CARRIE STOOD BEHIND HER DESK AND RAMMED HER ARMS INTO the sleeves of a fresh white coat. Why did the laundry think so much starch was needed for a professional look? Sometimes she thought the deliveryman should just stand her coats in a corner of her office instead of hanging them in her closet.
Carrie was trying to open the side pocket to admit her stethoscope when her nurse, Lila, stuck her head in the office door.
“And a very happy Monday to us all.” Lila was a middle-aged divorcee, a bottle blonde, who still acted as if she were in her twenties. Today she looked as though she’d bitten the lime, only to reach for the tequila and find someone had hidden it.
“Party a bit too much over the weekend?” Carrie asked.
“Nope, didn’t party enough. I had at least another day’s worth of fun planned, but I turned around and it was time to start another week.” Lila eased into a chair, crossed her legs, and looked up at Carrie, who now struggled to button her white coat. “How about you?”
There were two ways to get news spread throughout the twelve-doctor, multispecialty clinic where Carrie worked: put a notice on the bulletin board or tell Lila. Carrie chose not to go either route. “Pretty routine.” She checked her pockets, lifted her gaze to Lila, and smiled. “Let’s get on with it.”
Lila stood and gave a mock cheer. “Once more the Rushton Clinic moves into high gear.”
The clinic’s official name was Jameson Medical Associates, but everyone called it the Rushton Clinic after Dr. Phil Rushton, the managing partner. He’d put together the group of physicians, helped work out a system for dividing profits and sharing expenses, made the administrative decisions most doctors were happy to avoid, and still found time to be the foremost cardiac surgeon in the region.
Carrie was one of two internal medicine specialists in the group. Her training was as good or better than that of the other internist, Thad Avery, and their practice sizes were about equal. She had no quarrel with the arrangement except for occasions when Phil Rushton’s actions made her grit her teeth. She was ready to see her first patient when a secretary hurried up. “The Emergency Room called. Mr. Berringer was brought in earlier by ambulance. Heart problems. The ER doc wants to know if you’d like to see him.”
Lila, now quite professional, said, “I’ll let patients know you’ve had an emergency. They can wait or we’ll reschedule. Go ahead.”
Carrie walked through the breezeway that connected the clinic with the hospital, then made her way to the ER. The charge nurse handed her a chart and pointed to a curtained cubicle.
Carrie flipped through the pages, noting the history of weakness, blurred vision, and a sense of palpitations, culminating in a fainting spell. The ER doctor had already ordered blood work, and the report was on the chart. Carrie scanned the figures, stopping when her eyes lit on the potassium level: 2.6 mEq/ml—definitely a contributory factor, and something that should be corrected as quickly as possible.
She pulled aside the curtains and took in the scene. “Mr. Berringer, what’s going on?”
The older man, pale and sweating, turned his head slightly toward her. The oxygen mask on his face added a hollow timbre to his voice. “I wish I knew, Doctor.” He opened his lips to say more, but instead closed his eyes, apparently spent by the effort.
Carrie turned to Berringer’s wife, who stood beside the gurney, alternately blotting beads of perspiration from her husband’s forehead and stroking his hand. “Mrs. Berringer, is your husband taking any medications other than the ones you told the emergency room doctor about?”
“Dr. Markham, they’re all medicines you prescribed. Don’t you have the list there?”
Carrie smiled at her and said gently, “Let’s pretend I don’t.”
The woman frowned. “You know about the heart pills and the cholesterol medicine. And, of course, there are those little tiny pink pills, but I don’t think they count. They’re just water pills of some kind.”
Carrie tried not to grind her teeth. “Do those little pink pills have a long name that’s shortened to some letters?”
“Oh, yes.” The woman’s face brightened. “I remember. HCZT or HTCZ or something like that.”
Hydrochlorothiazide, or HCTZ, was a diuretic given to patients with high blood pressure, but it also could deplete potassium levels in the body. And when this occurred in patients who’d taken an overdose of digitalis, the combination had the potential to be lethal.
Soon Carrie was able to put together the story. Henry Berringer refused to be “one of those people who use little pillboxes” to tell him if he’d taken his medicine on that particular day, choosing instead to rely on his memory. Apparently, for the past several days he’d taken his pills two or three times a day. The resulting digitalis overdose at first manifested itself as nausea and lack of appetite. He complained of seeing a yellow halo around lights, something he blamed on his early cataracts. But when he fainted in the living room, his wife called 911. His pulse was fifty and irregular when the paramedics arrived.
