10:40 p.m.
Manhattan General Hospital, New York City

   Terese Hagen tried to swallow, but it was difficult; her mouth was bone dry. A few minutes later her eyes blinked open, and for a moment she was disoriented. When she realized she was in a surgical recovery room it all came back to her in a flash.
   The problem had started without warning that evening just before she and Matthew were about to go out to dinner. There had been no pain. The first thing she was aware of was wetness, particularly on the inside of her thigh. Going into the bathroom, she was dismayed to find that she was bleeding. And it wasn’t just spotting. It was active hemorrhaging. Since she was five months pregnant, she was afraid it spelled trouble.
   Events had unfolded rapidly from that point. She’d been able to reach her physician, Dr. Carol Glanz, who offered to meet her at the Manhattan General’s emergency room. Once there, Terese’s suspicions had been confirmed and surgery scheduled. The doctor had said that it appeared as if the embryo had implanted in one of her tubes instead of the uterus—an ectopic pregnancy.
   Within minutes of her regaining consciousness, one of the recovery-room nurses was at her side, reassuring her that everything was fine.
   “What about my baby?” Terese asked. She could feel a bulky dressing over her disturbingly flat abdomen.
   “Your doctor knows more about that than I do,” the nurse said. “I’ll let her know you are awake. I know she wants to talk with you.”
   Before the nurse left, Terese complained about her dry throat. The nurse gave her some ice chips, and the cool fluid was a godsend.
   Terese closed her eyes. She guessed that she dozed off, because the next thing she knew was that Dr. Carol Glanz was calling her name.
   “How do you feel?” Dr. Glanz asked.
   Terese assured her she was fine thanks to the ice chips. She then asked about her baby.
   Dr. Glanz took a deep breath and reached out and put her hand on Terese’s shoulder. “I’m afraid I have double bad news,” she said.
   Terese could feel herself tense.
   “It was ectopic,” Dr. Glanz said, falling back on doctor jargon to make a difficult job a bit easier. “We had to terminate the pregnancy and, of course, the child was not viable.”
   Terese nodded, ostensibly without emotion. She had expected as much and had tried to prepare herself. What she wasn’t prepared for was what Dr. Glanz said next.
   “Unfortunately the operation wasn’t easy. There were some complications, which was why you were bleeding so profusely when you came into the emergency room. We had to sacrifice your uterus. We had to do a hysterectomy.”
   At first Terese’s brain was unable to comprehend what she’d been told. She nodded and looked expectantly at the doctor as if she anticipated more information.
   “I’m sure this is very upsetting for you,” Dr. Glanz said. “I want you to understand that everything was done that could have been done to avoid this unfortunate outcome.”
   Sudden comprehension of what she’d been told jolted Terese. Her silent voice broke free from its bounds and she cried: “No!”
   Dr. Glanz squeezed her shoulder in sympathy. “Since this was to be your first child, I know what this means to you,” she said. “I’m terribly sorry.”
   Terese groaned. It was such crushing news that for the moment she was beyond tears. She was numb. All her life she had assumed she would have children. It had been part of her identity. The idea that it was impossible was too difficult to grasp.
   “What about my husband?” Terese managed. “Has he been told?”
   “He has,” Dr. Glanz said. “I spoke to him as soon as I’d finished the case. He’s downstairs in your room, where I’m sure you’ll be going momentarily.”
   There was more conversation with Dr. Glanz, but Terese remembered little of it. The combined realization that she’d lost her child and would never be able to have another was devastating.
   A quarter hour later an orderly arrived to wheel her to her room. The trip went quickly; she was oblivious to her surroundings. Her mind was in turmoil; she needed reassurance and support.
   When she reached her room, Matthew was on his cellular phone. As a stockbroker, it was his constant companion.
   The floor nurses expertly transferred Terese to her bed and hung her IV on a pole behind her head. After making sure all was in order and encouraging her to call if she needed anything, they left.
   Terese looked over at Matthew, who had averted his gaze as he finished his call. She was concerned about his reaction to this catastrophe. They had been married for only three months.
   With a definitive click Matthew flipped his phone closed and slipped it into his jacket pocket. He turned to Terese and stared at her for a moment. His tie was loosened and his shirt collar unbuttoned.
   She tried to read his expression but couldn’t. He was chewing the inside of his cheek.
   “How are you?” he asked finally with little emotion.
   “As well as can be expected,” Terese managed. She desperately wanted him to come to her and hold her, but he kept his distance.
   “This is a curious state of affairs,” he said.
   “I’m not sure I know what you mean,” Terese said.
   “Simply that the main reason we got married has just evaporated,” Matthew said. “I’d say your planning has gone awry.”
   Terese’s mouth slowly dropped open. Stunned, she had to struggle to find her voice. “I don’t like your implication,” she said. “I didn’t get pregnant on purpose.”
   “Well, you have your reality and I have mine,” Matthew said. “The problem is: What are we going to do about it?”
   Terese closed her eyes. She couldn’t respond. It had been as if Matthew had plunged a knife into her heart. She knew from that moment that she didn’t love him. In fact she hated him…

