“I don’t know whether I can drive with this blurry eye,” said Cassi. She knew better than to respond to Thomas’s pejorative implication about psychiatry.
   “You have two choices,” said Thomas. “Hang around until the drops wear off or stay the night in the hospital. Whatever you think is best for you.” Thomas started for the door.
   “Wait,” called Cassi, her mouth dry. “I have to talk to you. Do you think I should have a vitrectomy?”
   There, it was out. Cassi looked down and saw she was wringing her hands. Self-consciously she pulled them apart, then didn’t know what to do with them.
   “I’m surprised you still care about my opinion,” snapped Thomas. His slight smile had vanished. “Unfortunately, I’m not an eye surgeon. I don’t have the slightest idea of whether you should have a vitrectomy. That’s why I sent you to Obermeyer.”
   Cassi could feel his rising anger. It was just as she feared. Telling him about her eye condition was only going to make matters worse.
   “Besides,” said Thomas. “Isn’t there a better time to talk about this kind of thing? I’ve got someone dying upstairs. You’ve had this problem with your eye for months. Now you show up when I’m in the middle of an emergency and want to discuss it. My God, Cassi. Think about other people once in a while, will you?”
   Thomas stalked over to the door, wrenched it open, and was gone.
   In a lot of ways Thomas was right, thought Cassi. Bringing up the problem of her eye in Thomas’s office was inappropriate. She knew when he said he had a patient “dying upstairs,” he meant it.
   Her jaw clenched, Cassi walked out of the office. Doris made a show of typing, but Cassi guessed she’d been listening. Walking down to the elevators, Cassi decided to go back to Clarkson Two. It would keep her from thinking too much. Besides, she knew she couldn’t drive, at least not for a while.
   She got back to the ward while the afternoon team meeting was still in progress.
   Cassi had arranged to take the rest of the day off and did not feel up to joining the group. She was afraid if she were among friends her delicate control would crumble and she’d burst into tears.
   Thankful for the unexpected opportunity of reaching her office unobserved, she slipped inside and quickly closed the door behind her. Stepping around the metal and Formica desk, which practically spanned the width of the room, she settled herself into the aged swivel desk chair. Cassi had tried to liven the cubbyhole with several bright prints of Impressionist paintings she bought at the Harvard co-op. The effort hadn’t helped much. With its harsh overhead fluorescent lighting, the room still looked like an interrogation cell.
   Resting her head in her hands, she tried to think, but all she could concentrate on were her problems with Thomas. She was almost relieved when there was a sharp knock on the door. Before she could answer it, William Bentworth stepped inside.
   “Mind if I sit down, Dr. Cassidy?” asked Bentworth with uncharacteristic politeness.
   “No,” said Cassi, surprised to see the colonel entering her office on his own accord. He was carefully dressed in tan slacks and a freshly pressed plaid shirt. His shoes evidenced a spit-and-polish shine.
   He smiled. “Mind if I smoke?”
   “No,” said Cassi. She did mind, but it was one of those sacrifices she felt she had to make. Some people needed all the help they could get in order to open up and talk. On occasion the process of lighting a cigarette was an important crutch. Bentworth leaned back and smiled. For the first time his brilliant blue eyes seemed cordial and warm. He was a handsome man, with broad shoulders, thick dark hair, and angular, aristocratic features.
   “Are you all right, Doctor?” asked Bentworth, leaning forward again to examine Cassi’s face.
   “I’m perfectly fine. Why do you ask?”
   “You look a bit distraught.”
   Cassi looked up at the Monet print of the little girl and her mother in the poppy field. She tried to collect her thoughts. It frightened her a little to realize that a patient could be so perceptive.
   “Perhaps you feel guilty,” offered Bentworth, considerately blowing smoke away from Cassi.
   “And why should I feel guilty?”
   “Because I think you have been deliberately avoiding me.”
   Cassi remembered Jacob’s comment about borderline personalities being inconsistent, and she contrasted Bentworth’s current behavior with his previous refusal to talk to her.
   “And I know why you’ve been avoiding me,” continued Bentworth. “I think I scare you. I’m sorry if that’s the case. Having been in the army so long and being accustomed to giving orders, I suppose I can be overbearing at times.”
   For the first time in Cassi’s short psychiatric career, something that she’d read in the literature was occurring spontaneously between herself and one of her patients. She knew, without any doubt, that Bentworth was trying to manipulate her.
   “Mr. Bentworth…” began Cassi.
   “Colonel Bentworth,” corrected William with a smile. “If I call you Doctor, it’s only reasonable you call me Colonel. It’s a sign of mutual respect.”
   “Fair enough,” said Cassi. “The fact of the matter is that you have been the one who has made it impossible for us to have a session together. I’ve tried, if you can remember, on numerous occasions to schedule a meeting, but you have always professed to have a prior commitment. Now I understand that you get more out of the group milieu than private conversation, so I haven’t pushed the situation. If you’d like to meet, let’s schedule it.”
   “I would love to talk with you,” said Bentworth. “How about right now? I have the time. Do you?”
   Cassi was not willing to fall prey to Bentworth’s manipulation, thinking that it would ultimately have a negative effect on their relationship. She wasn’t prepared now and Bentworth did frighten her despite his newly found charm.
   “How about tomorrow morning?” said Cassi. “Right after team meeting.”
   Colonel Bentworth stood up and stubbed out his cigarette in the ashtray on Cassi’s desk. “All right. I’ll look forward to it. And I hope whatever is troubling you works out for the best.”
   After he was gone, Cassi breathed the smoky air while her mind envisioned Colonel Bentworth in a dress uniform. She could imagine he would be gallant and dashing, and his mental problems would seem fictitious. Knowing the depth of his disorder, she found the fact that it could be so easily camouflaged disturbing.
   Before she could even dictate her notes, her door opened again, and Maureen Kavenaugh came in and sat down. Maureen had been admitted a month previously for recurrent major depression. She’d had a serious setback when her husband had come in and slapped her around. Seeing her out of her room was as much a surprise as having William Bentworth voluntarily pay a visit. Cassi wondered if some miracle drug were being secretly added to the patients’ food.
   “I saw the colonel go into your office,” said Maureen. “I thought you said you weren’t going to be here this afternoon.” Her voice was flat and emotionless.
   “I hadn’t planned on it,” said Cassi.
   “Well, since you are here, can I talk to you for a moment?” asked Maureen timidly.
   “Of course,” said Cassi. She watched Maureen advance into the room, closing the door and sitting down.
   “Yesterday when we talked…” Maureen hesitated and her eyes filled with tears.
   Cassi pushed the box of tissues toward the woman.
   “You… you asked me if I’d like to see my sister.” Maureen’s voice was so low that Cassi could barely hear. She nodded quickly, wondering what Maureen was thinking. The woman had not shown much interest in anything since her relapse even though Cassi had started her on Elavil. At team meeting several people had suggested electric shock, but Cassi had argued against it, thinking the Elavil and supportive sessions would be adequate. What amazed Cassi was Maureen’s insight into the dynamics of her condition. But for Maureen an understanding of her illness did not automatically give her the power to influence it.
   Maureen acknowledged her hostility to her mother, who had abandoned both Maureen and her younger sister when they were toddlers, and the repressed jealousy she felt toward that pretty younger sister who had run off and married, leaving Maureen to live by herself. Out of desperation she’d married an inappropriate man.
   “Do you think my sister would want to see me?” asked Maureen finally, her face wet with tears.
   “I think she might,” said Cassi. “But we won’t know unless you ask her.”
   Maureen blew her nose. Her hair was stringy and in need of a wash. Her face was drawn, and, despite her medication, she’d continued to lose weight.
   “I’m afraid to ask her,” admitted Maureen. “I don’t think she’ll come. Why should she? I’m not worth it. It’s hopeless.”
   “Just thinking about talking to your sister is a hopeful sign,” Cassi said gently.
   Maureen let out a long sigh. “I can’t make up my mind. If I call her and ask her and she says no, then everything will be worse. I want someone else to do it. Would you call her?”
   Cassi flushed. She thought of her own indecisiveness in facing Thomas. Maureen’s feelings of dependency and helplessness seemed all too familiar. She too wanted someone else to make her decisions. With exhausting effort, Cassi tried to concentrate on the woman sitting across from her.
   “I’m not sure it’s my place to contact your sister,” said Cassi. “But it’s something we can talk about. As far as seeing your sister, I think that is a good idea. Why don’t we talk about it more tomorrow? I think you’re scheduled for a session at two.”
   Maureen agreed and, after taking several more tissues, went out, leaving the door open.
   Cassi sat for some time, staring blankly at the wall. She felt certain that identifying with one of her patients was a sign of her inexperience.
   “Hey! How come you aren’t in team meeting?” said Joan Widiker, doing a double take in the corridor after catching a glimpse of Cassi.
   Cassi glanced up but didn’t answer.
   “What’s going on?” asked Joan. “You look a little worse for wear.” She stepped into Cassi’s office and sniffed. “And I didn’t know you smoked.”
   “I don’t,” said Cassi. “Colonel Bentworth does.”
   “He came to see you?” Joan raised her eyebrow. “You’re doing better than you think.” She paused and then sat down.
   “I thought I’d let you know that Jerry Donovan and I went out. Have you talked with him?”
   Cassi shook her head.
   “It didn’t work out too well. All he wanted…” Joan stopped in midsentence. “Cassi, what’s the matter with you?”
   Tears overflowed Cassi’s eyes and ran down her cheeks.
   As she had feared, a friendly presence destroyed her self-control. She finally let go and, dropping her face into her hands, wept openly.
   “Jerry Donovan wasn’t that bad,” said Joan, hoping a little humor might help. “Besides, I didn’t give in. I’m still a virgin.”
   Cassi’s body shook with sobs. Joan came around the end of the desk and put her arm around her friend’s shoulder. For a few moments she said nothing. As a psychiatry resident, she didn’t have the usual negative reaction to tears that lay people did. From the strength of Cassi’s emotion Joan guessed that she needed the outlet.
   “I’m sorry,” said Cassi, reaching for the tissues just as Maureen had. “I didn’t want to do this.”
   “Sounds like you needed it. Do you want to talk?”
   Cassi took a deep breath. “I don’t know. It all seems so hopeless.” As soon as she said the word, Cassi remembered Maureen had said the same thing.
   “What’s so hopeless?” asked Joan.
   “Everything,” said Cassi.
   “Give me an example,” said Joan, challengingly.
   Cassi pulled her hands away from her tear-streaked face.
   “I went to the ophthalmologist today. He wants to operate, but I don’t know if I should.”
   “What does your husband say?” asked Joan.
   “That’s part of the problem.” As soon as Cassi spoke, she regretted it. She knew Joan, being both sensitive and clever, would piece together the whole picture, and, in the back of her mind, Cassi could hear Thomas telling her not to discuss her medical problems with anyone.
   Joan took her hand from Cassi’s shoulder. “I think you need someone to talk to. As the official department consult, I’m at your service. Besides, anyone can afford my fee.”
   Cassi managed a weak smile. Intuitively she knew she could trust Joan. She needed someone’s insight, and God knows she wasn’t doing too well on her own.
   “I don’t know if you have any idea of Thomas’s schedule,” began Cassi. “He works harder than anyone I know. You’d think he was an intern. Last night he stayed in the hospital. Tonight he’ll stay in the hospital. He doesn’t have a lot of extra time…”
   “Cassi,” said Joan politely. “I don’t like to interrupt but why not save the excuses. Have you spoken to your husband about this operation?”
   Cassi sighed. “I tried to bring it up a few hours ago, but it was the wrong time and place.”
   “Listen,” said Joan. “I rarely make judgments. But when it comes to talking about eye surgery with your husband, there is no wrong time or place.”
   Cassi digested this comment. She wasn’t sure if she agreed or not.
   “What did he say?” asked Joan.
   “He said he wasn’t an eye surgeon.”
   “Ah, he wants to delegate his responsibility.”
   “No,” said Cassi emphatically. “Thomas made sure I went to the best ophthalmologist.”
   “It still seems a rather callous reaction.”
   Cassi looked down at her hands, thinking Joan was too clever. She had the distinct impression that Joan could take this conversation further than Cassi would like.
   “Cassi,” asked Joan, “is everything all right between you and Thomas?”
   Cassi could feel the tears filling her eyes again. She tried to stop them but was only partially successful.
   “That’s one way of answering,” said Joan empathetically. “Do you want to talk about it?”
   Cassi bit her trembling lower lip. “If something happened to my relationship with Thomas,” she said, “I don’t know if I could go on. I think my life would fall apart. I need him desperately.”

   “I can sense you feel that way. I also think that you don’t really want to talk about the problem. Am I right?”
   Cassi nodded. She felt torn between her fear of Thomas and her guilt at rejecting Joan’s offer of friendship.
   “Okay,” said Joan, “but before I go, I think some advice is in order. Maybe it’s presumptuous for me to say this, and it’s certainly not professional, but I have a feeling that you should try to lessen your dependency on Thomas. Somehow I don’t think you give yourself the credit you deserve. And that kind of dependence can really hurt a relationship in the long run. Well, enough unsolicited advice.”
   Joan opened Cassi’s door, then stopped. “Did you say that Thomas was going to spend tonight in the hospital?”
   “I think he has emergency surgery,” said Cassi, preoccupied with the concept of dependency. “When he does, he usually sleeps over rather than suffer the forty-minute commute.”
   “Fine!” said Joan. “Why don’t you come home with me tonight? I’ve got a sofa bed in the living room and a fully stocked refrigerator.”
   “And by midnight you’d know all my secrets,” said Cassi, only half in jest.
   “I’d be on my honor not to probe,” said Joan.
   “Anyway, I can’t,” said Cassi. “I appreciate the offer, but there’s always the chance Thomas might not have surgery and, in that case, he could come home. Under the circumstances I want to be there. Maybe we’ll talk.”
   Joan smiled sympathetically. “You do have it bad. Well, if you change your mind, give me a call. I’ll be in the hospital for another hour or so.” She opened the door again and this time really left.
   Cassi stared at the Monet trying to decide if it was safe for her to drive. It was reassuring to note that her vision had significantly improved; the drops were finally wearing off.

