jack spread open the lung like a butterfly.
   “Lots of bronchopneumonia and early tissue necrosis,” Calvin said. “Looks pretty similar to Nodelman.”
   “I don’t know,” Jack said. “Seems to me there is an equal amount of pathology but less consolidation. And look at these nodal areas. They almost look like early granulomas with caseation.”
   Clint listened to this pathological jargon with little interest or comprehension. He remembered the terms from medical school, but had long since forgotten their meaning. “Does it look like plague?” he asked.
   “Consistent,” Calvin said. “Let’s look at the liver and the spleen.”
   Jack carefully pulled these organs from the pan and sliced into them. As he’d done with the lung, he spread open their cut surfaces so everyone could see. Even Laurie had stepped over from her table.
   “Lots of necrosis,” Jack said. “Certainly just as virulent a case as with Nodelman or with the case I did earlier.”
   “Looks like plague to me,” Calvin said.
   “But why was the fluorescein antibody negative?” Jack said. “That’s telling me something, especially combined with the lung appearance.”
   “What’s with the lungs?” Laurie asked.
   Jack moved the liver and the spleen aside and showed Laurie the cut surface of the lung. He explained what he thought of the pathology.
   “I see what you mean now that you mention it,” Laurie said. “It is different from Nodelman. His lungs definitely had more consolidation. This looks more like some sort of horribly aggressive TB.”
   “Whoa!” Calvin said. “This isn’t TB. No way.”
   “I don’t think Laurie was suggesting it was,” Jack said.
   “I wasn’t,” Laurie agreed. “I was just using TB as a way of describing these infected areas.”
   “I think it is plague,” Calvin said. “I mean, I wouldn’t if we hadn’t just had a case from the same hospital yesterday. Chances are it is plague regardless of what their lab said.”
   “I don’t think it is,” Jack said. “But let’s see what our lab says.”
   “How about double or nothing with that ten dollars,” Calvin said. “Are you that sure?”
   “No, but I’ll take you up on it. I know how much the money means to you.”
   “Are we finished here?” Clint asked. “If so, I think I’ll be going.”
   “I’m essentially finished,” Jack said. “I’ll do a little more on the lymphatics, and then I’ll be obtaining samples for the microscopic. You won’t be missing anything if you take off now.”
   “I’ll head out with you,” Calvin said.
   Calvin and Clint disappeared through the door to the washroom.
   “If you don’t think this case is plague, what do you think it is?” Laurie asked, looking back at the woman’s corpse.
   “I’m embarrassed to tell you,” Jack said.
   “Come on,” Laurie urged. “I won’t tell anybody.”
   Jack looked at Vinnie. Vinnie held up his hands. “My lips are sealed.”
   “Well, I’d have to fall back on my original differential I had for Nodelman,” Jack said. “To narrow it down more than that, I have to again go out on thin ice. If it isn’t plague, the nearest infectious disease both pathologically and clinically is tularemia.”
   Laurie laughed. “Tularemia in a twenty-eight-year-old postpartum female in Manhattan?” she questioned. “That would be pretty rare, although not as rare as your diagnosis yesterday of plague. After all, she could have a hobby of rabbit hunting on weekends.”
   “I know it’s not very probable,” Jack said. “Once again I’m relying totally on the pathology and the fact that the test for plague was negative.”
   “I’d be willing to bet a quarter,” Laurie said.
   “Such a spender!” Jack joked. “Fine! We’ll bet a quarter.”
   Laurie returned to her own case. Jack and Vinnie turned their attention back to Susanne Hard. While Vinnie did his tasks, Jack finished the lymphatic dissection he wanted to do, then took the tissue samples he felt appropriate for microscopic study. When the samples were all in the proper preservatives and appropriately labeled, he helped Vinnie suture the corpse.
   Leaving the autopsy room, Jack properly dealt with his isolation equipment. After plugging in his rechargeable ventilator battery, he took the elevator up to the third floor to see Agnes Finn. He found her sitting in front of a stack of petri dishes examining bacterial cultures.
   “I’ve just finished another infectious case that’s suspected plague,” he told her. “All the samples will be coming up shortly. But there is a problem. The lab over at the Manhattan General claims the patient tested negative. Of course, I want to repeat that, but at the same time I want you to rule out tularemia, and I want it done as quickly as possible.”
   “That’s not easy,” she said. “Handling Francisella tularen-sis is hazardous. It’s very contagious to laboratory workers if it gets into the air. There is a fluorescein antibody stain for tularemia, but we don’t have it.”
   “How do you make the diagnosis, then?” Jack asked.
   “We have to send any samples out,” she said. “Because of the risk of handling the bacteria the reagents are generally kept only at reference labs where the personnel are accustomed to dealing with the microbe. There is such a lab here in the city.”
   “Can you send it right away?” Jack asked.
   “We’ll messenger it over as soon as it gets here,” she said. “If I call and put a rush on it, we’ll have a preliminary result in less than twenty-four hours.”
   “Perfect,” Jack said. “I’ll be waiting. I’ve got ten dollars and twenty-five cents riding on the outcome.”
   Agnes gave Jack a look. He considered explaining, but feared he’d sound even more foolish. Instead he fled upstairs to his office.

13. Thursday, 10:45 a.m., March 21, 1996
New York City

   “I’m liking it more and more,” Terese said. She straightened up from Colleen’s drawing board. Colleen was showing her tissues that her team had comped up just that morning using the theme they’d discussed the night before.
   “The best thing is that the concept is consistent with the Hippocratic oath,” Colleen said. “Particularly the part about never doing harm to anyone. I love it.”
   “I don’t know why we didn’t think about it before,” Terese said. “It’s such a natural. It’s almost embarrassing that it took this damn plague epidemic to make us think of it. Did you catch what’s happening on morning TV?”
   “Three deaths!” Colleen said. “And several people sick. It’s terrible. In fact, it scares me to death.”
   “I had a headache from the wine last night when I woke up this morning,” Terese said. “The first thing that went through my mind was whether I had the plague or not.”
   “I thought the same thing,” Colleen said. “I’m glad you admitted it. I was too embarrassed.”
   “I hope to hell those guys were right last night,” Terese said. “They seemed pretty damn confident it wasn’t going to be a big problem.”
   “Are you worried being around them?” Colleen asked.
   “Oh, it’s gone through my mind,” Terese admitted. “But as I said, they were so confident. I can’t imagine their acting that way if there were any risk.”
   “Are we still on for dinner tonight?” Colleen asked.
   “By all means,” Terese said. “I have a sneaking suspicion that Jack Stapleton will turn out to be an unknowing fountain of ad ideas. He might be bitter about something, but he’s sharp and opinionated, and he certainly knows the business.”
   “I can’t believe how well this is working out,” Colleen said. “I was a lot more drawn to Chet; he’s fun and open and easy to talk with. I have enough problems of my own, so I’m not attracted to the anguished, brooding type.”
   “I didn’t say anything about being attracted to Jack Stapleton,” Terese said. “That’s something else entirely.”
   “What’s your gut reaction to this idea of using Hippocrates himself in one of our ads?”
   “I think it has fantastic potential,” Terese said. “Run with it. Meanwhile I’m going to head upstairs and talk with Helen Robinson.”
   “Why?” Colleen asked. “I thought she was the enemy.”
   “I’m taking to heart Taylor’s admonition that we creatives and the account people should work together,” Terese said breezily.
   “Yeah, sure! Likely story!”
   “Seriously,” Terese said. “There’s something I’d like her to do. I need a fifth column. I want Helen to confirm that National Health is clean when it comes to nosocomial or hospital-based infections. If their record is atrocious, the whole campaign could backfire. Then, not only would I lose my bid for the presidency, but you and I would probably be out selling pencils.”
   “Wouldn’t we have heard by this time?” Colleen asked. “I mean, they’ve been clients for a number of years.”
   “I doubt it,” Terese said. “These health-care giants are loath to publicize anything that might adversely affect their stock price. Surely a bad record in regard to nosocomial infections would do that.”
   Terese gave Colleen a pat on the shoulder and told her to keep cracking the whip, then headed for the stairwell.
   Terese emerged breathless onto the administrative floor, having taken the stairs two at a time. From there she marched directly toward the carpeted realm of the account executives. Her mood was soaring; it was the absolute antithesis of the anxiety and dread of the day before. Her intuition told her she was onto something big with National Health and would soon be scoring a deserved triumph… .

   As soon as the impromptu meeting with Terese had ended and Terese had disappeared around the corner, Helen returned to her desk and put a call in to her main contact at National Health Care. The woman wasn’t immediately available, but Helen didn’t expect her to be. Helen merely left her name and number with a request to be called as soon as possible.
   With the call accomplished Helen took a brush from her desk and ran it through her hair several times in front of a small mirror on the inside of her closet door. Once she was satisfied with her appearance, she walked out of her office and headed down to Robert Barker’s.
   “You have a minute?” Helen called to him from his open door.
   “For you I have all day,” Robert said. He leaned back in his chair.
   Helen stepped into the room and turned to close the door. As she did so, Robert surreptitiously turned over the photo of his wife that stood on the corner of the desk. His wife’s stern stare made him feel guilty whenever Helen was in his office.
   “I just had a visitor,” Helen said as she came into the room. As was her custom she sat cross-legged on the arm of one of the two chairs facing Robert’s desk.
   Robert felt perspiration appear along his hairline in keeping with his quickening pulse. From his vantage point, Helen’s short skirt afforded him a view of her thigh that didn’t stop.
   “It was our creative director,” Helen continued. She was very conscious of the effect she was having on her boss, and it pleased her. “She asked me to get some information for her.”
   “What kind of information?” Robert asked. His eyes didn’t move, nor did he blink. It was as if he were hypnotized.
   Helen explained what Terese wanted and described the brief conversation about the plague outbreak. When Robert didn’t respond immediately, she stood up. That broke the trance. “I tried to tell her not to use it as the basis of an ad campaign,” Helen added, “but she thinks it’s going to work.”
   “Maybe you shouldn’t have said anything,” Robert remarked. He loosened his shirt and took a breath.
   “But it’s a terrible idea,” Helen said. “I couldn’t think of anything more tasteless.”
   “Exactly,” Robert said. “I’d like her to propose a tasteless campaign.”
   “I see your point,” Helen said. “I didn’t think of that on the spur of the moment.”
   “Of course not,” Robert said. “You’re not as devious as I am. But you’re a quick study. The problem with the idea about nosocomial infection in general is that it could be a good one. There might possibly be a legitimate difference between National Health and AmeriCare.”
   “I could always tell her the information wasn’t available,” Helen said. “After all, it might not be.”
   “There is always risk in lying,” Robert said. “She might already have the information and be testing us to make us look bad. No, go ahead and see what you can find out. But let me know what you learn and what you pass on to Terese Hagen. I want to keep a step ahead of her.”

