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Patricia's room was a mess. The debris from the cardiac resuscitation attempt littered the floor. In the frenzy of the event, some of the wrappers, syringes, medication containers, and the like had been merely tossed aside. The bed had been cranked down flat, raised to help with the CPR, and the resuscitation board was still in place. A few telltale droplets of blood were sprinkled across the wrinkled, white sheet.

Unfortunately, what Roger was looking for was not in evidence. The IV pole was in its usual position at the head of the bed, but without the bottle or plastic container of fluid that had to have hung there. As a consequence of being on the scene, Roger had gotten the idea of having the IV contents checked. Since Laurie had told him that toxicology had come up short, maybe testing the IV fluid would yield something.

Roger turned around and went back to the nursing station. He got Meryl's attention and asked her about the missing bottle.

Meryl shrugged her shoulders. "I don't have any idea where it is." She then turned around and yelled to the medical resident who'd been in charge of the resuscitation, asking the same question. He shook his head, indicating that he didn't know, either, before getting back to his sidewalk mini-conference. He and the other residents were still loudly debating why they had been unsuccessful.

"I guess it went down with the patient," Meryl said. "We always at least leave the IVs in place, along with any other tubes."

"This might be a silly question, but I haven't been on staff that long. Where exactly did the patient go?"

"To the morgue, or what we use as the morgue. It's the old autopsy theater in the basement."

"Thanks," Roger said.

"Not at all," Meryl said.

Roger went back to the elevators. He pressed the down button but then eyed the sign for the stairs. He suddenly had it in his mind to ask Ms. Rakoczi why she went to the OB-GYN floor so often, and what it was that she needed that night. Since the elevator was taking its time arriving, Roger used the stairs. As he descended, he acknowledged that the caffeine was finally starting to wear off. His legs felt heavy. He decided that he'd have one more chat with Ms. Rakoczi, hunt briefly for the IV bottle, and then head for home.

The surgical floor was as quiet as it had been earlier. Roger surmised that the nurses were all attending to their patients. He saw some of them as he passed open doors into the patients' rooms. Rather than bother anyone, he thought he'd wait at the nurses'

station for Ms. Rakoczi to return. To his surprise, he found her where he'd found her earlier, in the same position, reading the same magazine.

"I thought you said you had patients to see," Roger said. He knew he was being abrasively provocative with someone with a volatile temperament, but he couldn't help himself. This woman was obviously goldbricking.

"I saw them. Now I'm manning the nurses' station. Do you have a problem with that?"

"Luckily for both of us it's not my bailiwick," Roger said. "But I do have another question for you. I followed your suggestion and went upstairs to OB-GYN and spoke with Meryl Lanigan. She said you were a frequent visitor to her floor. In fact, she said you were up there earlier. I'd like to know why."

"For my continuing education," Jazz said. "OB-GYN interests me, but I didn't get much exposure to it with the Marines, for obvious reasons. So I frequently go up there on my breaks. Now that I've learned a bit about the field, I'm thinking of putting in for an opening in OB-GYN."

"So it was for continuing education that took you up there tonight?"

"Is that so hard to believe? Instead of going down to the cafeteria on my lunch hour with my half of the surgical-floor team and talking about drivel, I went up to OB-GYN to learn something. I don't know what it is about this place. Whenever you make an extra effort to improve yourself, you get nothing but grief."

"I don't want to add to your burden," Roger said, struggling to keep the sarcasm from his voice. "But there seems to be a discrepancy. Ms. Lanigan told me that when she confronted you earlier, you said you wanted to borrow something."

"Is that what she said?" Jazz questioned with a scornful laugh. "Well, she's right in one sense. I did need to borrow some infusion lines, thanks to central supply not restocking us, but that was an afterthought. What I was really doing up there was sucking up information from reading nursing notes. She probably doesn't want to admit that, because she's probably worried I'm gunning for her job."

"That wouldn't be my take," Roger said. "But what do I know? Thanks for your time, Ms. Rakoczi. I'll be back in touch if I have any more questions."