1. Wednesday, 7:15 a.m., March 20, 1996
New York City

   “Excuse me,” Jack Stapleton said with false civility to the darkly complected Pakistani cabdriver. “Would you care to step out of your car so we can discuss this matter fully?”
   Jack was referring to the fact that the cabdriver had cut him off at the intersection of Forty-sixth Street and Second Avenue. In retaliation Jack had kicked the cab’s driver-side door when they had both stopped at a red light at Forty-fourth Street. Jack was on his Cannondale mountain bike that he used to commute to work.
   This morning’s confrontation was not unusual. Jack’s daily route included a hair-raising slalom down Second Avenue from Fifty-ninth Street to Thirtieth Street at breakneck speed. There were frequent close calls with trucks and taxicabs and the inevitable arguments. Anyone else would have found the trip nerve-racking. Jack loved it. As he explained to his colleagues, it got his blood circulating.
   Choosing to ignore Jack until the light turned green, the Pakistani cabdriver then cursed him soundly before speeding off.
   “And to you too!” Jack yelled back. He accelerated standing up until he reached a speed equal to the traffic. Then he settled onto the seat while his legs pumped furiously.
   Eventually he caught up with the offending cabdriver, but Jack ignored him. In fact, he whisked past him, squeezing between the taxi and a delivery van.
   At Thirtieth Street Jack turned east, crossed First Avenue, and abruptly turned into the loading bay of the Office of the Chief Medical Examiner for the City of New York. Jack had been working there for five months, having been offered a position as an associate medical examiner after finishing his pathology residency and a year’s fellowship in forensics.
   Jack wheeled his bike past the security office and waved at the uniformed guard. Turning left, he passed the mortuary office and entered the morgue itself. Turning left again, he passed a bank of the refrigerated compartments used to store bodies prior to autopsy. In a corner where simple pine coffins were stored for unclaimed bodies heading for Hart Island, Jack parked his bike and secured it with several Kryptonite locks.
   The elevator took Jack up to the first floor. It was well before eight in the morning and few of the daytime employees had arrived. Even Sergeant Murphy wasn’t in the office assigned to the police.
   Passing through the communications room, Jack entered the ID area. He said hello to Vinnie Amendola, who returned the greeting without looking up from his newspaper. Vinnie was one of the mortuary techs who worked with Jack frequently.
   Jack also said hello to Laurie Montgomery, one of the board-certified forensic pathologists. It was her turn in the rotation to be in charge of assigning the cases that had come in during the night. She’d been at the Office of the Chief Medical Examiner for four and a half years. Like Jack, she was usually one of the first to arrive in the morning.
   “I see you made it into the office once again without having to come in feet first,” Laurie said teasingly. She was referring to Jack’s dangerous bike ride. “Coming in feet first” was office vernacular for arriving dead.
   “Only one brush with a taxi,” Jack said. “I’m accustomed to three or four. It was like a ride in the country this morning.”
   “I’m sure,” Laurie said without belief. “Personally I think you are foolhardy to ride your bike in this city. I’ve autopsied several of those daredevil bicycle messengers. Every time I see one in traffic I wonder when I’ll be seeing him in the pit.” The “pit” was office vernacular for the autopsy room.
   Jack helped himself to coffee, then wandered over to the desk where Laurie was working.
   “Anything particularly interesting?” Jack asked, looking over her shoulder.
   “The usual gunshot wounds,” Laurie said. “Also a drug overdose.”
   “Ugh,” Jack said.
   “You don’t like overdoses?”
   “Nah,” Jack said. “They’re all the same. I like surprises and a challenge.”
   “I had a few overdoses that fit into that category during my first year,” Laurie said.
   “How so?”
   “It’s a long story,” Laurie said evasively. Then she pointed to one of the names on her list. “Here’s a case you might find interesting: Donald Nodelman. The diagnosis is unknown infectious disease.”
   “That would certainly be better than an overdose,” Jack said.
   “Not in my book,” Laurie said. “But it’s yours if you want it. Personally I don’t care for infectious disease cases, never have and never will. When I did the external exam earlier, it gave me the creeps. Whatever it was, it was an aggressive bug. He’s got extensive subcutaneous bleeding.”
   “Unknowns can be a challenge,” Jack said. He picked up the folder. “I’ll be glad to do the case. Did he die at home or in an institution?”
   “He was in a hospital,” Laurie said. “He was brought in from the Manhattan General. But infectious disease wasn’t his admitting diagnosis. He’d been admitted for diabetes.”
   “It’s my recollection that the Manhattan General is an AmeriCare hospital,” Jack said. “Is that true?”
   “I think so,” Laurie said. “Why do you ask?”
   “Because it might make this case personally rewarding,” Jack said. “Maybe I’ll be lucky enough for the diagnosis to be something like Legionnaires’ disease. I couldn’t think of anything more enjoyable than giving AmeriCare heartburn. I’d love to see that corporation squirm.”
   “Why’s that?” Laurie asked.
   “It’s a long story,” Jack said with an impish smile. “One of these days we should have a drink and you can tell me about your overdoses and I’ll tell you about me and AmeriCare.”
   Laurie didn’t know if Jack’s invitation was sincere or not. She didn’t know much about Jack Stapleton beyond his work at the medical examiner’s office; her understanding was that no one else did either. Jack was a superb forensic pathologist, despite the fact that he’d only recently finished his training. But he didn’t socialize much, and he was never very personally revealing in his small talk. All Laurie knew was that he was forty-one, unmarried, entertainingly flippant, and came from the Midwest.
   “I’ll let you know what I find,” Jack said as he headed toward the communications room.
   “Jack, excuse me,” Laurie called out.
   Jack stopped and turned around.
   “Would you mind if I gave you a bit of advice,” she said hesitantly. She was speaking impulsively. It wasn’t like her, but she appreciated Jack and hoped that he would be working there for some time.
   Jack’s impish smile returned. He stepped back to the desk. “By all means,” he said.
   “I’m probably speaking out of turn,” Laurie said.
   “Quite the contrary,” Jack said. “I honor your opinion. What’s on your mind?”
   “Just that you and Calvin Washington have been at odds,” Laurie said. “I know it’s just a clash of personalities, but Calvin has had a long-standing relationship with the Manhattan General, as AmeriCare does with the mayor’s office. I think you should be careful.”
   “Being careful hasn’t been one of my strong points for five years,” Jack said. “I have utmost respect for the deputy chief. Our only disagreement is that he believes rules to be carved in stone while I see them as guidelines. As for AmeriCare, I don’t care for their goals or methods.”
   “Well, it’s not my business,” Laurie said. “But Calvin keeps saying he doesn’t see you as a team player.”
   “He’s got a point there,” Jack said. “The problem is that I’ve developed an aversion to mediocrity. I’m honored to work with most people around here, especially you. However, there are a few whom I can’t deal with, and I don’t hide it. It’s as simple as that.”
   “I’ll take that as a compliment,” Laurie said.
   “It was meant as one,” Jack said.
   “Well, let me know what you find on Nodelman,” Laurie said. “Then I’ll have at least one more case for you to do.”
   “My pleasure,” Jack said. He turned and headed for the communications room. As he walked past Vinnie, he snatched away his paper.
   “Come on, Vinnie,” Jack said. “We’re going to get a jump on the day.”
   Vinnie complained but followed. While trying to retrieve his paper he collided with Jack, who had abruptly stopped outside of Janice Jaeger’s office. Janice was one of the forensic investigators, frequently referred to as PAs or physician’s assistants. Her tour of duty was the graveyard shift, from eleven to seven. Jack was surprised to find her still in her office. A petite woman with dark hair and dark eyes, she was obviously tired.
   “What are you still doing here?” Jack asked.
   “I’ve got one more report to finish.”
   Jack held up the folder in his hand. “Did you or Curt handle Nodelman?”
   “I did,” Janice said. “Is there a problem?”
   “Not that I know about yet,” Jack said with a chuckle. He knew Janice to be extremely conscientious, which made her ideal for teasing. “Was it your impression the cause of death was a nosocomial infection?”
   “What the hell is a ‘nosocomial infection’?” Vinnie asked.
   “It’s an infection acquired in a hospital,” Jack explained.
   “It certainly seems so,” Janice said. “The man had been in the hospital five days for his diabetes before developing symptoms of an infectious disease. Once he got them, he died within thirty-six hours.”
   Jack whistled in respect. “Whatever the bug was, it certainly was virulent.”
   “That’s what worried the doctors I spoke with,” Janice said.
   “Any laboratory results from microbiology?” Jack questioned.
   “Nothing has grown out,” Janice said. “Blood cultures were negative as of four o’clock this morning. The terminal event was acute respiratory distress syndrome, or ARDS, but sputum cultures have been negative as well. The only positive thing was the gram stain of the sputum. That showed gram-negative bacilli. That made people think of pseudomonas, but it hasn’t been confirmed.”
   “Any question of the patient being immunologically compromised?” Jack asked. “Did he have AIDS or had he been treated with antimetabolites?”
   “Not that I could ascertain,” Janice said. “The only problem he had listed was diabetes and some of the usual sequelae. Anyway, it’s all in the investigative report if you’d care to read it.”
   “Hey, why read when I can get it from the horse’s mouth?” Jack said with a laugh. He thanked Janice and headed for the elevator.
   “I hope you are planning to wear your moon suit,” Vinnie said. The moon suit, the completely enclosed, impervious outfit complete with a clear plastic face mask, was designed for maximum protection. Air was forced into the suit by a fan worn at the small of the back, pulling air through a filter before circulating it within the headpiece. That provided enough ventilation to breathe but guaranteed sauna-like temperatures inside. Jack detested the setup.
   As far as Jack was concerned the moon suit was bulky, restrictive, uncomfortable, hot, and unnecessary. He’d not worn one throughout his training. The problem was that the New York chief, Dr. Harold Bingham, had decreed that the suits be used. Calvin, the deputy chief, was intent on enforcing it. Jack had endured several confrontations as a result.
   “This might be the first time the suit is indicated,” Jack said, to Vinnie’s relief. “Until we know what we are dealing with we have to take all precautions. After all, it could be something like Ebola virus.”
   Vinnie stopped in his tracks. “You really think it’s possible?” he asked, his eyes opened wide.
   “Not a chance,” Jack said. He slapped him on the back. “Just kidding.”
   “Thank God,” Vinnie said. They started walking again.
   “But maybe plague,” Jack added.
   Vinnie stopped again. “That would be just as bad,” he said.
   Jack shrugged his shoulders. “All in a day’s work,” he said. “Come on, let’s get it over with.”
   They changed into scrubs, and then while Vinnie put on his moon suit and went into the autopsy room, Jack went through the contents of Nodelman’s folder. It had a case work sheet, a partially completed death certificate, an inventory of medical-legal case records, two sheets for autopsy notes, a telephone notice of death as received that night by communications, a completed identification sheet, Janice’s investigative report, a sheet for the autopsy report, and a lab slip for HIV antibody analysis.
   Despite having spoken with Janice, Jack read her report carefully as he always did. When he was finished he went into the room next to the pine coffins and put on his moon suit. He took his ventilation unit from where it had been charging and hooked himself up. Then he set out for the autopsy room on the other side of the morgue.
   Jack cursed the suit as he walked past most of the 126 refrigerated compartments for bodies. Being encased in the contraption put him in a bad mood, and he eyed his surroundings with a jaundiced eye. The morgue had been state of the art at one time, but it was now in need of repair and upgrading. With its aged, blue tile walls and stained cement floor it looked like a set for an old horror movie.
   There was an entrance to the autopsy room directly from the hallway, but that wasn’t used any longer except to bring bodies in and out. Instead Jack entered through a small anteroom with a washbasin.
   By the time Jack entered the autopsy room Vinnie had Nodelman’s body on one of the eight tables and had assembled all the necessary equipment and paraphernalia necessary to do the case. Jack positioned himself on the patient’s right, Vinnie on the left.
   “He doesn’t look so good,” Jack said. “I don’t think he’s going to make it to the prom.” It was hard to talk in the moon suit, and he was already perspiring.
   Vinnie, who never quite knew how to react to Jack’s irreverent comments, didn’t respond even though the corpse did look terrible.
   “This is gangrene on his fingers,” Jack said. He lifted one of the hands and examined the almost-black fingertips closely. Then he pointed to the man’s shriveled genitals. “That’s gangrene on the end of his penis. Ouch! That must have hurt. Can you imagine?”
   Vinnie held his tongue.
   Jack carefully examined every inch of the man’s exterior. For Vinnie’s benefit he pointed out the extensive subcutaneous hemorrhages on the man’s abdomen and legs. He told him it was called purpura. Then Jack mentioned there were no obvious insect bites. “That’s important,” he added. “A lot of serious diseases are transmitted by arthropods.”
   “Arthropods?” Vinnie questioned. He never knew when Jack was joking.
   “Insects,” Jack said. “Crustaceans aren’t much of a problem as disease vectors.”
   Vinnie nodded appreciatively, although he didn’t know any more than he had when he’d asked his question. He made a mental note to try to remember to look up the meaning of “arthropods” when he had an opportunity.
   “What are the chances whatever killed this man is contagious?” Vinnie asked.
   “Excellent, I’m afraid,” Jack said. “Excellent.”
   The door to the hallway opened and Sal D’Ambrosio, another mortuary tech, wheeled in another body. Totally absorbed in the external exam of Mr. Nodelman, Jack did not look up. He was already beginning to form a differential diagnosis.
   A half hour later six of the eight tables were occupied by corpses awaiting autopsies. One by one the other medical examiners on duty that day began to arrive. Laurie was the first, and she came over to Jack’s table.
   “Any ideas yet?” she asked.
   “Lots of ideas but nothing definitive,” Jack said. “But I can assure you this is one virulent organism. I was teasing Vinnie earlier about its being Ebola. There’s a lot of disseminated intravascular coagulation.”
   “My God!” Laurie exclaimed. “Are you serious?”
   “No, not really,” Jack said. “But from what I’ve seen so far it’s still possible, just not probable. Of course I’ve never seen a case of Ebola, so that should tell you something.”
   “Do you think we ought to isolate this case?” Laurie asked nervously.
   “I can’t see any reason to,” Jack said. “Besides, I’ve already started, and I’ll be careful to avoid throwing any of the organs around the room. But I’ll tell you what we should do: alert the lab to be mighty careful with the specimens until we have a diagnosis.”
   “Maybe I’d better ask Bingham’s opinion,” Laurie said.
   “Oh, that would be helpful,” Jack said sarcastically. “Then we’ll have the blind leading the blind.”
   “Don’t be disrespectful,” Laurie said. “He is the chief.”
   “I don’t care if he’s the Pope,” Jack said. “I think I should just get it done, the sooner the better. If Bingham or even Calvin gets involved it will drag on all morning.”
   “All right,” Laurie said. “Maybe you’re right. But let me see any abnormality. I’ll be on table three.”
   Laurie left to do her own case. Jack took a scalpel from Vinnie and was about to make the incision when he noticed that Vinnie had moved away.
   “Where are you going to watch this from, Queens?” Jack asked. “You’re supposed to be helping.”
   “I’m a little nervous,” Vinnie admitted.
   “Oh, come on, man,” Jack said. “You’ve been at more autopsies than I have. Get your Italian ass over here. We’ve got work to do.”
   Jack worked quickly but smoothly. He handled the internal organs gently and was meticulously careful about the use of instruments when either his or Vinnie’s hands were in the field.
   “Whatcha got?” Chet McGovern asked, looking over Jack’s shoulder. Chet was also an associate medical examiner, having been hired in the same month as Jack. Of all the colleagues he’d become the closest to Jack, since they shared both a common office and the social circumstance of being single males. But Chet had never been married and at thirty-six, he was five years Jack’s junior.
   “Something interesting,” Jack said. “The mystery disease of the week. And it’s a humdinger. This poor bastard didn’t have a chance.”
   “Any ideas?” Chet asked. His trained eye took in the gangrene and the hemorrhages under the skin.
   “I got a lot of ideas,” Jack said. “But let me show you the internal. I’d appreciate your opinion.”
   “Is there something I should see?” Laurie called from table three. She’d noticed Jack conversing with Chet.
   “Yeah, come on over,” Jack said. “No use going through this more than once.”
   Laurie sent Sal to the sink to wash out the intestines on her case, then stepped over to table one.
   “The first thing I want you to look at is the lymphatics I dissected in the throat,” Jack said. He had retracted the skin of the neck from the chin to the collarbone.
   “No wonder autopsies take so long around here,” a voice boomed in the confined space.
   All eyes turned toward Dr. Calvin Washington, the deputy chief He was an intimidating six-foot-seven, two-hundred-and-fifty-pound African-American man who’d passed up a chance to play NFL football to go to medical school.
   “What the hell is going on around here?” he demanded half in jest. “What do you people think this is, a holiday?”
   “Just pooling resources,” Laurie said. “We’ve got an unknown infectious case that appears to be quite an aggressive microbe.”
   “So I heard,” Calvin said. “I already got a call from the administrator over at the Manhattan General. He’s justly concerned. What’s the verdict?”
   “A bit too soon to tell,” Jack said. “But we’ve got a lot of pathology here.”
   Jack quickly summarized for Calvin what was known of the history and pointed out the positive findings on the external exam. Then he started back on the internal, indicating the spread of the disease along the lymphatics of the neck.
   “Some of these nodes are necrotic,” Calvin said.
   “Exactly,” Jack said. “In fact most of them are necrotic. The disease was spreading rapidly through the lymphatics, presumably from the throat and bronchial tree.”
   “Airborne, then,” Calvin said.
   “It would be my first guess,” Jack admitted. “Now look at the internal organs.”
   Jack presented the lungs and opened the areas where he’d made slices.
   “As you can see, this is pretty extensive lobar pneumonia,” Jack said. “There’s a lot of consolidation. But there is also some necrosis, and I believe early cavitation. If the patient had lived longer, I think we would be seeing some abscess formation.”
   Calvin whistled. “Wow,” he said. “All this was happening in the face of massive IV antibiotics.”
   “It’s worrisome,” Jack agreed. He carefully slid the lungs back into the pan. He didn’t want them sloshing around, potentially throwing infective particles into the air. Next he picked up the liver and gently separated its cut surface.
   “Same process,” he announced, pointing with his fingers to areas of early abscess formation. “Just not as extensive as with the lungs.” Jack put the liver down and picked up the spleen. There were similar lesions throughout the organ. He made sure everyone saw them.
   “So much for the gross,” Jack said as he carefully replaced the spleen in the pan. “We’ll have to see what the microscopic shows, but I actually think we’ll be relying on the lab to give us the definitive answer.”
   “What’s your guess at this point?” Calvin asked.
   Jack let out a short laugh. “A guess it would have to be,” he said. “I haven’t seen anything pathognomonic yet. But its fulminant character should tell us something.”
   “What’s your differential diagnosis?” Calvin asked. “Come on, Wonderboy, let’s hear it.”
   “Ummmm,” Jack said. “You’re kinda putting me on the spot. But okay, I’ll tell you what’s been going through my head. First, I don’t think it could be pseudomonas as suspected at the hospital. It’s too aggressive. It could have been something atypical like strep group A or even staph with toxic shock, but I kinda doubt it, especially with the gram stain suggesting it was a bacillus. So I’d have to say it is something like tularemia or plague.”
   “Whoa!” Calvin exclaimed. “You’re coming up with some pretty arcane illnesses for what was apparently a hospital-based infection. Haven’t you heard the phrase about when you hear hoofbeats you should think of horses, not zebras?”
   “I’m just telling you what’s going through my mind. It’s just a differential diagnosis. I’m trying to keep an open mind.”
   “All right,” Calvin said soothingly. “Is that it?”
   “No, that’s not it,” Jack said. “I’d also consider that the gram stain could have been wrong and that would let in not only strep and staph but meningococcemia as well. And I might as well throw in Rocky Mountain spotted fever and hantavirus. Hell, I could even throw in the viral hemorrhagic fevers like Ebola.”
   “Now you’re getting out in the stratosphere,” Calvin said. “Let’s come back to reality. If I made you guess which one it is right now with what you know, what would you say?”
   Jack clucked his tongue. He had the irritated feeling he was being put back in medical school, and that Calvin, like many of his medical-school professors, was trying to make him look bad.
   “Plague,” Jack said to a stunned audience.
   “Plague?” Calvin questioned with surprise bordering on disdain. “In March? In New York City? In a hospitalized patient? You got to be out of your mind.”
   “Hey, you asked me for one diagnosis,” Jack said. “So I gave it to you. I wasn’t responding by probabilities, just pathology.”
   “You weren’t considering the other epidemiological aspects?” Calvin asked with obvious condescension. He laughed. Then, talking more to the others than Jack, he said: “What the hell did they teach you out there in the Chicago boonies?”
   “There are too many unknowns in this case for me to put a lot of weight on unsubstantiated information,” Jack said. “I didn’t visit the site. I don’t know anything about the deceased’s pets, travel, or contact with visitors. There are a lot of people coming and going in this city, even in and out of a hospital. And there are certainly more than enough rats around here to support the diagnosis.”
   For a moment a heavy silence hung over the autopsy room. Neither Laurie nor Chet knew what to say. Jack’s tone made them both uncomfortable, especially knowing Calvin’s stormy temperament.
   “A clever comment,” Calvin said finally. “You’re quite good at double entendre. I have to give you credit there. Perhaps that’s part of pathology training in the Midwest.”
   Both Laurie and Chet laughed nervously.
   “All right, smartass,” Calvin continued. “How much are you willing to put on your diagnosis of plague?”
   “I didn’t know it was customary to gamble around here,” Jack said.
   “No, it’s not common to gamble, but when you come up with a diagnosis of plague, I think it’s worthwhile to make a point of it. How about ten dollars?”
   “I can afford ten dollars,” Jack said.
   “Fine,” Calvin said. “With that settled, where’s Paul Plodgett and that gunshot wound from the World Trade Center?”
   “He’s down on table six,” Laurie said.
   Calvin lumbered away and for a moment the others watched him. Laurie broke the silence. “Why do you try to provoke him?” she asked Jack. “I don’t understand. You’re making it more difficult for yourself.”
   “I can’t help it,” Jack said. “He provoked me!”
   “Yeah, but he’s the deputy chief and it’s his prerogative,” Chet said. “Besides, you were pushing things with a diagnosis of plague. It certainly wouldn’t be on the top of my list.”
   “Are you sure?” Jack asked. “Look at the black fingers and toes on this patient. Remember, it was called the black death back in the fourteenth century.”
   “A lot of diseases can cause such thrombotic phenomena,” Chet said.
   “True,” Jack said. “That’s why I almost said tularemia.”
   “And why didn’t you?” Laurie asked. In her mind tularemia was equally improbable.
   “I thought plague sounded better,” Jack said. “It’s more dramatic.”
   “I never know when you are serious,” Laurie said.
   “Hey, I feel the same way,” Jack said.
   Laurie shook her head in frustration. At times it was hard to have a serious discussion with Jack. “Anyway,” she said, “are you finished with Nodelman? If you are, I’ve got another case for you.”
   “I haven’t done the brain yet,” Jack said.
   “Then get to it,” Laurie said. She walked back to table three to finish her own case.