“You’ve taken too much of some of your medicine,” Carrie said to Mr. Berringer. “We need to make sure that doesn’t happen again. In the meantime we’re going to do some things to reverse the effects of that overdose.”
Mrs. Berringer looked so relieved that Carrie thought she might burst into tears. “Thank you, Doctor,” she mouthed as Carried slipped through the curtains with a promise to be back as soon as she could.
Carrie spent the next several hours shuttling between the clinic and the ER. Finally, thanks to atropine, Digibind, and intravenous potassium, Mr. Berringer’s heart rate and rhythm were approaching normal levels. Carrie thought it would be best to watch him for a bit longer, and since he had a disturbance of cardiac rhythm and might have sustained heart muscle damage, there was no problem getting approval for his admission to the hospital’s medicine floor. If serial EKGs and cardiac enzymes showed no further problems, she’d let him go home—but with a lecture about his need to become “one of those people who uses pillboxes.” That was far better than becoming “one of those people who didn’t take their medicine properly and died as a result.”
Carrie was walking through the ER on her way back to her office when paramedic Rob Cole stopped her. “Dr. Markham, what’s the latest on the man we brought in with the digitalis toxicity?”
“He’s out of the woods,” Carrie responded. “Good pickup on the diagnosis, by the way. He’d also taken too much HCTZ, so his potassium was in the cellar.”
“Ouch. I noticed the atropine we gave him in the ambulance wasn’t enough to get him straightened out. Glad he’s doing better now.”
“Thank you for asking.”
Carrie turned away and had taken a step when Rob said, “Dr. Markham?”
She stopped and looked back at him. “Yes?”
He frowned and looked away. “Never mind. I’ll ask another time.”
As she traversed the enclosed breezeway that connected Centennial Hospital with the building that housed the Rushton Clinic, Carrie wondered what else Rob wanted to say. It seemed to her that, more and more, Rob went out of his way to run into her, sometimes in the ER when he and his partner dropped off a patient, occasionally in the cafeteria, once or twice in the halls.
It was flattering that he seemed to want to be around her. Rob was a little younger than Carrie, possessed of good looks that had all the nurses talking—wavy black hair, deep brown eyes, sparkling white teeth. There was no question he was what some of the staff would call “a hunk.”
Get a grip, she told herself. Stop wondering if Rob is coming on to you. This isn’t junior high. She looked at her bare finger and wondered if she’d acted hastily in giving back Adam’s ring. Until thirty-six hours ago, Carrie was sure she was in love with Adam Davidson. But what about this new Adam? And what about their future? With the old Adam, it seemed certain and secure. Now it was uncertain and dangerous.
It was obvious that Mrs. Berringer loved her husband. She was right beside him in the ER, putting into practice her vow to love him in sickness and in health. Carrie had been ready to make that vow and more to Adam, but now was she really prepared to be with him “for better or for worse”? Especially if “worse” meant running from someone trying to take his life . . . and hers along with it? That was the question she had to answer. She was hurt at his deception, but it ate at her that if she really loved him, she wouldn’t be running away when Adam needed her.
Carrie leaned against the wooden handrail that ran the length of the breezeway, pulled out her cell phone, then paused with her finger over the keys. She closed her eyes for a moment and tried to prepare for the call she was about to make. She at least needed to listen to his whole story. She’d set up another meeting with him. After that? She’d wait and see.
As hesitant as a child climbing onto a jungle gym for the first time, she pushed the speed-dial button.
When Adam felt the buzz of his cell phone in his pocket, he experienced the epitome of “mixed emotions.” The display showed that the call came from Carrie—and she’d be calling for one of two reasons: to give him a chance to explain, or tell him to get out of her life and stay out.
“I’m glad you called,” he said, hoping that her next words wouldn’t make him a liar.
“Adam, I don’t have long to talk. We need to finish our last conversation. But I want to meet somewhere safe. I don’t want to be a target again.”
