Terminal (A Medical Thriller)

March 5

Friday, 6:30 A.M.

As she drove along the General Douglas MacArthur Causeway heading for work, Janet tried to distract herself by admiring the impressive view over Biscayne Bay. She even tried to fantasize about taking a cruise with Sean on one of the dazzling white cruise ships lined up at the Dodge Island seaport. But nothing worked. Her mind kept returning to the previous night’s events.

After confronting that man in her bathroom, Janet wasn’t about to spend the night in 207. Not even Sean’s apartment seemed a safe haven to her. Instead, she insisted on moving to the Miami Beach unit she’d rented. Not wanting to be alone, she’d invited Sean to come with her and was relieved when he accepted and even offered to sleep on the couch. But once they got there, even Janet’s best resolutions fell to the wayside. They slept together in what Sean described as the “Platonic fashion.” They didn’t make love, but Janet had to admit, it felt good to be close to him.

Almost as much as the intruder’s break-in, Janet was troubled by her escapade with Sean. The episode in the administration office the previous night troubled her deeply. She couldn’t stop thinking about what would have happened had they been caught. On top of that, she’d begun to wonder what kind of man Sean was. He was smart and witty, of that there was no doubt. But given this new revelation of his past experience of thievery, she questioned what his true morals were.

All in all Janet felt profoundly distraught, and to make matters worse she was facing a day in which she was expected to obtain deceitfully a sample of medicine that was highly controlled. If she failed, she faced the possibility of Sean packing his things and leaving Miami. As she neared the hospital Janet found herself thinking longingly about Sunday, the first day she was scheduled to have off. The fact that she was already thinking about vacation time at the start of her second day on the job gave an indication of her level of stress.

The bustling atmosphere of the floor turned out to be a godsend for Janet’s troubled mind. Within minutes of her arrival, she was swept up in the tumult of the hospital. Nursing report gave the oncoming day shift a hint of the work ahead of them. Between diagnostic tests, treatments, and complicated medication protocols, all the nurses knew they would have little free time. The most disturbing news was that Helen Cabot had not improved overnight as the doctors had hoped. In fact, the night nurse taking care of her felt she’d actually lost ground, having had a small seizure around four A.M. Janet listened carefully to this part of the briefing since she’d arranged to be assigned to Helen Cabot for the day.

Regarding the controlled medicines, Janet had concocted a plan. Having seen the type of vials they came in, she’d made it a point to obtain similar vials that were empty. Now all she needed was some time alone with the medicine.

After report had concluded, Janet launched into work. The first order of business was to start an IV line for Gloria D’Amataglio. It was Gloria’s last day of IV medication on her current chemotherapy cycle. Having shown an early facility with venipuncture, Janet was in demand for the procedure. During report she’d offered to start Gloria’s IV since there had been some problems doing so in the past. The nurse scheduled to care for Gloria for the day had readily agreed.

Armed with all the necessary paraphernalia, Janet went into Gloria’s room. Gloria was sitting on the bed, leaning against a bank of pillows, obviously feeling better than she had the day before. While they chatted nostalgically about the beauty of the pond on the Wellesley campus and how romantic it had been on party weekends, Janet got the IV going.

“I hardly felt that,” Gloria said in admiration.

“Glad to help,” Janet said.

Leaving Gloria’s room, Janet felt her stomach tighten as she prepared herself for her next task: getting to the controlled medication. She had to dodge several gurneys, then did a kind of sidestep dance to get around the housekeeper and his bucket.

Reaching the nurses’ station, Janet got out Helen Cabot’s chart and turned to the order sheet. It indicated that Helen was to get her MB300C and MB303C starting at eight A.M. First Janet got the IV bottle and syringes; she then got the empty containers which she’d put aside. Finally she went to Marjorie and asked for Helen’s medication.

“Just a sec,” Marjorie said. She ran down the corridor to the elevators to give a completed X-ray form to an orderly taking a patient down to X-ray.

“That guy never remembers the requisition,” Tim commented with a shake of his head.

Marjorie returned to the nurses’ station at a jog. As she rounded the counter, she was already removing the key from around her neck for the special medication locker.

“What a day!” she said to Janet. “And to think it’s just starting!” She was obviously preoccupied with the welter of activity hospital wards faced at the beginning of each workday. Opening the small but stoutly built refrigerator, she reached in and brought out the two vials of Helen Cabot’s medicine. Consulting a ledger that was also stored in the refrigerator, she told Janet she should take 2 ccs of the larger vial and a half cc of the smaller. She showed Janet where to initial after she administered the medication and where Marjorie would initial when Janet was finished.

“Marjorie, I have Dr. Larsen on the line,” Tim said, interrupting them.

With the vials of clear fluid safely in hand, Janet retreated to the pharmacy closet. First she turned on the hot water in the small sink. After making sure no one was watching, she held the two MB vials under the hot water. When the gummed labels came loose, Janet pulled them off and placed them on the empty vials. She tucked the now unlabeled vials into the utility drawer back behind an assortment of plastic dosage cups, pencils, pads, and rubber bands.

After another precautionary glance into the busy nurses’ station, Janet held the two empty vials over her head and let them fall to the tile floor. Both smashed into tiny shards. After pouring a small amount of water onto the glass pieces, Janet turned and left the pharmacy closet.

Marjorie was still on the phone, and Janet had to wait for her to disconnect. As soon as she did, Janet put a hand on her arm.

“There’s been an accident,” Janet said. She tried to sound upset, which wasn’t difficult considering her nervousness.

“What happened?” Marjorie asked. Her eyes widened.

“I dropped the two vials,” Janet said. “They slipped out of my hand and broke on the floor.”

“Okay, okay!” Marjorie said, reassuring herself as well as Janet. “Let’s not get too excited. Accidents happen, especially when we’re busy and rushing about. Just show me.”

Janet led her back to the pharmacy closet and pointed at the remains of the two vials. Marjorie squatted down and, using her thumb and forefinger, gingerly pulled out the shards attached to the labels.

“I’m terribly sorry,” Janet said.

“It’s okay,” Marjorie said. She stood up and shrugged. “As I said, accidents happen. Let’s call Ms. Richmond.”

Janet followed Marjorie back to the nurses’ station where Marjorie placed a call to the director of nursing. After she explained what had happened, she had to get out the ledger from the medicine refrigerator. Janet could see the vials for the other two patients as she did so.

“There was 6cc in the larger and 4cc in the smaller,” Marjorie said into the phone. She listened, agreed several times, then hung up.

“No problem,” Marjorie said. She made an entry into the ledger, then handed the pen to Janet. “Just initial where I indicated what was lost,” she said.

Janet wrote her initials.

“Now head over to Ms. Richmond’s office in the research building, seventh floor,” Marjorie said. “Bring these labels with you.” She put the broken glass fragments with their attached labels in an envelope and handed them to Janet. “She’ll give you several new vials, okay?”

Janet nodded and apologized again.

“It’s all right,” Marjorie assured her. “It could have happened to anyone.” Then she asked Tim to page Tom Widdicomb to get him to mop up the pharmacy closet.

With her heart pounding and knowing her face was flushed, Janet walked toward the elevators as calmly as she could. Her ruse had worked, but she didn’t feel good about it. She felt like she was taking advantage of Marjorie’s trust and good nature. She was also concerned that someone might stumble across the unlabeled vials in the utility drawer. Janet would have liked to have removed them, but she felt she couldn’t risk it until later when she could give them directly to Sean.

Despite her preoccupation with Helen’s drugs, as Janet came abreast of Gloria’s door she noticed it was closed. Having just started her IV, this disturbed her. Except for the one incident when Marjorie had introduced Janet to Gloria, Gloria’s door was always ajar. Gloria had even commented that she liked to have it open so she could stay in touch with life on the ward.

Perplexed, Janet stopped and stared at the door, debating with herself what she should do. She was already behind with her work so she should get over to Ms. Richmond’s office. Yet Gloria’s door bothered her. Fearing Gloria might be feeling poorly, Janet stepped over to the door and knocked. When there was no response, she knocked again louder. When there was still no answer, Janet pushed the door open and peered inside. Gloria was flat on the bed. One of her legs was dangling over the side of the mattress. It seemed an unnatural position for a nap.

“Gloria?” Janet called.

Gloria didn’t respond.

Propping the door open with its rubber foot, Janet approached the bed. Off to the side was a slop bucket with a mop, but Janet didn’t see it because as she got closer she noted with alarm that Gloria’s face was a deep cyanotic blue!

“Code, room 409!” Janet shouted at the operator after snatching the phone from its cradle. She tossed the envelope with the glass shards on the bedside table.

Pulling Gloria’s head back and after making certain her mouth was clear, Janet started mouth-to-mouth resuscitation. With her right hand pinching Gloria’s nostrils, Janet forcibly inflated Gloria’s lungs several times. Noting the ease with which she was able to do this, she became confident there was no blockage. With her left hand she felt for a pulse. She found one, but it was weak.

Janet blew several more times as people began to arrive. Marjorie was there first, but soon others followed. By the time Janet was relieved from her resuscitative efforts by one of the other nurses, there were at least ten people in the room trying to help. Janet was impressed by the quick response: even the housekeeper was there.

Gloria’s color responded quickly, to everyone’s relief. Within three minutes several doctors including an anesthesiologist arrived from the second floor. By then a monitor had been set up showing a slow but otherwise normal heartbeat. The anesthesiologist deftly inserted an endotracheal tube and used an Ambu bag to inflate Gloria’s lungs. This was more efficient than mouth-to-mouth, and Gloria’s color improved even more.

But there were bad signs as well. When the anesthesiologist shone a penlight into Gloria’s eyes her widely dilated pupils did not react. When another doctor tried to elicit reflexes, she was unable to do so.

After twenty minutes Gloria started to make efforts to breathe. Minutes later, she was breathing on her own. Reflexes also returned but in a fashion that did not bode well. Her arms and legs extended while her hands and feet flexed.

“Uh oh,” the anesthesiologist said. “Looks like some signs of decerebrate rigidity. That’s bad.”

Janet did not want to hear this.

The anesthesiologist shook his head. “Too long without oxygen to the brain.”

“I’m surprised,” one of the other doctors said. She tilted the IV bottle to see what was running in. “I didn’t think respiratory failure was a complication of this regimen.”

“Chemo can do unexpected things,” the anesthesiologist said. “It could have started with a cerebral vascular incident. I think Randolph better hear about this.”

After rescuing her envelope, Janet stumbled out of the room. She knew scenes like this came with the territory, but knowing that hard fact didn’t make them any easier to bear.

Marjorie came out of Gloria’s room, saw Janet, and came over. She shook her head. “We’re not having much luck with these advanced breast cancer patients,” she said. “I think the powers that be better start questioning the treatment protocol.”

Janet nodded but didn’t speak.

“Being the first one on the scene is always tough,” she said. “You did all you could.”

Janet nodded again. “Thanks,” she said.

“Now get that medicine for Helen Cabot before we have more trouble,” Marjorie said. She gave Janet a sisterly pat on the shoulder.

Janet nodded. She took the stairs to get to the second floor, then crossed to the research building. She took an elevator to the seventh floor and, after asking for Ms. Richmond, was directed to her office.

The nursing director was expecting her and reached for the envelope. Opening it she poured the contents onto her desk blotter. With her index finger she pushed the shards around until she could read the labels.

Janet remained standing. Ms. Richmond’s silence made her fear that somehow the woman knew exactly what Janet had done. Janet began to perspire.

“Did this cause a problem?” Ms. Richmond asked finally in her surprisingly soft voice.

“What do you mean?” Janet asked.

“When you broke these vials,” Ms. Richmond said. “Did the glass cut you?”

“No,” Janet said with relief. “I dropped them on the floor. I wasn’t injured.”