2. Wednesday, 9:45 a.m., March 20, 1996
New York City

   Terese Hagen stopped abruptly and looked at the closed door to the “cabin,” the name given to the main conference room. It was called the cabin because the interior was a reproduction of Taylor Heath’s Squam Lake house up in the wilds of New Hampshire. Taylor Heath was the CEO of the hot, up-and-coming advertising firm Willow and Heath, which was threatening to break into the rarefied ranks of the advertising big leagues.
   After making sure she was not observed, Terese leaned toward the door and put her ear against it. She heard voices.
   With her pulse quickening, Terese hurried down the hall to her own office. It never took long for her anxiety to soar. She’d only been in the office five minutes and already her heart was pounding. She didn’t like the idea of a meeting she didn’t know about being held in the cabin, the CEO’s habitual domain. In her position as the creative director of the firm, she felt she had to know everything that was going on.
   The problem was that a lot was going on. Taylor Heath had shocked everybody with his previous month’s announcement that he planned to retire as CEO and was designating Brian Wilson, the current president, to succeed him. That left a big question mark about who would succeed Wilson. Terese was in the running. That was for sure. But so was Robert Barker, the firm’s executive director of accounts. And on top of that, there was always the worry that Taylor would pick someone from outside.
   Terese pulled off her coat and stuffed it into the closet. Her secretary, Marsha Devons, was on the phone, so Terese dashed to her desk and scanned the surface for any telltale message; but there was nothing except a pile of unrelated phone messages.
   “There’s a meeting in the cabin,” Marsha called from the other room after hanging up the phone. She appeared in the doorway. She was a petite woman with raven-black hair. Terese appreciated her because she was intelligent, efficient, and intuitive—all the qualities lacking in the year’s previous four secretaries. Terese was tough on her assistants, since she expected commitment and performance equivalent to her own.
   “Why didn’t you call me at home?” Terese demanded.
   “I did, but you’d already left,” Marsha said.
   “Who’s at the meeting?” Terese barked.
   “It was Mr. Heath’s secretary who called,” Marsha said. “She didn’t say who would be attending. Just that your presence was requested.”
   “Was there any indication what the meeting is about?” Terese asked.
   “No,” Marsha said simply.
   “When did it start?”
   “The call came through at nine,” Marsha said.
   Terese snatched up her phone and punched in Colleen Anderson’s number. Colleen was Terese’s most trusted art director. She was currently heading up a team for the National Health Care account.
   “You know anything about this meeting in the cabin?” Terese asked as soon as Colleen was on the line.
   Colleen didn’t, only that it was going on.
   “Damn!” Terese said as she hung up.
   “Is there a problem?” Marsha asked solicitously.
   “If Robert Barker has been in there all this time with Taylor, there’s a problem,” Terese said. “That prick never misses a beat to put me down.”
   Terese snatched the phone again and redialed Colleen. “What’s the status on National Health? Do we have any comps or anything I can show right now?”
   “I’m afraid not,” Colleen said. “We’ve been brainstorming, but we don’t have anything zippy like I know you want. I’m looking for a home run.”
   “Well, goose your team,” Terese said. “I have a sneaking suspicion I’m most vulnerable with National Health.”
   “No one’s been sleeping down here,” Colleen said. “I can assure you of that.”
   Terese hung up without saying good-bye. Snatching up her purse, she ran down the hall to the ladies’ room and positioned herself in front of the mirror. She pushed her Medusa’s head of highlighted tight curls into a semblance of order, then reapplied some lipstick and a bit of blush.
   Stepping back, she surveyed herself. Luckily she’d chosen to wear one of her favorite suits. It was dark blue wool gabardine and seriously severe, hugging her narrow frame like a second skin.
   Satisfied with her appearance, Terese hustled to the cabin door. After a deep breath she grasped the knob, turned it, and entered.
   “Ah, Miss Hagen,” Brian Wilson said, glancing at his watch. He was sitting at the head of a rough-hewn plank table that dominated the room. “I see you’re now indulging in banker’s hours.”
   Brian was a short man with thinning hair. He vainly tried to camouflage his bald spot by combing his side hair over it. As per usual he was attired in a white shirt and tie, loosened at the neck, giving him the appearance of a harried newspaper publisher. To complete the journalistic look, his sleeves were rolled up above his elbows and a yellow Dixon pencil was tucked behind his right ear.
   Despite the catty comment, Terese liked and respected Brian. He was an able administrator. He had a patented derogatory style, but he was equally demanding of himself.
   “I was in the office last night until one A.M.,” Terese said. “I certainly would have been here for this meeting if someone had been kind enough to have let me know about it.”
   “It was an impromptu meeting,” Taylor called out. He was standing near the window, in keeping with his laissez-faire management style. He preferred to hover above the group like an Olympian god, watching his demigods and mere mortals hammer out decisions.
   Taylor and Brian were opposite in most ways. Where Brian was short, Taylor was tall. Where Brian was balding, Taylor had a dense halo of silver-gray hair. Where Brian appeared as the harried newspaper columnist always with his back against the wall, Taylor was the picture of sophisticated tranquillity and sartorial splendor. Yet no one doubted Taylor’s encyclopedic grasp of the business and his uncanny ability to maintain strategic goals in the face of daily tactical disaster and controversy.
   Terese took a seat at the table directly across from her nemesis, Robert Barker. He was a tall, thin-faced man with narrow lips who seemed to take a cue from Taylor in regard to his dress. He was always attired nattily in dark silk suits and colorful silk ties. The ties were his trademark. Terese could not remember ever having seen the same tie twice.
   Next to Robert was Helen Robinson, whose presence made Terese’s racing heart beat even a little faster. Helen worked under Robert as the account executive assigned specifically to National Health. She was a strikingly attractive twenty-five-year-old woman with long, chestnut-colored hair that cascaded to her shoulders, tanned skin even in March, and full, sensuous features. Between her intelligence and looks she was a formidable adversary.
   Also sitting at the table was Phil Atkins, the chief financial officer, and Carlene Desalvo, the corporate director of account planning. Phil was an impeccably precise man with his perennial three-piece suit and wire-rimmed glasses. Carlene was a bright, full-figured woman who always dressed in white. Terese was mildly surprised to see both of them at the meeting.
   “We’ve got a big problem with the National Health account,” Brian said. “That’s why this meeting was called.”
   Terese’s mouth went dry. She glanced at Robert and detected a slight but infuriating smile. Terese wished to God she’d been there since the beginning of the meeting so she could have known everything that had been said.
   Terese was aware of trouble with National Health. The company had called for an internal review a month ago, which meant that Willow and Heath had to come up with a new advertising campaign if they expected to keep the account. And everybody knew they had to keep the account. It had mushroomed to somewhere around forty million annually and was still growing. Health-care advertising was in the ascendancy, and would hopefully fill the hole vacated by cigarettes.
   Brian turned to Robert. “Perhaps you could fill Terese in on the latest developments,” he said.
   “I defer to my able assistant, Helen,” Robert said, giving Terese one of his condescending smiles.
   Helen moved forward in her seat. “As you know, National Health has had misgivings about its advertising campaign. Unfortunately their displeasure has increased. Just yesterday their figures came in for the last open subscriber period. The results weren’t good. Their loss of market share to AmeriCare in the New York metropolitan area has increased. After building the new hospital, this is a terrible blow.”
   “And they blame our ad campaign for that?” Terese blurted out. “That’s absurd. They only made a twenty-five-point buy with our sixty-second commercial. That was not adequate. No way.”
   “That may be your opinion,” Helen said evenly. “But I know it is not National Health’s.”
   “I know you are fond of your ‘Health care for the modern era’ campaign, and it is a good tag line,” Robert said, “but the fact of the matter is that National Health has been losing market share from the campaign’s inception. These latest figures are just consistent with the previous trend.”
   “The sixty-second spot has been nominated for a Clio,” Terese countered. “It’s a damn good commercial. It’s wonderfully creative. I’m proud of my team for having put it together.”
   “And indeed you should be,” Brian interjected. “But it is Robert’s feeling that the client is not interested in our winning a Clio. And remember, as the Benton and Bowles agency held, ‘If it doesn’t sell, it isn’t creative.’ ”
   “That’s equally absurd,” Terese snapped. “The campaign is solid. It’s just that the account people couldn’t get the client to buy adequate exposure. There should have been ‘flights’ on multiple local stations at a bare minimum.”
   “With all due respect, they would have bought more time if they’d liked the commercial,” Robert said. “I don’t think they were ever sold on this idea of ‘them versus us,’ ancient medicine versus modern medicine. I mean it was humorous, but I don’t know if they were convinced the viewer truly associated the ancient methods with National Health Care’s competitors, particularly AmeriCare. My personal opinion is that it went over people’s heads.”
   “Your real point is that National Health Care has a very specific type of advertising it wants,” Brian said. “Tell Terese what you told me just before she came in here.”
   “It’s simple,” Robert said, making an open gesture with his hands. “They want either ‘talking heads’ discussing actual patient experiences, or a celebrity spokesperson. They couldn’t care less whether their ad wins a Clio or any of the other awards. They want results. They want market share, and I want to give it to them.”
   “Am I hearing that Willow and Heath wants to turn its back on its successes and become a mere vendor shop?” Terese asked. “We’re on the edge of becoming one of the big-league firms. And how did we get here? We got here by doing quality advertising. We’ve carried on in the Doyle-Dane-Bernback tradition. If we start letting clients dictate that we turn out slop, we’re doomed.”
   “What I’m hearing is the usual conflict between the account executive and the creative,” Taylor said, interrupting the increasingly heated discussion. “Robert, you think Terese is this self-indulgent child who is bent on alienating the client. Terese, you think Robert is this shortsighted pragmatist who wants to throw out the baby with the bathwater. The trouble is you are both right and both wrong at the same time. You have to use each other as a team. Stop arguing and deal with the problem at hand.”
   For a moment everyone was quiet. Zeus had spoken and everyone knew he was on target as usual.
   “All right,” Brian said finally. “Here’s our reality. National Health is a vital client to our long-term stability. Thirty-odd days ago it asked for an internal review, which we expected in a couple of months. They now have told us they want it next week.”
   “Next week!” Terese all but shouted. “My God.” It took months to put together a new campaign and pitch it.
   “I know that will put the creatives under a lot of pressure,” Brian said. “But the reality is National Health is the boss. The problem is that after our pitch, if they are not satisfied, they’ll set up an outside review. The account will then be up for grabs, and I don’t have to remind you that these health-care giants are going to be the advertising cash cows of the next decade. All the agencies are interested.”
   “As chief financial officer I think I should make it clear what the loss of the National Health account would do to our bottom line,” Phil Atkins said. “We’ll have to put off the restructuring because we won’t have the funds to buy back our junk bonds.”
   “Obviously it is in all our best interests that we not lose the account,” Brian said.
   “I don’t know if it is possible to put together a pitch for next week,” Terese said.
   “You have anything you can show us at the moment?” Brian asked.
   Terese shook her head.
   “You must have something,” Robert said. “I assume you have a team working on it.” The smile had returned to the corners of his mouth.
   “Of course we have a team on National Health,” Terese said. “But we haven’t had any ‘big ideas’ to date. Obviously we thought we had several more months.”
   “Perhaps you might assign some additional personnel,” Brian said. “But I’ll leave that up to your judgment.” Then to the rest of the group he said: “For now we’ll adjourn this meeting until we have something from Creative to look at.” He stood up. Everybody else did the same.
   Dazed, Terese stumbled out of the cabin and descended to the agency’s main studio on the floor below.
   Willow and Heath had reversed a trend that began during the seventies and eighties when New York advertising firms had experienced a diaspora to varying chic sections of the city like TriBeCa and Chelsea. The agency returned to the old stamping ground of Madison Avenue, taking over several floors of a modest-sized building.
   Terese found Colleen at her drawing board.
   “What’s the scoop?” Colleen asked. “You look pale.”
   “Trouble!” Terese exclaimed.
   Colleen had been Terese’s first hire. She was her most reliable art director. They got along famously both professionally and socially. Colleen was a milky-white-skinned strawberry blonde with a smattering of pale freckles over an upturned nose. Her eyes were a deep blue, a much stronger hue than Terese’s. She favored oversized sweatshirts that somehow seemed to accentuate rather than hide her enviable figure.
   “Let me guess,” Colleen said. “Has National Health pushed up the deadline for the review?”
   “How’d you know?”
   “Intuition,” Colleen said. “When you said ‘trouble,’ that’s the worst thing I could think of.”
   “The Robert-and-Helen sideshow brought in information that National Health has lost more market share to AmeriCare despite our campaign.”
   “Damn!” Colleen said. “It’s a good campaign and a great sixty-second commercial.”
   “You know it and I know it,” Terese said. “Problem is that it wasn’t shown enough. I have an uncomfortable suspicion that Helen undermined us and talked them out of the two-hundred– to three-hundred-point TV commercial buy they had initially intended to make. That would have been saturation. I know it would have worked.”
   “I thought you told me you had pulled out the stops to guarantee National Health’s market share would go up,” Colleen said.
   “I did,” Terese said. “I’ve done everything I could think of and then some. I mean, it’s my best sixty-second spot. You told me yourself.”
   Terese rubbed her forehead. She was getting a headache. She could still feel her pulse clanging away at her temples.
   “You might as well tell me the bad news,” Colleen said. She put down her drawing pencil and swung around to face Terese. “What’s the new time frame?”
   “National Health wants us to pitch a new campaign next week.”
   “Good Lord!” Colleen said.
   “What do we have so far?” Terese asked.
   “Not a lot.”
   “You must have some tissues or some preliminary executions,” Terese said. “I know I haven’t been giving you any attention lately since we’ve had deadlines with three other clients. But you have had a team working on this for almost a month.”
   “We’ve been having strategy session after strategy session,” Colleen said. “A lot of brainstorming, but no big idea. Nothing’s jumped out and grabbed us. I mean, I have a sense of what you are looking for.”
   “Well, I want to see what you have,” Terese said. “I don’t care how sketchy or preliminary. I want to see what the team has been doing. I want to see it today.”
   “All right,” Colleen said without enthusiasm. “I’ll get everybody together.”

3. Wednesday, 11:15 a.m., March 20, 1996

   Susanne Hard had never liked hospitals.
   A scoliotic back had kept her in and out of them as a child. Hospitals made her nervous. She hated the sense that she was not in control and that she was surrounded by the sick and the dying.
   Susanne was a firm believer in the adage If something can go wrong, it will go wrong. She felt this way particularly in relation to hospitals. Indeed, on her last admission, she’d been carted off to urology to face some frightful procedure before she’d finally been able to convince a reluctant technician to read the name on her wristband. They’d had the wrong patient.
   On her present admission Susanne wasn’t sick. The previous night her labor had started with her second child. In addition to her back problem, her pelvis was distorted, making a normal vaginal delivery impossible. As with her first child, she had to have a cesarean section.
   Since she’d just undergone abdominal surgery, her doctor insisted that she stay at least a few days. No amount of cajoling on Susanne’s part had been successful in convincing the doctor otherwise.
   Susanne tried to relax by wondering what kind of child she’d just birthed. Would he be like his brother, Allen, who had been a wonderful baby? Allen had slept through the night almost from day one. He’d been a delight, and now that he was three and already exerting independence, Susanne was looking forward to a new baby. She thought of herself as a natural mother.
   With a start, Susanne awoke. She’d surprised herself by nodding off. What had awakened her was a white-clad figure fiddling with the IV bottles that hung from a pole at the head of her bed.
   “What are you doing?” Susanne asked. She felt paranoid about anybody doing anything she didn’t know about.
   “Sorry to have awakened you, Mrs. Hard,” a nurse said. “I was just hanging up a new bottle of fluid. Yours is just about out.”
   Susanne glanced at the IV snaking into the back of her hand. As an experienced hospital patient, she suggested that it was time for the IV to come out.
   “Maybe I should check on that,” the nurse said. She then waltzed out of the room.
   Tilting her head back, Susanne looked at the IV bottle to see what it was. It was upside down, so she couldn’t read the label.
   She started to turn over, but a sharp pain reminded her of her recently sutured incision. She decided to stay on her back.
   Gingerly she took a deep breath. She didn’t feel any discomfort until right at the end of inspiration.
   Closing her eyes, Susanne tried again to calm down. She knew that she still had a significant amount of drugs “on board” from the anesthesia, so sleep should be easy. The trouble was, she didn’t know if she wanted to be asleep with so many people coming in and out of her room.
   A very soft clank of plastic hitting plastic drifted out of the background noise of the hospital and caught Susanne’s attention. Her eyes blinked open. She saw an orderly off to the side by the bureau.
   “Excuse me,” Susanne called.
   The man turned around. He was a handsome fellow in a white coat over scrubs. From where he was standing, Susanne could not read his name tag. He appeared surprised to be addressed.
   “I hope I didn’t disturb you, ma’am,” the young man said.
   “Everybody is disturbing me,” Susanne said without malice. “It’s like Grand Central Station in here.”
   “I’m terribly sorry,” the man said. “I can always return later if it would be more convenient.”
   “What are you doing?” Susanne asked.
   “Just filling your humidifier,” the man said.
   “What do I have a humidifier for?” Susanne said. “I didn’t have one after my last cesarean.”
   “The anesthesiologists frequently order them this time of year,” the man said. “Right after surgery, patients’ throats are often irritated from the endotracheal tube. It’s usually helpful to use a humidifier for the first day or even the first few hours. In what month did you have your last cesarean?”
   “May,” Susanne said.
   “That’s probably the reason you didn’t have one then,” the man said. “Would you like me to return?”
   “Do what you have to do,” Susanne said.
   No sooner had the man left than the original nurse returned. “You were right,” she said. “The orders were to pull the IV as soon as the bottle was through.”
   Susanne merely nodded. She felt like asking the nurse if missing orders was something she did on a regular basis. Susanne sighed. She wanted out of there.
   After the nurse had removed the IV, Susanne managed to calm herself enough to fall back asleep. But it didn’t last long. Someone was nudging her arm.
   Susanne opened her eyes and looked into the face of another smiling nurse. In the foreground and between them was a five-cc syringe.
   “I’ve got something for you,” the nurse said as if Susanne were a toddler and the syringe candy.
   “What is it?” Susanne demanded. She instinctively pulled away.
   “It’s the pain shot you requested,” the nurse said. “So roll over and I’ll give it to you.”
   “I didn’t request a pain shot,” Susanne said.
   “But of course you did,” the nurse said.
   “But I didn’t,” Susanne said.
   The nurse’s expression changed to exasperation like a cloud passing over the sun. “Well then, it’s doctor’s orders. You are supposed to have a pain shot every six hours.”
   “But I don’t have much pain,” Susanne said. “Only when I move or breathe deeply.”
   “There you are,” the nurse said. “You have to breathe deeply, otherwise you’ll get pneumonia. Come on now, be a good girl.”
   Susanne thought for a moment. On the one hand she felt like being contrary. On the other hand she wanted to be taken care of and there was nothing inherently wrong with a pain shot. It might even make her sleep better.
   “Okay,” Susanne said.
   Gritting her teeth, she managed to roll to the side as the nurse bared her bottom.