Adam ran through the choices. He figured his apartment was out. If the gunman had found his car, he’d no doubt located where Adam lived as well. And there was no way he would lead a potential killer to Carrie’s home. “How about the law firm where I work? Everyone is out of there by five—five thirty at the latest unless something unusual is going on.”
“Is it safe?”
“I’m not sure any place is safe anymore, but this seems the best option. I’ll leave the building with everyone else and drive around a bit to lose anyone who might be following me. Then I’ll park a block away and come in the back door.”
“So what do I do?”
Adam thought for a bit. “Hopefully the shooter doesn’t know your car. The lot’s well lit. Park right by the entrance and call me on my cell as soon as you get there. Hurry inside, and I’ll double lock the doors behind you.”
Carrie hesitated. If she said no to that idea, he wasn’t sure what he’d do next. But finally he heard the rush of a long exhalation. “Fine. I’ll be there as soon after six as I can make it.”
“Thanks,” Adam said. “I appreciate—” He stopped talking when he heard a click. Carrie had already ended the call. He stared at the dead phone, his heart sinking. He prayed their relationship wasn’t broken beyond repair.
Outside the clinic exam room, Carrie scanned the information on her next patient. George Harris, age sixty-two, complaining of swollen feet and ankles. A number of diagnostic possibilities ran through her head, disorders like “congestive heart failure” and “deep vein thrombosis.” That was what she liked about her internal medicine practice. Every day there were new challenges. Well, time to tackle this one.
She tapped on the door and stepped inside. The older man perched on the edge of the exam table had silver hair combed straight back. Blue eyes twinkled behind steel-rimmed glasses. He was already wearing an exam gown—Lila had seen to that—but he wore it with the same dignity as though it were a white tie and tails.
“Mr. Harris, I’m Dr. Markham. How can we help you today?”
“Frankly, I think I’m fine. But my daughter seems to have a different idea.”
There was a distinct British accent there. Carrie checked the address on the man’s papers and confirmed that he was local. Then the younger woman sitting in the corner spoke up and solved the mystery. “My father-in-law recently came to the United States to live with us. He says nothing is wrong, but we don’t believe it’s normal that his feet and ankles are so swollen.”
Carrie eased onto the rolling stool, positioned it midway between patient and daughter, and looked first to one and then the other. “Suppose we get a little more history. Mr. Harris, when did you first notice this?”
As the story unfolded, Carrie mentally laid aside several possible diagnoses until only one stood as the prime suspect. Mr. Harris worked in Great Britain for years in an electronics manufacturing plant. His job had been to solder and weld various components, and although provisions were made to avoid inhalation of the fumes from his work, he and many of his fellow workers had hated the respirators, disliked the noise of the exhaust fans, so they plied their trade without them at every opportunity. And as a result, he now presented to Carrie with the consequences of decades of inhaling cadmium-laced fumes: facial puffiness, swollen ankles and feet, protruding belly. Why? Because his kidneys were failing, causing the loss of a protein called albumin from the body, with resultant accumulation of tissue fluid in these areas.
“We’re going to start by checking some lab work,” Carrie said when she’d finished her exam. “Lila will help you with that. I’d like to see you back again tomorrow, when we can go over the results and talk about treatment.”
Carrie had just finished dictating her note when Lila appeared in the doorway of the cubicle. “Urinalysis and metabolic profile are cooking, but you don’t seem to have any doubt about the diagnosis.”
“No, I’m sure we’re dealing with nephrotic syndrome. That poor family is about to have its life turned upside down.” Special diet, medications to control blood pressure, regular trips to the dialysis lab. Carrie closed her eyes and balled her fists. God, why do You let these things happen?
Then again, why was God letting Adam break her heart? And why did God let good men like John die because a seemingly simple medical procedure went horribly wrong? As she headed for the next exam room, it was all Carrie could do to focus on the patient inside. She worked to put aside her situation with Adam. She struggled to stop thinking about the way her husband’s life had ended . . . and the role she played in that terrible event. Carrie thought she might pause and pray for help and guidance but quickly dismissed the idea. That avenue had been closed for quite a while.
As Carrie pulled into the law office parking lot, her heart thudded against her chest wall. It wasn’t only the potential danger that pushed her adrenaline level sky-high. It was the very real possibility that tonight Adam might tell her something that would fracture their relationship forever. She loved him—that was clear to her. But how much could that love withstand?