“Well, it’s not the first time or the last,” Ms. Richmond said. “I’m glad you didn’t hurt yourself.”

With surprising agility for her size, Ms. Richmond sprang up from behind her desk and went to a floor-to-ceiling cabinet that concealed a large, locked refrigerator. Unlocking and opening the refrigerator door, she took out two vials similar to the ones Janet had broken. The refrigerator was almost filled with such vials.

Ms. Richmond returned to her desk. Searching in a box in a side drawer, she took out printed labels identical to those on the shards on her desk. Licking the backs, she began applying the appropriate label to each vial. Before she was finished her phone rang.

Ms. Richmond answered and continued to work, holding the phone against her ear with a raised shoulder. But almost immediately the call took her full attention.

“What?” she cried. Her soft voice turned querulous. Her face reddened.

“Where?” Ms. Richmond demanded. “Fourth floor!” she said after a pause. “That’s almost worse! Damnation!”

Ms. Richmond slammed the phone down and for a moment stared ahead without blinking. Then, noting Janet’s presence with a start, she got up and handed over the vials. “I’ve got to go,” she said urgently. “Be careful with that medicine.”

Janet nodded and started to respond, but Ms. Richmond was already on her way out the door.

Janet paused at the threshold of Ms. Richmond’s office and watched her walk rapidly away. Looking over her shoulder, she gazed at the cabinet which concealed the locked refrigerator. Something wasn’t right about all this, but she wasn’t sure what it was. Too much was happening.

RANDOLPH MASON marveled at Sterling Rombauer. He had some idea of Sterling’s personal wealth as well as of his legendary business acumen, but he had no idea what motivated the man. Chasing around the country at other people’s bidding would not be the life Mason would lead if he had command of the assets Sterling did. Nonetheless, Mason was grateful for Sterling’s chosen occupation. Every time he hired the man, he got results.

“I don’t think you have anything to worry about until the Sushita plane shows up here in Miami,” Sterling was saying. “It had been waiting for Tanaka in Boston and was scheduled to go to Miami, but then it went to New York and on to Washington without him. Tanaka had to fly down here on a commercial flight.”

“And you will know if and when the plane comes?” Dr. Mason asked.

Sterling nodded.

Dr. Mason’s intercom crackled on. “Sorry to disturb you, Dr. Mason,” Patty, his secretary, said. “But you told me to warn you about Ms. Richmond. She’s on her way in and she seems upset.”

Dr. Mason swallowed hard. There was only one thing that could set Margaret off. He excused himself from Sterling and left his office to intercept his director of nursing. He caught her near Patty’s desk and drew her aside.

“It’s happened again,” Ms. Richmond snapped. “Another breast cancer patient with a cyanotic respiratory arrest. Randolph, you have to do something!”

“Another death?” Dr. Mason asked.

“Not a death yet,” Ms. Richmond said. “But almost worse, especially if the media gets involved. The patient is in a vegetative state with obvious brain damage.”

“Good Lord,” Dr. Mason exclaimed. “You’re right; it could be worse if the family starts asking questions.”

“Of course they will ask questions,” Ms. Richmond said. “Once again, I must remind you that this could ruin everything we’ve worked for.”

“You don’t have to tell me,” Dr. Mason said.

“Well, what are you going to do?”

“I don’t know what else to do,” Dr. Mason admitted. “Let’s get Harris up here.”

Dr. Mason had Patty call Robert Harris and told her to buzz him the moment Harris arrived. “I have Sterling Rombauer in my office,” he told Ms. Richmond. “Maybe you should hear what he has to say about our medical student extern.”

“That brat!” Ms. Richmond said. “When I caught him over in the hospital sneaking a look at Helen Cabot’s chart I felt like throttling him.”

“Calm down and come in and listen,” Dr. Mason said.

Ms. Richmond reluctantly allowed Dr. Mason to lead her into his office. Sterling got to his feet. Ms. Richmond told him he didn’t have to stand on her account.

Dr. Mason had everybody sit, then asked Sterling to bring Ms. Richmond up to date.

“Sean Murphy is an interesting and complicated individual,” Sterling said as he casually crossed his legs. “He’s lived a rather double life, changing drastically when he got into Harvard undergraduate school, yet still clinging to his blue-collar Irish roots. And he’s been successful. Currently he and a group of friends are about to start a company they intend to call Oncogen. Its goal will be to market diagnostic and therapeutic agents based on oncogene technology.”

“Then it’s clear what we should do,” Ms. Richmond said. “Especially considering his being insufferably brash.”

“Let Sterling finish,” Dr. Mason said.

“He’s extremely bright when it comes to biotechnology,” Sterling said. “In fact I’d have to say he’s gifted. His only real liability, as you’ve already guessed, is in the social realm. He has little respect for authority and manages to irritate a lot of people. That said, he’s already been involved with the founding of a successful company that was bought out by Genentech. And he’s had no significant difficulty finding funding for his second venture.”

“He’s sounding more and more like trouble,” Ms. Richmond said.

“Not in the way you think,” Sterling said. “The problem is that Sushita knows approximately as much as I do. It’s my professional opinion that they will deem Sean Murphy a threat to their investment here at Forbes. Once they do, they’ll be inspired to act. I’m not convinced a move to Tokyo and, essentially, a buyout, will work with Mr. Murphy. Yet if he stays here, I think they’ll consider reneging on renewing your grant.”

“I still don’t understand why we don’t send him back to Boston,” Ms. Richmond said. “Then it’s over. Why take the risk of jeopardizing our relationship with Sushita?”

Sterling looked at Dr. Mason.

Dr. Mason cleared his throat. “From my perspective,” he said, “I don’t want to be rash. The kid is good at what he does. This morning I went down to where he’s working. He’s got a whole generation of mice accepting the glycoprotein. On top of that, he showed me some promising crystals that he’s been able to grow. He insists he’ll have better in a week. No one else has been able to get this far. My problem is I’m caught between a rock and a hard place. A more dire threat to our Sushita funding is the fact that we have yet to provide them with a single patentable product. They expected something by now.”

“In other words, you think we need this brat even with the risks,” Ms. Richmond said.

“That’s not the way I would phrase it,” Dr. Mason said.

“Then why don’t you call Sushita and explain it to them,” Ms. Richmond said.

“That would not be advisable,” Sterling said. “The Japanese prefer indirect communication so that confrontation can be avoided. They would not understand such a direct approach. Such a ploy would cause more anxiety than it would alleviate.”

“Besides, I already alluded to all this with Hiroshi,” Dr. Mason said. “And they still went ahead to investigate Mr. Murphy on their own.”

“The Japanese businessman has a great problem with uncertainty,” Sterling added.

“So what is your take on this kid?” Ms. Richmond asked. “Is he a spy? Is that why he’s here?”

“No,” Sterling said. “Not in any traditional sense. He’s obviously interested in your success with medulloblastoma, but it’s from an academic point of view, not a commercial one.”

“He was very open about his interests in the medulloblastoma work,” Dr. Mason said. “The first time I met him he was clearly disappointed when I informed him he would not be permitted to work on the project. If he’d been some kind of spy, I think he’d keep a lower profile. Rocking the boat only draws further scrutiny.”

“I agree,” Sterling said. “As a young man he’s still motivated by idealism and altruism. He has not yet been poisoned by the new commercialism of science in general and medical research in particular.”

“Yet he’s already started his own company,” Ms. Richmond pointed out. “That sounds pretty commercial to me.”

“But he and his partners were essentially selling their products at cost,” Sterling said. “The profit motive did not play a role until the company was bought out.”

“So what’s the solution?” Ms. Richmond asked.

“Sterling will monitor the situation,” Dr. Mason said. “He’ll keep us informed on a daily basis. He’ll protect Mr. Murphy from the Japanese as long as he is a help to us. If Sterling decides he is acting as a spy, he’ll let us know. Then we’ll send him back to Boston.”

“An expensive babysitter,” Ms. Richmond said.

Sterling smiled and nodded in agreement. “Miami in March is very agreeable,” he said. “Particularly at the Grand Bay Hotel.”

A short burst of static from Dr. Mason’s intercom preceded Patty’s voice: “Mr. Harris is here.”

Dr. Mason thanked Sterling, indicating the meeting was over. As he accompanied Sterling out of the office. Dr. Mason couldn’t help but agree with Ms. Richmond’s assessment: Sterling was an expensive babysitter. But Dr. Mason was convinced the money was well spent and, thanks to Howard Pace, readily available.

Harris was standing next to Patty’s desk, and for the sake of propriety, Dr. Mason introduced him to Sterling. As he did, he couldn’t help but feel each man was the other’s antithesis.

After sending Harris into his office. Dr. Mason thanked Sterling for all he’d done and implored him to keep them informed. Sterling assured him he would, and left. Dr. Mason then went back into his office to deal with the current crisis.

Dr. Mason closed the door behind him. He noticed Harris was standing stiffly in the center of the room; his patent leather visored hat with its gold trim was wedged under his left arm.

“Relax,” Dr. Mason said as he went around behind his desk and sat down.

“Yes, sir,” Harris said smartly. He didn’t move.

“For crissake, sit down!” Dr. Mason said when he noticed Harris was still standing.

Harris took a seat, his hat remaining beneath his arm.

“I suppose you’ve heard another breast cancer patient has died,” Dr. Mason said. “At least for all practical purposes.”

“Yes, sir,” Harris said crisply.

Dr. Mason eyed his head of security with mild irritation. On the one hand he appreciated the professionalism of Robert Harris; on the other hand the militaristic playacting bothered him. It wasn’t appropriate for a medical institution. But he’d never complained because until these breast cancer deaths, security had never been a problem.

“As we told you in the past,” Dr. Mason said, “we believe some misguided demented individual is doing this. It’s becoming intolerable. It has to be stopped.

“I’ve asked you to make this your number-one priority. Have you been able to turn anything up?”

“I assure you, this problem has my undivided attention,” Harris said. “Following your advice I’ve done extensive background checks on most all of the professional staff. I’ve checked references by calling hundreds of institutions. No discrepancies have turned up so far. I’ll now be expanding the checks to other personnel who have access to patients. We tried to monitor some of the breast cancer patients, but there are too many to keep tabs on all the time. Perhaps we should consider putting security cameras in all the rooms.” Harris did not mention his suspicion of the possible connection between these cases and the death of a nurse and the attempted assault of another. After all, it was only a hunch.

“Maybe cameras in every breast cancer patient’s room is what we have to do,” Ms. Richmond said.

“It would be expensive,” Harris warned. “Not only the cost of the cameras and the installation, but also the additional personnel to watch the monitors.”

“Expense might be an academic concern,” Ms. Richmond said. “If this problem continues and the press gets hold of it, we might not have an institution.”

“I’ll look into it,” Harris promised.

“If you need additional manpower, let us know,” Dr. Mason said. “This has to be stopped.”

“I understand, sir,” Harris said. But he didn’t want help. He wanted to do this on his own. At this point it had become a matter of honor. No screwball psychotic was going to get the best of him.

“And what about this attack last night at the residence?” Ms. Richmond asked. “I have a hard enough time recruiting nursing personnel. We can’t have them attacked in the temporary housing we offer them.”

“It is the first time security has been a problem at the residence,” Harris said.

“Maybe we need security people there during the evening hours,” Ms. Richmond suggested.

“I’d be happy to put together a cost analysis,” Harris said.

“I think the patient issue is more important,” Dr. Mason said. “Don’t dilute your efforts at the present time.”

“Yes, sir,” Harris said.

Dr. Mason looked at Ms. Richmond. “Anything else?”

Ms. Richmond shook her head.

Dr. Mason glanced back at Harris. “We’re counting on you,” he said.

“Yes, sir,” Harris said as he got to his feet. By reflex he started to salute, but he caught himself in time.

