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From her perspective, they were both acting like a couple of preteens.

"I was a hopeless case on the basketball court," Jack said. "I couldn't do anything right."

"I'm sorry," Laurie said, but then immediately wanted to take it back. It sounded as though she was apologizing, when she was merely sympathizing.

"As I expected, the internal on my case was consistent with SIDS," Jack said to change the subject. It was obvious that he was equally uncomfortable.

"Really?" Laurie said.

"How was yours?" Jack asked as the elevator began its ascent. "When I bumped into Janice, she mentioned it seemed similar to your McGillan case, so I told Riva that you'd probably want it."

"I appreciate it," Laurie said. "I did want it. And you were right. It was exactly like McGillan to an uncomfortable degree."

"What do you mean 'uncomfortable'?" Jack asked.

"I'm beginning to think that your suggestion yesterday about forensics establishing a manner of death opposite to what was expected could be applicable. I'm thinking I might be dealing with homicide, sort of the Cromwell case in reverse. In other words, I might have stumbled onto the work of a serial killer. I can't help but think about some of those infamous health-institution serial murders, particularly the recent one over in New Jersey and Pennsylvania." Laurie did not have the same reservations about mentioning her suspicions to Jack as she had had with Fontworth.

"Whoa!" Jack said. "When I was talking about forensics providing some surprises, I was talking in general. I wasn't suggesting anything about your case."

"I thought you were," Laurie said.

Jack shook his head as the elevator door opened on the first floor. "Not at all. And I have to say that I think you're taking a quantum leap going from natural to homicide with the case you described to me. Why on Earth did it even occur to you?" He gestured for Laurie to exit ahead of him.

"Because I've now autopsied in successive days two relatively young, healthy people who have died suddenly, yet have no associated pathology. None!"

"Your case today didn't have any emboli or obvious cardiac abnormalities?"

"Absolutely none. It was clean! Well, there were a few uterine fibroids, but that was it.

Like McGillan, she was within twenty-four hours postsurgery with general anesthesia.

Like McGillan, she had been completely stable without complications, and then ...

bingo! She arrests and is totally unable to be resuscitated!" Laurie snapped her fingers for emphasis.

They passed through the communications room. The secretaries were bunched together and chatting. For the moment, the phone lines were quiet. After the mayhem of the morning commute, death generally took a breather in the city.

"Two cases don't make a series!" Jack asserted. He was dumbfounded by Laurie's suggestion of a serial killer.

"I think it is four cases, not two," Laurie said. "That's too many to be a coincidence."

While they helped themselves to the communal coffee, Laurie described her conversations with Kevin and George. As she spoke, she and Jack sat down in the two brown vinyl club chairs that Kevin and Arnold had been in earlier.

"What about toxicology?" Jack questioned. "If there turns out to be no pathology on gross or histologically, then the answer is going to come from toxicology, whether there was hanky-panky going on or even if there wasn't."

"George said he's still waiting on toxicology for his case. Obviously, for mine I've got a wait. Be that as it may, we're dealing with a curious set of circumstances here."

Jack and Laurie sipped from their respective cups, eyeing each other over the brims.

Both were aware of the other's current mindset in regard to Laurie's serial-killer theory.

Laurie's expression was challenging, while Jack's reflected his feeling that she was out in left field.

"If you want my opinion," Jack said finally, "I think you're letting your imagination run wild. Maybe you're upset because of our problems, and you're looking for a diversion."

Laurie felt a wave of irritation spread through her. It came from a combination of Jack's being patronizing on the one hand and his being correct on the other. She averted her gaze and took a breath. "What is it you wanted to talk about? I'm sure it wasn't our respective cases."

"Riva told me about your mother yesterday," Jack said. "I was tempted to call last night to ask you about her and extend my sympathies, but under the circumstances, I thought it better to talk in person."

"Thank you for your concern. She's doing fine."

"I'm glad," Jack said. "Is it appropriate if I send some flowers?"

"That's completely up to you."