   Thomas felt his hands tremble as he opened his office door and switched on the light. The clock on Doris’s desk indicated that it was almost six-thirty. It was already dark outside, making it hard to remember summer nights when it stayed light to nine-thirty. Closing the door, he held out his arm. It scared him to see his normally steady hand shake so violently. How could Cassi keep pressuring him when he was already so tense?
   Approaching his desk, he opened the second drawer and pulled out one of his small plastic bottles. The combination of the child-proof top and his agitation made opening the package impossible. He had to restrain himself from dashing the thing on the floor and stomping on it with his heel. Finally he managed to extract one of the yellow tablets. He placed it on his tongue despite its bitter taste and walked into the small washroom, which still reeked of Doris’s perfume.
   Forsaking a cup, Thomas bent and drank directly from the faucet. He went back to his office and sat at his desk. His anxiety seemed to be increasing. Wrenching open the second drawer again, he fumbled for the same plastic bottle. This time he was unsuccessful with the top. Slamming the bottle down on the desk top only succeeded in denting the wood surface and bruising his thumb.
   Closing his eyes, Thomas told himself that he had to stay in control. When he opened his eyes, he remembered that in order to open the bottle he had to line up the two arrows.
   But he did not take another pill. Instead his mind conjured up the image of Laura Campbell. There was no reason for him to be alone. “I wish there was something I could do for you,” she had said. “Anything!” Thomas knew he had her phone number in her father’s folder, ostensibly for emergency use. But wasn’t this an emergency? Thomas smiled. Besides, there were many ways to camouflage his intentions if he’d misread her signals.
   Thomas found Mr. Campbell’s folder and quickly dialed Laura’s number, hoping the woman was at home. She answered on the second ring.
   “This is Dr. Kingsley. Sorry to bother you.”
   “Is something wrong?” asked Laura worriedly.
   “No, no,” assured Thomas. “Your father is doing fine. I’m terribly sorry about his jaundice. It is one of those unfortunate complications. I wish we could have anticipated it, but it should clear soon. Anyway the reason I’m calling is that your father will undoubtedly be discharged soon, and I thought, perhaps, you’d like to discuss the case.”
   “Absolutely,” said Laura. “Just tell me when.”
   Thomas twisted the phone cord. “Well, that’s why I’m calling. I’m sure you can guess what my schedule is like. But it so happens I’m waiting for a surgery and am presently alone in my office. I thought, perhaps, you might consider coming over.”
   “Can you give me thirty minutes?” asked Laura.
   “I think so,” said Thomas. He knew he had plenty of time.
   “I’ll be there,” said Laura.
   “One other thing,” added Thomas. “To get into the Professional Building at this hour you must go through the hospital. The doors here are locked at six.”
   Thomas hung up. He felt much better. Excitement had replaced anxiety. Opening the desk drawer, he dropped in the container of pills. Then he called the cardiac catheterization lab to check on the patient in cardiogenic shock. As he had expected, the patient was still awaiting catheterization. No matter what the procedure showed, Thomas guessed he had several hours.
   Thomas met Laura at the door to the inner office and motioned her inside. He was pleased to see that again she was wearing a thin, clinging silk dress. It was a light beige, almost the color of her skin. Thomas could see the faint line of her panties.
   He didn’t speak for a moment, plotting his opening so that if he’d misread her signals there wouldn’t be any embarrassment. He began by reassuring her once again that her father would soon be discharged. Then he discussed Mr. Campbell’s long-term care, and under the pretense of discussing his exercise limitations, Thomas brought up the issue of sex.
   “Your father had asked me about this before the operation,” he said, watching Laura’s face. “I know that your mother passed away several years ago, and if this is an uncomfortable subject for you…”
   “Not at all,” said Laura with a smile. “I am an adult.”
   “Of course,” said Thomas, letting his eyes run over her dress. “That is very obvious.”
   Laura smiled again and smoothed her long ponytail off her shoulder.
   “A man like your father still has sexual needs,” said Thomas.
   “As a physician I’m sure you know that better than most,” said Laura. She’d uncrossed her legs and leaned forward. It was clear she wasn’t wearing a bra under the sheer silk.
   Thomas got up from his chair and came around in front of the desk. He was certain Laura hadn’t come to talk about her father. “I understand these needs all too well myself because I have a wife with a chronic, debilitating disease.”
   Laura smiled. “As I said, I wish there was something I could do for you.” She stood up and leaned against Thomas. “Can you think of anything?”
   Thomas led her into the dimly lit examining room. Slowly he helped her out of her dress and then stepped out of his own clothes, folding them neatly on a chair. When he turned back to face her, he was pleased to find himself fully erect.
   “What do you think?” he asked, with his palms spread out to the sides.
   “I love it,” said Laura huskily, reaching out for him.

   After having worried about driving, Cassi was glad that her trip home was pleasantly uneventful. The most hazardous part had been the walk from the garage to the house. She’d forgotten how early night came now that it was December.
   The house itself was ominously black, particularly the windows, which shone like pieces of polished onyx. Inside Cassi found a note from Harriet explaining how to heat up dinner. Whenever Harriet got the word that Thomas was not coming home, she left early. As contrary as Harriet could be, Cassi would have preferred not to be alone.
   She went through the house snapping on lights hoping to make the place a bit more cheerful. She found the rambling old house with its cavernous spaces particularly chilling, her footsteps echoing down the empty halls. The heat was supposed to be turned to sixty-five degrees, but Cassi could see her breath.
   Upstairs the morning room was considerably warmer, almost comfortable. In the master bath she had a supplementary quartz heater, which she turned on. After testing her blood sugar, Cassi went ahead with her usual insulin dose, then took a shower.
   She tried not to think too much. Her emotional outburst had left her drained and had settled nothing. She knew Joan was right about her dependency, and it reminded Cassi of the identification she’d felt with Maureen Kavenaugh. Just like her patient, Cassi felt hopeless, timid, and fearful. She wondered if she too lacked the ability to influence her life even when she understood her problem. Then in a flash of sudden horror, Cassi became aware of the power of her denial. One of the reasons she’d suspected that Thomas was abusing drugs was because of his pupils. So often of late they had been mere pinpoints, but Dexedrine caused dilated pupils! Other drugs caused small pupils. Other drugs that Cassi did not want to think about.
   Cassi could feel perspiration appear on her palms. She did not know if it was from sudden terror or from her insulin. Praying that her fears were groundless, she forced herself down the hall to Thomas’s study.
   Flipping on the light, she stood there, her eyes recording all the details of the room. Against her will, she recalled the consequences of her previous visit, and she fought against the urge to flee.
   The medicine cabinet in the bathroom was exactly as it had been two weeks earlier: a mess. It contained nothing that was suspicious. Getting down on her hands and knees, Cassi searched beneath the sink. Nothing. Then she went through the towel cabinets. Again nothing.
   Feeling a modicum of relief, Cassi went back to the study itself. Besides the desk and burgundy reading chair, there was the sofa bed, bordered by two end tables with lamps, a hassock, an entire wall of bookshelves, a liquor cabinet, and an antique highboy with claw feet. The floor was covered with an enormous Tabriz carpet.
   Cassi walked over to the desk. It was an imposing piece of furniture, which she knew had belonged to Thomas’s grandfather. As she reached out and touched the cool surface, she had the same naughty sensation she’d felt as a child, snooping in her parents’ bedroom. Shrugging her shoulders, she pulled out the center drawer. A plastic desk organizer was filled to overflowing with rubber bands, paper clips, and other odds and ends. She pulled the drawer out to its limit and carefully lifted the layers of papers toward the back. Nothing out of the ordinary. Satisfied, Cassi was about to push it closed when she thought she heard a door slam. Peering through the window, she could see the lights in Patricia’s apartment over the garage. She hadn’t heard a car, but that wasn’t too surprising. With the storm windows down, sounds from the outside did not penetrate the house too easily. She could see the garage door was closed. Had she closed it? She couldn’t remember. A moment later there were footsteps in the hall. Panic knotted her stomach. Obviously Thomas had come home. If he caught her in his study after the episode with Patricia, he’d be furious. She looked around frantically, wondering if she could slip out through the spare room. But before she could move, the door opened.
   It was Patricia. She was as surprised to find Cassi as Cassi her. The two women stared at each other in disbelief.
   “What are you doing in here?” Patricia said finally.
   “I was about to ask you the same question,” returned Cassi, standing behind the desk.
   “I saw the light go on in here. Naturally, I thought Thomas had come home after all. As his mother I think I’m entitled to see him.”
   Cassi unconsciously nodded as if she agreed. Actually it had been a constant source of irritation for her that Patricia had a key to the house and felt no compunction about entering whenever she wanted.
   “That’s my excuse,” said Patricia. “What’s yours?”
   Cassi knew she should have simply replied that it was her home and she could go into any room she pleased. But she didn’t. Her sense of guilt made it impossible.
   “I suppose I can guess,” said Patricia disdainfully, “even though it upsets me. Snooping through his possessions like this when he’s in the hospital saving lives! What kind of a wife are you?”
   Patricia’s question hung in the air like static electricity. Cassi didn’t try to answer. She’d begun to wonder herself what kind of a wife she was.
   “I think you should leave this room at once,” rasped Patricia.
   Cassi didn’t object. She walked past her mother-in-law with her head bowed. Patricia followed her out and closed the door. Without looking back, Cassi descended the stairs and headed for the kitchen. She heard the front door close and presumed Patricia had left. The woman would tell Thomas that Cassi had been in his study. It was inevitable.
   She looked at the meal Harriet had left on the stove with distaste, but she knew that after taking her normal insulin dose she required a certain amount of calories. Forcing down the warmed-over food, she made up her mind to return to the study and finish her search. Having already been caught, she no longer had anything to fear except what she’d find.
   There was still the chance Thomas could appear, but Cassi was prepared to listen for the sounds of the Porsche. In order to keep from having to face Patricia again, Cassi pulled the heavy drapes over the windows, and she used a flashlight, like a real burglar. She went directly to the desk and tried the side drawers, starting at the top and working her way down. She didn’t have far to go. In the back of the second drawer inside a stationery box, Cassi found a collection of plastic pill containers. Some were empty, but most were full. All of them had the same prescribing M.D., a Dr. Allan Baxter. The dates were all within the past three months.
   In addition to the Dexedrine, there were two other types of pills, and Cassi carefully took one of each. She replaced the vials in the stationery box and closed the drawer. Switching off the flashlight, she reopened the curtains and walked quickly back to her room. When she got out her Physician’s Desk Reference and compared the pills to the identification pictures, she realized that her suspicions were right. “Oh God!” she said out loud. “Dexedrine for exhaustion is one thing. Percodan and Talwin are something else entirely.”
   For the second time that day Cassi burst into tears. This time she did not even try to check her sobs. She flung herself down on the bed and wept uncontrollably.

   Despite his interlude with Laura, Thomas decided to keep his planned visit with Doris. He was disappointed enough that the man in cardiac cath had suffered a second heart attack and couldn’t be scheduled for surgery. He certainly wasn’t going to ruin the night further by the long drive home.
   Doris buzzed him in the minute he touched the bell. When he reached the second floor, he found her peering coyly around the door. When she opened it, he realized why she’d stayed inside. She was dressed in a diaphanous, short black camisole that laced up the front and snapped between her legs. It covered about the same area as a one-piece bathing suit.
   “Glenlivet with Perrier,” said Doris, handing Thomas a tumbler and pressing herself up against him before he could get his coat off.
   Thomas took the drink in one hand and put the other on Doris’s backside. The only light in the room came from a Scandinavian-style oil lamp that painted the room with warm, golden tones. The coffee table was also laid for dinner with an uncorked bottle of wine standing nearby.
   When Doris retreated to the kitchen, Thomas called the hospital page operator. He gave her Doris’s number along with the admonition it was for the thoracic resident-on-call only. She was not to give it to anyone else, and if there were a question she should call herself.

Six

   “I gotta be moving,” said Clark Reardon. My woman told me not to be late.” Clark had pulled a straight-back metal chair over to Jeoffry Washington’s bed.
   “Well, it was great to see you, man,” said Jeoffry. “Thanks for coming in. I really appreciate it.”
   “No problem,” said Clark, standing up. He raised his hand, and when Jeoffry put his out, he slapped it affectionately.
   “So when you breaking outta here?” asked Clark.
   “Pretty soon. Maybe in a couple days. I’m not sure. I still got this IV.” Jeoffry raised his left arm, indicating the coiled plastic tubing. “I had some inflammation in my legs right after the operation. At least that’s what Dr. Sherman told me, so they started giving me antibiotics. It was a little rough for a couple days, but it’s better now. The best thing that happened to me was when they took away the cardiac monitor. I tell you, the beep from that mother drove me crazy.”
   “How long you been in here so far?”
   “Nine days.”
   “That ain’t bad.”
   “Not from this end. But I tell you, I was pretty scared in the beginning. But I had no choice. They told me I was going to die if I didn’t get operated on. So what can you do?”
   “Nothing! I’ll see you tomorrow night and I’ll bring in those books you wanted. Anything else?”
   “I’d love a little grass.”
   “Come on, man.”
   “I’m just joking.”
   Clark turned and waved at the door before disappearing down the hall.
   Jeoffry surveyed his room. He was glad that he was leaving soon. The other bed in the semiprivate room was empty. His roommate had been discharged that day and no new patient had arrived. Jeoffry was sorry to be alone, especially now that Clark had left and he had nothing to look forward to. As far as Jeoffry was concerned, a hospital was not a place to be alone. There were too many frightening machines and procedures to face without support.
   Jeoffry switched on the miniature TV set connected to the head of the bed. Toward the end of the second situation comedy, Miss DeVries, a spunky LPN, entered. Pretending she had some delectable treat for Jeoffry, she insisted he close his eyes and open his mouth. As he did so, he had a pretty good idea of what was coming, and he was right. It was a thermometer.
   Ten minutes later she returned and exchanged the thermometer for a sleeping pill. Jeoffry took the pill with water he had on the side table while the LPN examined the thermometer.
   “Do I have a temperature?” asked Jeoffry.
   “Everybody has a temperature,” said Miss DeVries.
   “How could I forget,” said Jeoffry. They’d been through this before. “Okay, do I have a fever?”
   “That’s classified information,” said Miss DeVries.
   Jeoffry never could understand why the nurses could not tell him if he had a temperature; correction, a fever. They always said that was up to the doctor, which was crazy. It was his body.
   “What about this IV?” asked Jeoffry as Miss DeVries started for the door. “When’s it coming out so I can take a real shower?”
   “That’s something I know nothing about.” She waved before disappearing.
   Jeoffry twisted his head and looked up at the IV bottle. For a moment he watched the regular fall of each drop in the small chamber. Turning back to the TV and the evening news, he sighed. It was going to be a relief when his tether was removed. He reminded himself to ask Dr. Sherman about it in the morning.