14. Thursday, 12:00 p.m., March 21, 1996

   “Hey, sport, how the hell are you?” Chet asked Jack as Jack scooted into their shared office and dumped several folders onto his cluttered desk.
   “Couldn’t be better,” Jack said.
   Thursday had been a paper day for Chet, meaning he’d been at his desk and not in the autopsy room. Generally the associate medical examiners only did autopsies three days a week. The other days they spent collating the voluminous paperwork necessary to “sign out” a case. There was always material that needed to be gathered from PA investigators, the lab, the hospital or local doctors, or the police. Plus each doctor had to read the microscopic slides the histology lab processed on every case.
   Jack sat down and pushed some of the paper debris away from the center of the desk to give him some room to work.
   “You feel all right this morning?” Chet asked.
   “A little wobbly,” Jack admitted. He rescued his phone from beneath lab reports. Then he opened up one of the folders he’d just brought in with him and began searching through the contents. “And you?”
   “Perfect,” Chet said. “But I’m accustomed to a little wine and such. Remembering those chicks helped, particularly Colleen. Hey, we still on for tonight?”
   “I was going to talk to you about that,” Jack said.
   “You promised,” Chet said.
   “I didn’t exactly promise,” Jack said.
   “Come on,” Chet pleaded. “Don’t let me down. They’re expecting both of us. They might not stay if only I show up.”
   Jack glanced over at his officemate.
   “Come on,” Chet repeated. “Please!”
   “All right, for chrissake,” Jack said. “Just this once. But I truly don’t understand why you think you need me. You do fine by yourself.”
   “Thanks, buddy,” Chet said. “I owe you one.”
   Jack found the ID sheet that had the phone numbers for Maurice Hard, Susanne’s husband. There was both a home number and an office number. He dialed the home.
   “Who you calling?” Chet asked.
   “You are a nosy bastard,” Jack said jokingly.
   “I’ve got to watch over you so you don’t get yourself fired,” Chet said.
   “I’m calling the spouse of another curious infectious case,” Jack said. “I just did the post, and it’s got me bewildered. Clinically it looked like plague, but I don’t think it was.”
   A housekeeper picked up the phone. When Jack asked for Mr. Hard, he was told Mr. Hard was at the office. Jack dialed the second number. This time it was answered by a secretary. Jack had to explain who he was and was then put on hold. “I’m amazed,” Jack said to Chet, his hand over the receiver. “The man’s wife just died and he’s at work. Only in America!”
   Maurice Hard came on the line. His voice was strained. He was obviously under great stress. Jack was tempted to tell the man he knew something of what he was feeling, but something made him hold back. Instead he explained who he was and why he was calling.
   “Do you think I should talk to my lawyer first?” Maurice asked.
   “Lawyer? Why your lawyer?”
   “My wife’s family is making ridiculous accusations,” Maurice said. “They’re suggesting I had something to do with Susanne’s death. They’re crazy. Rich, but crazy. I mean, Susanne and I had our ups and downs, but we never would have hurt each other, no way.”
   “Do they know your wife died of an infectious disease?” Jack questioned.
   “I’ve tried to tell them,” Maurice said.
   “I don’t know what to say,” Jack said. “It’s really not my position to advise you about your personal legal situation.”
   “Well, hell, go ahead and ask your questions,” Maurice said. “I can’t imagine it would make any difference. But let me ask you a question first. Was it plague?”
   “That still has not been determined,” Jack said. “But I’ll call you as soon as we know for sure.”
   “I’d appreciate that,” Maurice said. “Now, what are your questions?”
   “I believe you have a dog,” Jack said. “Is the dog healthy?”
   “For a seventeen-year-old dog he’s healthy,” Maurice said.
   “I’d like to encourage you to take the pet to your vet and explain that your wife died of a serious infectious disease. I want to be sure the dog isn’t carrying the illness, whatever it was.”
   “Is there a chance of that?” Maurice asked with alarm.
   “It’s small, but there is a chance,” Jack said.
   “Why didn’t the hospital tell me that?” he demanded.
   “That I can’t answer,” Jack said. “I assume they talked to you about taking antibiotics.”
   “Yeah, I’ve already started,” Maurice said. “But it bums me out about the dog. I should have been informed.”
   “There’s also the issue of travel,” Jack said. “I was told your wife didn’t do any recent traveling.”
   “That’s right,” Maurice said. “She was pretty uncomfortable with her pregnancy, especially with her back problem. We haven’t gone anywhere except to our house up in Connecticut.”
   “When was the last visit to Connecticut?” Jack asked.
   “About a week and a half ago,” Maurice said. “She liked it up there.”
   “Is it rural?” Jack asked.
   “Seventy acres of fields and forest land,” Maurice said proudly. “Beautiful spot. We have our own pond.”
   “Did your wife ever go out into the woods?” Jack asked.
   “All the time,” Maurice said. “That was her main enjoyment. She liked to feed the deer and the rabbits.”
   “Were there many rabbits?” Jack asked.
   “You know rabbits,” Maurice said. “Every time we went up there there were more of them. I actually thought they were a pain in the neck. In the spring and summer they ate all the goddamn flowers.”
   “Any problem with rats?”
   “Not that I know of,” Maurice said. “Are you sure this is all significant?”
   “We never know,” Jack said. “What about your visitor from India?”
   “That was Mr. Svinashan,” Maurice said. “He’s a business acquaintance from Bombay. He stayed with us for almost a week.”
   “Hmm,” Jack said, remembering the plague outbreak in 1994 in Bombay. “As far as you know, he’s healthy and well?”
   “As far as I know,” Maurice said.
   “How about giving him a call,” Jack suggested. “If he’s been sick, let me know.”
   “No problem,” Maurice said. “You don’t think he could have been involved, do you? After all, his visit was three weeks ago.”
   “This episode has baffled me,” Jack admitted. “I’m not ruling anything out. What about Donald Nodelman? Did you or your wife know him?”
   “Who’s he?” Maurice asked.
   “He was the first victim in this plague outbreak,” Jack said. “He was a patient in the Manhattan General. I’d be curious if your wife might have visited him. He was on the same floor.”
   “In OB-GYN?” Maurice questioned with surprise.
   “He was on the medical ward on the opposite side of the building. He was in the hospital for diabetes.”
   “Where did he live?”
   “The Bronx,” Jack said.
   “I doubt it,” Maurice said. “We don’t know anyone from the Bronx.”
   “One last question,” Jack said. “Did your wife happen to visit the hospital during the week prior to her admission?”
   “She hated hospitals,” Maurice said. “It was difficult to get her to go even when she was in labor.”
   Jack thanked Maurice and hung up.
   “Now who are you calling?” Chet asked as Jack dialed again.
   “The husband of my first case this morning,” Jack said. “At least we know this case had plague for sure.”
   “Why don’t you let the PAs make these calls?” Chet asked.
   “Because I can’t tell them what to ask,” Jack said. “I don’t know what I’m looking for. I just have this suspicion that there is some missing piece of information. Also I’m just plain interested. The more I think about this episode of plague in New York in March, the more unique I think it is.”
   Mr. Harry Mueller was a far cry from Mr. Maurice Hard. He was devastated by his loss and had trouble speaking despite a professed willingness to be cooperative. Not wishing to add to the man’s burden, Jack tried to be quick. After corroborating Janice’s report of no pets or travel and no recent visitors, Jack went through the same questions concerning Donald Nodelman as he had with Maurice.
   “I’m certain my wife did not know this individual,” Harry said, “and she rarely met any patients directly, especially sick patients.”
   “Did your wife work in central supply for a long time?” Jack asked.
   “Twenty-one years,” Harry said.
   “Did she ever come down with any illness that she thought she’d contracted at the hospital?” Jack asked.
   “Maybe if one of her co-workers had a cold,” Harry said. “But nothing more than that.”
   “Thank you, Mr. Mueller,” Jack said. “You’ve been most kind.”
   “Katherine would have wanted me to help,” Harry said. “She was a good person.”
   Jack hung up the phone but left his hands drumming on the receiver. He was agitated.
   “Nobody, including me, has any idea what the hell is going on here,” he said.
   “True,” Chet said. “But it’s not your worry. The cavalry has already arrived. I heard that the city epidemiologist was over here observing this morning.”
   “He was here all right,” Jack said. “But it was in desperation. That little twerp hasn’t the foggiest notion of what’s going on. If it weren’t for the CDC’s sending someone up here from Atlanta, nothing would be happening. At least someone’s out there trapping rats and looking for a reservoir.”
   Suddenly Jack pushed back from the desk, got up, and pulled on his bomber jacket.
   “Uh-oh!” Chet said. “I sense trouble. Where are you going?”
   “I’m heading back to the General,” Jack said. “My gut sense tells me the missing information is over there at the hospital, and by God I’m going to find it.”
   “What about Bingham?” Chet said nervously.
   “Cover for me,” Jack said. “If I’m late for Thursday conference, tell him…” Jack paused as he tried to think up some appropriate excuse, but nothing came to mind. “Oh, screw it,” he said. “I won’t be that long. I’ll be back way before conference. If anybody calls, tell them I’m in the john.”
   Ignoring further pleas to reconsider, Jack left and rode uptown. He arrived in less than fifteen minutes and locked his bike to the same signpost as the day before.
   The first thing Jack did was take the hospital elevator up to the seventh floor and reconnoiter. He saw how the OB-GYN and medical wards were completely separate without sharing any common facilities like lounges or lavatories. He also saw that the ventilation system was designed so as to preclude any movement of air from one ward to the other.
   Pushing through the swinging doors into the OB-GYN area, Jack walked down to the central desk.
   “Excuse me,” he said to a ward secretary. “Does this ward share any personnel with the medical ward across the elevator lobby?”
   “No, not that I know of,” the young man said. He looked about fifteen with a complexion that suggested he had yet to shave. “Except, of course, cleaning people. But they clean all over the hospital.”
   “Good point,” Jack said. He hadn’t thought of the housekeeping department. It was something to consider. Jack then asked which room Susanne Hard had occupied.
   “Can I ask what this is in reference to?” the ward clerk asked. He had finally noticed that Jack was not wearing a hospital ID. Hospitals all require identification badges of their employees, but then frequently do not have the personnel to enforce compliance.
   Jack took out his ME’s badge and flashed it. It had the desired effect. The ward secretary told Jack that Mrs. Hard had been in room 742.
   Jack started out for the room, but the ward clerk called out to him that it was quarantined and temporarily sealed.
   Believing that viewing the room would not have been enlightening anyway, Jack left the seventh floor and descended to the third, which housed the surgical suites, the recovery room, the intensive-care units, and central supply. It was a busy area with a lot of patient traffic.
   Jack pushed through a pair of swinging doors into central supply and was confronted by an unmanned counter. Beyond the counter was an immense maze of floor-to-ceiling metal shelving laden with all the sundry equipment and supplies needed by a large, busy hospital. In and out of the maze moved a team of people attired in scrubs, white coats, and hats that looked like shower caps. A radio played somewhere in the distance.
   After Jack had stood at the counter for a few minutes, a robust and vigorous woman caught sight of him and came over. Her name tag said “Gladys Zarelli, Supervisor.” She asked if he needed some help.
   “I wanted to inquire about Katherine Mueller,” Jack said.
   “God rest her soul,” Gladys said. She made the sign of the cross. “It was a terrible thing.”
   Jack introduced himself by displaying his badge, then questioned whether she and her co-workers were concerned that Katherine had died of an infectious disease.
   “Of course we’re concerned,” she said. “Who wouldn’t be? We all work closely with one another. But what can you do? At least the hospital is concerned as well. They have us all on antibiotics, and thank God, no one is sick.”
   “Has anything like this ever happened before?” Jack asked. “What I mean is, a patient died of plague just the day before Katherine. That suggests that Katherine could very well have caught it here at the hospital. I don’t mean to scare you, but those are the facts.”
   “We’re all aware of it,” Gladys said. “But it’s never happened before. I imagine it’s happened in nursing, but not here in central supply.”
   “Do you people have any patient contact?” Jack asked.
   “Not really,” Gladys said. “Occasionally we might run up to the wards, but it’s never to see a patient directly.”
   “What was Katherine doing the week before she died?” Jack asked.
   “I’ll have to look that up,” Gladys said. She motioned for Jack to follow her. She led Jack into a tiny, windowless office where she cracked open a large, cloth-bound daily ledger.
   “Assignments are never too strict,” Gladys said. Her finger ran down a row of names. “We all kinda pitch in as needed, but I give some basic responsibility to some of the more senior people.” Her finger stopped, then moved across the page. “Okay, Katherine was more or less in charge of supplies to the wards.”
   “What does that mean?” Jack asked.
   “Whatever they needed,” Gladys said. “Everything except drugs and that sort of stuff. That comes from pharmacy.”
   “You mean like things for the patients’ rooms?” Jack asked.
   “Sure, for the rooms, for the nurses’ station, everything,” Gladys said. “This is where it all comes from. Without us the hospital would grind to a halt in twenty-four hours.”
   “Give me an example of the things you deal with for the rooms,” Jack said.
   “I’m telling you, everything!” Gladys said with a touch of irritation in her voice. “Bedpans, thermometers, humidifiers, pillows, pitchers, soap. Everything.”
   “You wouldn’t have any record of Katherine going up to the seventh floor during the last week or so, would you?”
   “No,” Gladys said. “We don’t keep records like that. I could print out for you everything sent up there, though. That we have a record of.”
   “Okay,” Jack said. “I’ll take what I can get.”
   “It’s going to be a lot of stuff,” Gladys warned as she made an entry into her computer terminal. “Do you want OB-GYN or medical or both?” she asked.
   “Medical,” Jack said.
   Gladys nodded, pecked at a few more keys on her terminal, and soon her printer was cranking away. In a few minutes she handed Jack a stack of papers. He glanced through them. As Gladys had suggested there were a lot of items. The length of the list gave Jack respect for the logistics of running the institution.
   Leaving central supply, Jack descended a floor and wandered into the lab. He did not feel he was making any progress, but he refused to give up. His conviction remained that there was some major missing piece of information. He just didn’t know where he would find it.
   Jack asked the same receptionist to whom he’d shown his badge the day before for directions to microbiology, which she gave him without question.
   Jack walked unchallenged through the extensive lab. It was an odd feeling to see so much impressive equipment running unattended. It reminded Jack of the director’s lament the day before that he’d been forced to cut his personnel by twenty percent.
   Jack found Nancy Wiggens working at a lab bench plating bacterial cultures.
   “Howdy,” Jack said. “Remember me?”
   Nancy glanced up and then back at her work.
   “Of course,” she said.
   “You guys made the diagnosis on the second plague case just fine,” he said.
   “It’s easy when you suspect it,” Nancy said. “But we didn’t do so well on the third case.”
   “I was going to ask you about that,” Jack said. “What did the gram stain look like?”
   “I didn’t do it,” Nancy said. “Beth Holderness did. Do you want to talk with her?”
   “I would,” Jack said.
   Nancy slid off her stool and disappeared. Jack took the opportunity to glance around at the microbiology section of the lab. He was impressed. Most labs, particularly microbiology labs, had an invariable clutter. This lab was different. It appeared highly efficient with everything crystal-clean and in its place.
   “Hi, I’m Beth!”
   Jack turned to find himself before a smiling, outgoing woman in her mid-twenties. She exuded a cheerleader-like zeal that was infectious. Her hair was tightly permed and radiated away from her face as if charged with static electricity.
   Jack introduced himself and was immediately charmed by Beth’s natural conversation. She was one of the friendliest women he’d ever met.
   “Well, I’m sure you didn’t come here to gab,” Beth said. “I understand you are interested in the gram stain on Susanne Hard. Come on! It’s waiting for you.”
   Beth literally grabbed Jack by the sleeve and pulled him around to her work area. Her microscope was set up with Hard’s slide positioned on its platform and the illuminator switched on.
   “Sit yourself right here,” Beth said as she guided Jack’s lower half onto her stool. “How is that? Low enough?”
   “It’s perfect,” Jack said. He leaned forward and peered into the eyepieces. It took a moment for his eyes to adapt. When they did, he could see the field was filled with reddish-stained bacteria.
   “Notice how pleomorphic the microbes are,” a male voice commented.
   Jack looked up. Richard, the head tech, had materialized and was standing to Jack’s immediate left, almost touching him.
   “I didn’t mean to be such a bother,” Jack said.
   “No bother,” Richard said. “In fact, I’m interested in your opinion. We still haven’t made a diagnosis on this case. Nothing has grown out, and I presume you know that the test for plague was negative.”
   “So I heard,” Jack said. He put his eyes back to the microscope and peered in again. “I don’t think you want my opinion. I’m not so good at this stuff,” he admitted.
   “But you do see the pleomorphism?” Richard said.
   “I suppose,” Jack said. “They’re pretty small bacilli. Some of them almost look spherical, or am I looking at them on end?”
   “I believe you are seeing them as they are,” Richard said. “That’s more pleomorphism than you see with plague. That’s why Beth and I doubted it was plague. Of course, we weren’t sure until the fluorescein antibody was negative.”
   Jack looked up from the scope. “If it’s not plague, what do you think it is?”
   Richard gave a little embarrassed laugh. “I don’t know.”
   Jack looked at Beth. “What about you? Care to take a chance?”
   Beth shook her head. “Not if Richard won’t,” she said diplomatically.
   “Can’t someone even hazard a guess?” Jack asked.
   Richard shook his head. “Not me. I’m always wrong when I guess.”
   “You weren’t wrong about plague,” Jack reminded him.
   “That was just lucky,” Richard said. He flushed.
   “What’s going on here,” an irritated voice called out.
   Jack’s head swung around in the opposite direction. Beyond Beth was the director of the lab, Martin Cheveau. He was standing with his legs apart, his hands on his hips, and his mustache quivering. Behind him was Dr. Mary Zimmerman, and behind her was Charles Kelley.
   Jack got to his feet. The lab techs slunk back. The atmosphere was suddenly tense. The lab director was clearly irate.
   “Are you here in an official capacity?” Martin demanded. “If so, I’d like to know why you didn’t have the common courtesy to come to my office instead of sneaking in here? We have a crisis unfolding in this hospital, and this lab is in the middle of it. I am not about to brook interference from anyone.”
   “Whoa!” Jack said. “Calm down.” He hadn’t expected this blowup, especially from Martin, who had been so hospitable the day before.
   “Don’t tell me to calm down,” Martin snapped. “What the devil are you doing here, anyway?”
   “I’m just doing my job, investigating the deaths of Katherine Mueller and Susanne Hard,” Jack said. “I hardly think I’m interfering. In fact I thought I was being rather discreet.”
   “Is there something in particular you are looking for in my lab?” Martin demanded.
   “I was just going over a gram stain with your capable staff,” Jack said.
   “Your official mandate is to determine the cause and the manner of death,” Dr. Zimmerman said, pushing her way in front of Martin. “You’ve done that.”
   “Not quite,” Jack corrected. “We haven’t made a diagnosis on Susanne Hard.” He returned the infection-control officer’s beady stare. Since she wasn’t wearing the mask she’d had on the day before, Jack was able to appreciate how stern her thin-lipped face was.
   “You haven’t made a specific diagnosis in the Hard case,” Dr. Zimmerman corrected, “but you have made a diagnosis of a fatal infectious disease. Under the circumstances I think that is adequate.”
   “Adequate has never been my goal in medicine,” Jack said.
   “Nor mine,” Dr. Zimmerman shot back. “Nor is it for the Centers for Disease Control or the City Board of Health, who are actively investigating this unfortunate incident. Frankly your presence here is disruptive.”
   “Are you sure they don’t need a little help?” Jack asked. He couldn’t hold back the sarcasm.
   “I’d say your presence is more than disruptive,” Kelley said. “In fact, you’ve been downright slanderous. You could very well be hearing from our lawyers.”
   “Whoa!” Jack said again, lifting his hands as if to fend off a bodily attack. “Disruptive I can at least comprehend. Slanderous is ridiculous.”
   “Not from my point of view,” Kelley said. “The supervisor in central supply said you told her Katherine Mueller had contracted her illness on the job.”
   “And that has not been established,” Dr. Zimmerman added.
   “Uttering such an unsubstantiated statement is defamatory to this institution and injurious to its reputation,” Kelley snapped.
   “And could have a negative impact on its stock value,” Jack said.
   “And that too,” Kelley agreed.
   “The trouble is I didn’t say Mueller had contracted her illness on the job,” Jack said. “I said she could have done so. There’s a big difference.”
   “Mrs. Zarelli told us you told her it was a fact,” Kelley said.
   “I told her ‘those were the facts’ referring to the possibility,” Jack said. “But look, we’re quibbling. The real fact is that you people are overly defensive. It makes me wonder about your nosocomial infection history. What’s the story there?”
   Kelley turned purple. Given the man’s intimidating size advantage, Jack took a protective step backward.
   “Our nosocomial infection experience is none of your business,” Kelley sputtered.
   “That’s something I’m beginning to question,” Jack said. “But I’ll save looking into it for another time. It’s been nice seeing you all again. Bye.”
   Jack broke off from the group and strode away. He heard sudden movement behind him and cringed, half expecting a beaker or some other handy piece of laboratory paraphernalia to sail past his ear. But he reached the door to the hallway without incident. Descending a floor, he unlocked his bike and headed south.
   Jack weaved in and out of the traffic, marveling at his latest brush with AmeriCare. Most confusing was the sensitivity of the people involved. Even Martin, who’d been friendly the day before, now acted as if Jack were the enemy. What could they all be hiding? And why hide it from Jack?
   Jack didn’t know who at the hospital had alerted the administration of his presence, but he had a good idea who would be informing Bingham that he’d been there. Jack entertained no illusions about Kelley complaining about him again.
   Jack wasn’t disappointed. As soon as he came in the receiving bay, the security man stopped him.
   “I was told to tell you to go directly to the chief’s office,” the man said. “Dr. Washington himself gave me the message.”
   As Jack locked his bike, he tried to think of what he was going to say to Bingham. Nothing came to mind.
   While ascending in the elevator, Jack decided he’d switch to offense since he couldn’t think of any defense. He was still formulating an idea when he presented himself in front of Mrs. Sanford’s desk.
   “You’re to go right in,” Mrs. Sanford said. As usual she didn’t look up from her work.
   Jack stepped around her desk and entered Bingham’s office. Immediately he saw that Bingham wasn’t alone. Calvin’s huge hulk was hovering near the glass-fronted bookcase.
   “Chief, we have a problem,” Jack said earnestly. He moved over to Bingham’s desk and gave it a tap with his fist for emphasis. “We don’t have a diagnosis on the Hard case, and we got to give it to them ASAP. If we don’t we’re going to look bad, especially the way the press is all stirred up about the plague. I even went all the way over to the General to take a look at the gram stain. Unfortunately, it didn’t help.”
   Bingham regarded Jack curiously with his rheumy eyes. He’d been about to lambaste Jack; now he demurred. Instead of speaking he removed his wire-rimmed spectacles and absently cleaned them while he considered Jack’s words. He glanced over at Calvin. Calvin responded by stepping up to the desk. He wasn’t fooled by Jack’s ruse.
   “What the hell are you talking about?” Calvin demanded.
   “Susanne Hard,” Jack said. “You remember. The case you and I have the ten-dollar double-or-nothing bet on.”
   “A bet!” Bingham questioned. “Is there gambling going on in this office?”
   “Not really, Chief,” Calvin said. “It was just a way of making a point. It’s not routine.”
   “I should hope not,” Bingham snapped. “I don’t want any wagering around here, especially not in regard to diagnoses. That’s not the kind of thing I’d like to see in the press. Our critics would have a field day.”
   “Getting back to Susanne Hard,” Jack said. “I’m at a loss as to how to proceed. I’d hoped that by talking directly to the hospital lab people I might have made some headway, but it didn’t work. What do you think I should do now?” Jack wanted the conversation to move away from the gambling issue. It might divert Bingham, but Jack knew he’d have hell to pay with Calvin later on.
   “I’m a little confused,” Bingham said. “Just yesterday I specifically told you to stay around here and get your backload of cases signed out. I especially told you to stay the hell away from the Manhattan General Hospital.”
   “That was if I were going there for personal reasons,” Jack said. “I wasn’t. This was all business.”
   “Then how the hell did you manage to get the administrator all bent out of shape again?” Bingham demanded. “He called the damn mayor’s office for the second day in a row. The mayor wants to know if you have some sort of mental problem or whether I have a mental problem for hiring you.”
   “I hope you reassured him we’re both normal,” Jack said.
   “Don’t be impertinent on top of everything else,” Bingham said.
   “To tell you the honest truth,” Jack said, “I haven’t the slightest idea why the administrator got upset. Maybe the pressure of this plague episode has gotten to everybody over there, because they’re all acting weird.”
   “So now everyone seems weird to you,” Bingham said.
   “Well, not everyone,” Jack admitted. “But there’s something strange going on, I’m sure of it.”
   Bingham looked up at Calvin, who shrugged and rolled his eyes. He didn’t understand what Jack was talking about. Bingham’s attention returned to Jack.
   “Listen,” Bingham said. “I don’t want to fire you, so don’t make me. You’re a smart man. You have a future in this field. But I’m warning you, if you willfully disobey me and continue to embarrass us in the community, I’ll have no other recourse. Tell me you understand.”
   “Perfectly,” Jack said.
   “Fine,” Bingham said. “Then get back to your work, and we’ll see you later in conference.”
   Jack took the cue and instantly disappeared.
   For a moment Bingham and Calvin remained silent, each lost in his own thoughts.
   “He’s an odd duck,” Bingham said finally. “I can’t read him.”
   “Nor can I,” Calvin said. “His saving grace is that he is smart and truly a hard worker. He’s very committed. Whenever he’s on autopsy, he’s always the first one in the pit.”
   “I know,” Bingham said. “That’s why I didn’t fire him on the spot. But where does this brashness come from? He has to know it rubs people the wrong way, yet he doesn’t seem to care. He’s reckless, almost self-destructive, as he admitted himself yesterday. Why?”
   “I don’t know,” Calvin said. “Sometimes I get the feeling it’s anger. But directed at what? I haven’t the foggiest. I’ve tried to talk with him a few times on a personal level, but it’s like squeezing water out of a rock.”