"Then I will." Jack said. He paused, fidgeted, and then said hesitantly, "I don't know if I should bring this up about your mother ..."

Then don't,
Laurie said to herself. She was disappointed. She had allowed herself to be set up after all. She didn't want to talk about her mother.

"... but I'm sure you are aware there is a hereditary aspect to breast cancer."

"I am," Laurie said. She looked at Jack with exasperation, wondering where he was going with this conversation.

"I don't know if your mother has been tested for the markers indicating BRCA gene mutations, but the results would have significance concerning treatment. More important for you, it would have significance concerning prevention. One way or the other, I think you should definitely be tested. I mean, I don't want to alarm you, but it would be prudent."

"My mother is positive for a BRCA mutation," Laurie admitted.

Some of her anger, although not her disappointment, abated when she realized that Jack was being solicitous about her health and not just her mother's.

"That's an even greater reason for you to be tested," Jack said. "Have you thought about it?"

"I've thought about it," Laurie admitted. "But I'm not convinced it would have much significance and may just add to my anxiety. I'm not about to have my breasts and ovaries removed."

"Mastectomy and oophorectomy are not the only preventive measures available," Jack said. "Last night, I went on the Internet and read up on all this."

Laurie found herself almost smiling. She wondered if she and Jack had visited the same websites.

"More frequent mammograms is another option," Jack added. "Eventually, you might even consider tamoxifen treatment. But that's down the road. Anyway, the bottom line is that it just makes sense. I mean, if this predictive information is available, you should do it. In fact, I would like to ask you to do it. No, I take that back. I would like to plead with you to do it... for me."

To Laurie's surprise, Jack leaned forward and gripped her forearm with unexpected strength to emphasize his commitment to the cause.

"You're really convinced?" Laurie questioned, marveling at the "for me" part.

"Absolutely! No question!" Jack responded. "Even if the only effect is to make you more prone to have regular checkups. That would be an enormously positive effect.

Laurie, please!"

"Is it a blood test? I don't even know."

"Yes, it's a simple blood test. Do you have a primary-care physician over at the Manhattan General, where we are now obligated to go?"

"Not yet," Laurie admitted. "But I can call my old college chum, Sue Passero. She's on staff in internal medicine. I'm sure she could set me up."

"Perfect," Jack said. He rubbed his hands together. "Should I call to make sure you do it?"

Laurie laughed. "I'll do it."

"Today."

"All right, for goodness' sakes. I'll do it today."

"Thank you," Jack said. He released Laurie's arm that he'd been firmly clutching.

"Now that we've got that settled, I want to ask about whether we can compromise about your moving out of my apartment."

For a moment, Laurie was nonplussed. Just when she thought Jack wasn't going to bring up their relationship, he did.

"As I said," he continued, "I missed you last night. Worst of all, my basketball game was a disaster. The defenses I had carefully erected against your absence had been undermined by a pregame run-in with a pair of your pantyhose."

"What pantyhose?" Laurie asked, raising her guard again. She purposefully didn't laugh at Jack's reversion to witty sarcasm. For her, there was nothing funny about suggesting that Jack's prowess on the basketball court was a determining factor in her moving back to his apartment.

"A pair you left in the bathroom. But don't worry, they're safely ensconced in the bureau."

"What do you mean by 'compromise'?" Laurie asked dubiously.

Jack fidgeted in his chair. It was apparent that he was uncomfortable with the question. Laurie let him take all the time he wanted. Finally, he made a gesture of confusion by hunching his shoulders and extending his free hand, palm up. "We'll agree to make sure we discuss the issues on a regular basis."

Laurie's heart sank. "That's no compromise," she said with a voice that reflected her discouragement. "Jack, we both know what the issues are. At this point, more talk is not going to solve anything. I know that sounds contrary to what I've usually said about the importance of communication. The fact of the matter is that I've been compromising from the beginning, and particularly over the last year. I think I understand where you are coming from, and I'm sympathetic, which is what has kept me in a circumstance that has not been satisfying my needs. It's really as simple as that. I believe we love each other, but we're at a crossroads. I'm not twenty-five anymore. I need a family; I need commitment. To use one of your expressions, the ball is in your court. It's your decision.