“VERY IMPRESSIVE!” Sean said aloud. He was sitting by himself in the glass-enclosed office in the middle of his expansive lab. He was at an empty metal desk, and he had the copies of the thirty-three charts spread out in front of him. He’d chosen the office in case someone suddenly appeared. If they did he’d have enough time to sweep the charts into one of the empty file drawers. Then he’d pull over the ledger featuring the protocol he’d developed to immunize the mice with the Forbes glycoprotein.

What Sean found so impressive were the statistics concerning the medulloblastoma cases. The Forbes Cancer Center had indeed achieved a one hundred percent remission rate over the last two years, which contrasted sharply with the one hundred percent fatality rate over the eight years prior to that. Through follow-up MRI studies, even large tumors were shown to have completely disappeared after successful treatment. As far as Sean was concerned, such consistent results were unheard of in the treatment of cancer except for the situation of cancer in situ, meaning extremely small, localized neoplasia that could be completely excised or otherwise eliminated.

For the first time since he’d arrived, Sean had had a reasonable morning. No one had bothered him; he hadn’t seen Hiroshi or any of the other researchers. He’d started the day by injecting more of the mice which had given him a chance to get the copies of the charts up to his office. Then he’d toyed with the crystallization problem, growing a few crystals that he thought would keep Dr. Mason content for a week or so. He’d even had the director come down to see some of the crystals. Sean knew he’d been impressed. At that point, reasonably confident he wouldn’t be disturbed, Sean had retired into the glass office to review the charts.

First he’d read through all the charts to gain an overall impression. Then he’d gone back, checking on epidemiological aspects. He’d noted that the patients represented a wide range of ages and races. They were also of varying sex. But the predominant group consisted of middle-aged white males, not the typical group seen with medulloblastoma. Sean guessed that the statistics were skewed due to economic considerations. The Forbes was not a cheap hospital. People needed adequate medical insurance or sizable savings accounts to be patients there. He also noted that the cases came from various major cities around the country in a truly national distribution.

But then, as if to show how dangerous generalizations were, he discovered a case from a small southwestern Florida town: Naples, Florida. Sean had seen the town on a map. It was the southernmost town on the west coast of Florida, just north of the Everglades. The patient’s name was Malcolm Betencourt, and he was nearing two years since the commencement of his treatment. Sean noted the man’s address and phone number. He thought he might want to talk with him.

As for the tumors themselves, Sean noted that most were multifocal rather than being a single lesion, which was more common. Since they were multifocal, the attending physicians in most cases had initially believed they were dealing with a metastatic tumor, one that had spread to the brain from some other organ like lung, kidney, or colon. In all these cases, the referring physicians had expressed surprise when the lesions turned out to be primary brain tumors arising from primitive neural elements. Sean also noted that the tumors were particularly aggressive and fast-growing. They would have undoubtedly led to rapid death had not therapy been instituted.

Concerning therapy, Sean noted that it did not vary. The dosage and rate of administration of the coded medication was the same for all patients although it was adjusted for weight. All patients had experienced about a week of hospitalization and after discharge were followed in the outpatient clinic at intervals of two weeks, four weeks, two months, six months, then annually. Thirteen of the thirty-three patients had reached the annual-visit stage. Sequelae from the illness were minimal and were associated with mild neurological deficits secondary to the expanding tumor masses prior to treatment rather than to the treatment itself.

Sean was also impressed with the charts themselves. He knew he was looking at a wealth of material that would probably take him a week to digest.

Concentrating as deeply as he was, Sean was startled when the phone on his desk began to ring. It was the first time it had ever rung. He picked it up, expecting a wrong number. To his surprise, it was Janet.

“I have the medicine,” she said tersely.

“Great!” Sean said.

“Can you meet me in the cafeteria?” she asked.

“Absolutely,” Sean said. He could tell something was wrong. Her voice sounded strained. “What’s the matter?”

“Everything,” Janet said. “I’ll tell you when I see you. Can you leave now?”

“I’ll be there in five minutes,” Sean said.

After hiding all the charts, Sean descended in the elevator and crossed over the pedestrian bridge to the hospital. He guessed he was being observed by camera and felt like waving to indicate as much, but resisted the temptation.

When he arrived in the cafeteria Janet was already there, sitting at a table with a cup of coffee in front of her. She didn’t look happy.

Sean slid into a chair across from her.

“What’s wrong?” he asked.

“One of my patients is in a coma,” Janet said. “I’d just started an IV on her. One minute she was fine, the next minute not breathing.”

“I’m sorry to hear that,” Sean said. He’d had some exposure to the emotional traumas of hospital life, so he could empathize to an extent.

“At least I got the medicine,” she said.

“Was it difficult?” Sean asked.

“Emotionally more than anything else,” Janet said.

“So where is it?”

“In my purse,” she said. She glanced around to make sure no one was watching them. “I’ll give the vials to you under the table.”

“You don’t have to make this so melodramatic,” Sean said. “Sneaking around draws more attention than just acting normal and handing them over.”

“Humor me,” Janet said. She fumbled with her purse.

Sean felt her hand hit his knee. He reached under the table and two vials dropped into his hand. Respecting Janet’s sensitivity he slipped them into his pockets, one on each side. Then he scraped back his chair and stood up.

“Sean!” Janet complained.

“What?” he asked.

“Do you have to be so obvious? Can’t you wait five minutes like we’re having a conversation?”

He sat down. “People aren’t watching us,” he said. “When are you going to learn?”

“How can you be so sure?” she asked.

Sean started to say something, then thought better of it.

“Can we talk about something fun for a change?” Janet asked. “I’m completely stressed out.”

“What do you want to talk about?”

“What we can do come Sunday,” Janet said. “I need to get away from the hospital and all this tension. I want to do something relaxing and fun.”

“Okay, it’s a date,” Sean promised. “Meanwhile, I’m eager to get back to the lab with this medicine. Would it be so obvious if I were to leave now?”

“Go!” Janet commanded. “You’re impossible.”

“See you back at the beach apartment,” Sean said. He moved away quickly lest Janet say something about his not being invited. He looked back and waved as he left the cafeteria.

Hurrying over the bridge between the two buildings, he thrust his hands into his pockets and palmed the two vials. He couldn’t wait to get started. Thanks to Janet, he felt some of the investigative excitement he’d expected when he’d made the decision to come to the Forbes Cancer Center.

ROBERT HARRIS carried the cardboard box of employee files into his small windowless office and set them on the floor next to his desk. Sitting down, he opened the top of the box and pulled out the first file.

After the conversation with Dr. Mason and Ms. Richmond, Harris had gone directly to personnel. With the help of Henry Falworth, the personnel manager, he’d compiled a list of non-professionals who had access to patients. The list included food service personnel who distributed menus and took orders and those who delivered meals and picked up the trays. The list also included the janitorial and maintenance staffs who were occasionally called to patient rooms for odd jobs. Finally, the list ran to housekeeping: those who cleaned the rooms, the halls, and the lounges of the hospital.

All in all, the number of people on the list was formidable. Unfortunately he had no other ideas to pursue save for the camera surveillance, and he knew such an operation would prove too costly. He would investigate prices and put together a proposal, but he knew Dr. Mason would find the price unacceptable.

Harris’s plan was to go through the fifty or so files rather quickly to see if anything caught his attention, anything that might seem unlikely or strange. If he found something that was questionable, he’d put the file in a group to investigate first. Harris wasn’t a psychologist any more than he was a doctor, but he thought that whoever was crazy enough to be killing patients would have to have something weird on his record.

The first file belonged to Ramon Concepcion, a food service employee. Concepcion was a thirty-five-year-old man of Cuban extraction who’d worked a number of food service jobs in hotels and restaurants since he was sixteen. Harris read through his employment application and looked at the references. He even glanced at his health care utilization. Nothing jumped out at him. He tossed the file on the floor.

One by one, Harris worked through the box of files. Nothing caught his eye until he came to Gary Wanamaker, another food service employee. Under the heading experience Gary had listed five years’ work in the kitchen at Rikers Island Prison in New York. In the employment photo the man had brown hair. Harris put that file on the corner of his desk.

It was only five files later that Harris came across another file that caught his eye. Tom Widdicomb worked in housekeeping. What got Harris’s attention was the fact that the man had trained as an emergency medical technician. Even though he’d had a series of housekeeping jobs subsequent to his EMT training, including a stint at Miami General Hospital, the thought of a guy with emergency medical training working housekeeping seemed odd. Harris looked at the employment photo. The man had brown hair. Harris put Widdicomb’s file on top of Wanamaker’s.

A few files later, Harris came across another file that tweaked his curiosity. Ralph Seaver worked for the maintenance department. This man had served time for rape in Indiana. There it was right in the file! Included was even a phone number of the man’s former probation officer in Indiana. Harris shook his head. He’d not expected to find such fertile material. The professional staff files had been boring in comparison. Except for a few substance abuse problems and one child molestation allegation, he’d not found anything. But with this group, he’d only gone through a quarter of the files and had already yanked three that he thought deserved a closer look.

INSTEAD OF sitting down and having coffee on her afternoon coffee break, Janet took the elevator to the second floor and visited the intensive care unit. She had a lot of respect for the nurses who worked there. She never understood how they could take the constant strain. Janet had tried the ICU after graduation. She found the work intellectually stimulating, but after a few weeks decided it wasn’t for her. There was too much tension, and too little patient interaction. Most of the patients were in no position to relate on any level; many of them were unconscious.

Janet went over to Gloria’s bed and looked down at her. She was still in a coma and had not improved although she was still breathing without mechanical assistance. Her widely dilated pupils had not constricted, nor did they react to light. Most disturbing of all, an EEG showed very little brain activity.

A visitor was gently stroking Gloria’s forehead. She was about thirty years old with coloring and features similar to Gloria’s. As Janet raised her head, their eyes met.

“Are you one of Gloria’s nurses?” the visitor asked.

Janet nodded. She could tell the woman had been crying.

“I’m Marie.” she said. “Gloria’s older sister.”

“I’m very sorry this happened,” Janet said.

“Well,” Marie said with a sigh, “maybe it’s for the best. This way she won’t have to suffer.”

Janet agreed for Marie’s benefit, although in her own heart she felt differently. Gloria had still had a shot at beating breast cancer, especially with her positive, upbeat attitude. Janet had seen people with even more advanced disease go into remission.

Fighting tears of her own, Janet returned to the fourth floor. Again, she threw herself into her work. It was the easiest way to avoid thoughts that would only leave her cursing the unfairness of it all. Unfortunately the ruse was only partly successful, and she kept seeing the image of Gloria’s face as she thanked Janet for starting her IV. But men suddenly the ruse was no longer needed. A new tragedy intervened that matched Gloria’s and overwhelmed Janet.

A little after two, Janet gave an intramuscular injection to a patient whose room was at the far end of the corridor. On her way back to the nurses’ station, she decided to check in on Helen Cabot.

Earlier that morning and about an hour after Janet had added the coded medication to Helen’s IV and adjusted the rate, Helen complained of a headache. Concerned about her condition, Janet had called Dr. Mason and informed him of this development. He’d recommended treating the headache minimally and asked to be called back if it got worse.

Although the headache had not gone away after the administration of an oral analgesic, it had not grown worse. Nevertheless, Janet had checked on Helen frequently at first, then every hour or so throughout the day. With the headache unchanged and her vital signs and level of consciousness remaining normal, Janet’s concern had lessened.

Now, almost 2:15, as Janet came through the door, she was alarmed to discover that Helen’s head had lolled to the side and off the pillow. Approaching the bed, she noticed something even more disturbing: the woman’s breathing was irregular. It was waxing and waning in a pattern that suggested a serious neurological dysfunction. Janet phoned the nurses’ station and told Tim she had to speak with Marjorie immediately.