4. Wednesday, 2:05 p.m., March 20, 1996

   “You know, Laurie’s right,” Chet McGovern said.
   Chet and Jack were sitting in the narrow office they shared on the fifth floor of the medical examiner’s building. They both had their feet up on their respective gray metal desks. They’d finished their autopsies for the day, eaten lunch, and were now supposedly doing their paperwork.
   “Of course she’s right,” Jack agreed.
   “But if you know that, why do you provoke Calvin? It’s not rational. You’re not doing yourself any favors. It’s going to affect your promotion up through the system.”
   “I don’t want to rise up in the system,” Jack said.
   “Come again?” Chet asked. In the grand scheme of medicine, the concept of not wanting to get ahead was heresy.
   Jack let his feet fall off the desk and thump onto the floor. He stood up, stretched, and yawned loudly. Jack was a stocky, six-foot man accustomed to serious physical activity. He found that standing at the autopsy table and sitting at a desk tended to cause his muscles to cramp, particularly his quadriceps.
   “I’m happy being a low man on the totem pole,” Jack said, cracking his knuckles.
   “You don’t want to become board certified?” Chet asked with surprise.
   “Ah, of course I want to be board certified,” Jack said. “But that’s not the same issue. As far as I’m concerned, becoming board certified is a personal thing. What I don’t care about is having supervisory responsibility. I just want to do forensic pathology. To hell with bureaucracy and red tape.”
   “Jesus,” Chet remarked, letting his own feet fall to the floor. “Every time I think I get to know you a little, you throw me a curveball. I mean, we’ve been sharing this office for almost five months. You’re still a mystery. I don’t even know where the hell you live.”
   “I didn’t know you cared,” Jack teased.
   “Come on,” Chet said. “You know what I mean.”
   “I live on the Upper West Side,” Jack said. “It’s no secret.”
   “In the seventies?” Chet asked.
   “A bit higher,” Jack said.
   “Eighties?”
   “Higher.”
   “You’re not going to tell me higher than the nineties, are you?” Chet asked.
   “A tad,” Jack said. “I live on a Hundred and Sixth Street.”
   “Good grief,” Chet exclaimed. “You’re living in Harlem.”
   Jack shrugged. He sat down at his desk and pulled out one of his unfinished files. “What’s in a name?” he said.
   “Why in the world live in Harlem?” Chet asked. “Of all the neat places to live in and around the city, why live there? It can’t be a nice neighborhood. Besides, it must be dangerous.”
   “I don’t see it that way,” Jack said. “Plus there are a lot of playgrounds in the area and a particularly good one right next door. I’m kind of a pickup basketball nut.”
   “Now I know you are crazy,” Chet said. “Those playgrounds and those pickup games are controlled by neighborhood gangs. That’s like having a death wish. I’m afraid we might see you in here on one of the slabs even without the mountain bike heroics.”
   “I haven’t had any trouble,” Jack said. “After all, I paid for new backboards and lights and I buy the balls. The neighborhood gang is actually quite appreciative and even solicitous.”
   Chet eyed his officemate with a touch of awe. He tried to imagine what Jack would look like out running around on a Harlem neighborhood blacktop. He imagined Jack would certainly stand out racially with his light brown hair cut in a peculiar Julius Caesar-like shag. Chet wondered if any of the other players had any idea about Jack, like the fact that he was a doctor. But then Chet acknowledged that he didn’t know much more.
   “What did you do before you went to medical school?” Chet asked.
   “I went to college,” Jack said. “Like most people who went to medical school. Don’t tell me you didn’t go to college.”
   “Of course I went to college,” Chet said. “Calvin is right: You are a smartass. You know what I mean. If you just finished a pathology residency, what did you do in the interim?” Chet had wanted to ask the question for months, but there had never been an opportune moment.
   “I became an ophthalmologist,” Jack said. “I even had a practice out in Champaign, Illinois. I was a conventional, conservative suburbanite.”
   “Yeah, sure, just like I was a Buddhist monk.” Chet laughed. “I mean I suppose I can see you as an ophthalmologist. After all, I was an emergency-room physician for a few years until I saw the light. But you conservative? No way.”
   “I was,” Jack insisted. “And my name was John, not Jack. Of course, you wouldn’t have recognized me. I was heavier. I also had longer hair, and I parted it along the right side of my head the way I did in high school. And as far as dress was concerned, I favored glen-plaid suits.”
   “What happened?” Chet asked. Chet glanced at Jack’s black jeans, blue sports shirt, and dark blue knitted tie.
   A knock on the doorjamb caught both Jack’s and Chet’s attention. They turned to see Agnes Finn, head of the micro lab, standing in the doorway. She was a small, serious woman with thick glasses and stringy hair.
   “We just got something a little surprising,” she said to Jack. She was clutching a sheet of paper in her hand. She hesitated on the threshold. Her dour expression didn’t change.
   “Are you going to make us guess or what?” Jack asked. His curiosity had been titillated, since Agnes did not make it a point to deliver lab results.
   Agnes pushed her glasses higher onto her nose and handed Jack the paper. “It’s the fluorescein antibody screen you requested on Nodelman.”
   “My word,” Jack said after glancing at the page. He handed it to Chet.
   Chet looked at the paper and then leaped to his feet. “Holy crap!” he exclaimed. “Nodelman had the goddamn plague!”
   “Obviously we were taken aback by the result,” Agnes said in her usual monotone. “Is there anything else you want us to do?”
   Jack pinched his lower lip while he thought. “Let’s try to culture some of the incipient abscesses,” he said. “And let’s try some of the usual stains. What’s recommended for plague?”
   “Giemsa’s or Wayson’s,” Agnes said. “They usually make it possible to see the typical bipolar ‘safety pin’ morphology.”
   “Okay, let’s do that,” Jack said. “Of course, the most important thing is to grow the bug. Until we do that, the case is only presumptive plague.”
   “I understand,” Agnes said. She started from the room.
   “I guess I don’t have to warn you to be careful,” Jack said.
   “No need,” Agnes assured him. “We have a class-three hood, and I intend to use it.”
   “This is incredible,” Chet said when they were alone. “How the hell did you know?”
   “I didn’t,” Jack said. “Calvin forced me to make a diagnosis. To tell the truth, I thought I was being facetious. Of course, the signs were all consistent, but I still didn’t imagine I had a snowball’s chance in hell of being right. But now that I am, it’s no laughing matter. The only positive aspect is that I win that ten dollars from Calvin.”
   “He’s going to hate you for that,” Chet said.
   “That’s the least of my worries,” Jack said. “I’m stunned. A case of pneumonic plague in March in New York City, supposedly contracted in a hospital! Of course, that can’t be true unless the Manhattan General is supporting a horde of infected rats and their fleas. Nodelman had to have had contact with some sort of infected animal. It’s my guess he was traveling recently.” Jack snatched up the phone.
   “Who are you calling?” Chet asked.
   “Bingham, of course,” Jack said as he punched the numbers. “There can’t be any delay. This is a hot potato I want out of my hands.”
   Mrs. Sanford picked up the extension but informed Chet that Dr. Bingham was at City Hall and would be all day. He had left specific instructions he was not to be bothered since he’d be closeted with the mayor.
   “So much for our chief,” Jack said. Without putting down the receiver, he dialed Calvin’s number. He didn’t have any better luck. Calvin’s secretary told him that Calvin had had to leave for the day. There was an illness in the family.
   Jack hung up the phone and drummed his fingers on the surface of the desk.
   “No luck?” Chet asked.
   “The entire general staff is indisposed,” Jack said. “We grunts are on our own.” Jack suddenly pushed back his chair, got up, and started out of the office.
   Chet bounded out of his own chair and followed. “Where are you going?” he asked. He had to run to catch up with Jack.
   “Down to talk to Bart Arnold,” Jack said. He got to the elevator and hit the Down button. “I need more information. Somebody has to figure out where this plague came from or this city’s in for some trouble.”
   “Hadn’t you better wait for Bingham?” Chet asked. “That look in your eye disturbs me.”
   “I didn’t know I was so transparent,” Jack said with a laugh. “I guess this incident has caught my interest. It’s got me excited.”
   The elevator door opened and Jack got on. Chet held the door from closing. “Jack, do me a favor and be careful. I like sharing the office with you. Don’t ruffle too many feathers.”
   “Me?” Jack questioned innocently. “I’m Mister Diplomacy.”
   “And I’m Muammar el Qaddafi,” Chet said. He let the elevator door slide closed.
   Jack hummed a perky tune while the elevator descended. He was definitely keyed up, and he was enjoying himself. He smiled when he remembered telling Laurie that he’d hoped Nodelman turned out to have something with serious institutional consequences like Legionnaires’ disease so he could give AmeriCare some heartburn. Plague was ten times better. And on top of sticking it to AmeriCare, he’d have the pleasure of collecting his ten bucks from Calvin.
   Jack exited on the first floor and went directly to Bart Arnold’s office. Bart was the chief of the PAs, or physician’s assistants. Jack was pleased to catch him at his desk.
   “We’ve got a presumptive diagnosis of plague. I’ve got to talk with Janice Jaeger right away,” Jack said.
   “She’ll be sleeping,” Bart said. “Can’t it wait?”
   “No,” Jack said.
   “Bingham or Calvin know about this?” Bart asked.
   “Both are out, and I don’t know when they’ll be back,” Jack said.
   Bart hesitated a moment, then opened up the side drawer of his desk. After looking up Janice’s number, he made the call. When she was on the line, he apologized for having awakened her and explained that Dr. Stapleton needed to speak with her. He handed the phone to Jack.
   Jack apologized as well and then told her about the results on Nodelman. Any sign of sleepiness in Janice’s voice disappeared instantly.
   “What can I do to help?” she asked.
   “Did you find any reference to travel in any of the hospital records?” Jack asked.
   “Not that I recall,” Janice said.
   “Any reference to contact with pets or wild animals?” Jack asked.
   “Negative,” Janice said. “But I can go back there tonight. Those questions were never specifically asked.”
   Jack thanked her and told her that he’d be looking into it himself. He handed the phone back to Bart and hurried back to his own office.
   Chet looked up as Jack dashed in. “Learn anything?” he asked.
   “Not a thing,” Jack said happily. He pulled out Nodelman’s folder and rapidly shuffled through the pages until he found the completed identification sheet. On it were phone numbers for the next of kin. With his index finger marking Nodelman’s wife’s number, Jack made the call. It was an exchange in the Bronx.
   Mrs. Nodelman answered on the second ring.
   “I’m Dr. Stapleton,” Jack said. “I’m a medical examiner for the City of New York.”
   At that point Jack had to explain the role of a medical examiner, because even the archaic term “coroner” didn’t register with Mrs. Nodelman.
   “I’d like to ask you a few questions,” Jack said once Mrs. Nodelman understood who he was.
   “It was so sudden,” Mrs. Nodelman said. She had started to cry. “He had diabetes, that’s true. But he wasn’t supposed to die.”
   “I’m very sorry for your loss,” Jack said. “But did your late husband do any recent traveling?”
   “He went to New Jersey a week or so ago,” Mrs. Nodelman said. Jack could hear her blow her nose.
   “I was thinking of travel to more distant destinations,” Jack said. “Like to the Southwest or maybe India.”
   “Just to Manhattan every day,” Mrs. Nodelman said.
   “How about a visitor from some exotic locale?” Jack asked.
   “Donald’s aunt visited in December,” Mrs. Nodelman said.
   “And where is she from?”
   “Queens,” Mrs. Nodelman said.
   “Queens,” Jack repeated. “That’s not quite what I had in mind. How about contact with any wild animals? Like rabbits.”
   “No,” Mrs. Nodelman said. “Donald hated rabbits.”
   “How about pets?” Jack asked.
   “We have a cat,” Mrs. Nodelman said.
   “Is the cat sick?” Jack asked. “Or has the cat brought home any rodents?”
   “The cat is fine,” Mrs. Nodelman said. “She’s a house cat and never goes outside.”
   “How about rats?” Jack asked. “Do you see many rats around your house? Have you seen any dead ones lately?”
   “We don’t have any rats,” Mrs. Nodelman said indignantly. “We live in a nice, clean apartment.”
   Jack tried to think of something else to ask, but for the moment nothing came to mind. “Mrs. Nodelman,” he said, “you’ve been most kind. The reason I’m asking you these questions is because we have reason to believe that your husband died of a serious infectious disease. We think he died of plague.”
   There was a brief silence.
   “You mean bubonic plague like they had in Europe long ago?” Mrs. Nodelman asked.
   “Sort of,” Jack said. “Plague comes in two clinical forms, bubonic and pneumonic. Your husband seems to have had the pneumonic form, which happens to be the more contagious. I would advise you to go to your doctor and inform him of your potential exposure. I’m sure he’ll want you to take some precautionary antibiotics. I would also advise you to take your pet to your vet and tell him the same thing.”
   “Is this serious?” Mrs. Nodelman asked.
   “It’s very serious,” Jack said. He then gave her his phone number in case she had any questions later. He also asked her to call him if the vet found anything suspicious with the cat.
   Jack hung up the phone and turned to Chet. “The mystery is deepening,” he said. Then he added cheerfully: “AmeriCare is going to have some severe indigestion over this.”
   “There’s that facial expression again that scares me,” Chet said.
   Jack laughed, got up, and started out of the room.
   “Where are you going now?” Chet asked nervously.
   “To tell Laurie Montgomery what’s going on,” Jack said. “She’s supposed to be our supervisor for today. She has to be apprised.”
   A few minutes later Jack returned.
   “What’d she say?” Chet asked.
   “She was as stunned as we were,” Jack said. He grabbed the phone directory before taking his seat. He flipped open the pages to the city listings.
   “Did she want you to do anything in particular?” Chet asked.
   “No,” Jack said. “She told me to tread water until Bingham is informed. In fact she tried to call our illustrious chief, but he’s still incommunicado with the mayor.”
   Jack picked up the phone and dialed.
   “Who are you calling now?” Chet asked.
   “The Commissioner of Health, Patricia Markham,” Jack said. “I ain’t waiting.”
   “Good grief!” Chet exclaimed, rolling his eyes. “Hadn’t you better let Bingham do that? You’ll be calling his boss behind his back.”
   Jack didn’t respond. He was busy giving his name to the commissioner’s secretary. When she told him to hold on, he covered the mouthpiece with his hand and whispered to Chet: “Surprise, surprise, she’s in!”
   “I guarantee Bingham is not going to like this,” Chet whispered back.
   Jack held up his hand to silence Chet. “Hello, Commissioner,” Jack said into the phone. “Howya doing. This is Jack Stapleton here, from over at the ME’s office.”
   Chet winced at Jack’s breezy informality.
   “Sorry to spoil your day,” Jack continued, “but I felt I had to call. Dr. Bingham and Dr. Washington are momentarily unavailable and a situation has developed that I believe you should know about. We’ve just made a presumptive diagnosis of plague in a patient from the Manhattan General Hospital.”
   “Good Lord!” Dr. Markham exclaimed loud enough for Chet to hear. “That’s frightening, but only one case, I trust.”
   “So far,” Jack said.
   “All right, I’ll alert the City Board of Health,” Dr. Markham said. “They’ll take over and contact the CDC. Thanks for the warning. What was your name again?”
   “Stapleton,” Jack said. “Jack Stapleton.”
   Jack hung up with a self-satisfied smile on his lips. “Maybe you should sell short your AmeriCare stock,” he told Chet. “The commissioner sounds concerned.”
   “Maybe you’d better brush off your résumé,” Chet said. “Bingham is going to be pissed.”
   Jack whistled while he leafed through Nodelman’s file until he came up with the investigative report. Once he had located the name of the attending physician, Dr. Carl Wainwright, he wrote it down. Then he got up and put on his leather bomber jacket.
   “Uh oh,” Chet said. “Now what?”
   “I’m going over to the Manhattan General,” Jack said. “I think I’ll make a site visit. This case is too important to leave up to the generals.”
   Chet swung around in his chair as Jack went through the door.
   “Of course, you know that Bingham doesn’t encourage us MEs doing site work,” Chet said. “You’ll be adding insult to injury.”
   “I’ll take my chances,” Jack said. “Where I was trained it was considered necessary.”
   “Bingham thinks it’s the job of the PAs,” Chet said. “He’s told us that time and again.”
   “This case is too interesting for me to pass up,” Jack called from down the hall. “Hold down the fort. I won’t be long.”