Talk is superfluous at this point. I'm not going to try to convince you, which, at this stage, talk would begin to sound like. And one final point: I didn't leave in a moment of pique. It's been a long time coming."

For a few minutes, they merely stared at each other without moving. Finally, Laurie was the one who moved. She leaned forward and gave Jack's thigh a squeeze just above the knee. "This doesn't mean I don't want to talk in general," she said. "It doesn't mean we're not friends. It just means that unless we can truly compromise, I'll be better off staying at my apartment. And meanwhile, I'll get back to my diversion."

Laurie stood up, smiled down at Jack without rancor, and then walked back through the communications room en route to the elevator.

SEVEN

WITH A MIGHTY YAWN THAT brought tears to her eyes, Laurie put down her pencil, stretched, and then viewed her handiwork. She had created a matrix on a piece of graph paper that had the names of the four patients of her supposed series on the left-hand side of the page. Running along the top of the page and creating columns were all parameters of the cases that she thought might be important, including: the age of the patient, the sex of the patient, the type of surgery involved, the name of the surgeon, the anesthesiologist and anesthetic agent used, the sedative and pain medication employed, where in the hospital the patient was boarded, how the patient was discovered and by whom, the time the patient was discovered, who did the autopsy, any potentially relevant pathology, and the toxicology results.

Currently, Laurie had preliminary entries in all the boxes of her matrix, except for the names of the surgeons and anesthesiologists, the type of anesthetic and drugs used, the toxicology results on the two cases she had posted, and any possible relevant pathology on Darlene Morgan. To fill in the empty boxes, she needed the hospital charts and the continued cooperation of Peter and Maureen. In the toxicology boxes of the two cases posted by Kevin and George, Laurie had written: negative screen, further testing pending.

One piece of information that the matrix had already brought to her attention, which she thought important and mildly damning for her theory of a serial killer, was that the cases were not on the same ward. Two of the patients had been on the general surgical floor, while the other two had been on the orthopedic and neurosurgical floor. Since none of the patients had had neurosurgery and since one of the orthopedic cases had been on general surgery, Laurie had already called the Manhattan General admitting office for an explanation. The explanation turned out to be simple: Because the hospital operated at near capacity, beds frequently had to be allocated irrespective of the type of surgery.

From the moment Laurie had left Jack in the ID room, she had been a human dynamo in regard to investigating the four patients. Her motivation was twofold. There was the continued need for a diversion to keep from obsessing about her own problems, as Jack had surmised. That hadn't changed. What had changed was a strong desire to vindicate her intuitive belief that these cases did not represent a coincidence. Jack's blithe dismissal of the idea had been both belittling and galling.

First, she had gone up to histology to see Maureen, who'd been happy to present her with a tray of McGillan's HE-stained microscopic sections in less than twenty-four hours.

With the burden of processing eight thousand autopsies a year, overnight histology-slide service was unheard-of. Laurie had thanked her profusely for her efforts and had immediately taken the slides back to her office to study them painstakingly. As she had suspected, she found no pathology in general, and specifically, she found the heart entirely normal. There were no signs of active or healed inflammation of the cardiac muscle or the coronary vessels, and she saw no abnormalities of the valves or conduction system.

Next, she had gone down to the fourth-floor toxicology lab, where she'd run into a minor setback by bumping into John DeVries. Thanks to the bad blood between them and John's territoriality, he'd demanded to know what she was doing wandering around in his laboratory. Not wishing to get Peter in trouble with his boss, Laurie had to be creative. She happened to have been standing next to the mass spectrometer, so she said she had never completely understood mass spectrometry and was hoping to learn something about it. Mollified to a degree, John had provided her with some printed literature before excusing himself to go down to the serology lab.