   When the phone first rang, Thomas sat up, confused as to where he was. On the second ring, Doris turned over to face him in the half-light of her apartment.
   “Do you want to get it or should I?” Doris’s voice was thick with sleep. She pushed herself up on one elbow.
   Thomas looked at her in the semidarkness. She appeared grotesque with her thick hair radiating from her head as if a thousand volts of electricity had passed through her body. Instead of eyes she had black holes. It took him a moment to remember who she was.
   “I’ll get it,” said Thomas, staggering to his feet. His head felt heavy.
   “It’s in the corner near the window,” said Doris, flopping back onto the pillow.
   Groping with his hands, Thomas went along the wall until he got to the open doorway of the bedroom. In the living room, the bay window let in more light.
   “Dr. Kingsley, this is Peter Figman,” said the thoracic resident when Thomas picked up the receiver. “I hope you don’t mind my calling, but you asked me to let you know if any service cases were going to the OR. We have a stab wound of the chest that’s due within the hour.”
   Thomas leaned on the small phone table. The chill in the room helped organize his mind. “What time is it?”
   “A little after one A.M.”
   “Thank you,” said Thomas. “I’ll be right over.”
   As Thomas stepped out of Doris’s vestibule to the street, the icy December wind sent a chill through his body. Pulling the lapels of his coat more tightly around his neck, he set off toward the Memorial. Every so often sudden gusts would swirl down the street, moving a line of papers and other debris against his feet, forcing Thomas to turn and walk backwards for a few steps. He was relieved when he rounded the corner and could see the complex of buildings that comprised Boston Memorial.
   Approaching the main entrance, he passed the parking garage on his left. It was a cement structure, open to the elements. Although it was jammed during the day, now it was almost deserted. As he glanced in to admire his Porsche, he noticed another familiar car. It was a Mercedes 300 turbo diesel painted puke green. There was only one person in the whole hospital whose taste was that bad. The car belonged to George Sherman.
   Thomas was practically at the hospital door, mulling over the absurdity of getting such a good car in such a terrible color, when he began to wonder why George was there. He turned to look again. It was his car all right. There was no chance of confusing it with another. Thomas glanced at his watch. It was 1:15 A.M.
   Thomas went directly to the OR, changed, and while passing through the surgical lounge, saw one of the OR nurses knitting. He asked her if George Sherman had a case that night.
   “Not that I know of,” said the nurse. “Hasn’t been a chest except for the stab wound you’re covering.”
   Outside of OR room 18, Thomas met Peter Figman scrubbing. He was a baby-faced, slight fellow who appeared as if he didn’t have to shave yet. Thomas had seen him on numerous occasions but never had the opportunity of working with him. He had a reputation of being smart, dedicated, and of having good hands.
   As soon as he saw Thomas, Peter launched into a detailed presentation of the case. The patient had been stabbed during a hockey game at the Boston Garden but was in stable condition, although there had been some trouble with his blood pressure when he’d first been admitted to the emergency room. He’d been typed and crossed for eight units of blood, but none had been given yet. The first thought had been that the knife had punctured one of the great vessels.
   While Thomas listened to the presentation, he took a surgical mask from the box on the shelf above the scrub sink. He preferred the older-style masks that tied behind the neck and head as compared to the molded masks that were secured with a single elastic band behind the head. Tonight, however, he kept dropping one or the other of the straps. Then the mask slipped from his grasp and fell to the floor. Thomas cursed under his breath and took another. As he reached into the box, Peter noticed that the older man’s hand had a slight tremor.
   Peter stopped his presentation. “Are you all right, Dr. Kingsley?”
   His hand in the box, Thomas slowly rotated his head to look directly at Peter. “What do you mean, am I all right?”
   “I thought maybe you weren’t feeling well,” said Peter timidly.
   Thomas snapped the mask out of the box, pulling an extra one with it which fell into the scrub sink. “And why did you think I might not be feeling well?”
   “I don’t know, just a hunch,” said Peter evasively. He was sorry now he’d said anything.
   “For your information, I feel perfectly fine,” said Thomas, making no attempt to conceal his anger. “But there’s one thing I will not tolerate from the residents, and that is insolence. I hope you understand.”
   “I understand,” said Peter, eager to drop the subject.
   Leaving the resident to finish his scrub, Thomas pushed through the OR door. “For Christ’s sake,” thought Thomas, “doesn’t the kid realize I was just awakened from a deep sleep; everybody has a little tremor until they have a chance to fully wake up.”
   The OR was a buzz of activity. The patient was already fully anesthetized and junior house staff were in the process of prepping the patient’s chest. Thomas walked over to review the X rays. Then, while his back was to the room, he held up his hand. The tremor was slight. He’d had worse. “Just wait until that cocky kid rotates on cardiac surgery,” Thomas mused with some satisfaction.
   Thomas parked himself in the back of the OR and watched carefully as the case began. He was ready to intervene if needed, but to Peter’s credit, he was a good technical surgeon. Thomas quizzed all the residents about possible hemopericardium. None of them, including Peter, had thought of the diagnosis despite the fact that it had been discussed at the last death conference. When Thomas was certain the case was routine and would go smoothly, he stood up and stretched. He wandered over to the door. “I’ll be available if anything goes wrong. You fellows are doing a good job.”

   When the OR door closed behind Thomas, Peter Figman glanced up and whispered: “I think Dr. Kingsley’s had one too many tonight.”
   “I think you’re right,” said a junior resident.

  Thomas had felt a sudden sleepiness steal over him as he’d sat in the OR. Fear of nodding off had driven him out. On the way to the surgical lounge he took several deep breaths. He couldn’t remember how many Scotches he’d had with Doris. He’d have to be more careful in the future.
   Unfortunately, the lounge was occupied by two nurses on their coffee break. He’d planned to stretch out on the couch but decided he’d use one of the cots in the locker room instead. As he passed the window, he glanced out and noticed a light in one of the offices across the way in the Scherington Building. Counting the windows from the end, Thomas realized that it was Ballantine’s. He looked up at the clock over the coffee maker. It was close to 2:00 A.M.! Had the janitor just forgotten to turn it off?
   “Excuse me,” called Thomas to the two nurses, “I’ll be in the locker room if they call me from surgery. In case I fall asleep, would one of you mind coming in and giving me a nudge?”
   As Thomas went through the swinging doors to the locker room, he wondered if the light in Ballantine’s office had anything to do with the fact that George Sherman’s car was in the parking lot. There was something disturbing about those two facts.
   The windowless alcove with the two cots was not completely dark. Light from the surgical lounge drifted through the short hall to the locker room. As usual the cots were empty. Thomas had the suspicion that he was the only person ever to use them.
   Reaching into the pocket of his scrub shirt, he found the small yellow pill he’d placed there. Deftly he snapped the tablet in half. One half went into his mouth where he let it dissolve on his tongue. The other half went back into his pocket in case he needed it later. Before he closed his eyes, he wondered how long he had before he would get called.

   At 2:45 A.M., the stairwell seemed to belong in a gigantic mausoleum rather than a hospital. The long vertical drop acted like a chimney of sorts, and there was a low-pitched whine of wind coming from somewhere in the bowels of the building. As the figure in the stairwell opened the door on the eighteenth floor, air hissed out as from a vacuum jar.
   In usual hospital dress, the man was not afraid of being seen but still preferred not to be. He checked carefully to make sure the corridor was deserted for its entire length before allowing the door to close behind him. As it swung shut there was the same rude sucking noise.
   One hand thrust into the pocket of his white coat, the man moved silently down the hall to Jeoffry Washington’s room. There he stopped and waited for a moment. There was no sound of activity coming from the nurses’ station. All that could be heard were distant, muted sounds of the cardiac monitors and respiratory machines.
   In a blink of the eye the man was inside the room, slowly closing the door to the hall. The only light came from the bathroom where the door was cracked an eighth of an inch. As soon as his eyes adjusted to the dimness, he pulled his hand out of his pocket, gripping a full syringe. He dropped the cap from the needle into the opposite pocket and moved rapidly to the bedside. Then he froze.
   The bed was empty!

   His jaw straining to its limits, Jeoffry Washington yawned hard enough to bring tears to his eyes. He shook his head and tossed the three-week-old Time magazine onto the low table. He was sitting in the patient lounge across from the treatment room. Getting up, he pushed his IV pole ahead of him out of the lounge toward the semidarkened nurses’ station. He’d hoped that a stroll down the corridor would have helped his insomnia, but it hadn’t worked. He wasn’t any sleepier than he’d been tossing in his bed.
   Pamela Breckenridge watched his progress through the doorless opening of the chart room. She’d become accustomed to his appearances over the past two nights. To save money she’d been brown bagging it rather than using the cafeteria, and Jeoffry would appear just as she was ready to eat.
   “Is it possible for me to have another sleeping pill?” he called.
   Pamela swallowed, told him it was, and directed the LPN to get Jeoffry another Dalmane. Dr. Sherman had obliged by adding a “repeat × 1” after his initial order.
   As if he were standing at a bar, Jeoffry accepted the pill and the miniature paper cup of water the LPN extended toward him over the counter of the station. Jeoffry popped the pill and tossed off the water. God, what he wouldn’t have done for a few tokes of grass. Then he began the slow trip back up the corridor.
   The hall darkened as he moved away from the nurses. Presently he saw his shadow appear in front of him on the vinyl floor, growing as he walked. The IV pole made it look as if he were some prophet clutching a staff. To open his door he thumped it with the wheeled footplate. Inside he hooked the door with his foot and shoved it closed. If there were any chance of dropping off to sleep, he had to shield himself from the noise and lights from the corridor.
   Arranging the pole next to the bed, he turned and sat down, intending to lift his feet and stretch out. Instead he stifled a scream.
   Like an apparition, a white-clad figure emerged from the bathroom.
   “My God!” said Jeoffry, letting out his breath. “You really startled me.”
   “Lie down, please.”
   Jeoffry complied immediately. “I never expected you at this hour.”
   Jeoffry watched as the visitor pulled out a syringe and started to inject the contents into Jeoffry’s IV bottle. He seemed to have some difficulty in the darkness as Jeoffry heard the bottle clank repeatedly against the pole.
   “What kind of medication am I getting?” asked Jeoffry, unsure if he should say anything but sufficiently confused as to what was going on to overcome his hesitancy.
   “Vitamins.”
   To Jeoffry it seemed like a strange time to be getting vitamins, but the hospital was a strange place.
   Jeoffry’s visitor gave up trying to get the needle into the base of the IV bottle and switched to the injection site in the plastic tubing close to Jeoffry’s wrist. This was far easier and the needle immediately slipped through the small rubber cap. Jeoffry watched as the plunger was rapidly depressed, causing the fluid to back up in the tubing, raising the level in the chamber above his head. He felt a twinge of pain but assumed it was just the rise in pressure in the IV.
   But the pain did not disappear. Instead it got worse. Much worse.
   “My God!” cried Jeoffry. “My arm! It’s killing me!” Jeoffry could feel a white-hot sensation that began at the IV site rise up in his arm.
   The visitor grabbed Jeoffry’s hand to keep it still and opened the IV so it ran in a steady stream.
   The pain that Jeoffry thought had been unbearable got worse and spread like molten lava into his chest. He swung his free hand over to grasp his visitor.
   “Don’t touch me, you friggin’ faggot.”
   Despite the pain, Jeoffry let go. To his bewilderment was added fear… a terrible fear that something awful was happening. Desperately Jeoffry tried to free his arm with the IV from the intruder’s grip.
   “What are you doing?” gasped Jeoffry. He started to scream, but a hand was clamped roughly over his mouth.
   At that moment Jeoffry’s body experienced its first convulsion, arching up off the bed. His eyes rolled up and disappeared inside his head. Within seconds the spasms increased to become a grand mal seizure, rocking the bed back and forth. The intruder dropped Jeoffry’s arm and pulled the bed away from the wall to reduce the banging. Then he checked the corridor and ran back to the stairwell.
   Jeoffry convulsed in silence until his heart, which had begun to beat irregularly, fibrillated for a few seconds, then stopped. Within minutes Jeoffry’s brain ceased functioning. He continued to convulse until his muscles exhausted their depleted store of oxygen…
   • • •
   Thomas felt as though he’d just closed his eyes when the nurse bent over and shook him awake. He rolled over in a daze and looked into the woman’s smiling face.
   “They need you in the OR, Dr. Kingsley.”
   “Be right there,” he said thickly.
   Thomas waited while the nurse beat a hasty retreat, then swung his feet to the floor. He paused a few minutes for the dizziness to clear. Sometimes, thought Thomas, sleeping for too short a time was worse than no sleep at all. He steadied himself at the entrance, then stumbled over to his locker. Getting out a Dexedrine, he washed it down with water from the drinking fountain. Then he changed into a fresh scrub suit, but not before he’d rescued the half pill he’d left in the soiled shirt’s breast pocket.
   By the time Thomas got down to OR 18, the Dexedrine had cleared his head. He considered scrubbing right away but then decided it was better to find out first what he was up against.
   The residents were standing around the anesthetized patient, their gloved hands resting within the sterile field. The scene did not look auspicious.
   “What’s the…” began Thomas, his voice hoarse. He hadn’t spoken since awakening except for the few words to the nurse. He cleared his throat. “What’s the problem?”
   “You were right about the hemopericardium,” said Peter with respect. “The knife penetrated the pericardium and cut the surface of the heart. There’s no bleeding, but we wondered if we should close the laceration.”
   Thomas had the circulation nurse locate a stool and put it behind Peter. From that vantage point, he could see into the incision. Peter pointed to the laceration and bent to the side.
   Thomas was relieved. The laceration was inconsequential, having missed any significant coronary vessels.
   “Just leave it as is,” said Thomas. “The marginal benefits of suturing it aren’t worth the possible problems the suture might cause.”
   “Good enough,” said Peter.
   “Leave the pericardium open, too,” warned Thomas. “It will reduce the chances of running into a problem with tamponade in the postoperative course. It will serve as a drainage point if there is any bleeding.”

   An hour later Thomas crossed from the hospital to the Professional Building. When he entered his office he felt unpleasantly wired from the Dexedrine. Over and over he kept worrying about Ballantine and Sherman’s presence in the hospital that night. It was obvious they were having some kind of secret meeting, and, as he wondered what they were plotting, he felt his anxiety mount. Now he knew he would be unable to sleep unless he took something.
   He rarely got such a surge from a single Dexedrine but decided it was probably due to his general exhaustion. Going over to his desk, he gobbled another Percodan. Then, fearful that he might have trouble waking up in the morning, Thomas called Doris. He had to let the phone ring a long time. Mentally he retraced the complicated route from her bed to the phone by the bay window. He wondered why she didn’t get an extension.
   “Listen,” said Thomas when she answered. “You’ve got to come into the office at six-thirty.”
   “That’s only a couple hours from now,” protested Doris.
   “Jesus Christ,” shouted Thomas angrily. “You don’t have to tell me what time it is. Don’t you think I know? But I have three bypasses starting at seven-thirty. I want you over here to make sure I’m up.”
   Thomas slammed the phone down in its cradle, seething. “Goddamn selfish bitch,” he said out loud as he punched his pillow into submission.