15. Thursday, 8:30 p.m., March 21, 1996

   Terese and Colleen climbed out of the cab on Second Avenue between Eighty-ninth and Eighty-eighth streets a few doors away from Elaine’s and walked to the restaurant. They couldn’t get out right in front because of several limos inconveniently double-parked.
   “How do I look?” Colleen asked as they paused under the canvas awning. She’d pulled off her coat for Terese’s inspection.
   “Too good,” Terese said, and she meant it. Colleen had discarded her signature sweatshirt and jeans for a simple black dress that revealed her ample bust to perfection. Terese felt dowdy by comparison. She still had on her tailored suit that she’d worn to work that day, not having found time to go home to change.
   “I don’t know why I’m so nervous,” Colleen admitted.
   “Relax,” Terese said. “With that dress Dr. McGovern doesn’t stand a chance.”
   Colleen gave their names to the maître d’ who immediately indicated recognition. He motioned for the women to follow him. He started to the rear.
   It was an obstacle course of sorts to weave among the densely packed tables and scurrying waiters. Terese had the sensation of being in a fishbowl. Everyone, male and female alike, gave them the once-over as they passed.
   The men were at a tiny table squeezed into the far corner. They got to their feet as the women approached. Chet held out Colleen’s chair. Jack did the same for Terese. The women draped their coats over the backs of the chairs before sitting down.
   “You men must know the owner to have gotten such a great table,” Terese said.
   Chet, who misinterpreted Terese’s remark as a compliment, bragged he’d been introduced to Elaine a year previously. He explained she was the woman seated at the cash register at the end of the bar.
   “They tried to seat us up in the front,” Jack said. “But we declined. We thought you women wouldn’t like the draft from the door.”
   “How thoughtful,” Terese said. “Besides, this is so much more intimate.”
   “You think so?” Chet questioned. His face visibly brightened. They were, in reality, packed in like proverbial sardines.
   “How could you question her?” Jack asked Chet. “She’s so sincere.”
   “All right, enough!” Chet said good-naturedly. “I might be dense, but eventually I catch on.”
   They ordered wine and appetizers from the waiter who’d immediately appeared after the women had arrived. Colleen and Chet fell into easy conversation. Terese and Jack continued to be teasingly sarcastic with each other, but eventually the wine blunted their witticisms. By the time the main course was served, they were conversing congenially.
   “What’s the inside scoop on the plague situation?” Terese asked.
   “There were two more deaths at the General,” Jack said. “Plus a couple of febrile nurses are being treated.”
   “That was in the morning news,” Terese said. “Anything new?”
   “Only one of the deaths was actually plague,” Jack said. “The other resembled plague clinically, but I personally don’t think it was.”
   Terese stopped a forkful of pasta midway to her mouth. “No?” she questioned. “If it wasn’t plague, what was it?”
   Jack shrugged. “I wish I knew,” he said. “I’m hoping the lab can tell me.”
   “The Manhattan General must be in an uproar,” Terese said. “I’m glad I’m not a patient there now. Being in the hospital is scary enough under the best of circumstances. With the worry of diseases like plague around, it must be terrible.”
   “The administration is definitely agitated,” Jack said. “And for good reason. If it turns out the plague originated there, it will be the first modern episode of nosocomial plague. That’s hardly an accolade as far as the hospital is concerned.”
   “This concept of nosocomial infections is new to me,” Terese said. “I’d never thought much about it before you and Chet talked about this current plague problem last night. Do all hospitals have such problems?”
   “Absolutely,” Jack said. “It’s not common knowledge, but usually five to ten percent of hospitalized patients fall victim to infections contracted while they are in the hospital.”
   “My God!” Terese said. “I had no idea it was such a widespread phenomenon.”
   “It’s all over,” Chet agreed. “Every hospital has it, from the academic ivory tower to the smallest community hospital. What makes it so bad is that the hospital is the worst place to get an infection because many of the bugs hanging out there are resistant to antibiotics.”
   “Oh, great!” Terese said cynically. After she thought for a moment she asked, “Do hospitals differ significantly in their infection rates?”
   “For sure,” Chet said.
   “Are these rates known?” Terese said.
   “Yes and no,” Chet said. “Hospitals are required by the Joint Commission of Accreditation to keep records of their infection rates, but the rates aren’t released to the public.”
   “That’s a travesty!” Terese said with a surreptitious wink at Colleen.
   “If the rates go over a certain amount the hospital loses its accreditation,” Chet said. “So all is not lost.”
   “But it’s hardly fair to the public,” Terese said. “By not having access to those rates people can’t make their own decisions about which hospitals to patronize.”
   Chet opened his hands palms up like a supplicant priest. “That’s politics,” he said.
   “I think it’s awful,” Terese said.
   “Life’s not fair,” Jack said.
   After dessert and coffee Chet and Colleen began campaigning to go someplace where there was dancing, like the China Club. Both Terese and Jack were disinclined. Chet and Colleen tried their best to change their minds, but they soon gave up.
   “You guys go,” Terese said.
   “Are you sure?” Colleen asked.
   “We wouldn’t want to hold you back,” Jack said.
   Colleen looked at Chet.
   “Let’s go for it,” Chet said.
   Outside the restaurant Chet and Colleen happily piled into a cab. Jack and Terese waved as they drove off.
   “I hope they enjoy themselves,” Terese said. “I couldn’t have thought of anything worse. Sitting in a smoke-filled nightclub assaulted by music loud enough to damage my ears is not my idea of pleasure.”
   “At least we’ve finally found something we can agree on,” Jack said.
   Terese laughed. She was beginning to appreciate Jack’s sense of humor. It wasn’t too dissimilar from her own.
   For a moment of self-conscious indecision they stood at the curbside, each looking in a different direction. Second Avenue was alive with revelers despite a nippy temperature in the high thirties. The air was clear and the sky cloudless.
   “I think the weatherman forgot it was the first day of spring,” Terese said. She jammed her hands into her coat pockets and hunched up her shoulders.
   “We could walk around the corner to that bar where we were last night,” Jack suggested.
   “We could,” Terese said. “But I have a better idea. My agency is over on Madison. It’s not too far away. How about a quick visit?”
   “You’re inviting me to your office despite knowing how I feel about advertising?” Jack asked.
   “I thought it was only medical advertising you were against,” Terese said.
   “The truth is I’m not particularly fond of advertising in general,” Jack said. “Last night Chet jumped in before I had a chance to say it.”
   “But you’re not opposed to it per se?” Terese questioned.
   “Just the medical kind,” Jack said. “For the reasons I gave.”
   “Then how about a quick visit? We do a lot more than just medical advertising. You might find it enlightening.”
   Jack tried to read the woman behind the soft, pale blue eyes and sensuous mouth. He was confused because the vulnerability they suggested wasn’t in sync with the no-nonsense, goal-oriented, driven woman he suspected she was.
   Terese met his stare head-on and smiled back coquettishly. “Be adventuresome!” she challenged.
   “Why do I have the feeling you have an ulterior motive?” Jack asked.
   “Probably because I do,” Terese freely admitted. “I’d like your advice on a new ad campaign. I wasn’t going to admit you’d been a stimulus for a new idea, but tonight during dinner I changed my mind about telling you.”
   “I don’t know whether to feel used or complimented,” Jack said. “How did I happen to give you an idea for an ad?”
   “All this talk about plague at the Manhattan General Hospital,” Terese said. “It made me think seriously about the issue of nosocomial infection.”
   Jack considered this statement for a moment. Then he asked, “And why did you change your mind about telling me and asking my advice?”
   “Because it suddenly dawned on me that you might actually approve of the campaign,” Terese said. “You told me the reason you were against advertising in medicine was because it didn’t address issues of quality. Well, ads concerning nosocomial infections certainly would.”
   “I suppose,” Jack said.
   “Oh, come on,” Terese said. “Of course it would. If a hospital was proud of its record, why not let the public know?”
   “All right,” Jack said. “I give up. Let’s see this office of yours.”
   Having made the decision to go, there was the problem of Jack’s bike. At that moment it was locked to a nearby No Parking sign. After a short discussion they decided to leave the bike and go together in a cab. Jack would rescue the bike later on his way home.
   With little traffic and a wildly fast and reckless Russian-émigré taxi driver, they arrived at Willow and Heath’s building in minutes. Jack staggered out of the rear of the taxi.
   “God!” he said. “People accuse me of taking a risk riding my bike in this city. It’s nothing like riding with that maniac.”
   As if to underline Jack’s statement, the cab shot away from the curb and disappeared up Madison Avenue with its tires screeching.
   At ten-thirty the office building was locked up tight. Terese used her night key, and they entered. Their heels echoed noisily in the lonely marble hallway. Even the whine of the elevator seemed loud in the stillness.
   “Are you here often after hours?” Jack asked.
   Terese laughed cynically. “All the time,” she said. “I practically live here.”
   They rode up in silence. When the doors opened Jack was shocked to find the floor brightly illuminated and bustling with activity as if it were midday. Toiling figures bent over many of the innumerable drawing boards.
   “What do you have, two shifts?” Jack asked.
   Terese laughed again. “Of course not,” she said. “These people have been here since early this morning. Advertising is a competitive world. If you want to make it, you have to put in your time. We have several reviews coming up.”
   Terese excused herself and walked over to a woman at a nearby drawing table. While they conversed, Jack’s eyes roamed the expansive space. He was surprised there were so few partitions. There was only a handful of separate rooms, which shared a common wall with the bank of elevators.
   “Alice is going to bring in some material,” Terese said when she rejoined Jack. “Why don’t we go into Colleen’s office.”
   Terese led him into one of the rooms and turned on the lights. It was tiny, windowless, and claustrophobic when compared to the vast undivided space. It was also cluttered with papers, books, magazines, and videotapes. There were several easels set up with thick pads of drawing paper.
   “I’m sure Colleen won’t mind if I clear away a little area on her desk,” Terese said as she moved aside stacks of orange-colored tracing paper. Gathering up an armload of books, she set them on the floor. No sooner had she finished than Alice Gerber, another of Terese’s associates, appeared.
   After making introductions, Terese had Alice run through a number of the potential commercial ideas they’d comped up that day.
   Jack found himself interested more in the process than the content. He’d never stopped to think about how TV commercials were made, and he came to appreciate the creativity involved and the amount of work.
   It took Alice a quarter hour to present what she’d brought in. When she was finished, she gathered up the tissues and looked at Terese for further instructions. Terese thanked her and sent her back to her drawing board.
   “So there you have it,” Terese said to Jack. “Those’re some of the ideas stemming from this nosocomial infection issue. What do you think?”
   “I’m impressed with how hard you work on this sort of thing,” Jack said.
   “I’m more interested in your reaction to the content,” Terese said. “What do you think of the idea of Hippocrates coming into the hospital to award it the ‘do no harm’ medal?”
   Jack shrugged. “I don’t flatter myself to think I have the ability to intelligently critique a commercial.”
   “Oh, give me a break,” Terese said, rolling her eyes to the ceiling. “I just want your opinion as a human being. This isn’t an intellectual quiz. What would you think if you saw this commercial on the TV, say when you were watching the Super Bowl?”
   “I’d think it was cute,” Jack admitted.
   “Would it make you think the National Health hospital might be a good place to go, since its nosocomial infection rates were low?”
   “I suppose,” Jack said.
   “All right,” Terese said, trying to keep herself calm. “Maybe you have some other ideas. What else could we do?”
   Jack pondered for a few minutes. “You could do something about Oliver Wendell Holmes and Joseph Lister.”
   “Wasn’t Holmes a poet?” Terese asked.
   “He was also a doctor,” Jack said. “He and Lister probably did more for getting doctors to wash their hands when going from patient to patient than anybody. Well, Semmelweis helped too. Anyway, handwashing was probably the most important lesson that needed to be learned to prevent hospital-based infections.”
   “Hmm,” Terese said. “That sounds interesting. Personally, I love period pieces. Let me tell Alice to get someone to research it.”
   Jack followed Terese out of Colleen’s office and watched her talk with Alice. It only took her a few minutes.
   “Okay,” Terese said, rejoining Jack. “She’ll start the ball rolling. Let’s get out of here.”
   In the elevator Terese had another suggestion. “Why don’t we take a run over to your office,” she said. “It’s only fair now that you have seen mine.”
   “You don’t want to see it,” Jack said. “Trust me.”
   “Try me.”
   “It’s the truth,” Jack said. “It’s not a pretty place.”
   “I think it would be interesting,” Terese persisted. “I’ve only seen a morgue in the movies. Who knows, maybe it will give me some ideas. Besides, seeing where you work might help me understand you a little more.”
   “I’m not sure I want to be understood,” Jack said.
   The elevator stopped and the doors opened. They walked outside. They paused at the curb.
   “What do you say? I can’t imagine it would take too long, and it’s not terribly late.”
   “You are a persistent sort,” Jack commented. “Tell me: Do you always get your way?”
   “Usually,” Terese admitted. Then she laughed. “But I prefer to think of myself as tenacious.”
   “All right,” Jack said finally. “But don’t say I didn’t warn you.”
   They caught a taxi. After Jack gave the destination the driver looped around and headed south on Park Avenue.
   “You give me the impression of being a loner,” Terese said.
   “You’re very perspicacious,” Jack said.
   “You don’t have to be so caustic,” Terese said.
   “For once I wasn’t,” Jack said.
   The lambent reflections of the streetlights played over their faces as they regarded each other in the half-light of the taxi.
   “It’s difficult for a woman to know how to feel around you,” Terese said.
   “I could say the same,” Jack said.
   “Have you ever been married?” Terese said. “That is, if you don’t mind me asking.”
   “Yes, I was married,” Jack said.
   “But it didn’t work out?” Terese said leadingly.
   “There was a problem,” Jack admitted. “But I don’t really care to talk about it. How about you? Were you ever married?”
   “Yes, I was,” Terese said. She sighed and looked out her window. “But I don’t like talking about it either.”
   “Now we have two things we agree on,” Jack said. “We both feel the same about nightclubs and talking about our former marriages.”
   Jack had given directions to be dropped off at the Thirtieth Street entrance of the medical examiner’s office. He was glad to see that both mortuary vans were gone. He thought their absence was a sign that there wouldn’t be any fresh corpses lying around on gurneys. Although Terese had insisted on the visit, he was afraid of offending her sensibilities unnecessarily.
   Terese said nothing as Jack led her past the banks of refrigerated compartments. It wasn’t until she saw all the simple pine coffins that she spoke. She asked why they were there.
   “They’re for the unclaimed and unidentified dead,” Jack said. “They are buried at city expense.”
   “Does that happen often?” Terese asked.
   “All the time,” Jack said.
   Jack took her back to the area of the autopsy room. He opened the door to the washroom. Terese leaned in but didn’t enter. The autopsy room was visible through a windowed door. The stainless-steel dissecting tables glistened ominously in the half-light.
   “I expected this place to be more modern,” she said. She was hugging herself to keep from touching anything.
   “At one time it was,” Jack said. “It was supposed to have been renovated, but it didn’t happen. Unfortunately the city is always in some kind of budgetary crisis, and few politicians balk at pulling money away from here. Adequate funding for normal operating expenses is hard to come by, much less money to update the facility. On the other hand we do have a new, state-of-the-art DNA lab.”
   “Where’s your office?” Terese asked.
   “Up on the fifth floor,” Jack said.
   “Can I see it?” she asked.
   “Why not?” Jack said. “We’ve come this far.”
   They walked back past the mortuary office and waited for the elevator.
   “This place is a little hard to take, isn’t it?” Jack said.
   “It has its gruesome side,” Terese admitted.
   “We who work here often forget the effect it has on laypeople,” Jack said, though he was impressed with the degree of equanimity Terese had demonstrated.
   The elevator arrived and they got on. Jack pressed the fifth floor, and they started up.
   “How did you ever decide on this kind of career?” Terese asked. “Did you know back in medical school?”
   “Heavens, no,” Jack said. “I wanted something clean, technically demanding, emotionally fulfilling, and lucrative. I became an ophthalmologist.”
   “What happened?” Terese asked.
   “My practice got taken over by AmeriCare,” Jack said. “Since I didn’t want to work for them or any similar corporation, I retrained. It’s the buzzword these days for superfluous medical specialists.”
   “Was it difficult?” Terese asked.
   Jack didn’t answer immediately. The elevator arrived on the fifth floor and the doors opened.
   “It was very difficult,” Jack said as he started down the hall. “Mostly because it was so lonely.”
   Terese hazarded a glance in Jack’s direction. She’d not expected him to be the type to complain of loneliness. She’d assumed he was a loner by choice. While she was looking, Jack furtively wiped the corner of an eye with his knuckle. Could there have been a tear? Terese was mystified.
   “Here we are,” Jack announced. He opened his office door with his key and flipped on the light.
   The interior was worse than Terese had expected. It was tiny and narrow. The furniture was gray metal and old, and the walls were in need of paint. There was a single, filthy window positioned high on the wall.
   “Two desks?” Terese questioned.
   “Chet and I share this space,” Jack explained.
   “Which desk is yours?”
   “The messy one,” Jack said. “This plague episode has put me further behind than ususal. I’m generally behind because I’m rather compulsive about my reports.”
   “Dr. Stapleton!” a voice called out.
   It was Janice Jaeger, the PA investigator.
   “Security told me you were here when I just came through the receiving bay,” she said after being introduced to Terese. “I’ve been trying to reach you at home.”
   “What’s the problem?” Jack asked.
   “The reference lab called this evening,” Janice said. “They ran the fluorescein antibody on Susanne Hard’s lung tissue as you requested. It was positive for tularemia.”
   “Are you kidding?” Jack took the paper from Janice and stared at it with disbelief.
   “What’s tularemia?” Terese asked.
   “It’s another infectious disease,” Jack said. “It’s similar in some ways to plague.”
   “Where was this patient?” Terese asked, although she suspected the answer.
   “Also at the General,” Jack said. He shook his head. “I truly can’t believe it. This is extraordinary!”
   “I’ve got to get back to work,” Janice said. “If you need me to do anything just let me know.”
   “I’m sorry,” Jack said. “I didn’t mean to have you stand here. Thanks for getting this to me.”
   “No problem,” Janice said. She waved and headed back to the elevators.
   “Is tularemia as bad as plague?” Terese asked.
   “It’s hard to make comparisons,” Jack said. “But it’s bad, particularly the pneumonic form, which is highly contagious. If Susanne Hard were still here she could tell us exactly how bad it is.”
   “Why are you so surprised?” Terese asked. “Is it as rare as plague?”
   “Probably not,” Jack said. “It’s seen in a wider area in the U.S. than plague, particularly in southern states like Arkansas. But like plague it’s not seen much in the winter, at least not up here in the north. Here it’s a late-spring and summer problem, if it exists at all. It needs a vector, just like plague. Instead of the rat flea it’s usually spread by ticks and deerflies.”
   “Any tick or deerfly?” Terese asked. Her parents had a cabin up in the Catskills where she liked to go in the summer. It was isolated and surrounded by forest and fields. There were plenty of ticks and deerflies.
   “The reservoir for the bacteria is small mammals like rodents and especially rabbits,” Jack said. He started to elaborate but quickly stopped. He’d suddenly recalled that afternoon’s conversation with Susanne’s husband, Maurice. Jack remembered being told that Susanne liked to go to Connecticut, walk in the woods, and feed wild rabbits!
   “Maybe it was the rabbits,” Jack mumbled.
   “What are you talking about?” Terese asked.
   Jack apologized for thinking out loud. Shaking himself out of a momentary daze, he motioned for Terese to follow him into his office and to take Chet’s chair. He described his phone conversation with Susanne’s husband and explained about the importance of wild rabbits in relation to tularemia.
   “Sounds incriminating to me,” Terese said.
   “The only problem is that her exposure to the Connecticut rabbits was almost two weeks ago,” Jack mused. He drummed his fingers on his telephone receiver. “That’s a long incubation period, especially for the pneumonic form. Of course, if she didn’t catch it in Connecticut, then she had to catch it here in the city, possibly at the General. Of course, nosocomial tularemia doesn’t make any more sense than nosocomial plague.”
   “One way or the other the public has to know about this,” Terese said. She nodded toward his hand on the phone. “I hope you are calling the media as well as the hospital.”
   “Neither,” Jack said. He glanced at his watch. It was still before midnight. He picked up the phone and dialed. “I’m calling my immediate boss. The politics of all this are his bailiwick.”
   Calvin picked up on the first ring but mumbled as if he’d been asleep. Jack cheerfully identified himself.
   “This better be important,” Calvin growled.
   “It is to me,” Jack said. “I wanted you to be first to know you owe me another ten dollars.”
   “Get outta here,” Calvin boomed. The grogginess had disappeared from his voice. “I hope to God this isn’t some kind of sick joke.”
   “No joke,” Jack assured him. “The lab just reported it in tonight. The Manhattan General had a case of tularemia in addition to its two cases of plague. I’m as surprised as anyone.”
   “The lab called you directly?” Calvin said.
   “Nope,” Jack said. “One of the PAs just gave it to me.”
   “Are you in the office?” Calvin asked.
   “Sure am,” Jack said. “Working my fingers to the bone.”
   “Tularemia?” Calvin questioned. “I’d better read up on it. I don’t think I’ve ever seen a case.”
   “I read up on it just this afternoon,” Jack admitted.
   “Make sure there are no leaks from our office,” Calvin said. “I won’t call Bingham tonight, because there’s nothing to be done at the moment. I’ll let him know first thing in the morning, and he can call the commissioner, and she can call the Board of Health.”
   “Okay,” Jack said.
   “So you are going to keep it a secret,” Terese said angrily as Jack hung up the receiver.
   “It’s not my doing,” Jack said.
   “Yeah, I know,” Terese said sarcastically. “It’s not your job.”
   “I already got myself in trouble over the plague episode for calling the commissioner on my own,” Jack said. “I don’t see any benefit by doing it again. Word will be out in the morning through the proper channels.”
   “What about people over at the General who are suspected of having plague?” Terese questioned. “They might have this new disease. I think you should let everyone know tonight.”
   “That’s a good point,” Jack said. “But it doesn’t really matter. The treatment for tularemia is the same as the treatment for plague. We’ll wait until morning. Besides, it’s only a few hours away.”
   “What if I alerted the press?” Terese asked.
   “I’ll have to ask you not to do that,” Jack said. “You heard what my boss said. If it were investigated, the source would come back to me.”
   “You don’t like advertising in medicine and I don’t like politics in medicine,” Terese said.
   “Amen,” Jack said.