5. Wednesday, 2:50 p.m., March 20, 1996

   It was overcast and threatening rain, but Jack didn’t mind. Regardless of the weather, the vigorous bike ride uptown to the Manhattan General was a pleasure after having stood all morning in the autopsy room imprisoned inside his moon suit.
   Near the hospital’s front entrance Jack located a sturdy street sign to lock his mountain bike to. He even locked up his helmet and bomber jacket with a separate wire lock that also secured the seat.
   Standing within the shadow of the hospital, Jack glanced up at its soaring facade. It had been an old, respected, university-affiliated, proprietary hospital in its previous life. AmeriCare had gobbled it up during the fiscally difficult times the government had unwittingly created in health care in the early 1990s. Although Jack knew revenge was far from a noble emotion, he savored the knowledge that he was about to hand AmeriCare a public relations bomb.
   Inside Jack went to the information booth and asked about Dr. Carl Wainwright. He learned that the man was an AmeriCare internist whose office was in the attached professional building. The receptionist gave Jack careful directions.
   Fifteen minutes later, Jack was in the man’s waiting room. After Jack flashed his medical examiner’s badge, which looked for all intents and purposes like a police badge, the receptionist wasted no time in letting Dr. Wainwright know he was there. Jack was immediately shown into the doctor’s private office, and within minutes the doctor himself appeared.
   Dr. Carl Wainwright was prematurely white-haired and slightly stooped over. His face, however, was youthful with bright blue eyes. He shook hands with Jack and motioned for him to sit down.
   “It’s not every day we’re visited by someone from the medical examiner’s office,” Dr. Wainwright said.
   “I’d be concerned if it were,” Jack said.
   Dr. Wainwright looked confused until he realized Jack was kidding. Dr. Wainwright tittered. “Right you are,” he said.
   “I’ve come about your patient Donald Nodelman,” Jack said, getting right to the point. “We have a presumptive diagnosis of plague.”
   Dr. Wainwright’s mouth dropped open. “That’s impossible,” he said when he’d recovered enough to speak.
   Jack shrugged. “I guess it’s not,” he said. “Fluorescein antibody for plague is quite reliable. Of course, we haven’t yet grown it out.”
   “My goodness,” Dr. Wainwright managed. He rubbed a nervous palm across his face. “What a shock.”
   “It is surprising,” Jack agreed. “Especially since the patient had been in the hospital for five days before his symptoms started.”
   “I’ve never heard of nosocomial plague,” Dr. Wainwright said.
   “Nor have I,” Jack said. “But it was pneumonic plague, not bubonic, and as you know the incubation period is shorter for pneumonic, probably only two to three days.”
   “I still can’t believe it,” Dr. Wainwright said. “Plague never entered my thoughts.”
   “Anybody else sick with similar symptoms?” Jack asked.
   “Not that I know of,” Dr. Wainwright said, “but you can rest assured that we will find out immediately.”
   “I’m curious about this man’s lifestyle,” Jack said. “His wife denied any recent travel or visitors from areas endemic to plague. She also doubted he’d come in contact with wild animals. Is that your understanding as well?”
   “The patient worked in the garment district,” Dr. Wainwright said. “He did bookkeeping. He never traveled. He wasn’t a hunter. I’d been seeing him frequently over the last month, trying to get his diabetes under control.”
   “Where was he in the hospital?” Jack asked.
   “On the medical ward on the seventh floor,” Dr. Wainwright said. “Room seven-oh-seven. I remember the number specifically.”
   “Single room?” Jack asked.
   “All our rooms are singles,” Dr. Wainwright said.
   “That’s a help,” Jack said. “Can I see the room?”
   “Of course,” Dr. Wainwright said. “But I think I should call Dr. Mary Zimmerman, who’s our infection-control officer. She’s got to know about this immediately.”
   “By all means,” Jack said. “Meanwhile, would you mind if I went up to the seventh floor and looked around?”
   “Please,” Dr. Wainwright said as he gestured toward the door. “I’ll call Dr. Zimmerman and we’ll meet you up there.” He reached for the phone.
   Jack retraced his route back to the main hospital building. He took the elevator to the seventh floor, which he found was divided by the elevator lobby into two wings. The north wing housed internal medicine while the south wing was reserved for OB-GYN. Jack pushed through the doors that led into the internal-medicine division.
   As soon as the swinging door closed behind Jack, he knew that word of the contagion had arrived. A nervous bustle was apparent, and all the personnel were wearing newly distributed masks. Obviously Wainwright had wasted no time.
   No one paid Jack any attention as he wandered down to room 707. Pausing at the door, Jack watched as two masked orderlies wheeled out a masked and confused patient clutching her belongings who was apparently being transferred. As soon as they were gone, Jack walked in.
   Seven-oh-seven was a nondescript hospital room of modern design; the interior of the old hospital had been renovated in the not-too-distant past. The metal furniture was typical hospital issue and included a bed, a bureau, a vinyl-covered chair, a night table, and a variable-height bed table. A TV hung from an arm attached to the ceiling.
   The air-conditioning apparatus was beneath the window. Jack went over to it, lifted the top, and looked inside. A hot-water and a chill-water pipe poked up through the concrete floor and entered a thermostated fan unit that recirculated room air. Jack detected no holes large enough for any type of rodent much less a rat.
   Stepping into the bathroom, Jack glanced around at the sink, toilet, and shower. The room was newly tiled. There was an air return in the ceiling. Bending down, he opened the cabinet below the sink; again there were no holes.
   Hearing voices in the other room, Jack stepped back through the door. It was Dr. Wainwright clutching a mask to his face. He was accompanied by two women and a man, all of whom were wearing masks. The women were attired in the long, white professorial coats Jack associated with medical-school professors.
   After handing Jack a mask, Dr. Wainwright made the introductions. The taller woman was Dr. Mary Zimmerman, the hospital’s infection-control officer and head of the like-named committee. Jack sensed she was a serious woman who felt defensive under the circumstances. As she was introduced, she informed him that she was a board-certified internist with subspecialty training in infectious disease.
   Not knowing how to respond to this revelation, Jack complimented her.
   “I did not have an opportunity to examine Mr. Nodelman,” she added.
   “I’m certain you would have made the diagnosis instantly had you done so,” Jack said, consciously trying to keep sarcasm out of his voice.
   “No doubt,” she said.
   The second woman was Kathy McBane, and Jack was happy to turn his attention to her, especially since Ms. McBane had a warmer demeanor than her committee chairwoman. He learned she was an RN supervisor and a member of the Infection Control Committee. It was usual for such a committee to have representatives from most if not all the hospital departments.
   The man was George Eversharp. He was dressed in a heavy cotton twill blue uniform. As Jack suspected, he was the supervisor of the department of engineering and was also a member of the Infection Control Committee.
   “We certainly are indebted to Dr. Stapleton for his rapid diagnosis,” Dr. Wainwright said, trying to lighten the atmosphere.
   “Just a lucky guess,” Jack said.
   “We’ve already begun to react,” Dr. Zimmerman said in a deadpan voice. “I’ve ordered a list to be drawn up of possible contacts to start chemoprophylaxis.”
   “I think that is wise,” Jack said.
   “And as we speak, the clinical computer is searching our current patient database for symptom complexes suggestive of plague,” she continued.
   “Commendable,” Jack said.
   “Meanwhile we have to discover the origin of the current case,” she said.
   “You and I are thinking along the same lines,” Jack said.
   “I’d advise you to wear your mask,” she added.
   “Okay,” Jack said agreeably. He held it up to his face.
   Dr. Zimmerman turned to Mr. Eversharp. “Please continue with what you were saying about the air flow.”
   Jack listened as the engineer explained that the ventilation system in the hospital was designed so that there was a flow from the hall into each room and then its bathroom. The air was then filtered. He also explained that there were a few rooms where the air flow could be reversed for patients with compromised immune systems.
   “Is this one of those rooms?” Dr. Zimmerman asked.
   “It is not,” Mr. Eversharp said.
   “So there is no freak way plague bacteria could have gotten into the ventilation system and infected just this room?” Dr. Zimmerman asked..
   “No,” Mr. Eversharp said. “The air induction in the hall goes into all these rooms equally.”
   “And the chances of bacteria floating out of this room into the hall would be low,” Dr. Zimmerman said.
   “Impossible,” Mr. Eversharp said. “The only way it could leave would be on some sort of vector.”
   “Excuse me,” a voice called. Everyone turned to see a nurse standing in the doorway. She, too, had a mask pressed against her face. “Mr. Kelley would like you all to come to the nurses’ station.”
   Dutifully everyone started from the room. As Kathy McBane stepped in front of him, Jack got her attention. “Who’s Mr. Kelley?” he asked.
   “He’s the hospital president,” Ms. McBane said.
   Jack nodded. As he walked he nostalgically reminisced that the head of the hospital used to be called an administrator and was frequently a person who’d had medical training. That was back when patient care was paramount. Now that business was king and the goal was profit, the name had changed to president.
   Jack was looking forward to meeting Mr. Kelley. The hospital president was the on-site representative of AmeriCare, and giving him a headache was the equivalent of giving AmeriCare a headache.
   The atmosphere at the nurses’ station was tense. Word of the plague had spread like wildfire. Everyone who worked on the floor and even some of the ambulatory patients now knew they had been potentially exposed. Charles Kelley was doing his best to reassure them. He told them there was no risk and that everything was under control.
   “Yeah, sure!” Jack scoffed under his breath. Jack looked with disgust at this man who had the gall to utter such patently false platitudes. He was intimidatingly tall, a good eight inches taller than Jack’s six feet. His handsome face was tanned and his sandy-colored hair was streaked with pure, golden blond as if he’d just returned from a Caribbean vacation. From Jack’s perspective, he looked and sounded more like an unctuous car salesman than the business manager that he was.
   As soon as Kelley saw Jack and the others approach, he motioned for them to follow him. Breaking off his consoling speech, he made a beeline for the safety of the utility room behind the nurses’ station.
   As Jack squeezed in behind Kathy McBane, he noticed Kelley wasn’t alone. He was being shadowed by a slightly built man with a lantern jaw and thinning hair. In sharp contrast to Kelley’s sartorial splendor, this second man was dressed in a threadbare, cheap sports coat over slacks that appeared never to have been pressed.
   “God, what a mess!” Kelley said angrily to no one in particular. His demeanor had metamorphosed instantly from slippery salesman to sardonic administrator. He took a paper towel and wiped his perspiring brow. “This is not what this hospital needs!” He crumpled the towel and threw it into the trash. Turning to Dr. Zimmerman and in contrast to what he’d just said out in the nurses’ station, he asked her if they were taking a risk just being on the floor.
   “I sincerely doubt it,” Dr. Zimmerman said. “But we’ll have to make certain.”
   Turning to Dr. Wainwright, Kelley said: “No sooner had I heard about this disaster than I learned you already knew about it. Why didn’t you inform me?”
   Dr. Wainwright explained that he’d just heard the news from Jack and had not had time to call. He explained he thought it was more important to call Dr. Zimmerman to get corrective measures instituted. He then proceeded to introduce Jack.
   Jack stepped forward and gave a little wave. He was unable to suppress a smile. This was the moment he knew he’d savor.
   Kelley took in the chambray shirt, the knitted tie, and the black jeans. It was a far cry from his own Valentino silk suit. “Seems to me the Commissioner of Health mentioned your name when she called me,” Kelley said. “As I recall, she was impressed you’d made the diagnosis so quickly.”
   “We city employees are always glad to be of service,” Jack said.
   Kelley gave a short, derisive laugh.
   “Perhaps you’d like to meet one of your dedicated fellow city employees,” Kelley said. “This is Dr. Clint Abelard. He’s the epidemiologist for the New York City Board of Health.”
   Jack nodded to his mousy colleague, but the epidemiologist didn’t return the greeting. Jack got the sense that Jack’s presence was not wholly appreciated. Interdepartmental rivalry was a fact of bureaucratic life he was just beginning to appreciate.
   Kelley cleared his throat and then spoke to Wainwright and Zimmerman. “I want this whole episode kept as low-key as possible. The less that’s in the media the better. If any reporter tries to talk with either of you, send them to me. I’ll be gearing up the PR office to do damage control.”
   “Excuse me,” Jack said, unable to restrain himself from interrupting. “Corporate interests aside, I think you should concentrate on prevention. That means treating contacts and ascertaining where the plague bacteria came from. I think you have a mystery on your hands here, and until that’s solved, the media is going to have a field day no matter what damage control you attempt.”
   “I wasn’t aware anyone asked your opinion,” Kelley said scornfully.
   “I just felt you could use a little direction,” Jack said. “You seemed to be wandering a bit far afield.”
   Kelley’s face reddened. He shook his head in disbelief. “All right,” he said, struggling to control himself. “With your clairvoyance, I suppose you already have an idea of its origin.”
   “I’d guess rats,” Jack said. “I’m sure there are lots of rats around here.” Jack had been waiting to use that comment since it had had such a good effect with Calvin that morning.
   “We have no rats here at the Manhattan General,” Kelley sputtered. “And if I hear that you’ve said anything like that to the media, I’ll have your head.”
   “Rats are the classical reservoir for the plague,” Jack said. “I’m sure they’re around here if you know how to recognize them, I mean find them.”
   Kelley turned to Clint Abelard. “Do you think rats had anything to do with this case of plague?” he demanded.
   “I have yet to begin my investigation,” Dr. Abelard said. “I wouldn’t want to hazard a guess, but I find it hard to believe that rats could have been involved. We’re on the seventh floor.”