Roger walked out of the utility room and rounded the nurses' station countertop. He was now feeling genuinely fatigued. The caffeine had completely worn off. A few moments earlier, he'd entertained the idea after talking again with Ms. Rakoczi of returning to the OR to see if he could find Dr. Najah. As with Rakoczi, he wanted to ask him what he had been doing on the OB-GYN floor, but now he had second thoughts. He was exhausted. It was nearly four o'clock in the morning.

Roger resolved that the first thing he would do when he got into his office later that morning was call Rosalyn and beg for Jasmine Rakoczi's St. Francis record. He didn't care about the consequences. He found himself wondering how much the general nursing shortage had to do with the fact that Jasmine Rakoczi was employed. The overwhelming chances were that she was not a serial killer. That would be too easy. But the fact that she was employed as a nurse with her attitude was a travesty as far as he was concerned, and he intended to do something about it.

Roger pressed the elevator's down button and hazarded a glance back toward the surgical nurses' station. It was only for a split second, but he thought he caught a glimpse of Jazz eyeing him from around the edge of the door to the utility room. Roger wasn't so sure, and as tired as he suddenly felt, it could have been his imagination. The woman made him uneasy. He hated the thought of being a patient under her care.

The elevator came, and he boarded. Just before the doors closed, he looked back at the utility-room doorway. For the second time, he didn't know if it was his eyes or his brain that was tricking him, because he thought he saw her again.

He took the elevator down to the basement level, where he'd never been. In contrast with the rest of the hospital it was completely utilitarian. The walls were unadorned stained concrete, and myriad exposed pipes—some insulated, some not—ran along the ceiling. The lighting fixtures were simple porcelain sockets with wire cages. Just beyond the elevators, an old sign composed of peeling paint applied directly onto the concrete wall said "autopsy amphitheater," accompanied by a large red arrow.

The route was labyrinthine, but by following the red arrows, Roger eventually arrived at a set of double leather doors with oval windows set at eye-level height. The glass was covered with a greasy film. Although Roger could tell a light was shining in the room beyond, he couldn't make out any details. He pushed through, then propped the door open with an old brass doorstop.

Inside was an old-fashioned, semicircular two-story medical amphitheater, with rows of tiny seats that rose up on tiers into the shadows. Roger guessed it had been built a hundred years ago, when anatomy and pathology were kingpins in the academic medical curriculum. There was a lot of old, scraped, and pitted dark varnished wood, and the lighting came from a single, large, hooded lamp that hung on a long cord from the ceiling. The light was centered on an antiquated metal autopsy table that occupied the center of the pit. Against the back wall was a glass-fronted cabinet with a collection of stainless-steel autopsy tools. Roger wondered when they'd last been used. Outside the medical examiners' office, few autopsies were now done, particularly in managed-care hospitals like the Manhattan General.

Standing within the pit, along with the autopsy table, there were several shrouded hospital gurneys, obviously supporting corpses. Roger started forward, not knowing which was Patricia Pruit. As he approached the first body, he questioned, as he'd done in the past, why Laurie had chosen forensic pathology as her career. It seemed so contrary to her vibrant personality. With a shrug, he grabbed the edge of the sheet and lifted.

Roger grimaced. He was looking at the remains of an individual who had been involved in some kind of accident. The man's head was horribly distorted and crushed such that one eye was completely exposed. Roger replaced the sheet. His legs felt weak.

As a medical student, he'd not liked pathology, particularly forensic pathology, and this victim reminded him of that fact in an uncomfortably brutal fashion.

Roger took a few breaths before stepping over to the second gurney. He reached for the edge of the sheet, but his hand didn't make it. Instead, he was propelled forward off his feet, having been hit smack in the middle of his back with what felt like a two-by-four. He knew he was falling, and his arms reflexively flew out to cushion himself, but before he hit the tiled floor, the board hit him again, taking his breath away.

Roger collided with the floor and skidded forward on the glazed tile. His head thumped up against the wall that separated the pit from the tiers of seats. He tried to move, but blackness descended over him like a heavy, suffocating blanket.