“Helen Cabot is Cheyne-Stoking,” Janet said when Marjorie came on the line, referring to Helen’s breathing.

“Oh no!” Marjorie exclaimed. “I’ll call the neurologist and Dr. Mason.”

Janet took the pillow away and straightened Helen’s head. Then she took a small flashlight she always carried and shined it in each of Helen’s pupils. They weren’t equal. One was dilated and unresponsive to the light. Janet shuddered. This was something she’d read about. She guessed that the pressure had built up inside Helen’s head to the point that part of her brain was herniating from the upper compartment into the lower, a life-threatening development.

Reaching up, Janet slowed Helen’s IV to a “keep open” rate. For the moment that was all she could do.

Soon other people started to arrive. First it was Marjorie and other nurses. Then the neurologist, Dr. Burt Atherton, and an anesthesiologist, Dr. Carl Seibert, rushed in. The doctors began barking orders in an attempt to lower the pressure inside Helen’s head. Then Dr. Mason arrived, winded by his run from the research building.

Janet had never met Dr. Mason, although she’d spoken with him on the phone. He was titularly in charge of Helen’s case, but in this neurological crisis he deferred to Dr. Atherton.

Unfortunately, none of the emergency measures worked, and Helen’s condition deteriorated further. It was decided that emergency brain surgery was needed. To Janet’s dismay, arrangements were made to transfer Helen to Miami General Hospital.

“Why is she being transferred?” Janet asked Marjorie when she had a moment.

“We’re a specialty hospital,” Marjorie explained. “We don’t have a neurosurgical service.”

Janet was shocked. The kind of emergency surgery Helen needed required speed. It did not require an entire neurosurgical service, just an operating room and someone who knew how to make a hole in the skull. Obviously with the biopsies they’d been doing, that expertise was available at the Forbes.

With frantic preparations, Helen was readied to leave. She was moved from her bed onto a gurney. Janet aided in the transfer, moving Helen’s feet, then running alongside holding the IV bottle aloft as the gurney was rushed to the elevator.

In the elevator Helen took a turn for the worse. Her breathing, which had been irregular when Janet had entered her room, now stopped altogether. Helen’s pale face quickly began to turn blue.

For the second time that day, Janet started mouth-to-mouth resuscitation while the anesthesiologist yelled for someone to get an endotracheal tube and an Ambu bag as soon as they got to the first floor.

When the elevator stopped and the doors opened, one of the fourth-floor nurses rushed out. Another kept the doors from closing. Janet continued her efforts until Dr. Seibert nudged her aside and deftly slipped in an endotracheal tube. After connecting the Ambu bag, he began to inflate Helen’s lungs to near capacity. The blue cast to Helen’s face transformed into a translucent alabaster.

“Okay, let’s go,” Dr. Seibert yelled.

The tightly packed group rushed Helen out to the ambulance receiving dock, collapsed the gurney, and pushed it inside the waiting vehicle. Dr. Seibert boarded with Helen, maintaining her respiration. The doors were slammed shut and secured.

With flashing light and piercing siren, the ambulance roared out of the parking bay and disappeared around the building.

Janet turned to look at Marjorie, who was standing next to Dr. Mason. She was consoling him with her hand on his shoulder.

“I can’t believe it,” Dr. Mason was saying with a halting voice. “I suppose I should have prepared myself. It was bound to happen. But we’ve been so lucky with our medulloblastoma treatments. With every success, I thought just maybe we could avoid this kind of tragedy.”

“It’s the people in Boston’s fault,” Ms. Richmond said. She’d appeared on the scene just before the ambulance had left. “They wouldn’t listen to us. They kept her too long.”

“We should have put her in the ICU,” Dr. Mason said. “But she’d been so stable.”

“Maybe they’ll save her at Miami General,” Marjorie said, trying to be optimistic.

“It would be a miracle,” Dr. Atherton said. “It was pretty clear her uncus had herniated below the calyx and was compressing her medulla oblongata.”

Janet repressed an urge to tell the man to keep his thoughts to himself. She hated the way some doctors hid behind their jargon.

All at once, as if on some unseen cue, the entire group turned and disappeared through the swinging doors of the Forbes ambulance dock. Janet was left outside. She was just as glad to be alone. It was suddenly so peaceful by the lawn. A huge banyan tree graced the grounds. Behind the banyan was a flowering tree Janet had never seen before. A warm, moist tropical breeze caressed her face. But the pleasant scene was still marred by the undulating siren of the receding ambulance. To Janet, it sounded like a death knell for Helen Cabot.

TOM WIDDICOMB wandered from room to room in his mother’s ranch house, alternately crying and cursing. He was so anxious he couldn’t sit still. One minute he was hot, the next freezing. He felt sick.

In fact, he’d felt so sick he’d gone to his supervisor and told him as much. The supervisor had sent him home, commenting that he was pale. He’d even noticed that Tom was shaking.

“You’ve got the whole weekend,” the supervisor had said. “Go to bed, sleep it off. It’s probably a touch of the ‘snowbird flu.’”

So Tom had gone home, but he’d been unable to rest. The problem was Janet Reardon. He’d almost had a heart attack when she’d come knocking on Gloria’s door minutes after he’d put Gloria to sleep. In an absolute panic he’d fled into the bathroom, sure that he’d been cornered. He’d gotten desperate enough to take his gun out.

But then the pandemonium in the room gave him the diversion he needed to get away. When he’d emerged from the bathroom, no one had even noticed. He’d been able to slip into the hall with his bucket.

The problem was that Gloria was still alive. Janet Reardon had saved her, and Gloria was still suffering, although now she was out of reach. She was in the ICU where Tom was not allowed to go.

Consequently, Alice still wouldn’t talk to him. Tom had continued to plead, but without success. Alice knew Tom couldn’t get to Gloria until she was transferred out of the ICU and put back into a private room.

That left Janet Reardon. To Tom, she seemed like a devil sent to destroy the life that he and his mother had created. He knew he had to get rid of her. Only now he didn’t know where she lived. Her name had been removed from the residence chart in administration. She’d moved out.

Tom checked his watch. He knew her shift ended when his would have ended: three P.M. But he also knew nurses stayed longer because of their report. He’d have to be in the parking lot when she came out. Then he could follow her home and shoot her. If he was able to do that he was reasonably confident Alice would break this petulant silence and talk with him.

“HELEN CABOT died!” Janet repeated through sudden tears. As a professional it wasn’t like her to cry over the death of a patient, but she was extra sensitive since there’d been two tragedies in the same day. Besides, Sean’s response frustrated her. He was more interested in where Helen’s body was than the fact that the woman was dead.

“I understand she died,” Sean said soothingly. “I don’t mean to sound callous. Part of the way I respond is to cover the pain I feel. She was a wonderful person. It’s such a shame. And to think that her father runs one of the largest computer software companies in the world.”

“What difference does that make?” Janet snapped. She wiped under her eyes with the knuckle of her index finger.

“Not much,” Sean admitted. “It’s just that death is such a leveler. Having all the money in the world makes no difference.”

“So now you’re a philosopher,” Janet said wryly.

“All of us Irish are philosophers,” Sean said. “It’s how we deal with the tragedy of our lives.”

They were sitting in the cafeteria where Sean had agreed to come when Janet called him. She’d called him after report, before she left for the apartment. She’d said she needed to talk.

“I don’t mean to upset you,” Sean continued. “But I’m truly interested in the location of Helen’s body. Is it here?”

Janet rolled her eyes. “No, it’s not here,” she said. “I don’t know where it is truthfully. But I suppose it’s over at the Miami General.”

“Why would it be there?” Sean asked. He leaned across the table.

Janet explained the whole episode, indicating her indignation that they couldn’t do an emergency craniotomy at the Forbes.

“She was in extremities,” Janet said. “They never should have transferred her. She never even made it to the OR. We heard she died in the Miami General emergency room.”

“How about you and me driving over there?” Sean suggested. “I’d like to find her.”

For a moment, Janet thought Sean was kidding. She rolled her eyes again, thinking Sean was about to make some sick joke.

“I’m serious,” Sean said. “There’s a chance they’ll do an autopsy. I’d love to have a tumor sample. For that matter, I’d like to have some blood and even some cerebrospinal fluid.”

Janet shuddered in revulsion.

“Come on,” Sean said. “Remember, we’re in this thing together. I’m really sorry she died—you know I am. But now that she’s dead, we should concentrate on the science. With you in a nursing uniform and me in a white coat, we’ll have the run of the place. In fact, let’s bring some of our own syringes just in case.”

“In case of what?” Janet asked.

“In case we need them,” Sean said. He winked conspiratorially. “It’s best to be prepared,” he added.

Either Sean was the world’s best salesman or she was so stressed out, she was incapable of resisting. Fifteen minutes later she found herself climbing into the passenger side of Sean’s 4×4 to head over to a hospital she’d never visited, in hopes of obtaining the brain tissue of one of her patients who’d just expired.

“THAT’S HIM.” Sterling pointed at Sean Murphy through the car’s windshield for Wayne Edwards’s benefit. Wayne was a formidable Afro-American whose services Sterling enlisted when he did business in south Florida. Wayne was an ex-Army sergeant, ex-policeman, and ex-small businessman who’d gone into the security business. He was an ex from as many things as Sterling was, and like Sterling, he now used his varied experience for a similar career. Wayne was a private investigator, and although he specialized in domestic squabbles, he was talented and effective in other areas as well. Sterling had met him a few years previously when both were representing a powerful Miami businessman.

“He looks like a tough kid,” Wayne said. He prided himself on instantaneous assessments.

“I believe he is,” Sterling said. “He was an all-star hockey player from Harvard who could have played professionally if he’d been inclined.”

“Who’s the chick?” Wayne asked.

“Obviously one of the nurses,” Sterling said. “I don’t know anything about his female liaisons.”

“She’s a looker,” Wayne said. “What about Tanaka Yamaguchi? Have you seen him lately?”

“No, I haven’t,” Sterling said. “But I think I will. My contact at the FAA told me the Sushita jet has just refiled a flight plan to Miami.”

“Sounds like action,” Wayne said.

“In a way, I hope so.” Sterling said. “It will give us a chance to resolve this problem.”

Wayne started his dark green Mercedes 420SEL. The windows were heavily tinted. From the outside it was difficult to see within, especially in bright sunlight. He eased the car away from the curb and headed for the exit. Since a hospital shift had changed half an hour earlier, there was still considerable traffic leaving the parking area. Wayne allowed several cars to come between his car and Sean’s. Once on Twelfth, they headed north over the Miami River.

“I got sandwiches and drinks in the cooler in the back seat,” Wayne said while motioning over his shoulder.

“Good thinking,” Sterling said. That was one of the things he liked about Wayne. He thought ahead.

“Well, well,” Wayne said. “Short trip. They’re turning already.”

“Isn’t this another hospital?” Sterling asked. He leaned forward to survey the building Sean was approaching.

“This area is hospital city, man,” Wayne said. “You can’t drive a mile without running into one. But they’re heading to the mama hospital. That’s Miami General.”

“That’s curious,” Sterling said. “Maybe the nurse works there.”

“Uh oh,” Wayne said. “I do believe we have company.”

“What do you mean?” Sterling asked.

“See that lime green Caddy behind us?” Wayne asked.

“It would be hard to miss it,” Sterling said.

“I’ve been watching it since we crossed the Miami River,” Wayne said. “I have the distinct impression it’s following our Mr. Murphy. I wouldn’t have noticed it except I used to have wheels just like it in my younger days. Mine was burgundy. Good car, but a devil to parallel park.”

Sterling and Wayne watched as Sean and his companion entered the hospital through the emergency entrance. Not far behind was the man who’d arrived in the lime green Cadillac.