   “I’d suggest you start trapping rats,” Jack said. “Start in the immediate neighborhood. The first thing to find out is if plague has infiltrated the local urban rodent population.”
   “I’d like to switch the conversation away from rats,” Kelley said. “I would like to hear about what we should do for people who had direct contact with the deceased.”
   “That’s my department,” Dr. Zimmerman said. “Here’s what I propose…”
   While Dr. Zimmerman spoke, Clint Abelard motioned for Jack to accompany him out to the nurses’ station.
   “I’m the epidemiologist,” Clint said in an angry, forced whisper.
   “I’ve never disputed that fact,” Jack said. He was surprised and confused by the vehemence of Clint’s reaction.
   “I’m trained to investigate the origin of diseases in the human community,” he said. “It’s my job. You, on the other hand, are a coroner…”
   “Correction,” Jack said. “I’m a medical examiner with training in pathology. You, as a physician, should know that.”
   “Medical examiner or coroner, I couldn’t care less what term you guys use for yourselves,” Clint said.
   “Hey, but I do,” Jack said.
   “The point is that your training and your responsibility involve the dead, not the origin of disease.”
   “Wrong again,” Jack said. “We deal with the dead so that they speak to the living. Our goal is to prevent death.”
   “I don’t know how to make it much plainer to you,” Clint said with exasperation. “You told us a man died of plague. We appreciate that, and we didn’t interfere in your work. Now it is for me to figure out how he got it.”
   “I’m just trying to help,” Jack said.
   “Thank you, but if I need your help I’ll ask for it,” Clint said and strode off toward room 707.
   Jack watched Clint’s figure recede, when a commotion behind him attracted his attention. Kelley had emerged from the utility room and was immediately besieged by the people he’d been speaking with earlier. Jack was impressed by how quickly his plastic smile returned and with what ease he sidestepped all questions. Within seconds, he was on his way down the hall toward the elevators and the safety of the administrative offices.
   Dr. Zimmerman and Dr. Wainwright stepped out of the utility room deep in conversation. When Kathy McBane appeared, she was alone. Jack intercepted her.
   “Sorry to have been the bearer of bad news,” Jack offered.
   “Don’t be sorry,” Kathy said. “From my point of view, we owe you a vote of thanks.”
   “Well, it’s an unfortunate problem,” Jack said.
   “I’d guess it’s the worst since I’ve been on the Infection Control Committee,” she said. “I thought last year’s outbreak of hepatitis B was bad. I never dreamed we’d ever see plague.”
   “What is the Manhattan General’s experience in regard to nosocomial infections?” Jack asked.
   Kathy shrugged. “Pretty much the equivalent of any large tertiary-care hospital,” she said. “We’ve had our methicillin-resistant staph. Of course, that’s an ongoing problem. We even had klebsiella growing in a canister of surgical scrub soap a year ago. That resulted in a whole series of postoperative wound infections until it was discovered.”
   “How about pneumonias?” Jack asked. “Like this case.”
   “Oh, yeah, we’ve had our share of them too,” Kathy said with a sigh. “Mostly it’s been pseudomonas, but two years ago we had an outbreak of Legionella.”
   “I hadn’t heard about that,” Jack said.
   “It was kept quiet,” Kathy said. “Luckily no one died. Of course, I can’t say that about the problem we had just five months ago in the surgical intensive care. We lost three patients to enterobacterial pneumonia. We had to close the unit until it was discovered that some of our nebulizers had become contaminated.”
   “Kathy!” a voice called out sharply.
   Both Jack and Kathy abruptly turned to see that Dr. Zimmerman had come up behind them.
   “That is confidential information,” Dr. Zimmerman lectured.
   Kathy started to say something but then thought better of it.
   “We have work to do, Kathy,” Dr. Zimmerman said. “Let’s go to my office.”
   Suddenly abandoned, Jack debated what he should do. For a moment he considered going back to room 707, but after Clint’s tirade, he thought it best to leave the man alone. After all, Jack had intended to provoke Kelley, not Clint. Then he got an idea: It might be instructive to visit the lab. As defensively as Dr. Zimmerman had responded, Jack thought it was the lab that should have been chagrined. They were the ones who missed the diagnosis.
   After inquiring about the location of the lab, Jack took the elevator down to the second floor. Flashing his medical examiner’s badge again produced immediate results. Dr. Martin Cheveau, the lab director, materialized and welcomed Jack into his office. He was a short fellow with a full head of dark hair and pencil-line mustache.
   “Have you heard about the case of plague?” Jack asked once they were seated.
   “No, where?” Martin questioned.
   “Here at the Manhattan General,” Jack said. “Room seven-oh-seven. I posted the patient this morning.”
   “Oh, no!” Martin moaned. He sighed loudly. “That doesn’t sound good for us. What was the name?”
   “Donald Nodelman,” Jack said.
   Martin swung around in his seat and accessed his computer. The screen flashed all Nodelman’s laboratory results for the duration of his admission. Martin scrolled through until he got to the microbiology section.
   “I see we had a sputum gram stain showing weakly gram-negative bacilli,” Martin said. “There’s also a culture pending that was negative for growth at thirty-six hours. I guess that should have told us something, especially where I see pseudomonas was suspected. I mean, pseudomonas would have grown out without any trouble way before thirty-six hours.”
   “It would have been helpful if Giemsa’s or Wayson’s stain had been used,” Jack said. “The diagnosis could have been made.”
   “Exactly,” Martin said. He turned back to Jack. “This is terrible. I’m embarrassed. Unfortunately, it’s an example of the kind of thing that’s going to happen more and more often. Administration has been forcing us to cut costs and downsize even though our workload has gone up. It’s a deadly combination, as this case of plague proves. And it’s happening all over the country.”
   “You’ve had to let people go?” Jack asked. He thought that the clinical lab was one place hospitals actually made money.
   “About twenty percent,” Martin said. “Others we’ve had to demote. In microbiology we don’t have a supervisor any longer; if we had, he probably would have caught this case of plague. With the operating budget we’ve been allotted we can’t afford it. Our old supervisor got demoted to head tech. It’s discouraging. It used to be we strove for excellence in the lab. Now we strive for ‘adequate,’ whatever that means.”
   “Does your computer say which tech did the gram stain?” Jack asked. “If nothing else, we could turn this episode into a teaching experience.”
   “Good idea,” Martin said. He faced the computer and accessed data. The tech’s identity was in code. Suddenly he turned back to Jack.
   “I just remembered something,” he said. “My head tech thought of plague in relation to a patient just yesterday and asked me what I thought. I’m afraid I discouraged him by telling him the chances were somewhere on the order of a billion to one.”
   Jack perked up. “I wonder what made him think of plague?”
   “I wonder too,” Martin said. Reaching over to his intercom system, he paged Richard Overstreet. While they waited for the man to arrive, Martin determined that Nancy Wiggens had signed out on the original gram stain. Martin paged her as well.
   Richard Overstreet appeared within minutes. He was a boyish, athletic-looking individual with a shock of auburn hair that fell across his forehead. The hair had a habit of slipping over his eyes. Richard was ever pushing it back with his hand or throwing it back with a snap of his head. He wore a white jacket over surgical scrubs; his jacket pockets were crammed with test tubes, tourniquets, gauze pads, lab chits, and syringes.
   Martin introduced Richard to Jack, then asked him about the short discussion they’d had about plague the day before.
   Richard seemed embarrassed. “It was just my imagination getting the best of me,” he said with a laugh.
   “But what made you think of it?” Martin asked.
   Richard swept his hair from his face and for a moment left his hand on the top of his head while he thought. “Oh, I remember,” he said. “Nancy Wiggens had gone up to get a sputum culture and draw the man’s blood. She told me how sick he was and that he appeared to have some gangrene on the tips of his fingers. She said his fingers were black.” Richard shrugged. “It made me think of the black death.”
   Jack was impressed.
   “Did you follow up on it at all?” Martin asked.
   “No,” Richard said. “Not after what you’d said about the probability. As behind as we are in the lab, I couldn’t take the time. All of us, including me, have been out drawing blood. Is there some kind of problem?” Richard asked.
   “A big problem,” Martin said. “The man did have plague. Not only that, but he’s already dead.”
   Richard literally staggered. “My God!” he exclaimed.
   “I hope you encourage safety with your techs,” Jack said.
   “Absolutely,” Richard said, regaining his composure. “We have biosafety cabinets, both type two and three. I try to encourage my techs to use one or the other, especially with obviously serious infectious cases. Personally I like the type three, but some people find using the thick rubber gloves too clumsy.”
   At that moment Nancy Wiggens appeared. She was a shy woman who appeared more like a teenager than a college graduate. She could barely look Jack in the eye as they were introduced. She wore her dark hair parted down the middle of her head, and like that of her immediate boss, Richard, it constantly fell across her eyes.
   Martin explained to her what had happened. She was as shocked as Richard had been. Martin assured her she was not being blamed but that they should all try to learn from the experience.
   “What should I do about my exposure?” she questioned. “I was the one who got the specimen as well as the one who processed it.”
   “You’ll probably be taking tetracycline by mouth or streptomycin IM,” Jack said. “The hospital infection-control officer is working on that at the moment.”
   “Uh oh!” Martin voiced under his breath but loud enough for the others to hear. “Here comes our fearless leader and the chief of the medical staff, and both look unhappy.”
   Kelley swept into the room like an irate general after a military defeat. He towered over Martin with his hands on his hips and his reddened face thrust forward. “Dr. Cheveau,” he began with a scornful tone. “Dr. Arnold here tells me you should have made this diagnosis before…”
   Kelley stopped mid-sentence. Although he was content to ignore the two microbiology techs, Jack was a different story.
   “What in God’s name are you doing down here?” he demanded.
   “Just helping out,” Jack replied.
   “Aren’t you overstepping your mandate?” he suggested venomously.
   “We like to be thorough in our investigations,” Jack said.
   “I think you have more than exhausted your official capacity,” Kelley snapped. “I want you out of here. After all, this is a private institution.”
   Jack got to his feet, vainly trying to look the towering Kelley in the eye. “If AmeriCare thinks it can do without me, I think I’ll run along.”
   Kelley’s face turned purple. He started to say something else but changed his mind. Instead he merely pointed toward the door.
   Jack smiled and waved to the others before taking his leave. He was pleased with his visit. As far as he was concerned, it couldn’t have gone better.

6. Wednesday, 4:05 p.m., March 20, 1996

   Susanne Hard was looking through the small, round window of the door to the elevator lobby with rapt attention. The end of the corridor was as far as she was allowed to go on her ambulation. She’d been walking with little steps while supporting her freshly sutured abdomen. As unpleasant as the exercise was, she knew from experience that the sooner she mobilized herself, the sooner she’d be in a position to demand release.
   What had caught her attention out in the elevator lobby was the disturbing amount of traffic coming in and out of the medical ward as well as the nervous demeanor of the staff. Susanne’s sixth sense told her that something was wrong, especially with most of the people wearing masks.
   Before she could put a finger on the cause of the apparent stir, a literal chill passed through her like an icy arctic wind. Turning around, she expected to feel a draft. There wasn’t any. Then the chill returned, causing her to tense and shiver until it had passed. Susanne looked down at her hands. They had turned bone white.
   Increasingly anxious, Susanne started back to her room. Such a chill could not be a good sign. As an experienced patient she knew there was always the fear of a wound infection.
   By the time she entered her room she had a headache behind her eyes. As she climbed back into bed, the headache spread over the top of her head. It wasn’t like any headache she’d ever had before. It felt as if someone were pushing an awl into the depths of her brain.
   For a few panicky moments Susanne lay perfectly still, hoping that whatever had seemed wrong was now all right. But instead a new symptom developed: the muscles of her legs began to ache. Within minutes she found herself writhing in the bed, vainly trying to find a position that afforded relief.
   Close on the heels of the leg pain came an overall malaise that settled over her like a stifling blanket. It was so enervating that she could barely reach across her chest for the nurse’s call button. She pressed it and let her arm fall limply back to the bed.
   By the time the nurse came into the room, Susanne had developed a cough that chafed her already irritated throat.
   “I feel sick,” Susanne croaked.
   “How so?” the nurse questioned.
   Susanne shook her head. It was even hard to talk. She felt so terrible she didn’t know where to begin.
   “I have a headache,” she managed.
   “I believe you have a standing order of pain medication,” the nurse said. “I’ll get it for you.”
   “I need my doctor,” Susanne whispered. Her throat felt as bad as when she’d first awakened from the anesthesia.
   “I think we should try the pain medicine before we call your doctor,” the nurse said.
   “I feel cold,” Susanne said. “Terribly cold.”
   The nurse put a practiced hand on Susanne’s forehead, then pulled it back in alarm. Susanne was burning up. The nurse took the thermometer from its container on the bedside table and stuck it into Susanne’s mouth. While she waited for the thermometer to equilibrate, she wrapped a blood-pressure cuff around Susanne’s arm. The blood pressure was low.
   She then took the thermometer out of Susanne’s mouth. When she saw what the reading was, she let out a little gasp of surprise. It was 106° Fahrenheit.
   “Do I have a fever?” Susanne questioned.
   “A little one,” the nurse said. “But everything is going to be fine. I’ll go and give your doctor a call.”
   Susanne nodded. A tear came to the corner of her eye. She didn’t want this kind of complication. She wanted to go home.