SEVENTEEN

WHEN LAURIE'S ALARM shattered the silence early Saturday morning, she felt about the same way she had Friday morning. Once again, she hadn't slept well, and what sleep she did get was marred by anxious dreams.

The first thing she did after getting out of bed was repeat the pregnancy test with a new kit. As a doctor, she was well aware of the necessity to repeat tests to rule out false readings. When she returned to check the results, she was aware of a definite ambivalence. But again, it was clearly positive. There could be little doubt that she was pregnant.

Adding credence to the test results was the morning nausea, which seemed a little worse than it had been the previous days, but after eating some dry raisin bran, she felt better. The accompanying right lower quadrant discomfort was another thing. Luckily, it wasn't anything like she'd experienced the prior evening on her way home from her rendezvous with Jack. Then it had been frank pain, strong enough to make her writhe. It had come on suddenly in the taxicab like severe intestinal cramps. For a few seconds, she thought she'd have to put in a call to Laura Riley, but then, as suddenly as it appeared, it vanished. As intense as it was, Laurie was convinced it was related to her digestive system. Its quality was much sharper than a menstrual cramp, which made her think it couldn't have anything to do with her being pregnant. The only confusion was that in the mornings, it appeared along with the nausea, suggesting it was related.

Laurie put her empty cereal bowl down on the countertop. Concerned about the lingering discomfort, she gingerly pressed in on her abdomen in the general area of the pain with her index finger, trying to determine if there was any pinpoint pain. There wasn't, and curiously enough, the palpation alone seemed to be beneficial. When Laurie took her hand away, the discomfort had vanished, suggesting to her once again that the problem was intestinal, perhaps gas.

Relieved that the sensation had vanished, Laurie quickly dressed. She was on call for the weekend, which meant that of all the medical examiners at the OCME, it was her turn to go in and see what kind of cases had arrived during the night. She knew that she would probably be doing a few autopsies, unless they all could be put off until Monday, which in her experience had never happened. There was a person on second call in case of a flood of urgent cases, but in Laurie's experience that never happened, either.

The weather was typical for New York in March—drizzling and cold. Laurie huddled under her umbrella as she trudged north on First Avenue. She had briefly searched for a taxi, but whenever the weather turned sour, they were hard to find.

As she walked, Laurie thought more about her conversation with Jack. In hindsight, she realized how her emotions had understandably been careening from one extreme to another. Although she now felt self-conscious about her reaction to Jack asking who the father was, since it was, in the final analysis, a reasonable question, she gave herself credit in general for having admirably maintained her composure. Considering the stakes involved, it might have been one of the most important conversations in her life.

All she could do now was pray Jack would respond as she hoped. Given Jack's track record, she imagined the chances were only about fifty-fifty.

On the street outside the OCME were several TV media trucks, suggesting that something newsworthy had happened overnight, and Laurie's guard went up. Dealing with the media was not her favorite part of being a medical examiner. She'd had some unfortunate experiences with journalists in the past, to the extent of putting her job in jeopardy.

For a moment, Laurie hesitated and debated if she should head around to the 30th Street morgue entrance. She glanced back at the TV trucks. There were only three, and their antennae were not extended, suggesting that they were not anticipating breaking news. Guessing that whatever had drawn them to the OCME was not front-page news, Laurie climbed the steps and entered. A dozen or so journalists and three cameramen were making themselves at home in the lobby.

Waving a greeting to Marlene, who came in for a few hours every Saturday morning, Laurie tried to walk across the lobby to be buzzed in. Almost immediately, a journalist who recognized her blocked her way by thrusting a microphone in her face. Several bright lights switched on, bathing the lobby in stark illumination as cameramen hoisted their equipment to their shoulders.

"Doctor, do you care to comment on the accident?" the journalist questioned. Others crowded around, extending their own microphones. "In your opinion, was it a double suicide, or were the two boys pushed?"

Laurie shoved the microphone out of the way. "I have no idea what you are talking about, and any information coming from this office has to be cleared by the chief, the deputy chief, or the public relations office. You people know that."