16. Friday, 6:30 a.m., March 22, 1996

   Despite having gone to bed much later than usual for the second night in a row, Jack was wide awake at five-thirty Friday morning. He began mulling over the irony of a case of tularemia appearing in the middle of a plague outbreak. It was a curious coincidence, especially since he’d made the diagnosis. It was a feat certainly worth the ten dollars and twenty-five cents that he stood to win from Calvin and Laurie.
   With his mind churning, Jack recognized the futility of trying to go back to sleep. Consequently he got up, ate breakfast, and was on his bike before six. With less traffic than usual, he got to work in record time.
   The first thing Jack did was to visit the ID room to look for Laurie and Vinnie. Both had yet to arrive. Passing back through communications, he knocked on Janice’s door. She appeared even more beleaguered than usual.
   “What a night,” she said.
   “Busy?” Jack asked.
   “That’s an understatement,” she said. “Especially with these added infectious cases. What’s going on over there at the General?”
   “How many today?” Jack asked.
   “Three,” Janice said. “And not one of them tested positive for plague even though that’s their presumed diagnosis. Also, all three were fulminant cases. The people all died within twelve or so hours after their first symptoms. It’s very scary.”
   “All of these recent infectious cases have been fulminant,” Jack commented.
   “Do you think these three new ones are tularemia?” Janice asked.
   “There’s a good chance,” Jack said. “Especially if they tested negative for plague as you say. You didn’t mention Susanne’s diagnosis to anyone, did you?”
   “I had to bite my tongue, but I didn’t,” Janice said. “I’d learned in the past by sore experience that my role is to gather information, not give it out.”
   “I had to learn the same lesson,” Jack said. “Are you finished with these three folders?”
   “They’re all yours,” Janice said.
   Jack carried the folders back to the ID room. Since Vinnie had not arrived Jack made the coffee in the communal pot. Mug in hand, he sat down and began going through the material.
   Almost immediately he stumbled onto something curious. The first case was a forty-two-year-old woman by the name of Maria Lopez. What was surprising was that she worked in central supply of the Manhattan General Hospital! Not only that, but she had worked on the same shift as Katherine Mueller!
   Jack closed his eyes and tried to think of how two people from central supply could possibly have come down with two different fatal infectious diseases. As far as he was concerned, it could not be a coincidence. He was convinced their illnesses had to be work-related. The question was how?
   In his mind’s eye, Jack revisited central supply. He could picture the shelving and the aisles, even the outfits the employees wore. But nothing came to mind as a way for the employees to come in contact with contagious bacteria. Central supply had nothing to do with the disposal of hospital waste or even soiled linen, and as the supervisor had mentioned, workers there had little or no contact with patients.
   Jack read the rest of Janice’s investigative report. As she’d done with the cases since Nodelman, she included information about pets, travel, and visitors. For Maria Lopez, none of the three seemed a factor.
   Jack opened the second folder. The patient’s name was Joy Hester. In this case Jack felt there was little mystery. She’d been an OB-GYN nurse and had had significant exposure to Susanne Hard just prior to and after the onset of Susanne’s symptoms. The only thing that bothered Jack was recalling that he’d read that person-to-person transmission of tularemia rarely occurred.
   The third case was Donald Lagenthorpe, a thirty-eight-year-old petroleum engineer who’d been admitted to the hospital the previous morning. He’d come in through the ER with a refractory bout of asthma. He’d been treated with IV steroids and bronchodilators as well as humidified air and bed rest. According to Janice’s notes, he’d shown steady improvement and had even been campaigning to be released, when he’d had the sudden onset of a severe frontal headache.
   The headache had started in the late afternoon and was followed by shaking chills and fever. There was also an increase in cough and exacerbation of his asthmatic symptoms despite the continued treatment. At that point he was diagnosed to have pneumonia, which was confirmed by X ray. Curiously enough, however, a gram stain of his sputum was negative for bacteria.
   Myalgia also had become prominent. Sudden abdominal pain and deep tenderness had suggested a possible appendicitis. At seven-thirty in the evening Lagenthorpe had undergone an appendectomy, but the appendix proved to be normal. After the surgery his situation became progressively grave with apparent multisystem failure. His blood pressure dropped and became unresponsive to treatment. Urine output became negligible.
   Reading on in Janice’s report, Jack learned that the patient had visited isolated oil rigs in Texas the previous week and had literally been tramping around in desert conditions. Jack also learned that Mr. Lagenthorpe’s girlfriend had recently obtained a pet Burmese cat. But he’d not been exposed to any visitors from exotic places.
   “Wow! You’re here early!” Laurie Montgomery exclaimed.
   Jack was shocked out of his concentration in time to see Laurie sweep into the ID room and drape her coat over the desk she used for her early-morning duties. It was the last day of her current rotation as supervisor in charge of determining which of the previous night’s cases should be autopsied and who would do them. It was a thankless task that none of the board-certified doctors enjoyed.
   “I’ve got some bad news for you,” Jack said.
   Laurie paused on her way into communications; a shadow passed over her usually bright, honey-complected face.
   Jack laughed. “Hey, relax,” he said. “It’s not that bad. It’s just that you owe me a quarter.”
   “Are you serious?” she asked. “The Hard case was tularemia?”
   “The lab reported a positive fluorescein antibody last night,” Jack said. “I think it’s a firm diagnosis.”
   “It’s a good thing I didn’t bet any more than a quarter,” Laurie said. “You are amassing some impressive statistics in the infectious arena. What’s your secret?”
   “Beginner’s luck,” Jack said. “By the way, I have three of last night’s cases here. They’re all infectious and all from the General. I’d like to do at least two of them.”
   “I can’t think of any reason why not,” Laurie said. “But let me run over to communications and get the rest.”
   The moment Laurie left, Vinnie made his appearance. His face was a pasty color and his heavily lidded eyes were red. From Jack’s perspective he appeared as if he belonged in one of the coolers downstairs.
   “You look like death warmed over,” Jack said.
   “Hangover,” Vinnie remarked. “I went to a buddy’s bachelor party. We all got whacked.”
   Vinnie tossed his newspaper on a desk and went over to the cupboard where the coffee was stored.
   “In case you haven’t noticed,” Jack said, “the coffee is already made.”
   Vinnie had to stare at the coffee machine with its full pot for several beats until his tired mind comprehended that his current efforts were superfluous.
   “How about starting on this instead?” Jack said. He pushed the Maria Lopez folder over to Vinnie. “Might as well get set up. Remember, the early bird…”
   “Hold the clichés,” Vinnie said. He took the folder and let it fall open in his hands. “Frankly, I’m not in the mood for any of your sappy sayings. What bugs me is that you can’t come in here when everybody else does.”
   “Laurie’s here,” Jack reminded him.
   “Yeah, but this is her week for scheduling. You don’t have any excuse.” He briefly read portions of the folder. “Wonderful! Another infectious case! My favorite! I should have stayed in bed.”
   “I’ll be down in a few minutes,” Jack said.
   Vinnie irritably snapped up his newspaper and headed downstairs.
   Laurie reappeared with an armful of folders and dumped them on her desk. “My, my, but we do have a lot of work to do today,” she said.
   “I’ve already sent Vinnie down to get prepared for one of these infectious cases,” Jack said. “I hope I’m not overstepping my authority. I know you haven’t looked at them yet, but all of them are suspected plague but tested negative. At a minimum I think we have to make a diagnosis.”
   “No question,” Laurie said. “But I should still go downstairs and do my external. Come on, I’ll do it right away, and you can get started.” She grabbed the master list of all the previous night’s deaths.
   “What’s the story on this first case you want to do?” Laurie asked as they walked.
   Jack gave her a quick synopsis of what he knew about Maria Lopez. He emphasized the coincidence of her being employed in central supply at the General. He reminded her that the plague victim from the day before had also worked in that department. They boarded the elevator.
   “That’s kinda strange, isn’t it?” Laurie asked.
   “It is to me,” Jack agreed.
   “Do you think it’s significant?” Laurie asked. The elevator bumped to a stop, and they got off.
   “My intuition tells me it is,” Jack said. “That’s why I’m eager to do the post. For the life of me, I can’t figure out what the association could be.”
   As they passed the mortuary office Laurie beckoned to Sal. He caught up to them, and she handed him her master list. “Let’s see the Lopez body first,” she said.
   Sal took the list, referred to his own, then stopped at compartment 67, opened the door, and slid out the tray.
   Maria Lopez, like her late co-worker, Katherine Mueller, was an overweight female. Her hair was stringy and dyed a peculiar reddish orange. Several IVs were still in place. One was taped to the right side of her neck, the other to her left arm.
   “A fairly young woman,” Laurie commented.
   Jack nodded. “She was only forty-two.”
   Laurie held Maria Lopez’s full-body X ray up to the ceiling light. Its only abnormality was patchy infiltration in her lungs.
   “Go to it,” Laurie said.
   Jack turned on his heels and headed toward the room where his moon-suit ventilator was charging.
   “Of the other two cases you had upstairs, which one would you want to do if you only do one?” Laurie called after him.
   “Lagenthorpe,” Jack said.
   Laurie gave him a thumbs-up.
   Despite his hangover, Vinnie had been his usual efficient self in setting up the autopsy on Maria Lopez. By the time Jack read over the material in Maria’s folder for the second time and had climbed into his moon suit, all was ready.
   With no distractions from anyone in the pit besides himself and Vinnie, Jack was able to concentrate. He spent an inordinate amount of time on the external exam. He was determined to find an insect bite if there had been one. He was not successful. As with Mueller, there were a few questionable blemishes, which he photographed, but none he felt were bites.
   Jack’s concentration was inadvertently aided by Vinnie’s hangover. Preferring to nurse his headache, Vinnie remained silent, sparing Jack his usual quips and running commentary on sports trivia. Jack reveled in the thought-provoking silence.
   Jack handled the internal exam the same way he’d handled those of the previous infectious cases. He was extraordinarily careful to avoid unnecessary movement of the organs to keep bacterial aerosolization to a minimum.
   As the autopsy progressed, Jack’s overall impression was that Lopez’s case mirrored that of Susanne Hard, not Katherine Mueller. Hence, his preliminary diagnosis remained tularemia, not plague. This only highlighted his confusion of how two women from central supply had managed to catch these illnesses while other, more exposed hospital workers had avoided them.
   When he finished with the internal exam and had taken the samples he wanted, he put aside a special sample of lung to take up to Agnes Finn. Once he had similar samples from Joy Hester and Donald Lagenthorpe, he planned to have them all sent immediately to the reference lab to be tested for tularemia.
   By the time Jack and Vinnie had commenced stitching up Maria Lopez, they began to hear voices in the washroom and out in the hall.
   “Here come the normal, civilized people,” Vinnie commented.
   Jack didn’t respond.
   Presently the door to the washroom opened. Two figures entered in their moon suits and ambled over to Jack’s table. It was Laurie and Chet.
   “Are you guys finished already?” Chet said.
   “It’s not my doing,” Vinnie said. “The mad biker has to start before the sun is up.”
   “What do you think?” Laurie asked. “Plague or tularemia?”
   “My guess is tularemia,” Jack said.
   “That will be four cases if these other two are tularemia as well,” Laurie said.
   “I know,” Jack said. “It’s weird. Person-to-person spread is supposed to be rare. It doesn’t make a lot of sense, but that seems par for the course with these recent cases.”
   “How is tularemia spread?” Chet asked. “I’ve never seen a case.”
   “It’s spread by ticks or direct contact with an infected animal, like a rabbit,” Jack said.
   “I’ve got you scheduled for Lagenthorpe next,” Laurie told Jack. “I’m going to do Hester myself.”
   “I’m happy to do Hester as well,” Jack said.
   “No need,” Laurie said. “There aren’t that many autopsies today. A lot of last night’s deaths didn’t need to be posted. I can’t let you have all the fun.”
   Bodies began arriving. They were being pushed into the autopsy room by other mortuary techs and lifted onto their designated tables. Laurie and Chet moved off to do their own cases.
   Jack and Vinnie returned to their suturing. When they were finished, Jack helped Vinnie move the body onto a gurney. Then Jack asked how quickly Vinnie could have Lagenthorpe ready to go.
   “What a slave driver,” Vinnie complained. “Aren’t we going to have coffee like everybody else?”
   “I’d rather get it over with,” Jack said. “Then you can have coffee for the rest of the day.”
   “Bull,” Vinnie said. “I’ll be reassigned back in here helping someone else.”
   Still complaining, Vinnie pushed Maria Lopez out of the autopsy room. Jack wandered over to Laurie’s table. Laurie was engrossed in the external exam but straightened up when she caught sight of Jack.
   “This poor woman was thirty-six,” Laurie said wistfully. “What a waste.”
   “What have you found? Any insect bites or cat scratches?”
   “Nothing except a shaving nick on her lower leg,” Laurie said. “But it’s not inflamed, so I’m convinced it’s incidental. There is something interesting. She has definite eye infections.”
   Laurie carefully lifted the woman’s eyelids. Both eyes were deeply inflamed, although the corneas were clear.
   “I can also feel enlarged preauricular lymph nodes,” Laurie said. She pointed to visible lumps in front of the patient’s ears.
   “Interesting,” Jack commented. “That’s consistent with tularemia, but I didn’t see it on the other cases. Give a yell if you come across anything else unusual.”
   Jack stepped over to Chet’s table. He was happily engrossed in a multiple gunshot wound case. At the moment he was busy photographing the entrance and exit wounds. When he saw Jack he handed the camera to Sal, who was helping him, and pulled Jack aside.
   “How was your time last night?” Chet asked.
   “This is hardly the best time to discuss it,” Jack said. Conversation in the moon suits was difficult at best.
   “Oh, come on,” Chet said. “I had a blast with Colleen. After the China Club we went back to her pad on East Sixty-sixth.”
   “I’m happy for you,” Jack said.
   “What did you guys end up doing?” Chet asked.
   “You wouldn’t believe me if I told you,” Jack said.
   “Try me,” Chet challenged. He leaned closer to Jack.
   “We went over to her office, and then we came over here to ours,” Jack said.
   “You’re right,” Chet said. “I don’t believe you.”
   “The truth is often difficult to accept,” Jack said.
   Jack used Vinnie’s arrival with Lagenthorpe’s corpse as an excuse to return to his table. Jack pitched in to help set up the case because it was preferable to further grilling by Chet. Besides, it made it possible to start the case that much sooner.
   On the external exam the most obvious abnormality was the freshly sutured, two-inch-long appendectomy incision. But Jack quickly discovered more pathology. When he examined the corpse’s hands he found subtle evidence of early gangrene on the tips of the fingers. He found some even fainter evidence of the same process on the man’s earlobes.