7. Wednesday, 4:15 p.m., March 20, 1996

   “Do you honestly think that Robert Barker deliberately sabotaged our ad campaign?” Colleen asked Terese as they descended the stairs. They were on their way to the studio where Colleen wanted to show Terese what the creative team had put together for a new National Health campaign.
   “There’s not a doubt in my mind,” Terese said. “Of course, he didn’t do it himself. He had Helen do it by talking National Health out of buying adequate exposure time.”
   “But he’d be shooting himself in the foot. If we lose the National Health account and we can’t restructure, then his employee participation units are worth the same as ours: zilch.”
   “Screw his employee participation units,” Terese said. “He wants the presidency, and he’ll do anything to get it.”
   “God, bureaucratic infighting disgusts me,” Colleen said. “Are you sure you want the presidency?”
   Terese stopped dead on the stairs and looked at Colleen as if she’d just blasphemed. “I can’t believe you said that.”
   “But you’ve complained yourself that the more administrative duties you have, the less time you can spend on creativity.”
   “If Barker gets the presidency he’ll screw up the whole company,” Terese said indignantly. “We’ll start kowtowing to clients, and there goes creativity and quality in one fell swoop. Besides, I want to be president. It’s been my goal for five years. This is my chance, and if I don’t get it now, I’ll never get it.”
   “I don’t know why you’re not happy with what you’ve already accomplished,” Colleen said. “You’re only thirty-one and you’re already creative director. You should be content and do what you are good at: doing great ads.”
   “Oh, come on!” Terese said. “You know we advertising people are never satisfied. Even if I make president I’ll probably start eyeing CEO.”
   “I think you should cool it,” Colleen said. “You’re going to burn out before you’re thirty-five.”
   “I’ll cool it when I’m president,” Terese said.
   “Yeah, sure!” Colleen said.
   Once in the studio Colleen directed her friend into the small separate room that was affectionately called the “arena.” This was where pitches were rehearsed. The name came from the arenas of ancient Rome where Christians were thrown to the lions. At Willow and Heath the Christians were the low-level creatives.
   “You got a film?” Terese questioned. In the front of the room a screen had been pulled down over the chalkboards. At best she thought she’d be looking at sketchy storyboards.
   “We threw together a ‘ripomatic,’ ” Colleen explained. A ripomatic was a roughly spliced together amalgam of previously shot video that had been “stolen” from other projects to give a sense of a commercial.
   Terese was encouraged. She’d not expected video.
   “Now I’m warning you, this is all very preliminary,” Colleen added.
   “Save the disclaimers,” Terese said. “Run what you have.”
   Colleen waved to one of her underlings. The lights dimmed and the video started. It ran for a hundred seconds. It depicted a darling four-year-old girl with a broken doll. Terese recognized the footage immediately. It was part of a spot they’d done the year before for a national toy chain to promote the company’s generous return policy. Colleen had cleverly made it appear as if the child were bringing the doll to the new National Health hospital. The tag line was “We cure anything anytime.”
   As soon as the video stopped, the lights came on. For a few moments no one spoke. Finally Colleen broke the silence. “You don’t like it,” she said.
   “It’s cute,” Terese admitted.
   “The idea is to make the doll reflect different illnesses and injuries in different commercials,” Colleen said. “Of course, we’d have the child speak and extol the virtues of National Health in the video versions. In print we’d make sure the picture told the story.”
   “The problem is it’s too cute,” Terese said. “Even if I think it has some merit, I’m sure the client won’t like it, since Helen via Robert would certainly trivialize it.”
   “It’s the best that we’ve come up with so far,” Colleen said. “You’ll have to give us some direction. We need a creative brief from you; otherwise we’ll just keep wandering all over the conceptual landscape. Then there will be no chance to put anything together for next week.”
   “We have to come up with something that sets National Health apart from AmeriCare even though we know they are equivalent. The challenge is finding that one idea,” Terese said.
   Colleen motioned for her assistant to leave. Once she had, Colleen took a chair and put it in front of Terese’s. “We need more of your direct involvement,” she said.
   Terese nodded. She knew Colleen was right, but Terese felt mentally paralyzed. “The problem is that it’s hard to think with this presidency situation hanging over me like the sword of Damocles.”
   “I think you’ve got yourself in overdrive,” Colleen said. “You’re a ball of nerves.”
   “So what else is new?” Terese said.
   “When was the last time you went out for dinner and a few drinks?” Colleen said.
   Terese laughed. “I haven’t had time for anything like that for months.”
   “That’s my point,” Colleen said. “No wonder your creative juices aren’t flowing. You need to relax. Even if it’s just for a few hours.”
   “You really think so?” Terese asked.
   “Absolutely,” Colleen said. “In fact we’re going out tonight. We’ll go to dinner and we’ll have a few drinks. We’ll even try not to talk about advertising for one night.”
   “I don’t know,” Terese voiced. “We’ve got this dead-line…”
   “That’s exactly my point,” Colleen said. “We need to blow the tubes and clear out the cobwebs. Maybe then we’ll come up with that big idea. So don’t argue. I’m not taking no for an answer.”

8. Wednesday, 4:35 p.m., March 20, 1996

   Jack navigated his mountain bike between the two Health and Hospital Corporation mortuary vans parked at the receiving bay at the medical examiner’s office and rode directly into the morgue. Under normal circumstances he’d have dismounted by then and walked the bike, but he was in too good a mood.
   Jack parked his bike by the Hart Island coffins, locked it up, then whistled on his way to the elevators. He waved to Sal D’Ambrosio as he passed the mortuary office.
   “Chet, my boy, how are you?” Jack asked as he breezed into their shared fifth-floor office.
   Chet laid his pen down on his desk and turned to face his officemate. “The world’s been in here looking for you. What have you been doing?”
   “Indulging myself,” Jack said. He peeled off his leather jacket and draped it over the back of his desk chair before sitting down. He surveyed his row of files, deciding which one to attack first. His in-basket had a newly replenished pile of lab results and PA reports.
   “I wouldn’t get too comfortable,” Chet said. “One of those looking for you was Bingham himself. He told me to tell you to come directly to his office.”
   “How nice,” Jack said. “I was afraid he’d forgotten about me.”
   “I wouldn’t be so flippant about it,” Chet said. “Bingham was not happy. And Calvin stopped by as well. He’d like to see you, too, and smoke was coming out of his ears.”
   “Undoubtedly he’s eager to pay me my ten dollars,” Jack said. He got up from his desk and patted Chet on the shoulder. “Don’t worry about me. I have a strong survival instinct.”
   “You could have fooled me,” Chet said.
   As Jack descended in the elevator, he was curious how Bingham would handle the current situation. Since Jack had started working at the ME’s office, he’d had only sporadic contact with the chief. The day-to-day administrative problems were all handled by Calvin.
   “You can go right in,” Mrs. Sanford said without even looking up from her typing. Jack wondered how she knew it was him.
   “Close the door,” Dr. Harold Bingham commanded.
   Jack did as he was told. Bingham’s office was spacious with a large desk set back under high windows covered with ancient venetian blinds. At the opposite end of the room was a library table with a teaching microscope. A glass-fronted bookcase lined the far wall.
   “Sit down,” Bingham said.
   Dutifully Jack sat.
   “I’m not sure I understand you,” Bingham said in his deep, husky voice. “You apparently made a rather brilliant diagnosis of plague today and then foolishly took it upon yourself to call my boss, the Commissioner of Health. Either you are a completely apolitical creature or you have a self-destructive streak.”
   “It’s probably a combination of the two,” Jack said.
   “You’re also impertinent,” Bingham said.
   “That’s part of the self-destructive streak,” Jack said. “On the positive side, I’m honest.” He smiled.
   Bingham shook his head. Jack was testing his ability to control himself. “Just so I can try to understand,” he said as he entwined the fingers of his shovel-like hands, “did you not think that I would find it inappropriate for you to call the commissioner before talking with me?”
   “Chet McGovern suggested as much,” Jack said. “But I was more concerned about getting the word out. Ounce of prevention is worth a pound of cure, especially if we’re looking at a potential epidemic.”
   There was a moment of silence while Bingham considered Jack’s statement, which he had to admit contained a modicum of validity. “The second thing I wanted to discuss was your visit to the Manhattan General. Frankly, your decision to do this surprises me. During your orientation I know you were told that our policy is to rely on our excellent PAs to do site work. You do remember that, don’t you?”
   “Certainly I remember,” Jack said. “But I felt that the appearance of plague was unique enough to demand a unique response. Besides, I was curious.”
   “Curious!” Bingham blurted out. He momentarily lost control. “That’s the lamest excuse for ignoring established policy I’ve heard in years.”
   “Well, there was more,” Jack admitted. “Knowing the General was an AmeriCare hospital, I wanted to go over there and rub it in a little. I’m not fond of AmeriCare.”
   “What in heaven’s name do you have against AmeriCare?” Bingham asked.
   “It’s a personal thing,” Jack said.
   “Would you care to elaborate?” Bingham asked.
   “I’d rather not,” Jack said. “It’s a long story.”
   “Suit yourself,” Bingham said irritably. “But I’m not going to tolerate your going over there flashing your medical examiner’s badge for some personal vendetta. That’s an egregious misuse of official authority.”
   “I thought our mandate was to get involved in anything that could affect public health,” Jack said. “Certainly a case of plague falls under that rubric.”
   “Indeed,” Bingham pronounced. “But you had already alerted the Commissioner of Health. She in turn alerted the City Board of Health, who immediately dispatched the chief epidemiologist. You had no business being over there, much less causing trouble.”
   “What kind of trouble did I cause?” Jack asked.
   “You managed to irritate hell out of both the administrator and the city epidemiologist,” Bingham roared. “Both of them were mad enough to lodge official complaints. The administrator called the mayor’s office, and the epidemiologist called the commissioner. Both of these public servants can be considered my bosses, and neither one of them was pleased, and both of them let me know about it.”
   “I was just trying to be helpful,” Jack said innocently.
   “Well, do me a favor and don’t try to be helpful,” Bingham snapped. “Instead I want you to stay around here where you belong and do the work you were hired to do. Calvin informed me that you have a lot of cases pending.”
   “Is that it?” Jack asked when Bingham paused.
   “For now,” Bingham said.
   Jack got up and headed for the door.
   “One last thing,” Bingham said. “Remember that you are on probation for the first year.”
   “I’ll keep that in mind,” Jack said.
   Leaving Bingham’s office, Jack passed Mrs. Sanford and went directly across to Calvin Washington’s office. The door was ajar. Calvin was busy at his microscope.
   “Excuse me,” Jack called out. “I understand you were looking for me.”
   Calvin turned around and eyed Jack. “Have you been in to see the chief yet?” he growled.
   “Just came from there,” Jack said. “It’s reassuring to be in such demand around here.”
   “Dispense with your smartass talk,” Calvin said. “What did Dr. Bingham say?”
   Jack told Calvin what had been said and that Bingham had concluded by reminding him that he was on probation.
   “Damn straight,” Calvin said. “I think you’d better shape up or you’ll be out looking for work.”
   “Meanwhile I have one request,” Jack said.
   “What is it?” Calvin asked.
   “How about that ten dollars you owe me,” Jack said.
   Calvin stared back at Jack, amazed that under the circumstances Jack had the gall to ask for the money. Finally Calvin rolled to the side in his seat, withdrew his wallet, and pulled out a ten-dollar bill.
   “I’ll get this back,” Calvin vowed.
   “Sure you will,” Jack said as he took the bill.
   With the money comfortably in his pocket, Jack returned upstairs to his office. As he entered he was surprised to find Laurie leaning against Chet’s desk. Both she and Chet looked at Jack with expectant concern.
   “Well?” Chet questioned.
   “Well what?” Jack asked. He squeezed by the others to plop down in his seat.
   “Are you still employed?” Chet asked.
   “Seems that way,” Jack said. He started going through the lab reports in his in-basket.
   “You’d better be careful,” Laurie advised as she started for the door. “They can fire you at their pleasure during your first year.”
   “So Bingham reminded me,” Jack said.
   Pausing at the threshold, Laurie turned back to face Jack. “I almost got fired my first year,” she admitted.
   Jack looked up at her. “How come?” he asked.
   “It had to do with those challenging overdose cases I mentioned this morning,” Laurie said. “Unfortunately, while I followed up on them I got on the wrong side of Bingham.”
   “Is that part of that long story you alluded to?” Jack asked.
   “That’s the one,” Laurie said. “I came this close to being fired.” She held up her thumb and index finger about a quarter inch apart. “It was all because I didn’t take Bingham’s threats seriously. Don’t make the same mistake.”
   As soon as Laurie had gone Chet wanted a verbatim recounting of everything Bingham had said. Jack related what he could remember, including the part about the mayor and the Commissioner of Health calling Bingham to complain about him.
   “The complaints were about you specifically?” Chet asked.
   “Apparently,” Jack said. “And here I was being the Good Samaritan.”
   “What in God’s name did you do?” Chet asked.
   “I was just being my usual diplomatic self,” Jack said. “Asking questions and offering suggestions.”
   “You’re crazy,” Chet said. “You almost got yourself fired for what? I mean, what were you trying to prove?”
   “I wasn’t trying to prove anything,” Jack said.
   “I don’t understand you,” Chet said.
   “That seems to be a universal opinion,” Jack said.
   “All I know about you is that you were an ophthalmologist in a former life and you live in Harlem to play street basketball. What else do you do?”
   “That about sums it up,” Jack said. “Apart from working here, that is.”
   “What do you do for fun?” Chet asked. “I mean, what kind of social life do you have? I don’t mean to pry, but do you have a girlfriend?”
   “No, not really,” Jack said.
   “Are you gay?”
   “Nope. I’ve just sorta been out of commission for a while.”
   “Well, no wonder you’re acting so weird. I tell you what. We’re going out tonight. We’ll have some dinner, maybe have a few drinks. There’s a comfortable bar in the neighborhood where I live. It will give us time to talk.”
   “I haven’t felt like talking much about myself,” Jack said.
   “All right, you don’t have to talk,” Chet said. “But we’re going out. I think you need some normal human contact.”
   “What’s normal?” Jack questioned.