“I think my initial impression was correct,” Wayne said. “Looks to me like that dude is tighter on their tail than we are.”

“I don’t like this,” Sterling said. He opened the passenger door, got out, and glanced back at the dumpy Cadillac. Then he bent down to talk to Wayne. “This is not Tanaka’s style, but I can’t risk it. I’m going in. If Murphy comes out, follow him. If the man in the Cadillac comes out first, follow him. I’ll be in touch over the cellular phone.”

Grabbing his portable phone, Sterling hurried after Tom Widdicomb, who was climbing the steps on the side of the ambulance dock outside the Miami General emergency room.

WITH THE assistance of a harried resident in the emergency room who’d given them directions, it did not take Sean and Janet long to find the pathology department. Once there, Sean sought out another resident. He told Janet that between the residents and the nurses you could find out anything you wanted to know about a hospital.

“I’m not doing autopsies this month,” the resident said, trying to rush away.

Sean blocked his path. “How can I find out if a patient will be posted?” he asked.

“You have the chart number?” the resident asked.

“Just the name,” Sean said. “She died in the ER.”

“Then we probably won’t be autopsying the case,” the resident said. “ER deaths are usually assigned to the medical examiner.”

“How can I be sure?” Sean persisted.

“What’s the name?”

“Helen Cabot,” Sean said.

The resident graciously went over to a nearby wall phone and made a call. It took him less than two minutes to ascertain that Helen Cabot was not scheduled.

“Where do bodies go?” Sean asked.

“To the morgue,” the resident said. “It’s in the basement. Take the main elevators to B1 and follow the red signs with the big letter M on them.”

After the resident hurried on, Sean looked at Janet. “You game?” he asked. “If we find her then we’ll know her disposition for sure. We might even be able to get a little body fluid.”

“I’ve come this far,” Janet said with resignation.

TOM WIDDICOMB felt calmer than he had all day. At first he’d been dismayed when Janet had appeared with a young guy in a white coat, but then things took a turn for the better when the two went directly to the Miami General. Having worked there, Tom knew the place from top to bottom. He also knew that Miami General would be crowded with people at that time of day since formal visiting hours had just started. And crowds meant chaos. Maybe he would get his chance at Janet and wouldn’t even have to follow her home. If he had to shoot the fellow in the white coat, too bad!

Following the couple within the hospital had not been easy, especially once they went to pathology. Tom had thought he’d lost them and was about to return to the parking lot to keep an eye on the 4×4 when they suddenly reappeared. Janet came so close, he was sure she’d recognize him. He’d panicked, but luckily hadn’t moved. Fearing Janet would scream as she had in the Forbes residence, he’d gripped the pistol in his pocket. If she had screamed he would have had to shoot her on the spot.

But Janet glanced away without reacting. Obviously she’d failed to identify him. Feeling more secure, Tom followed the pair more closely. He even rode down in the same elevator with them, something he’d not been willing to do when they’d gone up to pathology.

Janet’s friend pushed the button for B1, and Tom was ecstatic. Of all the locations in Miami General, Tom liked the basement the best. When he’d worked at this hospital, he snuck down there many times to visit the morgue or to read the newspaper. He knew the labyrinthine tunnels like the back of his hand.

Tom’s anxiety about Janet recognizing him returned when everyone else but a doctor and a uniformed maintenance man got off on the first floor. But even with so slim a crowd to lose himself in, Janet failed to remember him.

As soon as the elevator reached the basement, the doctor and the maintenance man turned right and walked quickly away. Janet and Sean paused briefly, looking in both directions. Then they turned left.

Tom waited behind in the elevator until the doors began to shut. Bumping them open, he stepped out and followed the couple, keeping at a distance of about fifty feet. He slipped his hand in his pocket and gripped the gun. He even put his finger between the trigger and its guard.

The farther from the elevators the couple walked, the better Tom liked it. This was a perfect location for what he had to do. He couldn’t believe his luck. They were entering an area of the basement few people visited. The only sounds were their footfalls and the slight hissing of steam pipes.

“THIS PLACE feels appropriately like Hades,” Sean said. “I wonder if we’re lost.”

“There haven’t been any turnoffs since the last M sign,” Janet said. “I think we’re okay.”

“Why do they always put morgues in such isolated places?” Sean said. “Even the lighting is getting lousy.”

“It’s probably near a loading dock,” Janet said. Then she pointed ahead. “There’s another sign. We’re on the right track.”

“I think they want their mistakes as far away as possible,” Sean quipped. “It wouldn’t be good advertising to have the morgue near the front entrance.”

“I forgot to ask how you made out with the medicine I got for you.”

“I haven’t gotten very far,” Sean admitted. “What I did was start a gel electrophoresis.”

“That tells me a lot,” Janet said sarcastically.

“It’s actually simple,” Sean said. “I suspect the medicine is made up of proteins because they have to be using some sort of immunotherapy. Since proteins all have electric charges, they move in an electrical field. When you put them in a specific gel, which coats them with a uniform charge, they move only in relation to their size. I want to find out how many proteins I’m dealing with and what their approximate molecular weight is. It’s a first step.”

“Just make sure you learn enough to justify the effort for getting it,” Janet said.

“I hope you don’t think you’re off the hook with this one sample,” Sean said. “Next time I want you to get some of Louis Martin’s.”

“I don’t think I can do it again,” Janet said. “I can’t break any more vials. If I do, they’ll be suspicious for sure.”

“Try a different method,” Sean suggested. “Besides, I don’t need so much.”

“I thought by bringing the whole vial you’d have plenty,” Janet said.

“I want to compare the medicines from different patients,” Sean said. “I want to find out how they differ.”

“I’m not sure they differ,” Janet said. “When I went up to Ms. Richmond’s office to get another vial, she took it from a large stock. I got the feeling they are all being treated by the same two drugs.”

“I can’t buy that,” Sean said. “Every tumor is distinct antigenically, even the same kind of tumor. Oat cell cancer from one person will be different antigenically from the same type of cancer from another. In fact, if it arises as a new tumor even in the same person it will be antigenically distinct. And antigenically distinct tumors require different antibodies.”

“Maybe they use the same drug until they biopsy the tumor,” Janet suggested.

Sean looked at her with renewed respect. “That’s an idea,” he said.

Finally they rounded a corner and found themselves in front of a large insulated door. A metal sign at chest level read: Morgue. Unauthorized Entry Forbidden. Next to the door were several light switches.

“Uh oh,” Sean said. “I guess they were expecting us. That’s a rather formidable bolt action lock. And I didn’t bring my tools.”

Janet reached out and yanked on the door. It opened.

“I take that back,” Sean said. “Guess they didn’t expect us. At least not today.”

A cool breeze issued from the room and swirled about their legs. Sean flipped on the lights. For a split second there was no response. Then raw fluorescent light blinked on.

“After you,” Sean said gallantly.

“This was your idea,” Janet said. “You first.”

Sean stepped in with Janet immediately following. Several wide, concrete supporting piers blocked a view of the entire space, but it was obviously a large room. Old gurneys littered the room haphazardly. Each bore a shrouded body. The temperature, according to a gauge on the door, was forty-eight degrees.

Janet shivered. “I don’t like this.”

“This place is huge,” Sean said. “Either the architects had a low opinion of the competence of the medical staff, or they planned for a national disaster.”

“Let’s get this over with,” Janet said, hugging herself. The cold air was damp and penetrating. The smell was like a musty wet basement that had been closed for years.

Sean yanked back a sheet. “Oh, hello,” he said. The bloodied face of a partially crushed construction worker stared up at him. He was still in his work clothes. Sean covered the man and went to the next.

Despite her revulsion, Janet did the same, going in the opposite direction.

“Too bad they’re not in alphabetical order,” Sean said. “There must be fifty bodies in here. This is one scene the Miami Chamber of Commerce wouldn’t want to get up north.”

“Sean!” Janet called, since they’d moved apart. “I think your humor is tasteless.”

They worked around opposite ends of one of the concrete piers.

“Come on, Helen,” Sean called in a childlike singsong. “Come out, come out wherever you are.”

“That’s especially crude,” Janet said.

TOM WIDDICOMB was filled with excited anticipation. Even his mother had decided to break her long silence to tell him how clever he’d been to follow Janet and her friend into Miami General. Tom was well acquainted with the morgue. For what he intended to do, he couldn’t have found a better place.

Approaching the insulated door, Tom pulled his gun from his pocket. Holding the pistol in his right hand, he pulled the thick door open and looked inside. Not seeing Janet or her friend, he stepped into the morgue and let the door ease closed. He couldn’t see the couple but he could hear them. He distinctly heard Janet tell the man in the white coat to shut up.

Tom grasped the brass knob of the heavy lock on the door and slowly turned it. Silently the bolt slid into the striker plate. When Tom had worked at Miami General, the lock had never been used. He doubted if a key existed. Locking it ensured that he would not be disturbed.

“You’re a smart man,” Alice whispered.

“Thank you, Mom,” Tom whispered back.

Holding the gun in both hands as he’d seen them do on TV, Tom moved forward, heading toward the nearest of the concrete piers. He could tell from Janet and her friend’s voices that they were just on the opposite side of it.

“SOME OF these people have been in here for a while,” Sean said. “It’s like they’ve been forgotten.”

“I was thinking the same thing,” Janet said. “I don’t think Helen Cabot’s body is here. It would have been near the door. After all, she just died a few hours ago.”

Sean was about to agree when the lights went out. With no windows and the door heavily girdled with insulating weather stripping, it wasn’t just dark, it was absolutely black, like the vortex of a black hole.

The instant the lights went out there was an ear-piercing scream following by hysterical sobbing. At first Sean thought it was Janet, but having known where she was before the darkness enveloped him, he could tell that the crying was coming from behind the wall near the door to the hall.

So if it wasn’t Janet, Sean thought, who was it?

The agony was infectious. Even the sudden darkness wouldn’t have disturbed Sean ordinarily, but combined with the terrorized wailing, he found himself on the border of panic. What kept him from losing control was concern about Janet.

“I hate the dark,” the voice cried out suddenly amid weeping. “Someone help me!”

Sean didn’t know what to do. From the direction of the wailing came the sounds of frenzied commotion. Gurneys were bumping into each other, spilling their bodies onto the concrete floor.

“Help me!” the voice screamed.

Sean thought about calling out to try to calm the anguished individual, but he couldn’t decide if that was a good idea or not. Unable to decide, he stayed quiet.

After the sound of more gurneys clanking against each other, there was a low-pitched thump as if someone had hit up against the insulated door. That was followed by a mechanical click.

For a moment a small amount of light fingered its way around the concrete pier. Sean caught sight of Janet with her hands pressed against her mouth. She was only about twenty feet from him. Then the darkness descended again like a heavy blanket. This time it was accompanied by silence.

“Janet?” Sean called softly. “You okay?”

“Yes,” she answered. “What in God’s name was that?”

“Move toward me,” Sean said. “I’m coming toward you.”

“All right,” Janet said.

“This place is nuts,” Sean said, wanting to keep talking as they groped toward each other. “I thought Forbes was weird, but this place takes the prize hands down. Remind me not to match here for my internship.”

At last their groping hands met. Holding onto each other, they weaved their way through the gurneys in the direction of the door. Sean’s foot nudged a body on the floor. He warned Janet she’d have to step over it.

“I’ll have nightmares about this the rest of my life,” Janet said.

“This is worse than Stephen King,” Sean said.

Sean collided with the wall. Then, moving laterally, he felt the door. He pushed it open, and they both stumbled into the deserted corridor, blinking in the light.

Sean cupped Janet’s face in his hands. “I’m sorry,” he said.

“Life is never boring with you,” Janet said. “But it wasn’t your fault. Besides, we made it. Let’s get out of here.”