   “Reminds me of Nodelman,” Vinnie said. “It’s just less, and he doesn’t have any on his pecker. Do you think it’s plague again?”
   “I don’t know,” Jack said. “Nodelman didn’t have an appendectomy.”
   Jack spent twenty minutes diligently searching the rest of the body for any signs of insect or animal bites. Since Lagenthorpe was a moderately dark-skinned African-American, this was more difficult than it had been with the considerably lighter-skinned Lopez.
   Although Jack’s diligence didn’t reward him with any bite marks, it did make it possible for him to appreciate another subtle abnormality. On Lagenthorpe’s palms and soles there was a faint rash. Jack pointed it out to Vinnie, but Vinnie said he couldn’t see it.
   “Tell me what I’m looking for,” Vinnie said.
   “Flat, pinkish blotches,” Jack said. “Here’s more on the underside of the wrist.”
   Jack held up Lagenthorpe’s right arm.
   “I’m sorry,” Vinnie said. “I don’t see it.”
   “No matter,” Jack said. He took several photographs even though he doubted the rash would show up. The flash often washed out such subtle findings.
   As Jack continued the external exam he found himself progressively mystified. The patient had come in with a presumed diagnosis of pneumonic plague, and externally he resembled a plague victim, as Vinnie had pointed out. Yet there were discrepancies. The record indicated he’d had a negative test for plague, which made Jack suspect tularemia.
   But tularemia seemed implausible because the patient’s sputum test had shown no free bacteria. To complicate things further, the patient had had severe enough abdominal symptoms to suggest appendicitis, which he proved not to have. And on top of that he had a rash on his palms and soles.
   At that point Jack had no idea what he was dealing with. As far as he was concerned, he doubted the case was either plague or tularemia!
   Starting the internal exam, he immediately came across strong presumptive evidence that substantiated his belief. The lymphatics were minimally involved.
   Slicing open the lung, Jack also detected a difference even on gross from what he’d expect to see in either plague or tularemia. To Jack’s eye Lagenthorpe’s lung resembled heart failure more than it did infection. There was plenty of fluid but little consolidation.
   Turning to the other internal organs, Jack found almost all of them involved in the pathological process. The heart seemed acutely enlarged, as were the liver, the spleen, and the kidneys. Even the intestines were engorged, as if they had stopped functioning.
   “Got something interesting?” a husky voice demanded.
   Jack had been so absorbed, he hadn’t noticed that Calvin had nudged Vinnie aside.
   “I believe I do,” Jack managed.
   “Another infectious case?” another gruff voice asked.
   Jack’s head swung around to his left. He’d recognized the voice immediately, but he had to confirm his suspicion. He was right. It was the chief!
   “It came in as a presumed plague,” Jack said. He was surprised to see Bingham; the chief rarely came into the pit unless it was a highly unusual case or one that had immediate political ramifications.
   “Your tone suggests you don’t think it is,” Bingham said. He leaned over the open body and glanced in at the swollen, glistening organs.
   “You are very perceptive, sir,” Jack said. He made a specific effort to keep his patented sarcasm from his voice. This was one time he meant the compliment.
   “What do you think you have?” Bingham asked. He poked the swollen spleen gingerly with his gloved hand. “This spleen looks huge.”
   “I haven’t the faintest idea,” Jack said.
   “Dr. Washington informed me this morning that you’d made an impressive diagnosis on a case of tularemia yesterday,” Bingham said.
   “A lucky guess,” Jack said.
   “Not according to Dr. Washington,” Bingham said. “I’d like to compliment you. Following on the heels of your astute and rapid diagnosis of the case of plague, I’m impressed. I’m also impressed you left it up to me to inform the proper authorities. Keep up the good work. You make me happy I didn’t fire you yesterday.”
   “Now that’s a backhanded compliment,” Jack said. He chuckled, and so did Bingham.
   “Where’s the Martin case?” Bingham asked Calvin.
   Calvin pointed. “Table three, sir,” he said. “Dr. McGovern’s doing it. I’ll be over in a second.”
   Jack watched Bingham long enough to see Chet’s double take when he recognized the chief. Jack turned back to Calvin. “My feelings are hurt,” he said jokingly. “For a moment I thought the chief came all the way down here and suited up just to pay me a compliment.”
   “Dream on,” Calvin said. “You were an afterthought. He really came down about that gunshot wound Dr. McGovern is doing.”
   “Is it a problem case?” Jack asked.
   “Potentially,” Calvin said. “The police claim the victim was resisting arrest.”
   “That’s not so uncommon,” Jack said.
   “The problem is whether the bullets went in the front or the back,” Calvin said. “Also there were five of them. That’s a bit heavy-handed.”
   Jack nodded. He understood all too well and was glad he wasn’t doing the case.
   “The chief didn’t come down here to compliment you, but he did it just the same,” Calvin said. “He was impressed about the tularemia, and I have to admit I was too. That was a rapid and clever diagnosis. It’s worth ten bucks. But I’ll tell you something: I didn’t appreciate that little ruse you pulled in the chief’s office yesterday about our bet. You might have confused the chief for a moment, but you didn’t fool me.”
   “I assumed as much,” Jack said. “That’s why I changed the subject so quickly.”
   “I just wanted you to know,” Calvin said. Leaning over Lagenthorpe’s open corpse, he pushed on the spleen just as Bingham had done. “The chief was right,” he said. “This thing is swollen.”
   “So’s the heart and just about everything else,” Jack said.
   “What’s your guess?” Calvin asked.
   “This time I don’t even have a guess,” Jack admitted. “It’s another infectious disease, but I’m only willing to bet it’s not plague or tularemia. I’m really starting to question what they are doing over there at the General.”
   “Don’t get carried away,” Calvin said. “New York is a big city and the General is a big hospital. The way people move around today and with all the flights coming into Kennedy day in and day out, we can see any disease here, any time of the year.”
   “You’ve got a point,” Jack conceded.
   “Well, when you have an idea what it is, let me know,” Calvin said. “I want to win that twenty dollars back.”
   After Calvin left, Vinnie moved back into place. Jack took samples from all the organs and Vinnie saw to it that they were placed in preservative and properly labeled. After all the samples had been taken, they both sutured Lagenthorpe’s incision.
   Leaving Vinnie to take care of the body, Jack wandered over to Laurie’s table. He had her show him the cut surfaces of the lungs, liver, and spleen. The pathology mirrored that of Lopez and Hard. There were hundreds of incipient abscesses with granuloma formation.
   “Looks like another case of tularemia,” Laurie said.
   “I can’t argue with you,” Jack said. “But this issue of person-to-person spread being so rare bugs me. I don’t know how to explain it.”
   “Unless they all were exposed to the same source,” Laurie said.
   “Oh sure!” Jack exclaimed scornfully. “They all happened to go to the same spot in Connecticut and feed the same sick rabbit.”
   “I’m just suggesting the possibility,” Laurie complained.
   “I’m sorry,” Jack said. “You’re right. I shouldn’t jump on you. It’s just that these infectious disease cases are driving me bananas. I feel like I’m missing something important, and yet I have no idea what it could be.”
   “What about Lagenthorpe?” Laurie asked. “Do you think he had tularemia as well?”
   “No,” Jack said. “He seems to have had something completely different, and I have no idea what.”
   “Maybe you are getting too emotionally involved,” Laurie suggested.
   “Could be,” Jack said. He was feeling a bit guilty about wishing the worst for AmeriCare regarding the first case. “I’ll try to calm down. Maybe I should go do more reading on infectious diseases.”
   “That’s the spirit,” Laurie said. “Instead of stressing yourself out, you should treat these cases as an opportunity to learn. After all, that’s part of the fun of this job.”
   Jack tried vainly to peer through Laurie’s plastic face mask to get an idea of whether she was being serious or just mocking him. Unfortunately with all the reflections from the overhead lights, he couldn’t tell.
   Leaving Laurie, Jack stopped briefly at Chet’s table. Chet was not in a good mood.
   “Hell,” he said. “It’s going to take me all day to trace these bullet paths the way Bingham suggested. If he wants to be this particular, I wonder why he doesn’t do the case himself.”
   “Yell if you need any help,” Jack said. “I’ll be happy to come down and lend a hand.”
   “I might do that,” Chet said.
   Jack disposed of his protective gear, changed into his street clothes, and made sure his ventilation charger was plugged in. Then he got the autopsy folders for Lopez and Lagenthorpe. From Hester’s folder he looked up her next of kin. A sister was listed whose address was the same as the deceased. Jack surmised they were roommates. He copied down the phone number.
   Next Jack sought out Vinnie, whom he found coming out of the walk-in cooler where he’d just deposited Lagenthorpe’s corpse.
   “Where are all the samples from our two cases?” Jack asked.
   “I got ’em all under control,” Vinnie said.
   “I want to take them upstairs myself,” Jack said.
   “Are you sure?” Vinnie asked. Running up the samples to the various labs was always an excuse for a coffee break.
   “I’m positive,” Jack said.
   Once he was armed with all the samples plus the autopsy folders Jack set out for his office. But he made two detours. The first was to the microbiology lab, where he sought out Agnes Finn.
   “I was impressed with your diagnosis of tularemia,” Agnes said.
   “I’m getting a lot of compliments out of that one,” Jack said.
   “Got something for me today?” Agnes asked, eyeing Jack’s armful of samples.
   “I do, indeed,” Jack said. He found the appropriate sample from Lopez and put it on the corner of Agnes’s desk. “This is another probable tularemia. Another sample will come up from a case Laurie Montgomery is doing as we speak. I want them both tested for tularemia.”
   “The reference lab is very eager to follow up on the Hard case, so that won’t be difficult. I should have results back today. What else?”
   “Well, this one is a mystery,” Jack said. He put several samples from Lagenthorpe on Agnes’s desk. “I don’t have any idea what this patient had. All I know is that it’s not plague, and it’s not tularemia.”
   Jack went on to describe the Lagenthorpe case, giving Agnes all the positive findings. She was especially interested that no bacteria had been reported on the gram stain of the sputum.
   “Have you thought of virus?” Agnes asked.
   “As much as my limited infectious disease knowledge would allow,” Jack admitted. “Hantavirus crossed my mind, but there was not a lot of hemorrhage.”
   “I’ll start some viral screening with tissue cultures,” Agnes said.
   “I plan to do some reading and maybe I’ll have another idea,” Jack said.
   “I’ll be here,” Agnes assured him.
   Leaving microbiology, Jack went up to the fifth-floor histology lab.
   “Wake up, girls, we have a visitor,” one of the histology techs shouted. Laughter echoed around the room.
   Jack smiled. He always enjoyed visiting histology. The entire group of women who worked there always seemed to be in the best of moods. Jack was particularly fond of Maureen O’Conner, a busty redhead with a devilish twinkle in her eye. He was pleased when he saw her round the corner of the lab bench, wiping her hands on a towel. The front of her lab coat was stained a rainbow of colors.
   “Well now, Dr. Stapleton,” she said in her pleasant brogue. “What can we do for the likes of you?”
   “I need a favor,” Jack said.
   “A favor, he says,” Maureen repeated. “You hear that, girls? What should we ask in return?”
   More laughter erupted. It was common knowledge that Jack and Chet were the only two unmarried male doctors, and the histology women liked to tease them.
   Jack unloaded his armful of sample bottles, separating Lagenthorpe’s from Lopez’s.
   “I’d like to do frozen sections on Lagenthorpe,” he said. “Just a few slides from each organ. Of course, I want a set of the regular slides as well.”
   “What about stains?” Maureen asked.
   “Just the usual,” Jack said.
   “Are you looking for anything in particular?” Maureen inquired.
   “Some sort of microbe,” Jack said. “But that’s all I can tell you.”
   “We’ll give you a call,” Maureen said. “I’ll get right on it.”
   Back in his office, Jack went through his messages. There was nothing of interest. Clearing a space in front of himself, he set down Lopez’s and Lagenthorpe’s folders intending to dictate the autopsy findings and then call the next of kin. He even intended to call the next of kin of the case Laurie was doing. But instead his eye caught sight of his copy of Harrison’s textbook of medicine.
   Pulling out the book, Jack cracked it open to the section on infectious disease and began reading. There was a lot of material: almost five hundred pages. But he was able to scan quickly since much of it was information he’d committed to memory at some point in his professional career.
   Jack had gotten to the chapters on specific bacterial infections when Maureen called. She said that the frozen section slides were ready. Jack immediately walked down to the lab to retrieve them. He carried them back to his office and moved his microscope to the center of the desk.
   The slides were organized by organ. Jack looked at the sections of the lung first. What impressed him most was the amount of swelling of the lung tissue and the fact that he saw no bacteria.
   Looking at the heart sections, he could immediately see why the heart had appeared swollen. There was a massive amount of inflammation, and the spaces between the heart muscle cells were filled with fluid.
   Switching to a higher power of magnification, Jack immediately appreciated the primary pathology. The cells lining the blood vessels that coursed through the heart were severely damaged. As a result, many of these blood vessels had become occluded with blood clots, causing multiple tiny heart attacks!
   With a shot of adrenaline coursing through his own circulation from the excitement of discovery, Jack quickly switched back to the section of lung. Using the same high power he saw identical pathology in the walls of the tiny blood vessels, a finding he hadn’t noticed on his first examination.
   Jack exchanged the lung section with one from the spleen. Adjusting the focus, he saw the same pathology. Obviously it was a significant finding, one that immediately suggested a possible diagnosis.
   Jack pushed back from his desk and made a quick trip back to the micro lab and sought out Agnes. He found her at one of the lab’s many incubators.
   “Hold up on the tissue cultures on Lagenthorpe,” he said breathlessly. “I got some new information you’re going to love.”
   Agnes regarded him curiously through her thick glasses.
   “It’s an endothelial disease,” Jack said excitedly. “The patient had an acute infectious disease without bacteria seen or cultured. That should have given it away. He also had the faintest beginnings of a rash that included his palms and soles. Plus he’d been suspected of having appendicitis. Guess why?”
   “Muscle tenderness,” Agnes said.
   “Exactly,” Jack said. “So what does that make you think of?”
   “Rickettsia,” Agnes said.
   “Bingo,” Jack said, and he punched the air for emphasis. “Good old Rocky Mountain spotted fever. Now, can you confirm it?”
   “It’s as difficult as tularemia,” Agnes said. “We’ll have to send it out again. There is a direct immunofluorescent technique, but we don’t have the reagent. But I know the city reference lab has it, because there’d been an outbreak of Rocky Mountain spotted fever in the Bronx in eighty-seven.”
   “Get it over there right away,” Jack said. “Tell them we want a reading as soon as they can get it to us.”
   “Will do,” Agnes said.
   “You’re a doll,” Jack said.
   He started for the door. Before he got there Agnes called out to him: “I appreciate you letting me know about this as soon as you did,” she said. “Rickettsias are extremely dangerous for us lab workers. In an aerosol form it is highly contagious. It’s as bad or worse than tularemia.”
   “Needless to say, be careful,” Jack told her.