Seven

   Cassi’s eyes blinked open. It was a little after five in the morning and was not yet light outside. The alarm wasn’t scheduled to go off for another two hours.
   For a while she lay still, listening. She thought perhaps some sound had awakened her but as the minutes passed, she realized that the disturbance had come from within her head. It was the classical symptom of depression.
   At first Cassi tried turning over and drawing the covers up over her head, but she soon recognized it was useless. She couldn’t go back to sleep. She got out of bed, knowing full well that she would be exhausted that day, especially since Thomas had made her accept an invitation to go to the Ballantines that evening.
   The house was frigid, and she was shivering before she got on her bathrobe. In the bathroom she turned on the quartz heater and started the shower.
   Stepping under the water, Cassi reluctantly allowed herself to remember the reason for her depression—the discovery of the Percodan and the Talwin in Thomas’s desk. And Patricia was undoubtedly going to inform her son that Cassi had again been snooping in his study. Thomas would guess that she’d been looking for drugs.
   Getting out of the shower, Cassi tried to decide what to do. Should she admit she’d found the drugs and confront him? Was the presence of the drugs sufficiently incriminating? Could there be another explanation for their presence in Thomas’s desk? Cassi doubted it, considering the additional fact of Thomas’s frequently pinpointed pupils. As much as Cassi did not want to believe it, Thomas was most likely taking the Percodan and Talwin. How much, Cassi had no idea. Nor did she have any idea how much she was to blame.
   The thought occurred to Cassi that maybe she should seek help. But who to turn to? She had no idea. Patricia obviously wasn’t the answer, and if she went to any of the authorities, then Thomas’s career could be ruined. Cassi felt almost too depressed to cry. It was a no-win situation. No matter what she did or didn’t do, it was going to cause trouble. Lots of trouble. Cassi was aware that her relationship with Thomas could very well be at stake.
   It took all her strength to finish getting ready for work and make the long drive to the hospital.
   Cassi had no more than dumped her canvas bag on her desk when Joan’s head came through the door.
   “Feeling any better?” asked Joan brightly.
   “No,” said Cassi in a tired, flat voice.
   Joan could sense her friend’s depression. From a professional point of view she knew Cassi was worse than she’d been the previous afternoon. Unbidden, Joan came into Cassi’s office and closed the door. Cassi didn’t have the energy to object.
   “You know the old aphorism about the sick doctor,” said Joan: “ ‘He who insists on taking care of himself learns he has a fool for a patient.’ Well, that applies in the emotional realm as well. You don’t sound so good to me. I came in here to apologize for foisting my opinions on you yesterday, but looking at you now, I think it was the right thing to do. Cassi, what’s happening to you?”
   Cassi was immobilized.
   There was a knock on the door.
   Joan opened it and confronted a tearful Maureen Kavenaugh.
   “Sorry, Dr. Cassidy is occupied,” said Joan. She closed the door in Maureen’s face before the woman could respond.
   “Sit down, Cassi,” said Joan firmly.
   Cassi sat down. The idea of forceful direction was appealing.
   “Okay,” said Joan. “Let’s hear what’s going on. I know you have your hands full with your eye problem. But it’s more than that.”
   Once again Cassi recognized the seductive pressure of the psychiatric interview on the patient to talk. Joan inspired confidence. There was no doubt about that. And Cassi could be assured of confidentiality. And in the last analysis Cassi desperately wanted to share her burden with someone. She needed some insight if not merely support.
   “I think Thomas is taking drugs,” said Cassi in a voice so low Joan could barely hear. She watched Joan’s face for the expected signs of shock, but there weren’t any. Joan’s expression didn’t change.
   “What kind of drugs?” asked Joan.
   “Dexedrine, Percodan, and Talwin are the ones I know of.”
   “Talwin is very common among physicians,” said Joan. “How much is he taking?”
   “I don’t know. As far as I am aware, his surgery hasn’t suffered in the slightest. He’s working as hard as ever.”
   “Uh huh,” nodded Joan. “Does Thomas know you know?”
   “He knows I suspect the Dexedrine. Not the others. At least not yet.” Cassi wondered how soon Patricia would tell Thomas she’d been in his study.
   “There’s a euphemistic term for this,” said Joan. “It’s called the ‘impaired physician.’ Unfortunately it is not all that uncommon. Maybe you should read up on it; there’s a lot of material in the medical literature although doctors themselves usually hate to confront the problem. I’ll give you some reprints. But tell me, has Thomas exhibited any of the associated behavioral changes—like embarrassing social behavior or disruption of his appointment schedule?”
   “No,” said Cassi. “As I said before, Thomas is working harder than ever. But he did admit that he is getting less enjoyment from his work. And he seems to have less tolerance lately.”
   “Tolerance for what?”
   “For anything. For people, for me. Even his mother, who essentially lives with us.”
   Joan rolled her eyes. She couldn’t help it.
   “It’s not that bad,” said Cassi.
   “I’ll bet,” said Joan cynically.
   The two women studied each other in silence for a few minutes.
   Then Joan asked tentatively, “What about your married life?”
   “What do you mean?” asked Cassi evasively.
   Joan cleared her throat. “Often physicians abusing drugs will suffer episodes of impotence and actively seek extramarital affairs.”
   “Thomas has no time for extramarital affairs,” said Cassi without hesitation.
   Joan nodded, beginning to think that Thomas did not sound very “impaired.”
   “You know,” said Joan, “your comment about Thomas’s low frustration level and the fact that he’s getting less enjoyment from his work these days is suggestive. Many surgeons are slightly narcissistic and share some of the side effects of the disorder.”
   Cassi didn’t respond, but the concept made sense.
   “Well, it’s food for thought,” said Joan. “It’s an interesting idea that Thomas’s success could be a problem. Narcissistic men need the kind of structure and constant feedback you get in a competitive surgical residency.”
   “Thomas did remark that there was no longer anyone for him to compete with,” said Cassi, catching Joan’s train of thought.
   Just then Cassi’s phone rang. As Joan watched her friend pick up the receiver, she was pleased. Cassi was already acting less depressed. In fact, she managed a smile when she realized it was Robert Seibert.
   Cassi kept the conversation brief. After she hung up, she told Joan that Robert was in seventh heaven because he got another SSD case.
   “That’s wonderful,” said Joan sarcastically. “If you’re about to invite me to the autopsy, thanks but no thanks.”
   Cassi laughed. “No, in fact I declined myself. I’ve scheduled patients all morning, but I told Robert I’d come up at lunch to go over the results.” Talking about time made Cassi glance at her watch. “Uh oh! I’m late for team meeting.”
   The meeting went well. There’d been no catastrophes overnight nor any new admissions. In fact, the resident on call was pleased to report that he’d gotten nine hours of undisturbed sleep, which made everybody extremely jealous. Cassi got a chance to discuss Maureen’s sister, and the consensus was that Cassi should encourage Maureen to contact her herself. There was general agreement that it was worth the risks to bring the sister into the treatment process if possible.
   Cassi also described Colonel Bentworth’s apparent improvement as well as his attempts to manipulate her. Jacob Levine found this particularly interesting but warned Cassi about jumping to premature conclusions.
   “Remember, borderlines can be unpredictable,” said Jacob, taking off his glasses and pointing them at Cassi for emphasis.
   The meeting broke up early since there were no new admissions nor new problems. Cassi declined an offer of coffee, as she did not want to be late for Colonel Bentworth. When she got back to her office, he was waiting by the door.
   “Good morning,” said Cassi as brightly as she could, opening her office door and entering.
   The colonel was silent as he followed Cassi in and sat down. She self-consciously took her place behind the desk. Cassi didn’t know why, but the colonel exacerbated her professional insecurities, especially when he stared at her with those penetratingly blue eyes which she finally realized reminded her of Thomas’s. They were both the same startling turquoise.
   Bentworth again did not look like a patient. He was impeccably dressed and seemed to have totally regained his air of command. The only visible hint he was the same person Cassi had admitted several weeks earlier were the healing burns on his forearm.
   “I don’t know how to begin,” said Bentworth.
   “Maybe you could start by telling me why you’ve changed your mind about seeing me. Up until now you’ve refused private sessions.”
   “Do you want it straight?”
   “That’s always the best way,” said Cassi.
   “Well, to tell the truth, I want a weekend pass.”
   “But that kind of decision is usually made by the group.”
   Group was Bentworth’s major therapeutic agent at the moment.
   “That’s true,” said the colonel, “but the goddamn ignorant sons of bitches wouldn’t let me go. You could overrule them. I know that.”
   “And why would I want to overrule the people who know you the best?”
   “They don’t know me,” shouted Bentworth, slapping his hand on the desk.
   The sudden movement frightened Cassi, but she said quietly, “That kind of behavior is not going to get you anywhere.”
   “Jesus Christ!” said Bentworth. He got up and paced the small room. When Cassi didn’t react, he threw himself back into his chair. Cassi could see a small vein throbbing in his temple.
   “Sometimes I think it would be easier just to give up,” said Bentworth.
   “Why didn’t the members of your group think you should have a weekend pass?” asked Cassi. The only thing she was prepared for on Bentworth’s part was manipulative behavior, and she wasn’t going to fall for it.
   “I don’t know,” said the colonel.
   “You must have an idea.”
   “They don’t like me. Is that good enough? They’re all a bunch of jerks. Blue-collar workers, for Christ’s sake.”
   “That sounds pretty hostile.”
   “Yeah, well, I hate them all.”
   “They happen to be people like you with problems.”
   Bentworth didn’t respond immediately, and Cassi tried to remember what she’d read about treating borderline personalities. The actuality of psychiatry seemed a thousand times more difficult than the conceptualization. She knew that she was supposed to play a structuring role, but she wasn’t sure exactly what that meant in the context of the current session.
   “The crazy thing is that I hate them, yet I need them.” Bentworth shook his head as if he were confounded by his own statement. “I know that sounds weird, but I don’t like to be alone. The worst thing is for me to be alone. It makes me drink, and liquor makes me go nuts. I can’t help it.”
   “What happens?” asked Cassi.
   “I always get propositioned. It never fails. Some dude sees me and guesses I’m a stud, so he comes over and starts to talk to me. I end up beating the guy to a pulp. It’s one thing the army taught me. How to fight with my hands.”
   Cassi remembered reading that both borderline personalities and narcissists wanted to protect themselves from homosexual impulses. Homosexuality could be a potentially fertile area for future sessions, but for the moment she didn’t want to push into areas that were too sensitive.
   “What about your work?” asked Cassi to change the subject.
   “If you want to know the truth, I’m tired of being in the army. I liked the early competition. But now that I’m a colonel, that’s over. I’ve arrived. And I’m not going to make general because too many people envy me. There is no more challenge. Every time I go into the office I get this empty feeling—like what’s the use.”
   “An empty feeling?” echoed Cassi.
   “Yeah, empty. I feel the same after I’ve been living with a woman for a couple of months. At first it’s intense and exciting, but it always goes sour. It gets empty. I don’t know how else to explain it.”
   Cassi bit her lip.
   “The ideal relationship with a woman,” said Bentworth, “would be one month long. Then, puff, she’d disappear and another one would take her place. That would be perfect.”
   “But you were married.”
   “Yeah, I was married. Only lasted a year. I just about killed the broad. All she did was complain.”
   “Are you living with someone now?”
   “No. That’s why I’m here. The day before they picked me up, she walked out. I’d only known her for a couple of weeks, but she met some other guy and took off. That’s why I want to get out of here for the weekend. She’s still got a key to my apartment. I’m afraid she might clean me out.”
   “Why not call a friend and have him change the lock?” said Cassi.
   “There’s nobody I can trust,” said Bentworth, standing up. “Look, are you going to give me a weekend pass or is all this bull for nothing?”
   “I’ll bring it up at the next team meeting,” said Cassi. “We’ll discuss it.”
   Bentworth leaned over the desk. “The only thing I’ve learned in all my time in the hospital is that I hate psychiatrists. They think they’re so goddamned smart, but they’re not. They’re a hell of a lot crazier than I am.”
   Cassi returned his stare, noticing how cold his eyes had become. The thought went thought her mind that Colonel Bentworth should be committed. Then she remembered he was