Sean kissed the end of her nose. “My feelings exactly.”

Mild concern they would have trouble finding their way to the elevators proved unwarranted. In minutes the two were climbing into Sean’s 4×4 and heading out of the parking lot.

“What a relief,” Janet said. “Do you have any idea what happened in there?”

“I don’t,” Sean said. “It was so weird. It was like it was staged to scare us to death. Maybe there’s some troll living in the basement who does that to everyone.”

As they were about to exit the parking area, Sean put on the brake suddenly, enough to make Janet reach out to support herself against the dash.

“What now?” she asked.

Sean pointed. “Look what we have here. How convenient,” he said. “That brick building is the medical examiner’s office. I had no idea it was so close. It must be fate telling us that Helen’s body is over there. What do you say?”

“I’m not wild about the idea,” Janet admitted. “But as long as we’re here…”

“That’s the ticket,” Sean said.

Sean parked in visitor parking, and they entered the modern building. Inside they approached an information desk. A cordial black woman asked if she could be of assistance.

Sean told her that he was a medical student and Janet was a nurse. He asked to speak with one of the medical examiners.

“Which one?” the receptionist asked.

“How about the director?” Sean suggested.

“The chief is out of town,” the receptionist said. “How about the deputy chief?”

“Perfect,” Sean said.

After a short wait they were buzzed through an inner glass door and directed to a corner office. The deputy chief was Dr. John Stasin. He was about Sean’s height but of slight build. He seemed genuinely pleased that Sean and Janet had stopped by.

“Teaching is one of our major functions,” he said proudly. “We encourage the professional community to take an active interest in our work.”

“We’re interested in a specific patient,” Sean said. “Her name is Helen Cabot. She died this afternoon in the Miami General emergency room.”

“Name doesn’t ring a bell,” Dr. Stasin said. “Just a minute. Let me call downstairs.” He picked up the phone, mentioned Helen’s name, nodded, and said “yeah” a few times, then hung up. It all happened extremely rapidly. It was apparent that grass did not grow under Dr. Stasin’s feet.

“She arrived a few hours ago,” Dr. Stasin said. “But we won’t be posting her.”

“Why not?” Sean asked.

“Two reasons,” Dr. Stasin said. “First, she had documented brain cancer which her attending physician is willing to aver as the cause of death. Second, her family has expressed strong feelings against our posting her. In this kind of circumstance we feel it is better not to do it. Contrary to popular opinion, we’re receptive to the family’s wishes unless, of course, there is evidence of foul play or a strong suggestion that the public weal would be served by an autopsy.”

“Is there a chance of getting any tissue samples?” Sean asked.

“Not if we don’t do the autopsy,” Dr. Stasin said. “If we did, the tissues removed would be available at our discretion. But since we’re not posting the patient, property rights rest with the family. Besides, the body has already been picked up by the Emerson Funeral Home. It’s on its way to Boston sometime tomorrow.”

Sean thanked Dr. Stasin for his time.

“Not at all,” he said. “We’re here every day. Give a call if we can help.”

Sean and Janet retraced the route to the car. The sun was setting; rush hour was in full swing.

“Surprisingly helpful individual,” Janet said.

Sean only shrugged. He leaned his forehead against the steering wheel.

“This is depressing,” he said. “Nothing seems to be going our way.”

“If anyone should be melancholy it should be me,” Janet reminded him, noting how glum he’d suddenly become.

“It’s an Irish trait to be melancholy,” Sean said. “So don’t deny me. Maybe these difficulties we’re having are trying to tell me something, like I should be heading back to Boston to do some real work. I never should have come down here.”

“Let’s go get something to eat,” Janet said. She wanted to change the subject. “We could go back to that Cuban restaurant on the beach.”

“I don’t think I’m hungry,” Sean said.

“A little arroz con pollo will make all the difference in the world,” Janet said. “Trust me.”

TOM WIDDICOMB had every light on in the house despite the fact that it wasn’t even dark outside. But he knew it would be dark soon, and the idea terrified him. He did not like the dark. Even though it was hours after the terrible episode in the Miami General morgue he was still shaking. His mother had done something similar to him once when he was about six. He’d gotten irritated at her when she said he couldn’t have any more ice cream, and he’d threatened to tell the teacher at school that they slept together unless she gave him more. Her response had been to shut him in a closet overnight. It had been Tom’s worst experience. He’d been afraid of both the dark and closets ever since.

Tom had no idea how the lights had gone off in the morgue except that when he had finally found the door and pushed it open, he’d practically collided with a man dressed in a suit and tie. Since Tom had still had the gun in his hand, the man had backed away, giving Tom the opportunity to bolt down the corridor. The man had given chase, but Tom had lost him easily in the network of tunnels, corridors, and connecting rooms he knew so well. By the time Tom exited from an isolated basement door with outside steps leading to the parking area, the man was nowhere in sight.

Still panicked, Tom had run to his car, started it, and had headed toward the parking area exit. Fearing that whoever had chased him in the basement might have somehow gotten out faster than he, Tom had been watchful as he drove, and since the parking lot was not busy at that time, he’d seen the green Mercedes almost immediately.

Passing his intended exit, Tom had gone to another one that was seldom used. When the green Mercedes had followed suit, Tom was convinced he was being followed. Consequently, he concentrated on losing the car in the afternoon rush hour. Thanks to a traffic light and a few cars that had come between them, Tom had been able to speed away. He had driven aimlessly for half an hour just to make sure he was no longer being followed. Only then did he return home.

“You never should have gone into Miami General,” Tom said, lambasting himself for his mother’s benefit. “You should have stayed outside, waited, and followed her home.”

Tom still had no idea where Janet lived.

“Alice, talk to me!” he shouted. But Alice wasn’t saying a word.

All Tom could think to do was wait until Janet got off work on Saturday. Then he’d follow her. He’d be more careful. Then he’d shoot her.

“You’ll see, Mom,” Tom said to the freezer. “You’ll see.”

JANET HAD been right, although Sean wasn’t about to admit it. What had especially perked him up were the tiny cups of Cuban coffee. He’d even tried what the people at the neighboring table had done. He’d drunk them like shots of alcohol, letting the mouthful of strong, thick, sweet fluid fall into his stomach in a bolus. The taste had been intense and the mild euphoria almost immediate.

The other thing that had helped Sean out of his dejected mood was Janet’s positive attitude. Despite her difficult day and the episode at Miami General, she’d found the stamina to remain upbeat. She reminded Sean that they were doing rather well for only two days’ effort. They had the thirty-three charts of the previous medulloblastoma patients and she’d managed to get two vials of the secret medicine. “I think that’s pretty good progress,” Janet said. “At this rate we’re sure to get to the bottom of the Forbes success in treating these people Come on, cheer up! We can do it!”

Janet’s enthusiasm and the caffeine finally combined to win Sean over.

“Let’s find out where this Emerson Funeral Home is located,” he said.

“Why?” Janet asked, leery of such a suggestion.

“We can do a drive-by,” Sean said. “Maybe they’re working late. Maybe they give out samples.”

The funeral home was on North Miami Avenue near the city cemetery and Biscayne Park. It was a well-cared-for two-story Victorian clapboard structure with dormers. It was painted white with a gray slate roof and was surrounded on three sides by a wide porch. It gave the impression that it had been a private home.

The rest of the neighborhood was not inviting. The immediately adjacent buildings were constructed of concrete block. There was a liquor store on one side and a plumbing supply store on the other. Sean parked directly in front in a loading zone.

“I don’t think they’re open,” Janet said, gazing up at the building.

“Lots of lights,” Sean said. All the ground-floor lights were on except for the porch lights. The second floor was completely dark. “I think I’ll give it a try.”

Sean got out of the car, climbed the steps, and rang the bell. When no one answered, he looked into the windows. He even looked into some of the side windows before he came back to the car and got in. He started the engine.

“Where are we going now?” she asked.

“Back to the Home Depot,” Sean said. “I need some more tools.”

“I don’t like the sound of this,” Janet said.

“I can drop you off at the apartment,” Sean suggested.

Janet was silent. Sean drove first to the apartment out on Miami Beach. He pulled over to the curb and stopped. They hadn’t spoken en route.

“What exactly are you planning to do?” she asked at last.

“Continue my quest for Helen Cabot,” Sean said. “I won’t be long.”

“Are you planning on breaking into that funeral home?” Janet asked.

“I’m going to ‘ease in,’” Sean said. “That sounds better. I just want a few samples. If worse comes to worst, how bad is it? She’s already dead.”

Janet hesitated. At that point she had the door open and one foot out. As crazy as Sean’s plan was, she felt responsible to a degree. As Sean had already pointed out several times, this whole venture had been her idea. Besides, she thought she’d go crazy sitting in the apartment waiting for him to return. Pulling her foot back into the car, Janet told Sean that she’d changed her mind and that she’d go along.

“I’m coming as a voice of rationality,” she said.

“Okay by me,” Sean said equably.

At Home Depot Sean bought a glass cutter, a suction device for lifting large pieces of glass, a sheet rock knife, a small hand-held jigsaw, and a cooler. After that he stopped at a 7-Eleven where he bought ice for the cooler and a few cold drinks. Then he drove back to the Emerson Funeral Home and parked again in the loading zone.

“I think I’ll wait here,” Janet said. “By the way, I think you’re crazy.”

“You’re entitled to your opinion,” Sean said. “I’d rather think of myself as determined.”

“A cooler and cold drinks,” Janet commented. “It’s as if you think you’re going on a picnic.”

“I just like to be prepared,” Sean said.

Sean hefted his pack of tools and the cooler and went up onto the funeral home porch.

Janet watched him check the windows. Several cars drove by in both directions. She was amazed at his sangfroid. It was as if he believed himself to be invisible. She watched as he went to a side window toward the back and put down his sack. Bending over, he took out some of the tools.

“Damn it all!” Janet said. With irritation she opened the door, climbed the funeral home’s front steps, and walked around to where Sean was busily working. He’d attached the suction device to the window.

“A change of heart?” Sean asked without looking at Janet. He ran the glass cutter deftly around the perimeter of the window.

“Your lunacy floors me,” Janet said. “I can’t believe you’re doing this.”

“Brings back fond memories,” Sean said. With a decisive tug, he pulled a large segment of the window glass out and laid it on the porch planking. After leaning inside, he told Janet that the alarm was a simple sash alarm which was what he’d guessed.

Sean reached in with his tools and the cooler and set them on the floor. After stepping through the window himself, he leaned back out.

“If you’re not coming in, it would be better if you waited in the car,” he said. “A beautiful woman hanging around on a funeral home porch at this hour might attract some attention. This might take me a few minutes if I find Helen’s body.”

“Give me a hand!” Janet said impulsively as she tried to follow Sean’s easy step through the window.

“Watch the edges!” Sean warned. “They’re like razors.”

Once Janet was inside, Sean hefted the tools and handed the cooler to Janet.

“Nice of them to leave the lights on for us,” he said.

The two big rooms in the front were viewing rooms. The room they’d entered was a casket display room with eight caskets exhibited. Their lids were propped open. Across a narrow hall was an office. In the rear of the house, extending from one side to the other was the embalming room. The windows were covered with heavy drapes.

There were four stainless steel embalming tables. Two were occupied by shrouded corpses. The first was a heavyset woman who looked lifelike enough to be asleep except for the large Y-shaped, crudely sutured incision on the front of her torso. She’d been autopsied.

Moving to the second body, Sean lifted the sheet.

“Finally,” Sean said. “Here she is.”

Janet came over and mentally prepared herself before looking. The sight was less disturbing than she’d imagined. Like the other woman, Helen Cabot appeared in sleep-like repose. Her color was better than it had been in life. Over the last few days she’d become so pale.