17. Friday, 12:15 p.m., March 22, 1996

   Helen Robinson brushed her hair with quick strokes. She was excited. Having just hung up the phone with her main contact at National Health’s home office, she wanted to get in to see Robert Barker as soon as possible. She knew he was going to love what she had to tell him.
   Stepping back from the mirror, Helen surveyed herself from both the right and the left. Satisfied, she closed the closet door and headed out of her office.
   Her usual method of contacting Robert was merely to drop in on him. But she thought the information she now had justified a more formal approach; she’d asked one of the secretaries to call ahead. The secretary had reported back that Robert was available at that very moment, not that Helen was surprised.
   Helen had been cultivating Robert for the last year. She started when it became apparent to her that Robert could ascend to the presidency. Sensing the man had a salacious streak, she’d deliberately fanned the fires of his imagination. It was easy, although she knew she treaded a fine line. She wanted to encourage him, but not to the point where she would have to openly deny him. In reality, she found him physically unpleasant at best.
   Helen’s goal was Robert’s position. She wanted to be executive director of accounts and could see no reason why she shouldn’t be. Her only problem was that she was younger than the others in the department. She felt that was the handicap that her “cultivation” of Robert could overcome.
   “Ah, Helen, my dear,” Robert said as Helen demurely stepped into his office. He leaped to his feet and closed the door behind her.
   Helen perched on the arm of the chair as was her custom. She crossed her legs and her skirt hiked up well above her knee. She noticed the photo of Robert’s wife was lying facedown as usual.
   “How about some coffee?” Robert offered, taking his seat and assuming his customary hypnotic stare.
   “I’ve just spoken with Gertrude Wilson over at National Health,” Helen began. “I’m sure you know her.”
   “Of course,” Robert said. “She’s one of the more senior vice presidents.”
   “She’s also one of my most trusted contacts,” Helen said. “And she is a fan of Willow and Heath.”
   “Uh-huh,” Robert said.
   “She told me two very interesting things,” Helen said. “First of all, National Health’s main hospital here in the city compares very favorably with other similar hospitals when it comes to hospital-based infections, or what they like to call nosocomial infections.”
   “Uh-huh,” Robert repeated.
   “National Health has followed all the recommendations of the CDC and the Joint Commission on Accreditation,” Helen said.
   Robert shook his head slightly, as if waking up. It had taken a moment for Helen’s comments to penetrate his preoccupied brain. “Wait a second,” he said. He looked away to organize his thoughts. “This doesn’t sound like good news to me. I thought my secretary told me you had good news.”
   “Hear me out,” Helen said. “Although they have an overall good nosocomial record, they’ve had some recent troubles in their New York facility that they’re very sensitive about and would hate to be made public. There were three episodes in particular. One involved an extended outbreak of staph in the intensive-care units. That gave them a real problem until it was discovered a number of the nursing staff were carriers and had to be given courses of antibiotics. I tell you, this stuff is frightening when you hear about it.”
   “What were the other problems?” Robert asked. For the moment he tried to avoid looking at Helen.
   “They had another kind of bacterial problem originate in their kitchen,” Helen said. “A lot of patients got serious diarrhea. A few even died. And the last problem was an outbreak of hospital-based hepatitis. That killed several as well.”
   “That doesn’t sound like such a good record to me,” Robert said.
   “It is when you compare it with some of the other hospitals,” Helen said. “I tell you, it’s scary. But the point is that National Health is sensitive about this nosocomial infection issue. Gertrude specifically told me that National Health would never in a million years consider running an ad campaign based on it.”
   “Perfect!” Robert exclaimed. “That is good news. What have you told Terese Hagen?”
   “Nothing, of course,” Helen said. “You told me to brief you first.”
   “Excellent job!” Robert said. He pushed himself up onto his long, thin legs and paced. “This couldn’t be better. I’ve got Terese just where I want her.”
   “What do you want me to tell her?” Helen asked.
   “Just tell her that you have confirmed National Health has an excellent record vis-à-vis nosocomial infection,” Robert said. “I want to encourage her to go ahead with her campaign, because it will surely bomb.”
   “But we’ll lose the account,” Helen said.
   “Not necessarily,” Robert said. “You’ve found out in the past that they are interested in ‘talking heads’ spots with celebrities. We’ve communicated that to Terese time and time again and she has ignored it. I’m going to go behind her back and line up a few of the stars from some of the current hospital-based TV dramas. They’d be perfect for testimonials. Terese Hagen will bomb and we’ll be able to step in with our own campaign.”
   “Ingenious,” Helen said. She slid off the arm of her chair. “I’ll start the ball rolling by calling Terese Hagen immediately.”
   Helen scooted back to her own office and had a secretary put in a call to Terese. As she waited, she complimented herself on the conversation she’d just had with Robert. It couldn’t have gone any better had she scripted it. Her position in the firm was looking better and better.
   “Miss Hagen is downstairs in the arena,” the secretary reported. “Do you want me to call down there?”
   “No,” Helen said. “I’ll head down there in person.”
   Leaving the carpeted tranquillity of the account executive area, Helen descended the stairs to the studio floor. Her pumps echoed loudly on the metal steps. She liked the idea of talking with Terese in person, although she’d not wanted to go to Terese’s office, where she’d feel intimidated.
   Helen rapped loudly on the doorjamb before entering. Terese was sitting at a large table covered with storyboards and tissues. Also present were Colleen Anderson, Alice Gerber, and a man Helen did not know. He was introduced as Nelson Friedman.
   “I’ve got the information you requested,” Helen said to Terese. She forced her face into a broad smile.
   “Good news or bad?” Terese asked.
   “I’d say very good,” Helen said.
   “Let’s have it,” Terese said. She leaned back in her chair.
   Helen described National Health’s positive nosocomial record. She even told Terese something she hadn’t told Robert: National Health’s hospital infection rates were better than AmeriCare’s at the General.
   “Fabulous,” Terese said. “That’s just what I wanted to know. You’ve been a big help. Thank you.”
   “Glad to be of service,” Helen said. “How are you coming with the campaign?”
   “I feel good about it,” Terese said. “By Monday we’ll have something for Taylor and Brian to see.”
   “Excellent,” Helen said. “Well, if I can do anything else, just let me know.”
   “Certainly,” Terese said. She walked Helen to the door, then waved as Helen disappeared into the stairwell.
   Terese returned to the table and sat back down.
   “Do you believe her?” Colleen asked.
   “I do,” Terese said. “Accounts wouldn’t risk lying about stats that we could presumably get elsewhere.”
   “I don’t see how you can trust her,” Colleen said. “I hate that plastic smile. It’s unnatural.”
   “Hey, I said I believed her,” Terese said. “I didn’t say I trusted her. That’s why I didn’t share with her what we are doing here.”
   “Speaking of what we are doing here,” Colleen said, “you haven’t exactly said you like it.”
   Terese sighed as her eyes ranged around at the scattered storyboards. “I like the Hippocrates sequence,” she said. “But I don’t know about this Oliver Wendell Holmes and this Joseph Lister material. I understand how important washing hands is even in a modern hospital, but it’s not zippy.”
   “What about that doctor who was up here with you last night?” Alice asked. “Since he suggested this handwashing stuff, maybe he’ll have more of an idea now that we’ve sketched it out.”
   Colleen glanced up at Terese. She was dumbfounded. “You and Jack came here last night?” she asked.
   “Yeah, we stopped by,” Terese said casually. She reached out and adjusted one of the storyboards so she could see it better.
   “You didn’t tell me that,” Colleen said.
   “You didn’t ask,” Terese said. “But it’s no secret, if that’s what you are implying. My relationship with Jack is not romantic.”
   “And you guys talked about this ad campaign?” Colleen asked. “I didn’t think you wanted him to know about it, especially since he’d been kinda responsible for the idea.”
   “I changed my mind,” Terese said. “I thought he might like it since it deals with the quality of medical care.”
   “You’re full of surprises,” Colleen commented.
   “Having Jack and Chet take a look at this is not a bad idea,” Terese said. “A professional response might be helpful.”
   “I’d be happy to make the call,” Colleen offered.