  Cassi knocked on the doorjamb of Robert’s tiny office. As he looked up from his binocular scope, his face broke into a broad and infectious smile. He jumped up so quickly to hug Cassi that his chair sped back on its wheels to the opposite wall.
   “You look down,” said Robert examining her. “What’s wrong?”
   Cassi looked away. She had had enough talk in the past few hours. “I’m just exhausted. I thought psychiatry was going to be so easy.”
   “Then maybe you should transfer back to pathology,” said Robert as he pulled out a chair for Cassi. Leaning forward, he rested his hands on her knees. If any other man had done so, Cassi would have been annoyed, but she was comforted by Robert’s gesture.
   “What can I get for you? Coffee? Orange juice? Anything?”
   Cassi shook her head. “I wish you could give me a good night’s sleep. I’m beat, and I have to go to a party tonight at Doctor Ballantine’s home in Manchester.”
   “Wonderful,” cooed Robert. “What are you going to wear?”
   Cassi rolled her eyes in disbelief, saying she hadn’t given it a moment’s thought, at which point Robert, who had some knowledge of Cassi’s wardrobe, made several suggestions. Cassi interrupted to say that she’d come to hear about the autopsy, not for his fashion advice.
   Robert made an exaggerated expression of being hurt and said, “The only thing that you come up here for is business. I can remember when we used to be friends.”
   Cassi reached out to give Robert a friendly shake, but he eluded her by pushing back on his chair, which glided smoothly out of the way. They both laughed. Cassi sighed and realized she felt better than she had all day. Robert was like a tonic.
   “Did your husband tell you he saved me at the last surgical death conference?”
   “No,” said Cassi, surprised. She’d never mentioned Thomas’s antipathy to Robert, but it was all too obvious the few times they’d met.
   “I made a big mistake. I got this crazy notion that the cardiac surgeons would be overjoyed to hear about SSD, and I decided to make a preliminary presentation at yesterday’s conference. It turned out to be the worst thing I could have done. I suppose I should have realized their egos are such that they’d consider the study a form of criticism. Anyway, when I finished talking, Ballantine started to chew me out until Thomas interrupted with an intelligent question. That sparked a few more questions, and what could have been a total disaster was averted. I did get a lot of heat this morning from the chief of pathology. It seems George Sherman had asked him to muzzle me in the future.”
   Cassi was impressed and grateful for her husband’s intervention. She wondered why he hadn’t mentioned it to her until she remembered that she hadn’t given Thomas a chance. She’d brought up her eye surgery the second she’d seen him.
   “Maybe I’ll have to take back some of the nasty things I’ve said about your husband,” added Robert.
   There was an awkward silence. Cassi did not want to get into a discussion of her own feelings just then.
   “Well,” said Robert, rubbing his hands together enthusiastically. “To work! As I said on the phone, I think I found a new SSD case.”
   “Cyanotic like the last?” asked Cassi, eager to change the subject.
   “Nope,” said Robert. “Come on, I want to show you.”
   He leaped to his feet and dragged Cassi out of his office and into one of the autopsy rooms. A young, light-skinned black was laid out on the stainless steel table. The standard Y autopsy incision had been closed with heavy sutures and clumsy bites of tissue.
   “I asked them to leave the body so you could see something,” said Robert, his voice echoing in the tiled room.
   He let go of Cassi and inserted his thumb into Jeoffry Washington’s mouth, pulling down the lower jaw. “Look in here.”
   With her hands behind her back, Cassi bent over and looked into the patient’s mouth. The tongue was a mangled piece of meat.
   “Chewed hell out of it,” said Robert. “Obviously had one hell of a grand mal seizure.”
   Cassi straightened up, a little sickened by what she’d seen. If this was an SSD case, he was the youngest yet.
   “I think this one died of an arrhythmia,” said Robert, “but I won’t know for sure until the brain is fixed. You know, seeing this kind of case doesn’t help my anxiety about my own surgery.” Robert glanced over at Cassi.
   “When are you going to have it?” she asked. Robert’s statement sounded definitive.
   Robert smiled. “I told you, but you wouldn’t believe that I was going to get it over with. I’m being admitted tomorrow. What about yours?”
   Cassi shook her head. “It’s not definite yet.”
   “You chicken,” accused Robert with an air of superiority. “Why don’t you schedule yours for the day after tomorrow, too, so we can visit together in the recovery room.”
   Cassi didn’t want to tell Robert about her difficulties talking the matter over with Thomas. Reluctantly her eyes went back to the corpse.
   “How old?” asked Cassi, motioning toward Jeoffry Washington.
   “Twenty-eight,” said Robert.
   “God, that’s young,” said Cassi. “And it’s only been two weeks since the last case.”
   “That’s a fact,” said Robert.
   “You know, the more I think about it, the more disturbing these cases are.”
   “Why do you think I’ve persisted?” said Robert.
   “With the number you have now and the apparent increase in frequency, it’s getting harder and harder to ascribe the deaths to chance.”
   “I agree,” said Robert. “Ever since the last, I’ve had the nagging suspicion that these deaths are more closely related than we suspect. The only trouble with that idea is that it suggests a specific agent, and as your husband pointed out, the deaths are physiologically different. The facts don’t fit the theory.”
   Cassi walked around the table to Jeoffry’s right side. “Does this look swollen to you?” she said, reaching out and running her hand up the body’s forearm.
   Robert bent down to look. “I don’t know. Where?”
   Cassi pointed. “Was the patient on IV?”
   “I think so,” said Robert. “I think he was on antibiotics for phlebitis.”
   Cassi picked up Jeoffry’s left arm and looked at the IV site. It was red and puffy. “Just for interest’s sake, how about getting some sections of the vein where the IV was?”
   “Anything if it will get you to come up and visit.”
   Cassi replaced Jeoffry’s arm as carefully as if it were still sensate. “Do you happen to know if all the SSD cases were on IVs?” asked Cassi.
   “I don’t know, but I can find out,” said Robert. “I have an idea what you’re thinking, and I don’t like it.”
   “The other suggestion I have,” said Cassi, “is to collate the supposed physiological mechanisms of death and see if there is any pattern. You know what I mean.”
   “I know what you mean,” said Robert. “I can probably do that today. And I’ll get the sections of the vein, but you have to promise to come up and look at them. Agreed?”
   “Agreed,” said Cassi.

   As Cassi pressed the elevator button in the corridor outside the pathology department, she was aware she was dreading her upcoming session with Maureen Kavenaugh. Without doubt, Maureen’s depression exacerbated Cassi’s own. The fact that Cassi had reason to be depressed, as Joan had pointed out, did not make the symptoms easier to live with.
   Dreading the meeting with Maureen bothered Cassi because it forced her to admit that as a psychiatrist she was going to have to deal with her own value judgments. In other areas of medicine, if you were forced together with a patient you disliked, you concentrated on the pathology and cut the personal contact to a minimum. In psychiatry that was not possible.
   Happily, when she entered her office, Maureen still was nowhere to be seen. Cassi knew she was going to have difficulty concentrating on what Maureen had to say because Robert’s decision to have his surgery brought up the issue of her own. She knew Robert was right. After a moment’s indecision, she dialed Thomas’s office.
   Unfortunately, he was still in surgery.
   “I don’t know when he will be out,” said Doris. “But I know it will be late because he called me and told me to cancel his afternoon office hours.”
   Cassi thanked her and hung up. Blankly she stared at her Monet print. Joan’s comment about the “impaired physician” disrupting his appointment schedule flashed into her mind. Then she dismissed the thought. Thomas had obviously canceled his office hours because he was stuck in surgery.
   A knock interrupted her thoughts. Maureen’s listless face appeared in the doorway.
   “Come in,” said Cassi as cheerfully as she could. She suspected that the next fifty minutes were going to be a good example of the blind leading the blind.

   It was Doris, not Thomas, who called Cassi in the middle of the afternoon to say that Dr. Kingsley would meet her at the front entrance to the hospital at six o’clock sharp. She insisted Cassi be on time because of the party that night. Cassi was in the lobby promptly, but when the clock over the information booth showed twenty after six, she worried that she may have gotten the message wrong.
   The entrance of the hospital was crowded with waves of people coming and going. The people leaving were primarily employees, and they chattered and laughed, glad to see the workday come to an end. Those arriving were mostly visitors who seemed subdued and intimidated as they lined up in front of the information booth to get directions from the volunteers in their green smocks.
   Watching the crowds made time pass, and when Cassi looked back at the clock, it was almost six-thirty. Finally she decided to call Thomas’s office, but as she moved toward the phone, she caught a glimpse of his head above the crowd. He looked as tired as Cassi felt. His face was shadowed, which turned out to be an irregular growth of beard as if he’d not shaved carefully that morning. As he came closer, Cassi could see that his eyes were red-rimmed.
   Unsure of her reception, Cassi held her tongue. When she realized that Thomas had no intention of talking or even stopping, she hooked her arm in his and was carried toward the rapidly revolving door.
   Outside Cassi was confronted by a mixture of rain and snow, which melted the instant the flakes touched the ground. Hefting her bag onto her shoulder, she shielded her face and stumbled behind Thomas toward the parking garage.
   Once inside the garage, he stopped and, finally turning to Cassi, said, “Awful weather.”
   “We’re paying for such a nice fall,” said Cassi, encouraged that Thomas did not seem to be in a bad mood. Maybe Patricia would not tell him of the visit to his study.
   The engine of the Porsche reverberated like thunder in the garage. As he watched the dials and gauges, Cassi carefully did up her seat belt. It took a conscious effort for her not to tell Thomas to do his, especially given the bad weather, but remembering his previous response, Cassi remained silent.
   Whenever it snowed, traffic in Boston slowed to a frustrating stop-and-go mess. As Thomas and Cassi proceeded east on Storrow Drive, it was mostly stop. Although Cassi wanted to talk, she was afraid to break the silence.
   “Did you hear from Robert Seibert today?” Thomas finally asked.
   Cassi swung her head around. Thomas still had his eyes on the road despite the fact that the car was immobilized in a sea of red taillights. He seemed hypnotized by the rhythmic click-clack of the windshield wipers.
   “I did speak to Robert today,” admitted Cassi, surprised at the question. “How did you know?”
   “I’d heard that one of George Sherman’s patients had died. Apparently it wasn’t expected, and I wondered if your friend Robert was still interested in that series of his.”
   “Absolutely,” said Cassi. “I went up after the autopsy. And when I did, Robert told me how you rescued him at death conference. I think that was very nice of you, Thomas.”
   “I wasn’t trying to be nice,” said Thomas. “I was interested in what he had to say. But he was a fool to do what he did, and I still think he should get his butt kicked.”
   “I think he did get his butt kicked,” said Cassi.
   With a faint smile Thomas took advantage of the thin-ning traffic and goosed his car up the grade to the expressway.
   “Was this last death another suspicious one?” he asked as the car accelerated to seventy. He drove with both hands on the wheel, blinking his high beams furiously as he came up behind people traveling more slowly.
   “Robert thinks so,” said Cassi, her hands involuntarily gripping each other. Thomas’s driving always scared her. “But he hasn’t done the brain yet. He thinks the patient convulsed prior to death.”
   “So it wasn’t like the last case?” asked Thomas.
   “No,” said Cassi. “But Robert thinks the situations are related.” Purposely she kept her own role in the discussion secret. “Most of the patients, particularly over the last several years, have died after their acute postoperative course was over. One point that occurred to Robert today was that all the patients may have been on IV when they died. He’s checking on that now. It could be significant.”
   “Why? Does Robert think these deaths could be suspicious?” asked Thomas with shock.
   “I guess it’s occurred to him,” said Cassi. “After all, there was a case in New Jersey where a series of patients were given something like curare.”
   “That’s true, but they all died with the same symptoms.”
   “Well,” said Cassi. “I guess Robert feels that he has to consider all possibilities. I know it sounds awful and it certainly accentuates any insecurities Robert has about his own imminent surgery.” Cassi was hoping to shift the topic to her own operation.
   “What kind of surgery is Robert going to have?”
   “He’s finally having his impacted wisdom teeth removed. Since he had rheumatic heart disease as a child, he has to be treated with prophylactic antibiotics.”
   “He’d be a fool not to,” agreed Thomas. “Although he must have suicidal tendencies. That’s the only way I can explain his behavior at that death conference. Cassi, I want you to be sure to stay away from this so-called SSD study, especially if there are going to be ludicrous accusations. With everything else going on, I certainly don’t need that kind of grief.”
   Cassi watched the cars in front as the Porsche relentlessly passed them. The monotonous movement of the windshield wipers mesmerized her as she tried to find the courage to broach her own operation. She’d promised herself she’d start speaking as soon as they came abreast of that yellow car. But the yellow car soon dropped behind them. Then it was the bus. But they’d passed that, too, and still Cassi remained silent. She gave up in despair, hoping that Thomas would bring up the subject himself.
   The tension exhausted her. The idea of Ballantine’s party seemed less and less attractive. She had trouble understanding why Thomas, of all people, wanted to go. He hated hospital affairs. The idea occurred to Cassi that maybe he was going for her benefit. If that were the case, it was ridiculous. All Cassi could think about was clean sheets and their comfortable bed. She decided she’d say something when they got to the next overpass.
   “Do you really want to go to this party tonight?” asked Cassi hesitantly as an overpass flashed above them.
   “Why do you ask?” Thomas pulled the car sharply to the right, then gunned the engine to pass a car that had ignored his blinking high beam.
   “If you’re going for me,” said Cassi, “I’m exhausted. I’d much rather stay home.”
   “Goddammit,” shouted Thomas, banging the steering wheel. “Must you always think only of yourself! I told you weeks ago that the board of directors and the deans of the medical school are going to be there. Something strange is going on in the hospital that they are not telling me. But I don’t suppose you think that’s important?”
   As Thomas reddened with anger, Cassi sank in her seat. She had a feeling that no matter what she said, it would only make matters worse.
   Thomas lapsed into a sullen silence. He drove even more recklessly, taking the car up to ninety as they crossed the salt marshes. Despite the seat belt, Cassi found herself being thrown from side to side as the car rounded the sharp bends. She was relieved when he began to down shift before turning into their driveway.
   By the time they got to the front door, Cassi had become resigned about the party. She apologized for not understanding its implications and added gently, “You look tired yourself.”

  “Thanks! I appreciate your vote of confidence,” said Thomas sarcastically. He started for the stairs.
   “Thomas,” called Cassi desperately. She could tell he’d interpreted her concern as an insult. “Does it have to be like this?”
   “I think this is the way you want it.”
   Cassi tried to object.
   “Let’s not have a scene, please!” yelled Thomas. Then in a more controlled voice he said, “We’ll leave in an hour. You’re the one who looks terrible. Your hair is a mess. I hope you’re planning on doing something with it.”
   “I will,” said Cassi. “Thomas, I don’t want us to fight. It terrifies me.”
   “I’m not getting into this kind of discussion,” snapped Thomas. “Not now. Be ready in an hour.”
   Hurrying into his study he went directly to the bathroom, mumbling under his breath about Cassi’s selfishness. He’d told her very specifically about the party and why it was important, but she’d conveniently forgotten because she was too tired! “Why do I have to put up with this,” he said, running a hand over his beard.
   Getting out his shaving paraphernalia, Thomas washed and lathered his face. Cassi was becoming more than a source of irritation. She was becoming a burden. First her eye problems, then her preoccupation with the fact he took an occasional drug, and now her association with Seibert’s provocative paper.
   Thomas began to shave with short, irritated strokes. It was beginning to feel as if everyone were against him, both at home and in the hospital. At work the key offender was George Sherman, who was constantly undermining him with all the supposed teaching bullshit. Just thinking about it filled Thomas with such frustration that he threw his razor into the shower with all the force he could muster. It ricocheted off the tiled walls with a clatter before coming to rest near the drain.
   Leaving the razor where it was, Thomas got into the shower. The running water always tended to soothe him, and after he’d stood under the spray for a few minutes, he felt better. While he was drying, he heard the door to his study open. Expecting it was Cassi, he didn’t bother to look, but when he was done in the bathroom, he opened the door to find Patricia sitting in his armchair.
   “Didn’t you hear me come in?” she asked.
   “No,” said Thomas. It was easier to fib. He went to the cabinet below the bookshelves where he’d been keeping some of his clothes.
   “I can remember when you used to take me to these hospital parties,” said Patricia plaintively.
   “You’re welcome to come,” said Thomas.
   “No. If you’d really wanted me you would have invited me rather than making me ask.”
   Thomas thought it better not to respond. Whenever Patricia was in one of these “hurt” moods, it was safer to say nothing.
   “Last night I saw the light come on in the study here, and I thought you’d come home. Instead I found Cassandra in here.”
   “In my study?” demanded Thomas.
   “She was right over there behind your desk.” Patricia pointed.
   “What was she doing?”
   “I don’t know. I didn’t ask her.” Patricia stood up with a self-satisfied expression. “I told you she would be trouble. But, oh no! You knew better.” She sauntered out of the room and closed the door gently behind her.
   Thomas threw his clean clothes onto the sofa and went to his desk. Pulling out the drawer with his drugs, he was relieved to see the bottles of pills exactly as he’d left them behind the stationery.
   Even so Cassi was driving him crazy. He’d warned her to stay away from his belongings. Thomas could feel himself begin to shake. Instinctively he reached into his cache of pills and extracted two: a Percodan for the headache he could feel behind his eyes and a Dexedrine to wake him up. If it was worth going to this party, he should at least be alert.
   • • •
   Cassi could sense a tremendous change for the worse in Thomas’s mood as they drove toward Manchester. She’d heard Patricia come into the house and guessed that she’d visited Thomas. It didn’t take too much imagination to figure out what she’d told him. Since Thomas had already been in poor humor, she couldn’t have chosen a worse time.
   Cassi had made a real effort to look her best. After taking her evening insulin, which she’d upped because of sugar showing up in her urine, she’d bathed and washed her hair. Then she’d selected one of the dresses that Robert had suggested. It was a deep brown velvet with puffed sleeves and a tight bodice that gave her a charming medieval look.
   Thomas said nothing about her appearance. In fact he said nothing at all. He drove the way he had coming from the hospital, recklessly and fast. She wished he had a close friend she could go to—someone who really cared for him, but in truth he didn’t have many friends at all. For a moment she was reminded of her last meeting with Colonel Bentworth. Then she caught her breath. Identifying with Maureen Kavenaugh was one thing, but comparing her husband to a borderline personality was ridiculous. Cassi turned her attention to the window to keep from thinking and tried to see through the moisture. It was a dark, forbidding night.
   The Ballantines’ house fronted on the ocean, just like Thomas’s. But that was where the similarities ended. The Ballantines’ home was a large, stone mansion and had been in the family for a hundred years. In order to maintain the house, Dr. Ballantine had sold off some of the land to a developer, but since the original plot was so large, no other house could be seen from the main building. It gave the impression of being in the country.
   As they got out of the car, Cassi noticed that Thomas had a slight tremor. His coordination seemed slightly off as they mounted the front steps. Oh God, what had he taken?
   Thomas’s demeanor changed as soon as he joined the party. Cassi watched with amazement, although she knew how easily he could abandon an angry mood and become charming and animated. If only he would still expend some of that charm on her. Deciding it was safe to leave him, Cassi began to look for the food. Having given herself her evening insulin, she shouldn’t wait too long before eating. The dining room was to the right, and she made her way over to the arched entrance.