“Too bad,” Sean commented. “She’s already been embalmed. I’ll have to forgo the blood sample.”

“She appears so natural,” Janet said.

“These embalmers must be good,” Sean said. Then he pointed to a large glass-fronted metal cabinet. “See if you can find me some needles and a scalpel.”

“What size?”

“I’m not choosy,” Sean said. “The longer the needle the better.”

Sean plugged in the jigsaw. When he tried it, it made a fearful noise.

Janet found a collection of syringes, needles, even suture material, and latex rubber gloves. But no scalpels. She brought what she’d found over to the table.

“Let’s get the cerebrospinal fluid first,” Sean said. He pulled on a pair of the gloves.

He had Janet help roll Helen onto her side so that he could insert a needle in the lumbar area between two vertebrae.

“This will only hurt for a second,” Sean said as he patted Helen’s upturned hip.

“Please,” Janet said. “Don’t joke around. You’ll only upset me more than I already am.”

To Sean’s surprise he got cerebrospinal fluid on the first try. He’d only performed the maneuver on living patients a couple of times. He filled the syringe, capped it, and put it on the ice in the cooler. Janet let Helen roll back supine.

“Now for the hard part,” he said, coming back to the embalming table. “I’m assuming you’ve seen an autopsy.”

Janet nodded. She’d seen one but it had not been a pleasant experience. She braced herself as Sean prepared.

“No scalpels?” he asked.

She shook her head.

“Good thing I got this Sheetrock knife,” Sean said. He picked up the knife and extended the blade. Then he ran it around the back of Helen’s head from one ear to the other. Grasping the top edge of the incision, Sean yanked. With the kind of ripping sound of a weed being uprooted, Helen’s scalp pulled away from her skull. Sean pulled it all the way down over Helen’s face.

He palpated the craniotomy hole on the left side of Helen’s skull that had been done at the Boston Memorial, then looked for the one on the right, the one done at Forbes two days previously.

“That’s weird,” he said. “Where the hell is the second craniotomy hole?”

“Let’s not waste time,” Janet said. Although she’d been nervous when they had entered, her anxiety was steadily increasing with each passing minute.

Sean continued to look for the second craniotomy hole, but finally gave up.

Picking up the jigsaw, he looked at Janet. “Stand back. Maybe you don’t want to watch. This isn’t going to be pretty.”

“Just do it,” Janet said.

Sean pushed the jigsaw blade into the craniotomy hole he’d found and turned the saw on. It bit into the bone and almost yanked itself out of his hands. The job would not be as easy as Sean had envisioned.

“You have to steady the head,” Sean told Janet.

Grasping either side of Helen’s face, Janet vainly tried to keep the head from jerking from side to side as Sean struggled to hold the bucking jigsaw. With great difficulty he managed to saw off a skull cap of bone. He had intended to keep the blade depth equal to the thickness of the skull, but it had been impossible. The saw blade had dug into the brain in several places, shredding the surface.

“This is disgusting,” Janet said. She straightened up and brushed herself off.

“It’s not a bone saw,” Sean admitted. “We had to improvise.”

The next part was almost as difficult. The Sheetrock knife was much larger than a scalpel, and Sean had difficulty inserting it below the brain to cut through the spinal cord and cranial nerves. He did the best he could. Then, inserting his hands on either side within the skull, he grasped the mutilated brain and yanked it out.

After taking the cold drinks out of the cooler, Sean dropped the brain onto the ice. Then he popped the top on one of the drinks and offered it to Janet. Sweat was beading his forehead.

Janet declined. She watched as he took a long drink, shaking her head in amazement. “Sometimes I don’t believe you,” she said.

Suddenly they both heard a siren. Janet panicked and started back for the display room, but Sean restrained her.

“We have to get out of here,” Janet whispered urgently.

“No,” Sean said. “They wouldn’t come with a siren. It has to be something else.”

The sound of the siren built. Janet felt her heart racing faster and faster. Just when the siren sounded as if it were coming into the house, its pitch abruptly changed.

“Doppler effect,” Sean said. “A perfect demonstration.”

“Please!” Janet pleaded. “Let’s go. We got what you wanted.”

“We have to clean up,” Sean said, putting his drink down. “This is supposed to be a clandestine operation. See if you can find a broom or a mop. I’ll put Helen back together so no one will know the difference.”

Despite her agitation, Janet did as Sean asked. She worked feverishly. When she was done, Sean was still suturing the scalp back in place using subcutaneous stitches. When he was finished, he pulled her hair over the incision. Janet was impressed. Helen Cabot’s body appeared undisturbed.

They carried the tools and the cooler back to the casket display room.

“I’ll go out first and you hand me the stuff,” Sean said. He ducked and stepped through the window.

Janet handed out the things.

“You need help?” Sean asked. His arms were full.

“I don’t think so,” Janet said. Coming in had not been that difficult.

Sean started toward the car with his bundles.

Janet mistakenly grasped the edge of the glass before stepping through. In her haste she’d forgotten Sean’s earlier warning. Feeling the razor-sharp edge cut into four of her fingers, she recoiled in pain. Glancing at her hand she saw an oozing line of blood. She clutched her hand and silently cursed.

Since she was on the inside now, she decided it would be far easier and less dangerous to get out by opening the window. There was no need to risk getting cut by the glass again. Without thinking, she undid the lock and pushed up the sash. Immediately the alarm sounded.

Struggling out the window, Janet ran after Sean. She got to the car just after he’d stashed the cooler on the floor of the back seat. In unison, they jumped into the front and Sean started the car.

“What happened?” he demanded as he pulled the car into the street.

“I forgot about the alarm,” Janet admitted. “I opened the window. I’m sorry. I told you I wasn’t good at this.”

“Well, no problem,” Sean said as he turned right at the first intersection and headed east. “We’ll be long gone before anybody responds.”

What Sean didn’t see was the man who’d come out of the liquor store. He’d responded to the alarm immediately, and he’d seen Janet and Sean getting into the 4×4. He also got a good look at the license plate. Returning inside his store he wrote down the numbers before he forgot them. Then he called the Miami police.

Sean drove back to Forbes so that Janet could get her car. By the time they pulled into the parking area, Janet had calmed down to some degree. Sean stopped next to her rental car. She opened the door and started to get out.

“Are you coming right back to the apartment?” she asked.

“I’m going to head up to my lab,” Sean said. “You want to come?”

“I have to work tomorrow,” Janet reminded him. “And it’s been a tough day. I’m exhausted. But I’m afraid to let you out of my sight.”

“I’m not going to be long,” Sean said. “Come on! There are only a couple of things I want to do. Besides, tomorrow is Saturday and we’ll go on that little vacation I promised you. We’ll leave after you get off work.”

“Sounds like you’ve already decided where we’ll go,” Janet said.

“I have,” Sean said. “We’ll drive across the Everglades to Naples. I hear it is quite a place.”

“All right, it’s a deal,” Janet said, closing her door. “But tonight you have to get me home before midnight at the latest.”

“No problem,” Sean said as he drove around to the research building side of the parking lot.

“AT LEAST the Sushita jet hasn’t left Washington,” Sterling said. He was sitting in Dr. Mason’s office. Wayne Edwards was there too, as were Dr. Mason and Margaret Richmond. “I don’t believe Tanaka will make a move until the jet is here and available,” he added.

“But you said Sean had been followed,” Dr. Mason said. “Who was following him?”

“I was hoping you could enlighten us,” Sterling said. “Do you have any idea why someone would be following Mr. Murphy? Wayne noticed him when we crossed the Miami River.”

Dr. Mason glanced at Ms. Richmond, who shrugged. Dr. Mason looked back at Sterling. “Could this mystery individual be in the employ of Tanaka?”

“I doubt it,” Sterling said. “It’s not Tanaka’s style. If Tanaka makes a move, Sean will just disappear. There won’t be any warning. It will be smooth and professional. The individual who was following Sean was disheveled. He was wearing a soiled open-necked brown shirt and trousers. And he certainly wasn’t acting like the sort of professional Tanaka would enlist.”

“Tell me exactly what happened,” Dr. Mason demanded.

“We followed Sean and a young nurse out of the Forbes parking area around four,” Sterling said.

“The nurse would be Janet Reardon,” Ms. Richmond interjected. “The two are friends from Boston.”

Sterling nodded. He motioned for Wayne to write the name down. “We’ll need to investigate her as well. It’s important to eliminate the possibility of them working as a team.”

Sterling described following Sean to Miami General and his instructions to Wayne to follow the unknown man in brown if he came out first.

Dr. Mason was surprised to learn that Sean and his nurse friend had headed to the morgue. “What on earth were they doing there?”

“That was something else I was hoping you could tell us,” Sterling said.

“I can’t imagine,” Dr. Mason said, shaking his head. He again looked at Ms. Richmond. She shook her head as well.

“When the mysterious man entered the morgue behind Sean Murphy and Miss Reardon,” Sterling continued, “I only got a quick glimpse. But it was my impression he was holding a gun. That later proved to be correct. At any rate I was concerned for Mr. Murphy’s safety, so I rushed to the morgue door only to find it locked.”

“How dreadful,” Ms. Richmond said.

“There was only one thing I could do,” Sterling said. “I turned off the lights.”

“That’s a nice touch,” Dr. Mason said. “Good thinking.”

“I’d hoped the people within wouldn’t hurt each other until I could conceive of a way to get the door open,” Sterling said. “But there was no need. The man in brown apparently has a strong phobia of the dark. Within a short time he burst from the room significantly distraught. It was then that I saw the gun clearly. I gave chase, but unfortunately I was attired in leather-soled shoes, which put me at a distinct disadvantage to his running shoes. Besides, he seemed entirely familiar with the terrain. When it was clear that I’d lost him, I returned to the morgue. By then Sean and Miss Reardon had already departed as well.”

“And Wayne followed the man in brown?” Dr. Mason asked.

“He tried,” Sterling said.

“I lost him,” Wayne admitted. “It was rush hour, and I was unlucky.”

“So now we have no idea where Mr. Murphy is,” Dr. Mason moaned. “And we have a new worry about an unknown assailant.”

“We have a colleague of Mr. Edwards watching the Forbes residence for Sean’s return,” Sterling said. “It is important we find him.”

The phone on Dr. Mason’s desk rang. Dr. Mason answered it.

“Dr. Mason, this is Juan Suarez in security,” the voice at the other end told him. “You asked me to call if Mr. Sean Murphy appeared. Well, he and a nurse just came in and went up to the fifth floor.”

“Thank you, Juan,” Dr. Mason said with relief. He hung up the phone. “Sean Murphy is safe,” he reported. “He just came into the building, probably to inject more mice. What dedication! I tell you, I think the kid is a winner and worth all this trouble.”

IT WAS after ten o’clock at night when Robert Harris left Ralph Seaver’s apartment. The man had not been particularly cooperative. He’d resented Harris’s bringing up his rape conviction in Indiana which he’d dubbed “ancient history.” Harris didn’t think much of Seaver’s self-serving assessment, but he mentally took the man off his list of suspects the minute he laid eyes on him. The attacker had been described as being of medium height and medium build. Seaver was at least six-eight and probably weighed two hundred and fifty pounds.

Climbing into his dark blue Ford sedan, Harris picked up the last file in his priority category. Tom Widdicomb lived in Hialeah, not too far from where Harris was. Despite the hour, Harris decided to drive by the man’s home. If the lights were on, he’d ring the bell. Otherwise he’d let it go until morning.

Harris had already made several background calls regarding Tom Widdicomb. He’d found out that the man had taken an EMT course and had passed the exam for his license. A call to an ambulance firm where Tom had worked didn’t yield much information. The owner of the company refused to comment, explaining that the last time he talked about a former employee the tires of two of his ambulances were slashed.