18. Friday, 2:45 p.m., March 22, 1996

   Jack had been on the phone for over an hour, calling the next of kin of that day’s three infectious disease cases. He’d talked with Laurie before calling Joy Hester’s sister and roommate. Jack didn’t want Laurie to think he was trying to take over her case, but she assured him she didn’t mind.
   Unfortunately Jack did not learn anything positive. All he was able to do was to confirm a series of negatives, such as that none of the patients had had contact with wild animals in general or wild rabbits in particular. Only Donald Lagenthorpe had had contact with a pet, and that was his girlfriend’s newly acquired cat, which was alive and well.
   Hanging up at the end of the final call, Jack slouched down in his chair and stared moodily at the blank wall. The adrenaline rush he’d felt earlier with the tentative diagnosis of Rocky Mountain spotted fever had given way to frustration. He seemed to be making no headway.
   The phone startled Jack and pulled him out of his gloom. The caller identified himself as Dr. Gary Eckhart, a microbiologist at the city reference lab.
   “Are you Dr. Stapleton?”
   “Yes, I am,” Jack said.
   “I’m reporting a positive reaction for Rickettsia rickettsii,” Dr. Eckhart said. “Your patient had Rocky Mountain spotted fever. Will you be reporting this to the Board of Health or do you want me to do it?”
   “You do it,” Jack said. “I’m not even sure I’d know whom to call.”
   “Consider it done,” Dr. Eckhart said. He hung up.
   Jack slowly replaced the receiver. That his diagnosis had been confirmed was as much of a shock as it had been when his diagnoses of the plague and tularemia had been confirmed. These developments were incredible. Within three days he’d seen three relatively rare infectious diseases.
   Only in New York, he thought. In his mind’s eye he saw all those planes Calvin had made reference to arriving at Kennedy Airport from all over the world.
   But Jack’s shock began to metamorphose to disbelief. Even with all the planes and all the people arriving from exotic locales carrying all manner of vermin, bugs, and microbes, it seemed too much of a coincidence to see back-to-back cases of plague, tularemia, and now Rocky Mountain spotted fever. Jack’s analytical mind tried to imagine what the probability of such an occurrence would be.
   “I’d say about zero,” he said out loud.
   Suddenly Jack pushed back from his desk and stormed out of his office. His disbelief was now changing to something akin to anger. Jack was sure something weird was going on, and for the moment he was taking it personally. Believing that something had to be done, he headed downstairs and presented himself to Mrs. Sanford. He demanded to talk with the chief.
   “I’m afraid Dr. Bingham is over at City Hall meeting with the mayor and the chief of police,” Mrs. Sanford said.
   “Oh, hell!” Jack exclaimed. “Is he moving in over there or what?”
   “There’s a lot of controversy surrounding that gunshot case this morning,” Mrs. Sanford said warily.
   “When will he be back?” Jack demanded. Bingham’s being unavailable was adding to his frustration.
   “I just don’t know,” Mrs. Sanford said. “But I’ll be sure to tell him you want to speak with him.”
   “What about Dr. Washington?”
   “He’s at the same meeting,” Mrs. Sanford said.
   “Oh, great!”
   “Is there something I can help you with?” Mrs. Sanford asked.
   Jack thought for a moment. “How about a piece of paper,” he said. “I think I’ll leave a note.”
   Mrs. Sanford handed him a sheet of typing paper. In block letters Jack wrote: LAGENTHORPE HAD ROCKY MOUNTAIN SPOTTED FEVER. Then he drew a half dozen large question marks and exclamation points. Beneath that he wrote: THE CITY BOARD OF HEALTH HAS BEEN NOTIFIED BY THE CITY MICROBIOLOGICAL REFERENCE LAB.
   Jack handed the sheet to Mrs. Sanford, who promised that she’d personally see to it that Dr. Bingham got it as soon as he came in. Then she asked Jack where he’d be if the chief wanted to speak with him.
   “Depends on when he gets back,” Jack said. “I plan to be out of the office for a while. Of course, he might hear about me before he hears from me.”
   Mrs. Sanford regarded him quizzically, but Jack didn’t elaborate.
   Jack returned to his office and grabbed his jacket. Then he descended to the morgue and unlocked his bike. Bingham’s exhortations notwithstanding, Jack was on his way to the Manhattan General Hospital. For two days he’d had the suspicion that something unusual was going on over there; now he was sure of it.
   After a quick ride, Jack locked his bike to the same sign he’d used on his previous visits and entered the hospital. With visiting hours just beginning, the lobby was jammed with people, particularly around the information booth.
   Jack wormed his way through the crowd and climbed the stairs to the second floor. He went directly to the lab and waited in line to speak with the receptionist. This time he asked to see the director, even though his impulse was to march right in.
   Martin Cheveau made Jack wait for a half hour before seeing him. Jack tried to use the time to calm himself. He recognized that over the last four or five years he’d become less than tactful in the best of circumstances; when he was upset, as he was now, he could be abrasive.
   A laboratory tech eventually came out and informed Jack that Dr. Martin Cheveau would see him now.
   “Thanks for seeing me so promptly,” Jack said as he entered the office. Despite his best intentions he couldn’t avoid a touch of sarcasm.
   “I’m a busy man,” Martin said, not bothering to stand up.
   “I can well imagine,” Jack said. “With the string of rare infectious diseases emanating from this hospital on a daily basis, I’d think you’d be putting in overtime.”
   “Dr. Stapleton,” Martin said in a controlled voice. “I have to tell you that I find your attitude distinctly disagreeable.”
   “I find yours confusing,” Jack said. “On my first visit you were the picture of hospitality. On my second visit, you were just the opposite.”
   “Unfortunately I don’t have time for this conversation,” Martin said. “Is there something in particular you wanted to say to me?”
   “Obviously,” Jack said. “I didn’t come over here just for abuse. I wanted to ask your professional opinion about how you think three rare, arthropod-borne diseases have mysteriously occurred in this hospital. I’ve been cultivating my own opinion, but as the director of the lab I’m curious about yours.”
   “What do you mean three diseases?” Martin asked.
   “I just got confirmation that a patient named Lagenthorpe who expired here in the General last night had Rocky Mountain spotted fever.”
   “I don’t believe you,” Martin said.
   Jack eyed the man and tried to decide if he was a good actor or truly surprised.
   “Well then, let me ask you a question,” Jack said. “What would I accomplish by coming over here and telling you something that wasn’t true? Do you think of me as some sort of health-care provocateur?”
   Martin didn’t answer. Instead he picked up the phone and paged Dr. Mary Zimmerman.
   “Calling in reinforcements?” Jack asked. “Why can’t you and I have a talk?”
   “I’m not sure you are capable of normal conversation,” Martin said.
   “Good technique,” Jack commented. “When defense doesn’t work, switch to offense. The problem is, strategies won’t change the facts. Rickettsias are extremely dangerous in the laboratory. Maybe we should make sure whoever handled Lagenthorpe’s specimens did so with proper precautions.”
   Martin pressed his intercom button and paged his chief microbiology tech, Richard Overstreet.
   “Another thing I’d like to discuss,” Jack said. “On my first visit here you told me how discouraging it was to run your lab with the budgets foisted on you by AmeriCare. On a scale of one to ten, how disgruntled are you?”
   “What are you implying?” Martin demanded ominously.
   “At the moment I’m not implying anything,” Jack said. “I’m just asking.”
   The phone rang and Martin picked it up. It was Dr. Mary Zimmerman. Martin asked her if she could come down to the lab since something important had just come up.
   “The problem as I see it is that the probability of these three illnesses popping up as they have is close to zero,” Jack said. “How would you explain it?”
   “I don’t have to listen to this,” Martin snarled.
   “But I think you have to consider it,” Jack said.
   Richard Overstreet appeared in the doorway dressed as he’d been before, in a white lab coat over surgical scrubs. He appeared harried.
   “What is it, Chief?” he asked. He nodded a greeting to Jack, who returned the gesture.
   “I’ve just learned a patient by the name of Lagenthorpe expired from Rocky Mountain spotted fever,” Martin said gruffly. “Find out who got the samples and who processed them.”
   Richard stood for a moment, obviously shocked by the news. “That means we had rickettsia in the lab,” he said.
   “I’m afraid so,” Martin said. “Get right back to me.” Richard vanished and Martin turned back to Jack. “Now that you have brought us this happy news, perhaps you could do us the favor and leave.”
   “I’d prefer to hear your opinion as to the origin of these diseases,” Jack said.
   Martin’s face flushed, but before he could respond Dr. Mary Zimmerman appeared at his door.
   “What can I do for you, Martin?” she asked. She started to tell him that she’d just been paged to the ER when she caught sight of Jack. Her eyes narrowed. She was obviously no happier than Martin to see Jack.
   “Howdy, Doctor,” Jack said cheerfully.
   “I was assured we would not see you again,” Dr. Zimmerman said.
   “You can never believe everything you hear,” Jack said.
   Just then Richard returned, clearly distraught. “It was Nancy Wiggens,” he blurted out. “She’s the one who got the sample and processed it herself. She called in sick this morning.”
   Dr. Zimmerman consulted a note she held in her hand. “Wiggens is one of the patients I’ve just been called to see in the ER,” she said. “Apparently she’s suffering from some sort of fulminant infection.”
   “Oh, no!” Richard said.
   “What’s going on here?” Dr. Zimmerman demanded.
   “Dr. Stapleton just brought news that a patient of ours died from Rocky Mountain spotted fever,” Martin said. “Nancy was exposed.”
   “Not here in the lab,” Richard said. “I’ve been a bear about safety. Ever since the plague case I have insisted all infectious material be handled in the biosafety III cabinet. If she were exposed it had to be from the patient.”
   “That’s not likely,” Jack said. “The only other possibility is that the hospital is lousy with ticks.”
   “Dr. Stapleton, your comments are tasteless and inappropriate,” Dr. Zimmerman said.
   “They are a lot worse than that,” Martin said. “Just before you got here, Dr. Zimmerman, he slanderously suggested that I had something to do with the spread of these latest illnesses.”
   “That’s not true,” Jack corrected. “I was merely implying that the idea of deliberate spread has to be considered when the probability of them occurring by chance is so negligible. It only makes sense. What’s wrong with you people?”
   “I think such thoughts are the product of a paranoid mind,” Dr. Zimmerman said. “And frankly I don’t have time for this nonsense. I’ve got to get to the ER. In addition to Miss Wiggens, there are two other employees with the same severe symptoms. Good-bye, Dr. Stapleton!”
   “Just a minute,” Jack said. “Let me guess what areas these two other stricken employees work in. Could they be from nursing and central supply?”
   Dr. Zimmerman, who was already several steps away from Martin’s door, paused and looked back at Jack. “How did you know that?” she asked.
   “I’m beginning to see a pattern,” Jack said. “I can’t explain it, but it’s there. I mean, the nurse is regrettable but understandable. But someone from central supply?”
   “Listen, Dr. Stapleton,” Dr. Zimmerman said. “Perhaps we’re in your debt for once again having alerted us to a dangerous disease. But we will take over from here, and we certainly don’t need any of your paranoid delusions. Good day, Dr. Stapleton.”
   “Hold on a minute,” Martin called out to Dr. Zimmerman. “I’ll come with you to the ER. If this is rickettsial disease I want to be sure all samples are handled safely.”
   Martin grabbed his long white lab coat from a hook behind the door and ran after Dr. Zimmerman.
   Jack shook his head in disbelief. Every visit he’d made to the General had been strange, and this one was no exception. On previous occasions he’d been chased out. This time he’d been all but deserted.
   “Do you really think these illnesses could have been spread deliberately?” Richard asked.
   Jack shrugged. “To tell you the truth, I don’t know what to think. But there certainly has been some defensive behavior, particularly on the part of those two who just left. Tell me, is Dr. Cheveau generally mercurial? He seemed to turn on me rather suddenly.”
   “He’s always been a gentleman with me,” Richard said.
   Jack got to his feet. “It must be me, then,” he said. “And I suppose our relations won’t improve after today. Such is life. Anyway, I’d better be going. I sure hope Nancy is okay.”
   “You and me both,” Richard said.
   Jack wandered out of the lab debating what to do next. He thought about either going to the emergency room to see about the three sick patients or heading up to central supply for another visit. He decided on the emergency room. Even though Dr. Zimmerman and Dr. Cheveau had headed down there, Jack thought the chance of another run-in was remote, given the size of the ER and the constant activity there.
   As soon as he arrived he detected a general panic. Charles Kelley was anxiously conferring with several other administrators. Then Clint Abelard came dashing through the main ambulance entry only to disappear down the central corridor.
   Jack went over to one of the nurses who was busy behind the main counter. He introduced himself and asked if the hubbub was about the three sick hospital staff.
   “It most certainly is,” she said. “They’re trying to decide how best to isolate them.”
   “Any diagnosis?” Jack asked.
   “I just heard they suspect Rocky Mountain spotted fever,” the nurse said.
   “Pretty scary,” Jack said.
   “Very,” the nurse said. “One of the patients is a nurse.”
   Out of the corner of his eye Jack saw Kelley approaching. Jack quickly faced away. Kelley came to the desk and asked the nurse for the phone.
   Jack left the bustling ER. He thought about going up to central supply, but decided against it. Having come close to another confrontation with Charles Kelley, he thought it best to head back to the office. Although he hadn’t accomplished anything, at least he was leaving on his own volition.
   “Uh-oh! Where have you been?” Chet asked as Jack came into their office.
   “Over at the General,” Jack admitted. He started organizing the clutter on his desk.
   “At least you must have behaved yourself; there haven’t been any frantic calls from the front office.”
   “I was a good boy,” Jack said. “Well, reasonably good. The place is in an uproar. They have another outbreak. This one is Rocky Mountain spotted fever. Can you believe it?”
   “That’s incredible,” Chet said.
   “That’s my feeling exactly,” Jack said. He went on to tell Chet how he’d implied to the head of the lab that outbreaks of three rare, infectious, arthropod-borne diseases in as many days couldn’t occur naturally.
   “I bet that went over well,” Chet said.
   “Oh, he was indignant,” Jack said. “But then he got preoccupied with some fresh cases and forgot about me.”
   “I’m surprised you weren’t thrown out again,” Chet said. “Why do you do this to yourself?”
   “Because I’m convinced that there’s ‘something rotten in the state of Denmark,’ ” Jack said. “But enough about me. How did your case go?”
   Chet gave a short, scornful laugh. “And to think I used to like gunshot cases,” he said. “This one is kicking up a storm. Three of the five bullets entered through the back.”
   “That’s going to give the police department a headache,” Jack said.
   “And me too,” Chet said. “Oh, by the way, I got a call from Colleen. She wants you and me to come by their studio when we leave work tonight. Listen to this: They want our opinion about some ads. What do you say?”
   “You go,” Jack said. “I’ve got to get some of these cases of mine signed out. I’m so far behind it’s scaring me.”
   “But they want both of us,” Chet said. “Colleen specifically said that. In fact, she said they particularly wanted you there because you had helped already. Come on, it will be fun. They are going to show us a bunch of sketches outlining some potential TV commercials.”
   “Is that really your idea of fun?” Jack asked.
   “Okay,” Chet admitted. “I’ve an ulterior motive. I’m enjoying spending time with Colleen. But they want both of us. Help me out.”
   “All right,” Jack said. “But for the life of me I don’t understand why you think you need me.”