   Thomas was pleased. As he’d expected, most of the hospital trustees and the deans of the medical school were at the party. He’d seen them over the shoulders of the small group of people he’d joined when first arriving. He was particularly interested in finding the chairman of the board. Picking up a fresh drink, he began to make his way through the crowd toward the men when Ballantine came over to him.
   “Ah, there you are Thomas.” Ballantine had been drinking heavily, and the circles under his eyes were pronounced, giving him more the appearance of a Basset hound than usual. “Glad that you could make it.”
   “Wonderful party,” said Thomas.
   “You better believe it,” said Ballantine with a forceful wink. “Things are really happening at the old Boston Memorial. God, it’s exciting.”
   “What are you talking about?” asked Thomas, backing up a step. Dr. Ballantine had a habit of spitting when he pronounced “Ts” after he’d had a few drinks.
   Ballantine stepped closer. “I’d like to tell you, but I can’t,” he whispered. “But maybe soon, and I think you should join us. Have you given any thought to my offer of full professorship?”
   Thomas felt his patience evaporate. He didn’t want to hear about joining the full-time staff. He had no idea what Ballantine was referring to when Ballantine said, “Things are really happening.” But Thomas didn’t like the sound of it. As far as he was concerned, any change in the status quo was worrisome. He suddenly recalled seeing Ballantine’s office light blazing at 2:00 A.M.
   “What were you doing in your office so late last night?”
   Ballantine’s happy face clouded. “Why do you ask?”
   “Just curiosity,” said Thomas.
   “That’s a strange question just coming outta the blue,” said Dr. Ballantine.
   “I was in surgery last night. I saw your office light from the lounge.”
   “Must have been cleaning people,” said Ballantine. He raised his glass and stared at it. “Looks like I need a refill.”
   “I also saw George Sherman’s car in the garage,” said Thomas. “It seemed an odd coincidence.”
   “Ah,” said Ballantine, with a wave of his hand. “George’s been having trouble with that car for a month. Something with the electrical system. Can I get you another drink? You’re as low as I.”
   “Why not?” said Thomas. He was sure Ballantine was lying. The moment the chief edged toward the bar, Thomas recommenced his search for the chairman. It was more important than ever to find out what was going on at the Memorial.
   • • •
   Cassi stayed by the buffet table for a while eating and chatting with several other wives. When she was sure she had absorbed enough calories to balance her insulin, she decided she’d better find Thomas. She had no idea what drugs he’d taken, and she was nervous. She had just started for the living room when George Sherman stopped her.
   “You look beautiful, as usual,” he said with a warm smile.
   “You look good yourself, George,” said Cassi. “I like you far better in a tuxedo than that old corduroy jacket of yours.”
   George laughed self-consciously.
   “I’ve been meaning to ask how you find psychiatry. I was surprised when I heard you’d made the switch. In a lot of ways, I envy you.”
   “Don’t tell me you give psychiatry any credibility. I didn’t think any surgeon did.”
   “My mother suffered a severe postpartum depression after my younger brother was born. I’m convinced her psychiatrist saved her life. I might have chosen it as a specialty if I thought I would have been successful. It takes a sensitivity I don’t have.”
   “Nonsense,” said Cassi. “You have the sensitivity. I think it would be the passivity that would give you trouble. It’s the patient who has to do the work in psychiatry.”
   George was silent for a moment, and as Cassi watched his face she suddenly thought of fixing him up with Joan. They were both such nice people.
   “Are you interested in meeting an attractive new woman these days?”
   “I’m always interested in attractive women. Though few measure up to you.”
   “Her name is Joan Widiker. She’s a third-year psychiatry resident.”
   “Wait a second,” said George. “I’m not sure I can handle a psychiatrist. She’ll probably ask me all sorts of tough questions when I drag out my whips and chains. I might be too self-conscious. Worse than when I was with you. Remember that first date?”
   Cassi laughed. How could she forget? George had clumsily knocked her hand during dinner so that she’d spilled linguini Alfredo into her lap. Then, in his eagerness to help mop it up, he’d knocked her Chianti Classico into her lap as well.
   “I don’t mean to sound ungrateful,” said George. “I do appreciate your thinking of me and I’ll give Joan a call. But Cassi, I wanted to talk to you about something a little more serious.”

   Cassi unconsciously straightened, unsure of what was coming.
   “As a colleague, I’m worried about Thomas.”
   “Oh?” said Cassi as casually as she could.
   “He works too damn hard. It’s one thing to be dedicated, quite another to be obsessed. I’ve seen it before. Often physicians can go along at nine hundred miles an hour for years and then suddenly burn themselves out. The reason I’m saying all this is to ask you to try to get Thomas to slow down, maybe take a vacation. He’s been wound up like a coiled spring. There’s gossip he’s had a couple of bad arguments with the residents and nurses.”
   George’s words awakened all Cassi’s submerged tears. She bit her lip, but remained silent.
   “If you could get him to take some vacation time, I’ll be happy to cover his practice if need be.” George was startled to see Cassi’s eyes fill with tears. She turned away, hiding her face.
   “I didn’t mean to upset you,” said George. Reaching out, he put his hand on her shoulder.
   “It’s all right,” said Cassi, struggling to regain her composure. “I’m okay.” She looked up and managed a smile.
   “Dr. Ballantine and I have discussed Thomas,” said George. “We’d like to help. We both think that when someone works as hard as Thomas, he has to recognize that there’s an emotional price to pay.”
   Cassi nodded as if she understood. She gave George’s hand a squeeze.
   “If you feel uncomfortable talking to me, maybe see Dr. Ballantine. He thinks the world of your husband. Maybe you’d like the chief’s private extension at the hospital?”
   Cassi evaded George’s warm gaze. Concentrating on her purse, she extracted a small notepad and pencil. When George gave her the number, she wrote it down. When she looked up, her heart almost stopped. She found herself looking directly into Thomas’s unblinking stare. With knowledge born of intimacy, she instantly knew he was violently angry. All at once, George’s hand felt heavy on her shoulder.
   She quickly excused herself, but by the time she moved toward the door, Thomas had disappeared.

   Thomas hadn’t been so angry since he was a freshman in college and one of his roommates had dated Thomas’s girl friend. No wonder George had been acting so strangely. He’d been renewing his affair with Cassi, and Cassi had no more sense than to display her interest in front of all Thomas’s colleagues. The cold knot of fear in the pit of his stomach stirred. His hand shook so badly he almost spilled his drink. Quickly tossing it off, he stepped through the French doors onto the veranda, welcoming the sharp ocean breeze.
   Frantically he searched his pockets for a pill. The evening had gone badly from the start. A trustee who’d already made several trips to the bar had stopped to offer congratulations on the hospital’s new teaching program. When Thomas had stared blankly in response, the man had muttered a quick apology and backed out of the room. Thomas had been about to search out Ballantine and demand an explanation when he’d seen Cassi.
   God, what a fool he’d been. Now that he thought about it, it was obvious George and Cassi were having an affair. No wonder she never complained when he stayed so often in the hospital. Mercilessly his mind teased him with the idea that they met in his house. The image of George in their bedroom made Thomas cry out in rage. Glancing over his shoulder, he saw a couple standing in the doorway, and Thomas was suddenly afraid they were aware of the affair. Obviously they were talking about him. He pulled out another pill, swallowed it, and went back inside for another drink.

   Frantic to find Thomas, Cassi began to work her way around the living room, excusing herself as she squeezed among the guests.
   She was on her way into the bar when she found herself face to face with Dr. Obermeyer.
   “What a coincidence!” he said. “My most difficult patient!”
   Cassi smiled nervously. She remembered she’d reneged on her promise to call him that day.
   “Unless my memory fails, you were supposed to schedule your surgery today,” said Dr. Obermeyer. “Did you talk to Thomas about it?”
   “Why don’t I come to your office tomorrow morning,” said Cassi evasively.
   “Maybe I should talk to your husband,” said Dr. Obermeyer. “Is he here?”
   “No,” said Cassi. “I mean, yes he’s here, but I don’t think this is the time…”
   A tremendous yell shook the room, halting all conversation and stopping Cassi in midsentence. Everyone looked confused; everyone but Cassi. She recognized the voice. It was Thomas! Running back toward the dining room, she heard another shout, followed by a crash of broken glass.
   Pushing her way through the other guests, Cassi saw Thomas standing in front of the buffet, his face flushed with anger, a number of broken plates at his feet. Staring at him in horrified surprise was George Sherman, a drink in one hand and a carrot stick in the other.
   As Cassi watched, George reached out and patted Thomas’s shoulder with the carrot, saying, “Thomas, you’re mistaken.”
   Thomas knocked George’s arm away with a vicious snap of his wrist. “Don’t touch me! And don’t ever touch my wife. Understand?” He jabbed a threatening finger into George’s face.
   “Thomas?” said George helplessly.
   Cassi ran between the two men. “What is the matter with you, Thomas?” she said, grabbing his jacket. “Control yourself!”
   “Control myself,” he repeated, turning toward her. “I think that applies more to you than me.”
   With a final sneer, he shook himself from Cassi’s grasp and headed for the front door. Ballantine, who’d been in the kitchen, followed, calling his name.
   Cassi apologized quickly to George and moved toward the door, her head bent to avoid the curious stares.
   Thomas meanwhile had found his coat and was saying angrily to Ballantine, “I’m terribly sorry about all this, but learning that one of your colleagues is having an affair with your wife is hard to take.”
   “I, I can’t believe that,” said Ballantine. “Are you sure?”
   “I’m sure,” said Thomas. He turned to open the door as Cassi ran up and caught his arm.
   “Thomas, what are you doing?” she said, fighting tears.
   Thomas didn’t answer. Buttoning his coat, he turned to leave.
   “Thomas, talk to me. What happened?”
   Thomas yanked his arm away from Cassi with such force she almost fell to the ground. She hesitated as he opened the door and stormed outside.
   Cassi caught up to him at the bottom of the steps.
   “Thomas, if you’re going to leave, then I’m coming. Let me get my coat.”
   Thomas stopped short. “I don’t want you with me. Why don’t you just stay here and enjoy your affair!”
   Confused, Cassi watched him walk away. “My affair? This is your affair. I didn’t want to come tonight!”
   Thomas didn’t respond. Cassi gathered up the skirt of her long dress and ran after him. By the time she reached the Porsche she was shaking violently, but she didn’t know whether it was from fear or the cold.
   “Why are you acting this way?” she sobbed.
   “I might be a lot of things, but I’m not stupid,” snapped Thomas, slamming the car door against her. The engine started with a roar.
   “Thomas, Thomas,” called Cassi, beating against the window with one hand and trying to open the door with the other. Thomas ignored her and backed up quickly. If Cassi had not stepped back, letting go of the car, she would have been pulled down. Staring mutely, she watched the Porsche roar down the long driveway.
   Mortified, she turned back to the house. Perhaps she could hide in one of the upstairs rooms until she could get a cab. When she reached the foyer, she was relieved to see the guests were again busy drinking and laughing. Only George and Dr. Ballantine were waiting at the door.
   “I’m so sorry,” Cassi said uneasily.
   “Don’t be sorry,” said Dr. Ballantine. “I understand George has had a little talk with you. We are concerned about Thomas and think he’s overworking. We have plans that will lighten his load, but he’s been so upset lately that we haven’t had the opportunity to discuss it with him.”
   Ballantine exchanged glances with George.
   “That’s right,” agreed George. “I think this unfortunate episode tonight just underlines what we’re saying.”
   Cassi was too upset and confused to respond.
   “George also mentioned,” said Ballantine, “that he gave you my private extension at the hospital. I’ll be happy to see you any time you want, Cassi. In fact, why don’t you stop by my office tomorrow?”
   “Now, would you like to rejoin the party?” asked Ballantine, “or would you rather one of my boys drove you home?”
   “I’d like to go home,” said Cassi, wiping her eyes with the back of her hand.
   “Fine,” said Ballantine. “Just a moment.” He turned and mounted the stairs to the second floor.
   “I am sorry,” said Cassi to George when they were alone. “I don’t know what got into Thomas.”
   George shook his head. “Cassi, if he knew how I really felt about you, he’d have every reason to be jealous. Now smile. I was just paying you a compliment.” He stood, gazing fondly at her until Ballantine’s son brought the car around.