9. Wednesday, 10:15 p.m., March 20, 1996

   Chet turned out to be extraordinarily resolute. No matter what Jack said, he insisted that they have dinner together. Finally Jack relented, and just before eight he’d ridden his bike across Central Park to meet Chet in an Italian restaurant on Second Avenue.
   After dinner Chet had been equally insistent about Jack’s accompanying him for a few drinks. Feeling beholden to his officemate since Chet had insisted on paying for the dinner, Jack had gone along. Now, as they mounted the steps to the bar, Jack was having second thoughts. For the past several years he’d been in bed by ten and up by five. At ten-fifteen after a half bottle of wine, he was fading fast.
   “I’m not sure I’m up for this,” Jack said.
   “We’re already here,” Chet complained. “Come on in. We’ll just have one beer.”
   Jack leaned back to look at the facade of the bar. He didn’t see a name. “What’s this place called?” he asked.
   “The Auction House,” Chet said. “Get your ass in here.” He was holding open the door.
   To Jack the interior looked vaguely like his grandmother’s living room back in Des Moines, Iowa, except for the mahogany bar itself. The furniture was an odd mishmash of Victorian, and the drapes were long and droopy. The high ceiling was brightly colored embossed tin.
   “How about sitting here,” Chet suggested. He pointed toward a small table set in the window overlooking Eighty-ninth Street.
   Jack complied. From where he was sitting Jack had a good view of the room, which he now noted had a high-gloss hardwood floor, not the usual for a bar. There were about fifty people in the room either standing at the bar or sitting on the couches. They were all well dressed and appeared professional. There was not one backward baseball cap in the group. The mix was about even between male and female.
   Jack mused that perhaps Chet had been right to have encouraged him to come out. Jack had not been in such a “normal” social environment in several years. Maybe it was good for him. Having become a loner carried its burdens. He wondered what these attractive people were saying to one another as their easy conversations drifted back to him in a babble of voices. The problem was he had zero confidence he could add to any of the discussions.
   Jack’s eyes wandered to Chet, who was at the bar, supposedly getting them each a beer. Actually he was in a conversation with a well-endowed, long-haired blonde in a stylish sweatshirt over tight jeans. Accompanying her was a svelte woman in a revealingly simple dark suit. She was not participating in the conversation, preferring to concentrate on her glass of wine.
   Jack envied Chet’s outgoing personality and the ease with which he indulged in social intercourse. During dinner he’d spoken of himself with utter ease. Among the things Jack learned was that Chet had recently broken off a long-term relationship with a pediatrician and hence was what he called “in between” and available.
   While Jack was eyeing his officemate, Chet turned toward him.
   Almost simultaneously the two women did the same, and then they all laughed. Jack felt his face flush. They were obviously talking about him.
   Chet broke away from the bar and headed in Jack’s direction. Jack wondered if he should flee or merely dig his fingernails into the tabletop. It was obvious what was coming.
   “Hey, sport,” Chet whispered. He purposefully positioned himself directly between Jack and the women. “See those two chicks at the bar?” He pointed into his own abdomen to shield the gesture from his new acquaintances. “What do you think? Pretty good, huh? They’re both knockouts and guess what? They want to meet you.”
   “Chet, this has been fun, but…” Jack began.
   “Don’t even think about it,” Chet said. “Don’t let me down now. I’m after the one in the sweatshirt.”
   Sensing that resistance would have required considerably more energy than capitulation, Jack allowed himself to be dragged to the bar. Chet made the introductions.
   Jack could immediately see what Chet saw in Colleen. She was Chet’s equal in terms of blithe repartee. Terese, on the other hand, was a foil for them both. After the introductions, she’d given Jack a once-over with her pale blue eyes before turning back to the bar and her glass of wine.
   Chet and Colleen fell into spirited conversation. Jack looked at the back of Terese’s head and wondered what the hell he was doing. He wanted to be home in bed, and instead he was being abused by someone as unsociable as himself.
   “Chet,” Jack called out after a few minutes. “This is a waste of time.”
   Terese spun around. “Waste of time? For whom?”
   “For me,” Jack said. He gazed curiously at the rawboned yet sensuously lipped woman standing in front of him. He was taken aback by her vehemence.
   “What about for me?” Terese snapped. “Do you think it’s a rewarding experience to be pestered by men on the prowl?”
   “Wait just one tiny second!” Jack said, with his own ire rising. “Don’t flatter yourself. I ain’t on the prowl. You can be damn sure about that. And if I were I sure wouldn’t…”
   “Hey, Jack,” Chet called out. “Cool it.”
   “You, too, Terese,” Colleen said. “Relax. We’re out here to enjoy ourselves.”
   “I didn’t say boo to this lady and she’s jumping all over me,” Jack explained.
   “You didn’t have to say anything,” Terese said.
   “Calm down, you guys.” Chet stepped between Jack and Terese, but eyed Jack. “We’re out here for some normal contact with fellow human beings.”
   “Actually, I think I should go home,” Terese said.
   “You’re staying right here,” Colleen ordered. She turned to Chet. “She’s wound up like a piano wire. That’s why I insisted she come out: try to get her to relax. She’s consumed by her work.”
   “Sounds like Jack here,” Chet said. “He has some definite antisocial tendencies.”
   Chet and Colleen were talking as if Jack and Terese couldn’t hear, yet they were standing right next to them, staring off in different directions. Both were irritated but both felt foolish at the same time.
   Chet and Colleen got a round of drinks and handed them out as they continued to talk about their respective friends.
   “Jack’s social life revolves around living in a crack neighborhood and playing basketball with killers,” Chet said.
   “At least he has a social life,” Colleen said. “Terese lives in a co-op with a bunch of octogenarians. Going to the garbage chute is the high point of a Sunday afternoon at home.”
   Chet and Colleen laughed heartily, took long pulls on their respective beers, and then launched into a conversation about a play both of them had seen on Broadway.
   Jack and Terese ventured a few fleeting looks at each other as they nursed their own drinks.
   “Chet mentioned you were a doctor; are you a specialist?” Terese asked finally. Her tone had mellowed significantly.
   Jack explained about forensic pathology. Overhearing this part of the conversation, Chet joined in.
   “We’re in the presence of one of the future’s best and brightest. Jack here made the diagnosis of the day. Against everyone else’s impression, he diagnosed a case of plague.”
   “Here in New York?” Colleen asked with alarm.
   “At the Manhattan General,” Chet said.
   “My God!” Terese exclaimed. “I was a patient there once. Plague is awfully rare, isn’t it?”
   “Most definitely,” Jack said. “A few cases are reported each year in the U.S., but they usually occur in the wilds of the west and during the summer months.”
   “Is it terribly contagious?” Colleen asked.
   “It can be,” Jack said. “Especially in the pneumonic form which this patient had.”
   “Are you worried about having gotten it?” Terese asked. Unconsciously she and Colleen had moved a step backward.
   “No,” Jack said. “And even if we had, we wouldn’t be communicative until after we got pneumonia. So you don’t have to stand across the room from us.”
   Feeling embarrassed, both women stepped closer. “Is there any chance this could turn into an epidemic here in the city?” Terese asked.
   “If plague bacteria has infected the urban rodent population, particularly the rats, and if there are adequate rat fleas, it could develop into a problem in the ghetto areas of the city,” Jack said. “But chances are it would be self-limited. The last real outbreak of plague in the U.S. occurred in 1919 and there were only twelve cases. And that was before the antibiotic era. I don’t anticipate there is going to be a current epidemic, especially since the Manhattan General is taking the episode extremely seriously.”
   “I trust you contacted the media about this case of plague,” Terese said.
   “Not me,” Jack said. “That’s not my job.”
   “Shouldn’t the public be alerted?” Terese asked.
   “I don’t think so,” Jack said. “By sensationalizing it, the media could make things worse. The mere mention of the word ‘plague’ can evoke panic, and panic would be counterproductive.”
   “Maybe,” Terese said. “But I bet people would feel differently if there was a chance they could avoid coming down with plague if they were forewarned.”
   “Well, the question is academic,” Jack said. “There’s no way that the media could avoid hearing about this. It’ll be all over the news. Trust me.”
   “Let’s change the subject,” Chet said. “What about you guys? What do you do?”
   “We’re art directors in a relatively large ad agency,” Colleen said. “At least I’m an art director. Terese was an art director. Now she’s part of the front office. She’s creative director.”
   “Impressive,” Chet said.
   “And in a strange way we’re currently tangentially involved with medicine,” she added.
   “What do you mean you are involved with medicine?” Jack asked.
   “One of our big accounts is National Health,” Terese said. “I imagine you’ve heard of them.”
   “Unfortunately,” Jack said. His tone was flat.
   “You have a problem with our working with them?” Terese asked.
   “Probably,” Jack said.
   “Can I ask why?”
   “I’m against advertising in medicine,” Jack said. “Especially the kind of advertising these new health-care conglomerates are engaged in.”
   “Why?” Terese asked.
   “First of all, the ads have no legitimate function except to increase profits by expanding enrollment. They’re nothing but exaggerations, half-truths, or the hyping of superficial amenities. They have nothing to do with the quality of health care. Secondly, the advertising costs a ton of money, and it’s being lumped into administrative costs. That’s the real crime: It’s taking money away from patient care.”
   “Are you finished?” Terese asked.
   “I could probably think up some more reasons if I gave it some thought,” Jack said.
   “I happen to disagree with you,” Terese said with a fervor that matched Jack’s. “I think all advertising draws distinctions and fosters a competitive environment which ultimately benefits the consumer.”
   “That’s pure rationalization,” Jack said.
   “Time out, you guys,” Chet said, stepping between Jack and Terese for the second time. “You two are getting out of control again. Let’s switch the topic of conversation. Why don’t we talk about something neutral, like sex or religion.”
   Colleen laughed and gave Chet a playful swat on the shoulder.
   “I’m serious,” Chet said while laughing with Colleen. “Let’s discuss religion. It’s been getting short shrift lately in bars. Let’s have everybody tell what they grew up as. I’ll be first…”
   For the next half hour they indeed did discuss religion, and Jack and Terese forgot their emotional outburst. They even found themselves laughing since Chet was a raconteur of some wit.
   At eleven-fifteen Jack happened to glance at his watch and did a double take. He couldn’t believe it was so late.
   “I’m sorry,” he said, interrupting the conversation. “I’ve got to go. I’ve got a bicycle ride ahead of me.”
   “A bike?” Terese questioned. “You ride a bike around this city?”
   “He’s got a death wish,” Chet said.
   “Where do you live?” Terese asked.
   “Upper West Side,” Jack said.
   “Ask him how ‘upper,’ ” Chet dared.
   “Exactly where?” Terese asked.
   “One-oh-six a Hundred and Sixth Street,” Jack said. “To be precise.”
   “But that’s in Harlem,” Colleen said.
   “I told you he has a death wish,” Chet said.
   “Don’t tell me you’re going to ride across the park at this hour,” Terese said.
   “I move pretty quickly,” Jack said.
   “Well, I think it’s asking for trouble,” Terese said. She bent down and picked up her briefcase, which she’d set on the floor by her feet. “I don’t have a bike, but I do have a date with my bed.”
   “Wait a second, you guys,” Chet said. “Colleen and I are in charge. Right, Colleen?” He put his arm loosely around Colleen’s shoulder.
   “Right!” Colleen said to be agreeable.
   “We’ve decided,” Chet said with feigned authority, “that you two can’t go home unless you agree to have dinner tomorrow night.”
   Colleen shook her head as she ducked away from Chet’s arm. “I’m afraid we’re not available,” she said. “We’ve got an impossible deadline, so we’ll be putting in some serious overtime.”
   “Where were you thinking of having dinner?” Terese asked.
   Colleen looked at her friend with surprise.
   “How about right around the corner at Elaine’s,” Chet said. “About eight o’clock. We might even see a couple of celebrities.”
   “I don’t think I can…” Jack began.
   “I’m not listening to any excuses from you,” Chet said, interrupting. “You can bowl with that group of nuns another night. Tomorrow you’re having dinner with us.”
   Jack was too tired to think. He shrugged.
   “It’s decided, then?” Chet said.
   Everyone nodded.

   Outside of the bar the women climbed into a cab. They offered Chet a ride home, but he said he lived in the neighborhood.
   “Are you sure you don’t want to leave that bike here for the night?” Terese asked Jack, who’d finished removing his panoply of locks.
   “Not a chance,” Jack said. He threw a leg over his bike and powered out across Second Avenue, waving over his head.
   Terese gave the cabdriver the address of the first stop, and the taxi made a left onto Second Avenue and accelerated southward. Colleen, who’d kept her eye on Chet out the back window, turned to face her boss.
   “What a surprise,” she said. “Imagine meeting two decent men at a bar. It always seems to happen when you least expect it.”
   “They were nice guys,” Terese agreed. “I suppose I was wrong about them being out at the meat market, and thank God they didn’t spout off about sports or the stock market. Generally that’s all men in this city can talk about.”
   “What tweaks my funny bone is that my mother has forever been encouraging me to meet a doctor,” Colleen said with a laugh.
   “I don’t think either one of them is a typical doctor,” Terese said. “Especially Jack. He’s got a strange attitude. He’s awfully bitter about something, and seems a bit foolhardy. Can you imagine riding a bike around this city?”
   “It’s easier than thinking about what they do. Can you imagine dealing with dead people all day?”
   “I don’t know,” Terese said. “Mustn’t be too different than dealing with account executives.”
   “I have to say you shocked me when you agreed to have dinner tomorrow night,” Colleen said. “Especially with this National Health disaster staring us in the face.”
   “But that’s exactly why I did agree,” Terese said. She flashed Colleen a conspiratorial smile. “I want to talk some more with Jack Stapleton. Believe it or not, he actually gave me a great idea for a new ad campaign for National Health! I can’t imagine what his reaction would be if he knew. With his philistine attitude about advertising, he’d probably have a stroke.”
   “What’s the idea?” Colleen asked eagerly.
   “It involves this plague thing,” Terese said. “Since AmeriCare is National Health’s only real rival, our ad campaign merely has to take advantage of the fact that AmeriCare got plague in its main hospital. As creepy as the situation is, people should want to flock to National Health.”
   Colleen’s face fell. “We can’t use plague,” she said.
   “Hell, I’m not thinking of using plague specifically,” Terese said. “Just emphasizing the idea of National Health’s hospital being so new and clean. The contrary will be evoked by inference, and it will be the public who will make the association with this plague episode. I know what the Manhattan General is like. I’ve been there. It might have been renovated, but it’s still an old structure. The National Health hospital is the antithesis. I can see ads where people are eating off the floor at National Health, suggesting it’s that clean. I mean, people like the idea that their hospital is new and clean, especially now with all the hullabaloo about bacteria making a comeback and becoming antibiotic-resistant.”
   “I like it,” Colleen said. “If that doesn’t increase National Health Care’s market share vis-à-vis AmeriCare, nothing will.”
   “I even have thought up a tag line,” Terese said smugly. “Listen: ‘We deserve your trust: Health is our middle name.’ ”
   “Excellent! I love it!” Colleen exclaimed. “I’ll get the whole team working on it bright and early.”
   The cab pulled up to Terese’s apartment. The women did a high-five before Terese got out.
   Leaning back into the cab, Terese said: “Thanks for getting me to go out tonight. It was a good idea for lots of reasons.”
   “You’re welcome,” Colleen said, flashing a thumbs-up sign.