19. Friday, 9:00 p.m., March 22, 1996

   Jack had insisted on working late. Chet had obliged by fetching Chinese takeout so Jack could continue. Once Jack got started, he hated to stop. By eight-thirty Colleen had called, wondering where they were. Chet had to nag Jack to get him to turn off his microscope and lay down his pen.
   The next problem was Jack’s bike. After much discussion it was decided that Chet would take a taxi and Jack would ride as he normally did. They then met in front of Willow and Heath after having arrived almost simultaneously.
   A night watchman opened the door for them and made them sign in. They boarded the only functioning elevator, and Jack promptly pressed the eleventh floor.
   “You really were here,” Chet said.
   “I told you I was,” Jack said.
   “I thought you were pulling my leg,” Chet remarked.
   When the doors opened Chet was as surprised as Jack had been the night before. The studio was in full swing, as if it were still sometime between nine and five, instead of almost nine in the evening.
   The two men stood for a few minutes watching the bustle. They were totally ignored.
   “Some welcoming party,” Jack commented.
   “Maybe someone should tell them it’s after quitting time,” Chet said.
   Jack peered into Colleen’s office. The lights were on but no one was there. Turning around, he recognized Alice toiling at her drawing board. He walked over to her, but she didn’t look up.
   “Excuse me?” Jack said. She was working with such concentration he hated to bother her. “Hello, hello.”
   Finally Alice’s head bobbed up, and when she caught sight of him, her face reflected instant recognition.
   “Oh, gosh, sorry,” she said, wiping her hands on a towel. “Welcome!” She acted self-conscious; she’d not seen them arrive as she stood and motioned for them to follow her. “Come on! I’m supposed to take you down to the arena.”
   “Uh-oh,” Chet said. “That doesn’t sound good. They must think we’re Christians.”
   Alice laughed. “Creatives are sacrificed in the arena, not Christians,” she explained.
   Terese and Colleen greeted them with air kisses: the mere touching of cheeks accompanied by a smacking sound. It was the kind of ritual that made Jack feel distinctly uncomfortable.
   Terese got right to business. She had the men sit at the table while she and Colleen began putting storyboards in front of them, maintaining a running commentary on what the storyboards represented.
   Both Jack and Chet were entertained from the start. They were particularly taken by the humorous sketches involving Oliver Wendell Holmes and Joseph Lister visiting the National Health hospital and inspecting the hospital’s handwashing protocols. At the conclusion of each commercial these famous characters in the history of medicine commented on how much more scrupulously the National Health hospital followed their teachings than that “other” hospital.
   “Well, there you have it,” Terese said after the last storyboard was explained and withdrawn. “What do you men think?”
   “They’re cute,” Jack admitted. “And probably effective. But they are hardly worth the money that’s going to be spent on them.”
   “But they deal with something associated with the quality of care,” Terese said defensively.
   “Barely,” Jack said. “The National Health subscribers would be better off if the millions spent on this were put into actual health care.”
   “Well, I love them,” Chet said. “They’re so fresh and delightfully humorous. I think they’re great.”
   “I assume the ‘other’ hospital refers to the competition,” Jack said.
   “Most assuredly,” Terese said. “We feel it would be in bad taste to mention the General by name, especially in light of the problems it’s been having.”
   “Their problems are getting worse,” Jack said. “They’ve had an outbreak of another serious disease. This makes three in three days.”
   “Good God!” Terese exclaimed. “That’s awful. I certainly hope this gets to the media, or is this one going to be a secret?”
   “I don’t know why you keep making this an issue,” Jack snapped. “There’s no way it can be kept a secret.”
   “It would be if AmeriCare had its way,” Terese said heatedly.
   “Hey, are you guys at it again?” Chet said.
   “It’s an ongoing argument,” Terese said. “I just can’t get over the fact that Jack does not feel it is his job as a public servant to let the media and hence the public know about these awful diseases.”
   “I told you I’ve been specifically informed it is not my job,” Jack shot back.
   “Wait! Time out,” Chet called out. “Listen, Terese, Jack is right. We can’t go to the media ourselves. That’s the chief’s domain via the PR office. But Jack is no slouch in all this. Today he went flying over to the General and implied right to their faces that these recent outbreaks aren’t natural.”
   “What do you mean, not ‘natural’?” Terese asked.
   “Exactly that,” Chet said. “If they are not natural, then they are deliberate. Somebody is causing them.”
   “Is that true?” Terese asked Jack. She was shocked.
   “It’s gone through my mind,” Jack admitted. “I’m having trouble explaining scientifically everything that has been going on over there.”
   “Why would someone do that?” Terese wondered. “It’s absurd.”
   “Is it?” Jack asked.
   “Could it be the work of some crazy person?” Colleen offered.
   “That I’d doubt,” Jack said. “There is too much expertise involved. And these bugs are dangerous to handle. One of the current victims is a lab technician.”
   “What about a disgruntled employee?” Chet suggested. “Someone with the knowledge and a grudge who’s snapped.”
   “That I think is more likely than some madman,” Jack said. “In fact, the director of the hospital lab is unhappy with the management of the hospital. He told me so himself. He’s had to lay off twenty percent of his workforce.”
   “Oh my God,” Colleen exclaimed. “Do you think it could be him?”
   “Actually I don’t,” Jack said. “Frankly, too many arrows would point to the director of the lab. He’d be the first suspect. He’s been acting defensive, but he’s not stupid. I think that if this series of diseases has been spread deliberately it has to be for a more venal reason.”
   “Like what?” Terese said. “I think we’re all jumping off the deep end here.”
   “Maybe so,” Jack said. “But we have to remember that AmeriCare is first and foremost a business. I even know something about their philosophy. Believe me, it is bottom-line oriented all the way.”
   “You’re suggesting that AmeriCare might be spreading disease in its own facility?” Terese asked incredulously. “That doesn’t make any sense.”
   “I’m just thinking out loud,” Jack explained. “For the sake of argument let’s assume these illnesses have been deliberately spread. Now, let’s look at the index case in each incidence. First, there was Nodelman, who had diabetes. Second, there was Hard, who had a chronic orthopedic problem, and lastly there was Lagenthorpe, who suffered from chronic asthma.”
   “I see what you’re suggesting,” Chet said. “All of the index cases were the type of patient prepaid plans hate because they lose money on them. They simply use too much medical care.”
   “Oh, come on!” Terese complained. “This is ridiculous. No wonder you doctors make such horrid businessmen. AmeriCare would never risk this kind of public relations disaster to rid itself of three problem patients. It would make no sense. Give me a break!”
   “Terese is probably right,” Jack admitted. “If AmeriCare was behind all this, they certainly could have done it more expeditiously. What truly worries me is that infectious agents are involved. If these outbreaks have been deliberate, the individual behind them wants to start epidemics, not just eliminate specific patients.”
   “That’s even more diabolical,” Terese said.
   “I agree,” Jack said. “It kind of forces us back to considering the improbable idea of a crazy person.”
   “But if someone is trying to start epidemics, why hasn’t there been one?” Colleen asked.
   “For several reasons,” Jack said. “First of all, the diagnosis has been made relatively rapidly in all three cases. Second, the General has taken these outbreaks seriously and has taken appropriate steps to control them. And third, the agents involved are poor choices for creating an epidemic here in New York in March.”
   “You’ll have to explain,” Colleen said.
   “Plague, tularemia, and Rocky Mountain spotted fever can be transmitted by airborne spread, but it is not their usual route. The usual route is through an arthropod vector, and those specific bugs are not available this time of year, especially not in a hospital.”
   “What do you think of all this?” Terese asked Chet.
   “Me?” Chet asked with a self-conscious laugh. “I don’t know what to think.”
   “Come on,” Terese prodded. “Don’t try to protect your friend here. What’s your gut reaction?”
   “Well, it is New York,” Chet said. “We see a lot of infectious diseases, so I suppose I’m dubious about this notion of a deliberate spread. I guess I’d have to say it sounds a little paranoid to me. I do know that Jack dislikes AmeriCare.”
   “Is that true?” Terese asked Jack.
   “I hate them,” Jack admitted.
   “Why?”
   “I’d rather not talk about it,” Jack said. “It’s personal.”
   “Well,” Terese said. She put her hand on top of the stack of storyboards. “Dr. Stapleton’s disdain for medical advertising aside, you men think these sketches are okay?”
   “I told you, I think they’re great,” Chet said.
   “I imagine they will be effective,” Jack grudgingly agreed.
   “Do either of you have any other suggestions we could use regarding preventing hospital infections?” Terese asked.
   “Maybe you could do something concerning steam sterilization for instruments and devices,” Jack said. “Hospitals differ in their protocols. Robert Koch was involved with that advance, and he was a colorful character.”
   Terese wrote down the suggestion. “Anything else?” she asked.
   “I’m afraid I’m not very good at this,” Chet admitted. “But why don’t we all head over to the Auction House for a couple of drinks. With the proper lubricant, who knows what I might come up with?”
   The women declined. Terese explained that they had to continue working on the sketches. She said that by Monday they had to have something significant to show to the president and the CEO.
   “How about tomorrow night?” Chet suggested.
   “We’ll see,” Terese said.
   Five minutes later Jack and Chet were heading down in the elevator.
   “That was the bum’s rush,” Chet complained.
   “They are driven women,” Jack said.
   “How about you?” Chet asked. “Want to stop for a beer?”
   “I think I’ll head home and see if the guys are playing basketball,” Jack said. “I could use some exercise. I feel wired.”
   “Basketball at this hour?” Chet questioned.
   “Friday night is a big night in the neighborhood,” Jack said.
   The two men parted company in front of the Willow and Heath building. Chet jumped into a cab, and Jack undid his medley of locks. Climbing on his bike, Jack pedaled north on Madison, then crossed over to Fifth Avenue at Fifty-ninth Street. From there he entered Central Park.
   Although his usual style was to ride fast, Jack kept his pace slow. He was mulling over the conversation he’d just had. It had been the first time that he’d put his suspicions into words; he felt anxious as a result.
   Chet had suggested he was paranoid, and Jack had to admit there had to be some truth in it. Ever since AmeriCare had effectively gobbled up his practice, Jack felt that death had been stalking him. First it had robbed him of his family, then it had threatened his own life with depression. It had even filled his daily routine with the second specialty he’d chosen. And now death seemed to be teasing him with these outbreaks, even mocking him with inexplicable details.
   As Jack rode deeper into the dark, deserted park, its gloomy and somber views added to his disquietude. In areas where he’d seen beauty that morning on his way to work, now he saw ghastly skeletons of leafless trees silhouetted against an eerily bleached sky. Even the distant sawtooth skyline of the city seemed ominous.
   Jack put muscle into his pedaling, and his bike gained speed. For an irrational moment he was afraid to look back over his shoulder. He had the creepy feeling that something was bearing down on him.
   Jack streaked into a puddle of light beneath a lonely streetlight, braked, and skidded to a stop. He forced himself to turn around and face his pursuer. But there was nothing there. Jack strained to see into the distant shadows, and as he did, he understood that what was threatening him was coming from inside his own head. It was the depression that had paralyzed him after his family’s tragedy.
   Angry with himself, Jack began pedaling again. He was embarrassed by his childlike fear. He thought he had more control. Obviously he was letting this episode with the outbreaks affect him far too much. Laurie had been right: He was too emotionally involved.
   Having faced his fears, Jack felt better, but he noticed that the park still looked sinister. People had warned him about riding in the park at night, but Jack had always ignored their admonitions. Now, for the first time, he wondered if he was being foolish.
   Emerging from the park onto Central Park West was like escaping from a nightmare. From the dark, scary loneliness of the park’s interior he was instantly thrust into a rallylike bustle of yellow cabs racing northward. The city had come alive. There were even people calmly walking on the sidewalks.
   The farther north Jack rode the more the environment deteriorated. Beyond 100th Street the buildings became noticeably shabbier. Some were even boarded up and appeared abandoned. There was more litter in the street. Stray dogs plundered overturned trash cans.
   Jack turned left onto 106th Street. As he rode along his street the neighborhood seemed more depressed than usual to him. The minor epiphany in the park had opened Jack’s eyes to just how dilapidated the area was.
   Jack stopped at the playground where he played basketball by grabbing onto the chain-link fence that separated it from the street. His feet remained snug in his toe clips.
   As Jack had expected, the court was in full use. The mercury vapor lights that he’d paid to be installed were ablaze. Jack recognized many of the players as they surged up and down the court. Warren, by far the best player, was there, and Jack could hear him urging his teammates to greater effort. The team that lost would have to sit out, since a bevy of other players waited impatiently on the sidelines. The competition was always fierce.
   While Jack was watching, Warren sank the final basket of the game and the losing team slunk off the court, momentarily disgraced. As the new game was being organized Warren caught sight of Jack. He waved and strutted over. It was the winning team walk.
   “Hey, Doc, whatcha know?” Warren asked. “You coming out to run or what?”
   Warren was a handsome African-American with a shaved head, a groomed mustache, and a body like one of the Greek statues in the Metropolitan Museum. It had taken Jack several months to cultivate Warren’s acquaintance. They had developed a friendship of sorts, but it was based more on a shared love of street basketball than anything else. Jack didn’t know much about Warren except that he was the best basketball player and also the de facto leader of the local gang. Jack suspected that the two positions went hand in hand.
   “I was thinking about coming out for a run,” Jack said. “Who’s got winners?”
   Getting into the game could be a tricky business. When Jack had first moved to the neighborhood, it had taken him a month of coming to the court and patiently waiting until he’d been invited to play. Then he’d had to prove himself. Once he’d demonstrated he was capable of putting the ball in the basket on a consistent basis, he’d been tolerated.
   Things got a bit better when Jack had paid to have the lights installed and the backboards refurbished, but not a lot. There were only two other honkies besides Jack who were allowed to play. Being Caucasian was a definite disadvantage on the neighborhood playground: you had to know the rules.
   “Ron’s got winners and then Jake,” Warren said. “But I can get you on my team. Flash’s old lady wants him home.”
   “I’ll be out,” Jack said. He pushed off from the fence and rode the rest of the way to his building.
   Jack got off his bike and hefted it up onto his shoulder. Before he entered his building he looked up at its facade. In his current critical state of mind he had to admit it wasn’t pretty. In fact, it was a downright sorry structure, although at one time it must have been rather fancy, because a small segment of highly decorative cornice still clung precariously to the roofline. Two of the windows on the third floor were boarded up.
   The building was six stories, constructed of brick, and had two apartments per floor. Jack shared the fourth floor with Denise, a husbandless teenager with two children.
   Jack pushed the front door open with his foot. It had no lock. He started up the stairs, careful to avoid any debris. As Jack passed the second floor he heard the sorry sounds of a vehement argument, followed by the noise of breaking glass. Unfortunately, this was a nightly occurrence.
   With the bike balanced on his shoulder, it took Jack some maneuvering to get himself situated in front of his apartment door. He was fumbling in his pocket for his key when he noticed he didn’t need it. The doorjamb opposite his lock was splintered.
   Jack pushed his door open. It was dark inside. He listened but only heard renewed yelling from 2A and the traffic out in the street. His apartment was eerily quiet. He put his bike down and reached in and turned on the overhead light.
   The living room was in shambles. Jack didn’t have much furniture, but what he had was either tipped over, emptied, or broken. He noticed that a small radio that usually stood on the desk was gone.
   Jack wheeled the bike into the room and leaned it against the wall. He took off his jacket and draped it over the bike. Then he walked over to the desk. The drawers had been pulled out and dumped. Amid the rubble on the floor was a photo album. Jack bent down and picked it up. He opened the cover and breathed a sigh of relief. It was unscathed. It was the only possession he cared about.
   Jack placed the photo album on the windowsill and walked into the bedroom. He switched on the light and saw a similar scene. Most of his clothes had been pulled from his closet and from his bureau and tossed onto the floor.
   The condition of the bathroom mirrored that of the living room and the bedroom. The contents of the medicine cabinet had been dumped into the bathtub.
   Jack walked from the bedroom to the kitchen. Expecting more of the same, he flipped on the light. A slight gasp escaped from his lips.
   “We were beginning to wonder about you,” a large African-American male said. He was sitting at Jack’s table, dressed totally in black leather, including gloves and a visorless hat. “We’d run out of your beer and we were getting antsy.”
   There were three other men dressed in identical fashion to the first. One was half sitting on the windowsill. The two others were to Jack’s immediate right, leaning against the kitchen cabinet. On the table was an impressive array of weaponry, including machine pistols.
   Jack didn’t recognize any of these men. He was shocked that they were still there. He’d been robbed before but nobody had stayed to drink his beer.
   “How about coming over and sitting yourself down?” the large black man said.
   Jack hesitated. He knew the door to the hall was open. Could he make it before they picked up their guns? Jack doubted it, and he wasn’t about to try.
   “Come on, man,” the black man said. “Get your white ass over here!”
   Reluctantly Jack did as he was told. Warily he sat down and faced his uninvited visitor.
   “We might as well be civilized about this,” the black man said. “My name is Twin. This here’s Reginald.” Twin pointed to the man at the window.
   Jack glanced in Reginald’s direction. He was toying with a toothpick and sucking his teeth. He regarded Jack with obvious disdain. Although he wasn’t quite as muscular as Warren, he was in the same category. Jack could see he had the words “Black Kings” tattooed on the volar surface of his right forearm.
   “Now Reginald is pissed,” Twin continued, “because you ain’t got shit here in this apartment. I mean, there isn’t even a TV. You see, part of the deal was that we’d have pickings over your stuff.”
   “What kind of deal are you talking about?” Jack asked.
   “Let’s put it this way,” Twin said. “Me and my brothers are being paid some small change to come way the hell over here to rough you up a bit. Nothing major, despite the artillery you see on the table. It’s supposed to be some kind of warning. Now, I don’t know the details, but apparently you’ve been making a pain of yourself at some hospital and got a bunch of people all riled up. I’m supposed to remind you to do your job and let them do theirs. Does that make any more sense to you than it does to me? I mean, I’ve never done anything like this before.”
   “I think I catch your drift,” Jack said.
   “I’m glad,” Twin said. “Otherwise we’d have to break a few fingers or something. We weren’t supposed to hurt you bad, but when Reginald starts, it’s hard to stop him, especially when he’s pissed. He needs something. Are you sure you don’t have a TV or something hidden around here?”
   “He just came in with a bike,” one of the other men said.
   “What about that, Reginald?” Twin asked. “You want a new bike?”
   Reginald leaned forward so he could see into the living room. He shrugged his shoulders.
   “I think you got yourself a deal,” Twin said. He stood up.
   “Who’s paying you to do this?” Jack asked.
   Twin raised his eyebrows and laughed. “Now, it wouldn’t be kosher of me to tell you that, now would it? But at least you’ve got the balls to ask.”
   Jack was about to ask another question when he was viciously cold-cocked by Twin. The force of the sucker punch knocked Jack over backward, and he sprawled limply on the floor. The room swam before his eyes. Hovering close to unconsciousness, he felt his wallet being pulled from his trousers. There was muffled laughter followed by a final agonizing kick in the stomach. Then there was absolute blackness.