   Cassi didn’t know what to expect when she turned the key in her front door. She was surprised to see a light in the living room. If Thomas was home and not in the hospital, she assumed he would be locked in his study. Nervously, she walked through the hall straightening her hair as best as she could.
   But it was her mother-in-law, not Thomas, who was waiting for her.
   Patricia was seated in a wingback chair, her face lost in the shadowy light of a single floorlamp. Upstairs, Cassi heard a toilet flush.
   For a long time neither woman spoke. Then Patricia stiffly stood up, her shoulders bowed as if under a heavy weight. Her face was drawn, accentuating the lines around her mouth. She walked directly up to Cassi and looked her in the eye.
   Cassi held her ground.
   “I’m shocked,” she said at last. “How could you have done this? Maybe if he weren’t my only child it wouldn’t hurt so much.”
   “What on earth are you talking about?” demanded Cassi.
   “And to pick one of Thomas’s colleagues,” Patricia went on, ignoring the younger woman. “A man who has been steadily trying to erode his position. If you wanted an affair, why not a stranger?”
   “I’m not having an affair,” said Cassi desperately. “This is absurd. Oh God, Thomas is not himself.”
   She watched her mother-in-law for some sign of understanding, but Patricia stood rigidly looking at her daughter-in-law with a mixture of sadness and anger.
   Cassi stretched her arms toward the woman. “Please,” she pleaded. “Thomas is in trouble. Won’t you help?”
   Patricia remained unresponsive.
   Letting her arms fall to her sides, Cassi watched as Patricia walked haltingly to the door. She seemed to have aged ten years since Cassi had last seen her. If only she’d listen. But Cassi realized at last that Patricia would rather break her heart over a lie than deal with the more frightening truth of Thomas’s addiction. As much as Patricia criticized Thomas, Cassi knew that she could never conceive of the possibility of something significantly wrong with her son.
   Cassi remained in the semidarkness of the living room for a long time after she heard the front door close. She’d cried more tears in the last forty-eight hours than she had for the previous twenty years. How could Thomas possibly believe she was having an affair? The idea was preposterous.
   With heavy steps she finally ascended the stairs to find Thomas. There was no way she could just go to bed. She had to try to speak to him. For a moment she hesitated outside the study. Then she knocked softly.
   There was no answer.
   She knocked again, louder. When there was still no reply, she tried the door. It was locked. Determined to talk with him, she walked to the guest room and entered the study through the connecting bathroom.
   He was sitting immobile in his easy chair, staring straight ahead, his eyes unfocused. If he heard Cassi, his expression did not change. A slight smile lifted the corners of his mouth. Even after Cassi knelt down and pressed his hand to her cheek, he did not move.
   “Thomas,” she called softly.
   Thomas finally looked down at her.
   “Thomas, I’ve never had an affair with George. I’ve never looked at anyone since we met. I love you. Please let me help.”
   “I don’t believe you,” Thomas said, badly slurring his words. Then his eyes rolled up and he passed out, leaving Cassi still holding his hand. She unfolded the sofa bed and tried to get him to move, but he refused. She sat with him for a while before going back to her own room to try to sleep.

Eight

   In the morning Cassi was up and dressed before she heard the alarm go off in the study. It kept ringing and ringing. Concerned, she ran down the hall and opened the door. Thomas was sprawled in his chair exactly as she had left him the night before.
   “Thomas,” she said, shaking him.
   “Wha-what?” he whispered.
   “It’s quarter to six. Don’t you have surgery this morning?”
   “I thought we were going to Ballantine’s party,” he muttered.
   “Thomas, that was last night. Oh God, maybe you should call in sick. You never take a day off. Let me call Doris and see if she can postpone your operations.”
   Thomas struggled to his feet. He swayed and steadied himself against the arm of the chair.
   “No, I’m fine.” His voice was still slightly slurred. “And with the cutback on my OR time, I won’t be able to reschedule for weeks. Some of the patients this month have already waited too long.”
   “Then let someone else…” Thomas raised his hand so quickly Cassi thought he was going to hit her, but instead he lunged into the bathroom, slamming the door. A few moments later she heard him turn on the shower. When he came downstairs he seemed in better shape. Probably because he had taken a couple of Dexedrines, thought Cassi.
   He quickly drank juice and a cup of coffee and then headed for the garage.
   “Even if I can get home tonight, I’ll be very late, so you better take your own car,” he said over his shoulder.
   Cassi remained sitting at the kitchen table for a long time before she, too, began the long trip to the hospital. “For the first time,” she thought, “it’s not just Thomas I’m worried about. It’s his patients. I don’t know if it’s safe for him to operate anymore.”
   By the time she reached Boston Memorial, Cassi had made up her mind to do three things the minute she was finished with team meeting. She would make an appointment to have her eye surgery, arrange to take the necessary time off, and she would see Dr. Ballantine and confide her fears about Thomas. After all, the problem affected the hospital as well as her marriage.
   Joan noted Cassi’s preoccupation, but before she had a chance to ask any questions, at the end of the meeting Cassi said something about seeing her ophthalmologist and hurried off the floor.
   Dr. Obermeyer interrupted his schedule the moment he heard Cassi had appeared. He came out of his inner office with his minerlike light still strapped to the top of his head.
   “I trust you’ve come to the right decision?” he said.
   Cassi nodded. “I’d like to be scheduled as soon as possible. In fact, the sooner the better before I have a chance to change my mind.”
   “I was hoping you’d say that,” said Dr. Obermeyer. “In fact, I took the liberty of scheduling you as a semi-emergency for the day after tomorrow. Is that all right with you?”
   Cassi’s mouth went dry, but she nodded obediently.
   “Perfect,” said Dr. Obermeyer with a smile. “Don’t you worry about a thing. We’ll take care of all the arrangements. You’ll be admitted to the hospital tomorrow.” Dr. Obermeyer buzzed for a secretary.
   “How long will I be unable to work?” said Cassi softly. “I will have to say something to the chief of psychiatry.”
   “That depends on what we find, but I’d guess a week to ten days.”
   “That long?” said Cassi. She wondered what would happen to her patients.
   Walking slowly back from the Professional Building, Cassi decided to phone Dr. Ballantine before her courage failed her. He answered the phone himself and assured her he had no surgery and could see her in half an hour.
   After arranging to take sick leave, Cassi decided to kill the rest of the time before her interview with Ballantine by visiting pathology. She could tell Robert about her surgery, and just seeing him always gave her confidence. But when she reached his office, it was empty. One of the technicians told her that Robert was not due in at all. He was being admitted early that afternoon for oral surgery, and he’d decided to go out to eat what would probably be his last real meal for a week.
   Cassi was back out at the elevator when she remembered Jeoffry Washington. Turning back into the lab, she asked the technician for the slides. The woman located Jeoffry Washington’s tray without difficulty but explained that only half the slides were finished. She said it took at least two days to do a case and suggested that Cassi come back the next day for the full set. Cassi said she understood, but was interested only in the H & E mounts of the vein, which were probably ready.
   The slides Cassi wanted were available and, in fact, were the first slides she saw when she opened the tray. There were six in all, labeled LEFT BASILIC VEIN, H & E STAIN, followed by Jeoffry Washington’s autopsy number.
   Cassi sat down at Robert’s microscope and, adjusting the eyepieces, focused on the first of the slides. There was a small collapsed ringed structure inside a smudge of pink tissue. Even under low power Cassi saw something strange. Looking closer, she identified multiple small white precipitates ringing the interior of the vein. Cassi then examined the walls of the vein. They looked completely normal. There was no infiltrate of inflammatory cells. Cassi wondered if the small white flakes had been introduced in the mounting process. There was no way to tell. She checked the rest of the slides and found the same precipitate in all but one.
   Taking them back to the lab, Cassi showed them to the technician, who was also perplexed. Cassi decided to tell Robert the moment she found out his room number. Glancing at her watch, she realized it was time to see Ballantine.
   He was having a sandwich at his desk and asked Cassi if his secretary could bring her something from the cafeteria. She shook her head. Given what she had to say, she wasn’t sure if she would ever want to eat again.
   She began by apologizing for the scene Thomas had caused, but Dr. Ballantine cut her off and assured her that the party had been a great success and he doubted if anyone even remembered the incident. Cassi wished she could believe that; unfortunately she knew it was just the kind of scandalous scene that stayed in peoples’ minds.
   “I’ve talked with Thomas several times this morning,” said Dr. Ballantine. “I happened to see him before surgery.”
   “How did he seem?” asked Cassi. In her mind’s eye she could see Thomas unconscious in the leather armchair, then stumbling into the bathroom.
   “Perfectly fine. Seemed to be in a good mood. I was pleased that everything was back to normal.”
   To her dismay Cassi’s eyes filled with tears. She’d promised herself it wouldn’t happen.
   “Now, now,” said Dr. Ballantine. “Everyone occasionally blows up under stress. Don’t place too much importance on last night’s incident. The way he’s been working, it’s entirely understandable. Maybe not excusable, but understandable. The house staff have even commented that he’s spending an unusual number of nights in the hospital. Tell me, my dear, has Thomas been acting normally at home?”
   “No,” said Cassi, dropping her line of sight to her hands that lay immobile in her lap. Once she started talking, the words came out easily. She told Dr. Ballantine Thomas’s reaction to her proposed operation and confessed that their relationship had been strained for some time, but she didn’t think the cause was really her illness. Thomas had known she had diabetes before they were married, and, except for the eye problem, her condition had not changed. She didn’t think her medical complications explained Thomas’s anger.
   She paused, beginning to perspire with anxiety.
   “I think the real problem is that Thomas has been taking too many pills. I mean lots of people take an occasional Dexedrine or sleeping pill, but Thomas may be overdoing it.” She paused again, looking up at Ballantine.
   “I have heard one or two things,” mused Ballantine. “One of the residents commented on a tremor. He didn’t realize I was behind him in the hall. What exactly has Thomas been taking?”
   “Dexedrine to keep awake and Percodan or Talwin to calm down.”
   Dr. Ballantine strode over to the window and stared into the surgical lounge directly opposite. Turning back to Cassi, he cleared his throat. His voice had not lost any of its warmth.
   “The availability of drugs can be a severe temptation for a doctor, particularly if he is as severely overworked as Thomas.” Ballantine moved back to his desk and eased into his chair.
   “But availability is only part of the story. Many physicians also have a sense of entitlement. They take care of people all day and feel they deserve a little aid themselves if they need it. Drugs or alcohol. It’s an all-too-common story. And since they have been trained to be self-sufficient, instead of talking to another doctor, they medicate themselves.”
   Cassi was enormously relieved that Dr. Ballantine absorbed the news about Thomas with such composure. For the first time in days she felt optimistic.
   “I think the most important thing is that we keep this to ourselves,” said Dr. Ballantine. “Gossip could be detrimental to both your husband and the hospital. What I will do is have a diplomatic talk with Thomas and see if we can’t take care of the problem before it gets out of hand. Having seen this kind of thing before, I can assure you, Cassi, that Thomas’s difficulties are minor. He has been carrying his usual surgical load.”
   “You’re not worried about his patients?” asked Cassi. “I mean, have you seen him operate recently?”
   “No,” admitted Dr. Ballantine. “But I would be the first to hear if something were amiss.”
   Cassi wondered.
   “I’ve known Thomas for seventeen years,” Ballantine said reassuringly. “I’d know if there was something seriously wrong.”
   “How will you bring up the subject?” asked Cassi.
   Dr. Ballantine shrugged. “I’ll play it by ear.”
   “You won’t mention that I spoke with you, will you?” asked Cassi.
   “Absolutely not,” said Dr. Ballantine.

   Carrying a handful of irises that she’d purchased in the hospital flower shop, Cassi walked down the eighteenth floor corridor to room 1847. The door was open about halfway. She rapped and peeked in. A figure was lying in the single bed holding a sheet up to his eyes. He was shaking in apparent terror.
   “Robert!” laughed Cassi. “What on earth…”
   Robert bounced out of the bed dressed in his own pajamas and robe. “I happened to see you coming,” he said. Eyeing the flowers, he asked, “Are those for me?”
   Cassi surrendered the small bouquet. Robert took the time to arrange them carefully in his water pitcher before placing them on the nightstand.
   Glancing around the room, Cassi could see she wasn’t the first. There were a dozen bouquets blooming on every surface.
   “Kinda looks like a funeral,” said Robert.
   “I don’t want to hear that kind of humor,” said Cassi, giving him a hug. “There is no such thing as too many flowers. It means you have a lot of friends.” She settled down on the foot of the bed.
   “I’ve never been a patient in a hospital,” said Robert, pulling up a chair as if he were the visitor. “I don’t like it. I feel so vulnerable.”
   “You get used to it,” said Cassi. “Believe me, I’m a pro.”
   “The real problem is that I know too much,” said Robert. “I can tell you, I’m terrified. I’ve convinced the anesthesiologist to double up on my sleep meds. Otherwise I know I’ll be up all night.”
   “In a couple of days you’ll wonder why you were nervous.”
   “It’s easy for you to say, dressed in street clothes.” Robert held up his wrist with its plastic name tag. “I’ve become a statistic.”
   “Maybe it will make you feel better to know that your courage has prodded me into action. I’m being admitted tomorrow.”
   Robert’s expression changed to one of compassion. “Now I feel foolish. Here I am worried sick over a couple of teeth while you face eye surgery.”
   “Anesthesia is anesthesia,” said Cassi.
   “I think you are doing the right thing,” said Robert. “And I have a feeling that your operation is going to be a hundred percent successful.”
   “What about your own chances,” teased Cassi.
   “Um… fifty-fifty,” said Robert, laughing. “Hey, I got something to show you.”
   Robert stood up and went over to the nightstand. Picking up a folder, he joined Cassi on the edge of the bed. “With the help of the computer, I collated the data we have on the SSD cases. I found some interesting things. First of all, as you suggested, all of the patients were on IVs. In addition, over the past two years, the cases increasingly involved patients who were in stable physical condition. In other words, the deaths have become more unexpected.”
   “Oh God,” said Cassi. “What else?”
   “I played around for a while with the data, punching in all the parameters for our study except surgery. The computer spat out some other cases, including a patient by the name of Sam Stevens. He died unexpectedly during cardiac catheterization. He was retarded but in excellent physical condition.”
   “Was he on IV?” asked Cassi.
   “Yup,” said Robert.
   They stared at each other for several minutes.
   “Finally,” said Robert, “the computer indicated that there was a preponderance of males. Curiously enough, where the information was available, the computer pointed out an unusually high number of homosexuals!”
   Cassi looked up from the papers to Robert’s friendly gaze. Homosexuality had never been mentioned between them, and Cassi felt a reluctance to discuss it.
   “I went to pathology to visit you this morning,” she said, changing the subject. “I missed you, but I did find some of Jeoffry Washington’s slides. When I looked at the sections taken from the IV site, I found white precipitate along the inside of the vein. At first I thought it was artifact, but they were present on all but one of the sections. Do you think they might be significant?”
   Robert pursed his lips. “No,” he said finally. “Doesn’t ring any bells. The only thing I can think of is that when calcium is inadvertently added to a bicarbonate solution, it causes a precipitation, but that would be in the IV bottle, not the vein. I suppose the precipitation could run into the vein, but it would be so apparent in the bottle that everyone would see it. Maybe I’ll have an idea when I look at the section. Meanwhile, enough of this morbid stuff. Tell me about the party last night. What did you wear?”
   Cassi glossed over the evening. There was a chance Robert would hear what had happened on the hospital grapevine, but she didn’t want to bring it up. In many ways Cassi was surprised Robert hadn’t noticed her reddened eyes. He was usually so observant. She decided he was understandably preoccupied with his admission to the hospital. Promising to visit the next day, Cassi left before she was tempted to burden him with her own troubles.