A call to Miami General had been a bit more helpful but not by much. A personnel officer said that Mr. Widdicomb and the hospital had parted ways by mutual agreement. The officer admitted he’d not met Mr. Widdicomb; he was merely reading from the employment file.

Harris had also checked with Glen, the housekeeping supervisor at the Forbes Hospital. Glen said that Tom was dependable from his point of view, but that he frequently clashed with his colleagues. He said that Tom worked better on his own.

The last call Harris had made was to a veterinarian by the name of Maurice Springborn. That number, however, was no longer in service and information did not have another number. So all in all, Harris hadn’t turned up anything incriminating concerning Tom Widdicomb. As he drove into Hialeah and searched for 18 Palmetto Lane, he was not optimistic.

“Well, at least the lights are on,” Harris said as he pulled over to the curb in front of an ill-kept ranch-style house. In sharp contrast to the other modest homes in the neighborhood, Tom Widdicomb’s was lit up like Times Square on New Year’s Eve. Every light inside and outside the house was blazing brightly.

Getting out of the car, Harris stared at the house. It was amazing how much light emanated from it. Shrubbery three houses away cast sharp shadows. As he walked up the driveway, he noticed the name on the mailbox was Alice Widdicomb. He wondered how she and Tom were related.

Mounting the front steps, Harris rang the bell. As he waited he eyed the house. It was decorated in a plain style with faded pastel colors. The trim was badly in need of paint.

When no one responded to the bell, Harris rang again and put his ear to the door to make sure the bell was functioning. He heard it clearly. It was hard to believe no one was home with all the lights on.

After a third ring, Harris gave up and returned to his car. Rather than leave immediately, he sat staring at the house, wondering what could motivate people to illuminate their house so brightly. He was just about to start his engine when he thought he saw some movement by the living room window. Then he saw it again. Someone in the house had definitely moved a drape. Whoever it was seemed to be trying to catch a peek at Harris.

Without a moment’s hesitation, Harris climbed out of his car and went back to the stoop. He leaned on the doorbell, giving it one long blast. But still no one came.

Disgustedly, Harris returned to his car. He used his car phone to call Glen to see if Tom Widdicomb was scheduled to work the next day.

“No, sir,” Glen said with his southern accent. “He’s not scheduled to work until Monday. Good thing, too. He was under the weather today. He looked terrible. I sent him home early.”

Harris thanked Glen before hanging up. If Widdicomb wasn’t feeling well and was home in bed, why all the lights? Was he feeling so bad he couldn’t even come to the door? And where was Alice, whoever she was?

As Harris drove away from Hialeah he pondered what he should do. There was something weird going on at the Widdicombs’. He could always go back and stake out the house, but that seemed extreme. He could wait until Monday when Tom showed up for work, but what about in the meantime? Instead, he decided he’d go back the following morning to see if he could catch a glimpse of Tom Widdicomb. Glen had said he was of medium height and medium build with brown hair.

Harris sighed. Sitting in front of Tom Widdicomb’s house was not his idea of a great Saturday, but he was desperate. He felt he’d better make some headway on the breast cancer deaths if he was interested in remaining employed at Forbes.

SEAN WAS whistling softly while he worked, the picture of contented concentration. Janet watched from a high stool similar to Sean’s that she’d dragged over to the lab bench. In front of him was an array of glassware.

It was at quiet times like this that Janet found Sean so appealingly attractive. His dark hair had fallen forward to frame his downturned face with soft ringlets, which had an almost feminine look in stark contrast to his hard, masculine features. His nose was narrow at the top where it joined the confluence of his heavy eyebrows. It was a straight nose except for the very tip where it slanted inward before joining the curve of his lips. His dark blue eyes were fixated unblinkingly on a clear plastic tray in his strong but nimble fingers.

He glanced up to look directly at Janet. His eyes were bright and shining. She could tell he was excited. At that moment she felt inordinately in love, and even the recent episode at the funeral home receded into her mind for the moment. She wanted him to take her in his arms and tell her that he loved her and wanted to spend the rest of his life with her.

“These initial silver stain electrophoresis gels are fascinating,” Sean said, shattering Janet’s fantasy. “Come and look!”

Janet pushed off her stool. At the moment she wasn’t interested in electrophoresis gels, but she felt she had little choice. She didn’t dare risk lessening his enthusiasm. Still, she was disappointed he didn’t sense her affectionate feelings.

“This is the sample from the larger vial,” Sean explained. “It’s a non-reducing gel so you can tell by the control that it has only one component, and its molecular weight is about 150,000 daltons.”

Janet nodded.

Sean picked up the other gel and showed it to her. “Now, the medicine in the small vial is different. Here there are three separate bands, meaning there are three separate components. All three have much smaller molecular weights. My guess is that the large vial contains an immunoglobulin antibody while the small vial most likely contains cytokines.”

“What’s a cytokine?” Janet asked.

“It’s a generic term,” Sean said. He got off his own stool. “Follow me,” he said. “I’ve got to get some reagents.”

They used the stairs. As they walked, Sean continued to explain. “Cytokines are protein molecules produced by cells of the immune system. They’re involved in cell-to-cell communication, signaling cues like when to grow, when to start doing their thing, when to get ready for an invasion of virus, bacteria, or even tumor cells. The NIH has been busy growing the lymphocytes of cancer patients in vitro with a cytokine called interleukin-2, then injecting the cells back into the patient. In some cases they’ve had some good results.”

“But not as good as the Forbes with their medulloblastoma cases,” Janet said.

“Definitely not as good,” Sean said.

Sean loaded himself and Janet with reagents from the storeroom; then they started back to his lab.

“This is an exciting time in biological science,” Sean said. “The nineteenth century was the century for chemistry; the twentieth century was the century for physics. But the twenty-first century will belong to molecular biology; it’s when all three—chemistry, physics, and biology—are going to merge. The results will be astounding, like science fiction come true. In fact, we’re already seeing it happen.”

By the time they got back in the lab Janet found herself becoming genuinely interested despite the day’s emotional traumas and her fatigue. Sean’s enthusiasm was infectious.

“What’s the next step with these medicines?” she asked.

“I’m not sure,” Sean admitted. “I suppose we should see what kind of reaction we get between the unknown antibody in the large vial and Helen Cabot’s tumor.”

Sean asked Janet to get out some scissors and a scalpel from a drawer near where she was standing. Sean took the cooler over to the sink, and after putting on a pair of latex rubber gloves, he lifted out the brain and rinsed it off. From beneath the sink he pulled out a cutting board. He put the brain on the board.

“I hope I don’t have trouble finding the tumor,” he said. “I’ve never tried to do anything like this before. Judging by the MRI we did in Boston, her largest tumor is in the left temporal lobe. That was the one they biopsied up there. I suppose that’s the one I should go after.” Sean oriented the brain so that he could determine the front from the back. Then he made several slices into the temporal lobe.

“I have an almost irresistible urge to joke about what I’m doing here,” he said.

“Please don’t,” Janet said. It was hard for her to deal with the fact that this was the brain of a person with whom she’d so recently related.

“Now this looks promising,” Sean said. He spread the edges of his most recent incision. At the base was a comparatively dense and more yellow-appearing tissue bearing tiny but visible cavities. “I think those spots might be areas where the tumor outgrew its own blood supply.”

Sean asked Janet to give him a hand, so she pulled on a pair of the rubber gloves and held the cut edges of the brain apart while Sean took a sample of the tumor with the scissors.

“Now we have to separate the cells,” he said, putting the sample in tissue culture medium, then adding enzymes. He put the flask in the incubator to give the enzymes a chance to work.

“Next we have to characterize this immunoglobulin,” he said, holding up the larger of the two vials of unknowns. “And to do this we have a test called ELISA where we use commercially made antibodies to identify specific types of immunoglobulins.” He placed the large vial on the countertop and picked up a plastic plate that had ninety-six tiny circular wells. In each of the wells he put a different capture antibody and allowed it to bind. Then he blocked any remaining binding sites in the wells with bovine serum albumin. Next he put a small aliquot of the unknown in each of the wells.

“Now I have to figure out which antibody has reacted to the unknown,” he said, washing each of the wells to rid them of any of the unknown immunoglobulin that hadn’t reacted. “We do this by adding to each well the same antibody that was originally in the well, only this time tagged with a compound that’s enzymatically capable of yielding a colored reaction.” This last substance had the characteristic of turning a pale lavender.

The whole time Sean was doing this test, he kept up a running explanation for Janet. She’d heard of the test but had never seen it performed.

“Bingo!” Sean said when one of the many wells turned the appropriate color to match controls he’d set up in sixteen of the end wells. “The unknown is no longer an unknown. It’s a human immunoglobulin called IgGI.”

“How did Forbes make it?” Janet asked.

“That’s a good question,” Sean said. “I’d guess by monoclonal antibody technique. Although it is not out of the question to make it by recombinant DNA technology. The problem there is that it’s a big molecule.”

Janet had a vague idea of what Sean was talking about and had definitely become interested in the process of figuring out what these unknown medicines were, but suddenly her physical exhaustion could no longer be ignored. Glancing at her watch she could understand why. It was almost midnight.

Feeling ambivalent about interrupting Sean’s enthusiasm which she’d been trying hard to bolster, she reached out and grasped his arm. He was holding a Pasteur pipette. He’d started ELISA plates for the second unknown.

“Do you have any idea of the time?” she asked.

Sean glanced at his watch. “My word, time does fly when you’re having a good time.”

“I’ve got to work tomorrow,” she said. “I’ve got to get some sleep. I suppose I could go back to the apartment by myself.”

“Not at this hour,” Sean said. “Just let me finish what I’m doing here, then I want to run a quick immuno-fluorescence test to see the level of reaction between the IgGI and Helen’s tumor cells. I’ll use an automatic diluter. It will only take a few minutes.”

Janet reluctantly agreed. But she couldn’t sit on a stool any longer. Instead she dragged out an armchair from the glass-enclosed office. Less than half an hour later, Sean’s enthusiasm went up another notch. The ELISA test on the second unknown had identified three cytokines: interleukin-2, which as he explained to Janet was a T lymphocyte growth factor; tissue necrosis factor alpha, which was a stimulant for certain cells to kill foreign cells like cancer cells; and interferon gamma, which was a substance that seemed to help activate the entire immune system.

“Aren’t the T cells the ones that disappear in AIDS?” Janet asked. She was having progressive difficulty staying awake.

“Right on,” Sean said. He was now holding a number of slides on which he’d run fluorescence antibody tests at different dilutions of the unknown immunoglobulin. Slipping one of the very high dilution slides under the objective of the fluorescein scope, Sean put his eyes to the eyepiece.

“Wow!” he exclaimed. “The intensity of this reaction is unbelievable. Even at a one to ten thousand dilution this IgGI antibody reacts with the tumor four plus. Janet, come and take a look at this!”

When Janet didn’t respond, Sean looked up from the eye-pieces of the binocular scope. Janet was slouched in the chair. She’d fallen fast asleep.

Seeing Janet sleeping. Sean immediately felt guilty. He hadn’t considered how exhausted she must be. Standing up and stretching his tired arms, he stepped over to Janet and looked down at her. She seemed particularly angelic in her repose. Her face was framed by her fine blond hair. Sean felt an urge to kiss her. Instead, he gently shook her shoulder.

“Come on,” he whispered. “Let’s get you to bed.”

Janet was already buckled in Sean’s car when her sleepy mind reminded her she’d brought her own car that morning. She mentioned it to Sean.

“Are you in any condition to drive?” Sean asked.

She nodded. “I want my car,” she said, leaving no room for discussion.

Sean pulled around to the hospital and let her out. Once she had her car started, he let her lead the way. And as they pulled out into the street, Sean was too intent on Janet to notice the dark green Mercedes which slowly began to follow them both without the benefit of its headlights.