   Larry Owen felt like a piano wire drawn out to its limit, ready to snap at the slightest increase in tension. Thomas Kingsley had arrived late that morning and was furious that Larry had waited for him to physically appear before beginning to open the first patient’s chest. Even though Larry completed the procedure with record speed, Thomas’s foul mood had not changed. Nothing pleased the surgeon. Not only had Larry done a piss-poor job, but the scrub nurses weren’t handing him the instruments properly; the residents weren’t giving him adequate exposure, and the anesthesiologist was an incompetent son of a bitch. As chance would have it, Thomas was given a faulty needle holder, which he’d thrown against the wall with such force it had snapped in two.
   Yet Larry had weathered this kind of abuse before. What was making him crazy was Thomas’s operative performance. It had been obvious from the moment he began work on his first patient that the surgeon was exhausted. His usually flawless coordination was off and his judgment faulty. And worst of all, Thomas had an uncontrollable tremor. It almost gave Larry heart failure to watch Thomas bend over the heart with a razor-sharp needle and try to direct the instrument to the dainty piece of saphenous vein he was attempting to sew to the minute coronary vessel.
   Vainly Larry had hoped the tremor would lessen as the morning progressed. Instead it got worse.
   “Would you like me to sew this one on?” asked Larry on several occasions. “I think I can see a bit better from my position.”
   “If I want your help, I’ll ask for it,” was Thomas’s only reply.
   Somehow they got through the first two cases with the bypasses sewn reasonably in place and the patients off the heart-lung machine. But Larry was not looking forward to the third case, a thirty-eight-year-old married man with two little children. Larry had opened the patient’s chest and was waiting for Kingsley to return from the lounge. The resident’s pulse was racing, and he had begun sweating heavily. When Thomas finally burst through the OR door, Larry felt his stomach knot with fear.
   At first, things went reasonably well, although Thomas’s shaking was no better and his frustration level seemed even lower. But the open-heart team, wary after the first two cases, was careful not to cross him in any way. The hardest job fell to Larry, who tried to anticipate Kingsley’s erratic movements and do as much of the actual work as Thomas would allow him. The real trouble didn’t begin until they’d started sewing the bypasses in place. Larry couldn’t watch and turned his head away as Thomas’s needle holder approached the heart.
   “Goddammit,” shouted Thomas.
   Larry felt his stomach churn as he saw Thomas yank his hand from the operative site, the needle buried in his own index finger. Inadvertently Thomas also pulled out one of the large catheters that took blood from the patient to the heart-lung machine. As if a faucet had been turned on, the wound filled with blood and in seconds began soaking the sterile drapes and dripping onto the floor.
   Desperately Larry plunged his hand into the wound and groped blindly for the clamp holding the suture around the vena cava. Luckily his hand hit it immediately. Deftly he pulled up on the tape and the blood loss slowed.
   “If I had decent exposure this kind of problem wouldn’t happen,” raged Thomas, pulling the needle out of his finger and dropping it on the floor. He stepped back from the table nursing his injured hand.
   Larry managed to suck out the blood from the wound. As he reinserted the catheter from the heart-lung machine, he tried to think what he should do. Thomas wasn’t fit to operate anymore that day, yet to say anything risked professional suicide. In the end Larry decided that he could no longer stand the tension. When he’d secured the operative site, he stepped away from the table and joined Thomas, who was being regloved by Miss Goldberg.
   “Excuse me, Dr. Kingsley,” said Larry with as much authority as he could muster. “This has been a trying day for you. I’m sorry we haven’t been more on the ball. The fact of the matter is that you are exhausted. I’ll take over from here. You needn’t reglove.”
   For a moment Larry thought Thomas was going to slug him, but he forced himself to continue. “You’ve done thousands of these operations, Dr. Kingsley. No one is going to fault you for being too tired to finish one of them.”
   Thomas began to shake. Then, to Larry’s astonishment and relief, he snapped off his gloves and left.
   Larry sighed and exchanged glances with Miss Goldberg.
   “I’ll be right back,” said Larry to the team. With his gloves and gown still on, Larry left the OR. He hoped that one of the other staff cardiac surgeons would be available and was relieved when he saw Dr. George Sherman coming out of OR No. 6. Larry took him aside and quietly related what had happened.
   “Let’s go,” said George. “And I don’t want to hear a word about this outside of the OR, understand? It could happen to any one of us, and if the public learned about the incident it would be disastrous, not just for Dr. Kingsley, but for the hospital.”
   “I know,” said Larry.

   Thomas was angrier than he had ever been. How dare Larry suggest he was too tired to proceed? The scene had been a nightmare. It was the haunting fear of such disaster that had originally forced him to take an occasional pill to sleep. He’d been perfectly capable of finishing the operation, and if he hadn’t been so upset over Cassi’s infidelity, he certainly would not have left. Furiously he stomped into the surgical lounge and used the phone by the coffee machine. He called Doris to make sure there were no emergencies and asked her to reschedule his afternoon patients for another day. He was already late, and he didn’t think he could stand to see patients. Doris was about to hang up when she remembered that Ballantine had called, asking if Thomas would stop by his office.
   “What did he want?” asked Thomas.
   “He didn’t say,” said Doris. “I asked him what it was in reference to, in case you’d need a patient folder. But he said he’d just like to see you.”
   Thomas told the nurse at the main desk that he’d be in Dr. Ballantine’s office in case there was a call. To steady himself and relieve his headache, which had gotten steadily worse, he took another Percodan from his locker. Then he donned a white lab coat and left the lounge wondering what the meeting could be about. He did not think the chief would call him in to discuss the scene at the party with George Sherman, and it certainly couldn’t have anything to do with the episode with Larry Owen. It must have something to do with the department in general. He remembered the trustee’s odd comment the night before and decided Ballantine was finally going to let Thomas in on his plans. There was always the chance that Ballantine was thinking about retiring and wanted to discuss turning over the department to Thomas.
   “Thanks for coming in to see me,” said Dr. Ballantine, as soon as Thomas was seated in his office. He seemed somewhat ill at ease, and Thomas shifted in his chair.
   “Thomas,” Ballantine finally began. “I think we should speak frankly. I assure you that whatever we say will not leave this room.”
   Thomas rested an ankle on his knee, steadying it with his hands while his foot began to pump rhythmically.
   “It’s been brought to my attention that you might be abusing drugs.”
   Thomas’s foot stopped its nervous movement. The low-grade headache became a pounding agony. Although anger flooded his consciousness, his expression stayed the same.
   “I want you to know,” said Dr. Ballantine, “that this is not an uncommon problem.”
   “What kind of drugs am I supposed to be taking?” asked Thomas, making a supreme effort to rein in his emotions.
   “Dexedrine, Percodan, and Talwin,” said Dr. Ballantine. “Not uncommon choices.”
   With narrowed eyes, Thomas studied Dr. Ballantine’s face. He hated the older man’s patronizing expression. The irony of being judged by this inept buffoon drove Thomas to the brink of frenzy. It was lucky that the Percodan he’d taken in the lounge was beginning to work.
   “I’d like to know who brought this ridiculous lie to your attention,” he managed to ask quietly.
   “That is not important. What matters…”
   “It’s important to me,” said Thomas. “When someone starts this kind of vicious rumor, they should be held accountable. Let me guess: George Sherman.”
   “Absolutely not,” said Dr. Ballantine. “Which reminds me. I spoke to George about the regrettable incident last night. He was mystified by your accusation.”
   “I’ll bet,” snapped Thomas. “It’s common knowledge that George tried unsuccessfully to marry Cassi before I met her. Then I gave them the opportunity by working so many nights…”
   Dr. Ballantine interrupted. “That doesn’t sound like much solid evidence, Thomas. Don’t you think that you might be overreacting?”
   “Absolutely not,” said Thomas, uncrossing his legs and letting his foot down with a bang. “You saw them together yourself at your party.”
   “All I saw was a very beautiful girl who seemed only interested in her husband. You’re a lucky man, Thomas. I hope you know that. Cassi is a special person.”
   Thomas was tempted to stand up and leave, but Ballantine was still talking.
   “I believe that you have been driving yourself too hard, Thomas. You’re trying to do too much. My God, man, what are you trying to prove? I can’t even remember the last time you took a day off.”
   Thomas started to interrupt, but Dr. Ballantine cut him off.
   “Everyone needs to get away. Besides, you have some responsibility to your wife. I happen to know Cassi needs eye surgery. Shouldn’t she be getting some of your time?”
   Thomas was now reasonably certain that Ballantine had talked with Cassi. As incredible as it sounded, she must have come to him with her wild stories about drug addiction. It wasn’t enough, thought Thomas with anger, that she went to his mother. She also had to see his chief of service. Thomas suddenly realized that Cassi could destroy him. She could ruin the career that he’d spent his whole life constructing.
   Luckily for Thomas, his sense of preservation was stronger than his anger. He forced himself to think with cold, hard logic as Ballantine finished.
   “I’d like to suggest that you take some well-earned vacation.”
   Thomas knew that the chief would love to have him out of the hospital while the teaching staff whittled away at his OR time, but he managed to smile.
   “Look, this whole thing has gotten out of hand,” Thomas said calmly. “Maybe I have been working too hard, but that’s because there has been so much to do. As far as Cassandra’s eye problem is concerned, of course I’m planning to spend time with her when she’s laid up. But it really is up to Obermeyer to tell her how best to handle her retinal problems.”
   Ballantine started to speak, but Thomas interrupted him.
   “I listened to you, now hear me,” said Thomas. “About this idea that I’m abusing drugs. You know that I don’t drink coffee. It’s never agreed with me. So it’s true that I occasionally take a Dexedrine. But it has no more effect than coffee. You just can’t dilute it with milk or cream. I admit it has different social implications, especially if someone takes it to escape from life, but I only use it on occasion to work more efficiently. And as far as the Percodan and Talwin are concerned: yes, I’ve taken them at times. I’ve had a propensity for migraines since I was young. I don’t get them often, but when I do, the only thing that helps is Percodan or Talwin. Sometimes the one, sometimes the other. And I’ll tell you something. I’ll be happy to have you or anyone else audit my prescribing habits. You’d see in an instant the amount of these drugs that I prescribe and for whom.”
   Thomas sat back and folded his arms. He was still trembling and did not want Ballantine to notice.
   “Well,” said Ballantine with obvious relief. “That certainly seems reasonable.”
   “You know as well as I,” said Thomas, “that all of us take a pill now and then.”
   “True,” said Dr. Ballantine. “The trouble comes when a physician loses control of the number he takes.”
   “But then they’re abusing the drug,” said Thomas. “I’ve never taken more than two in twenty-four hours, and that’s only with a migraine.”
   “I must tell you that I feel relieved,” said Dr. Ballantine. “Frankly, I was worried. You do work too hard. I still mean what I said about your taking some vacation.”
   I’m sure you do, thought Thomas.
   “And I want you to know,” continued Ballantine, “that the whole department only wants the best for you. Even if we see some changes down the line, you will always be the keystone of our service.”
   “That’s reassuring,” said Thomas. “I suppose it was Cassandra who came to you about the pills.” Thomas’s voice was matter of fact.
   “It really doesn’t matter who called it to my attention,” said Dr. Ballantine, standing up. “Especially since you’ve laid my fears to rest.”
   Thomas was now positive it had been Cassi. She must have looked in his desk and found bottles. He was swept by another wave of anger.
   He stood up, his fists tightly clenched. He knew he had to be alone for a while. Saying good-bye and forcing himself to thank Ballantine for his concern, Thomas hastily made his way out of the office.
   Ballantine stared after him for a moment. He felt better about Thomas, but not completely reassured. The scene at the party nagged him, and there were those persistent rumors that had cropped up recently among the house staff. He didn’t want trouble with Thomas. Not now. That could ruin everything.
   When the door to the waiting room opened, Doris quickly dropped the novel she was reading into a drawer and closed it with one smooth, practiced motion. Seeing Thomas, she picked up the telephone messages and came around from behind the desk. After being alone in the office all afternoon, she was happy to see another human being.
   Thomas behaved as if she were part of the furniture. To her surprise, he went past her without the slightest acknowledgment. She reached out to grasp his arm, but she missed, and Thomas continued into his office as if he were sleepwalking. Doris followed.
   “Thomas, Dr. Obermeyer called and…”
   “I don’t want to hear about anything,” he snapped, starting to close his door.
   In commendable saleswoman fashion, Doris got a foot over the threshold. She was intent on giving Thomas his messages.
   “Get out of here,” screamed Thomas. Doris stepped back in fright as the door slammed in her face with jarring force.
   The fury that he’d suppressed during the harrowing interview with Ballantine engulfed him. His eyes searched for some object on which he could vent his anger. He grabbed up a bud vase Cassi had given him when they were engaged and smashed it on the floor. Looking at the shattered pieces, he felt a little better. He went over to his desk, pulled out the second drawer, and grabbed a bottle of Percodan, spilling several of the tablets onto his desk. He took one, putting the rest back, then went into the washroom for a glass of water.
   Returning to his desk, he put away the pill container and closed the drawer. He began to feel more in control, but he still could not get over Cassi’s treachery. Didn’t she understand that all he really cared about was his surgery? How could she be so cruel as to try to jeopardize his career? First going to his mother, the one person who really had the power to upset him, then George, and now the head of his department. He would not tolerate this. He had loved her so much when they were first married. She had been so sweet, so delicate, so devoted. Why was she trying to destroy him? He would not let her. He would…
   Suddenly Thomas wondered if Ballantine was glad about all this. For some time he had the nagging feeling that something strange was going on with Ballantine and Sherman. Maybe it was all an elaborate play to undermine him.
   Thomas again felt a thrill of fear. He had to do something… but what?
   Slowly at first, and then more rapidly, ideas began to form. All at once he knew what he could do. He knew what he had to do.