She was about to find out.
The law offices occupied a small, two-story building. Adam had told her that the bottom floor contained offices, the upper story a conference room and law library. She punched his speed-dial number on her phone.
“Carrie?”
“I’m here.”
“I’m unlocking the door now,” Adam said.
She hurried the few steps from her car to the front entrance where Adam waited. They stepped into a reception area where a low-wattage light burned. The burgundy carpet was soft under her feet. Tasteful drapes of burgundy and tan framed the windows. Several upholstered chairs were situated along the walls. A cherry wood desk and chair faced outward from one corner, and behind it two lateral file cabinets of the same material flanked a door that probably led into a business office.
Adam pointed. “My office is back there.”
Carrie walked down a hall lit dimly by security lights. In Adam’s office, he flipped the light switch and gestured her to one of the two chairs across from his desk. He took the other and turned it sideways to face her. Adam seemed to have aged overnight. His face was haggard and his eyes were red-rimmed, accented by dark circles beneath them. Carrie almost felt sorry for him—almost. She recalled the love she’d felt for him—still felt. She wondered what her emotions would be after she learned more of his story.
Carrie nodded at Adam, as though to say, “It’s your turn.”
“Okay. Let’s hear the rest of it.”
Adam leaned toward her and she saw him struggle to keep his voice calm. Though they were alone in the building, he spoke in a quiet voice. “Thank you,” he said. “For meeting me . . . for giving me another chance.”
Carrie shook her head. “I should at least hear the whole story. I owe you that much.”
He moved as if to reach for her hand, then pulled back and let his own hands rest on the arms of his chair. “As I told you, I started life as Keith Branson. I went to law school at John Marshall in Chicago. While I was in school, I met a woman who worked in her father’s law office. She seemed perfect, and I fell hard for her. After a relatively short engagement, Bella and I were married. When I graduated, her father, Charlie DeLuca, took me into his practice.”
Carrie nodded but said nothing. She didn’t want to stop the flow of his narrative.
Adam went on to tell about an idyllic first year of marriage. But soon he discovered his father-in-law’s practice had a shady side. Charlie not only defended some of the biggest criminals in Chicago, he played a key role in laundering huge sums of money, was a cut-out in several narcotics rings, and acted as an advisor, if not a partner, for a group that controlled most of the prostitution in that part of the state.
Beads of sweat dotted Adam’s brow. “I finally told Bella what I’d found out about her father’s law practice—that it was part of a criminal enterprise—and that I wanted no part in it. She laughed and said, in effect, ‘The money’s good. Keep your mouth shut.’”
“But you didn’t,” Carrie said.
“I couldn’t. I tried, but it was harder with each day that passed. Sometimes the arguments lasted well into the night. Then Bella told me she was pregnant.”
Despite herself, Carrie caught her breath. Did Adam have a child?
“I was overjoyed,” Adam continued. “But Bella didn’t share my feelings. She wasn’t ready for motherhood. She told me she was going to visit a friend. She came back in a week and told me she’d lost the baby. It wasn’t long before I found out that actually she’d had an abortion. That was the last straw for me.”
“What did you do?”
Adam squeezed his eyes shut for a moment, as if he could drive away the images that plagued him. “I put together a detailed file to be used against my father-in-law and his associates. When I had everything ready, I contacted the District Attorney and said I was prepared to testify before a Grand Jury and at any resulting trial. In return, I wanted protection.”
“Obviously, they said yes.”
Adam nodded. “I told my wife and father-in-law that I needed some time away, packed a suitcase, and left. The next time I saw them was at his trial.”
The DA assured Adam that the U.S. Marshalls Service would keep him safe until after the trial. He was ferried back to Chicago from Milwaukee to testify before the Grand Jury. After that, the marshalls moved him from city to city, always under a new name, until finally he came back to Chicago to testify at his father-in-law’s trial. The process had been a slow one—two years, in fact. And as each day passed, Adam wondered if he’d made the right choice.
“What about your wife?” Carrie asked.
“Once she learned what I had done, she filed for no-fault divorce—in Illinois it’s called ‘irreconcilable differences.’ My absence sped up the process. Before I returned for her father’s trial, the divorce was final.”
“And your father-in-law?”
“The jury convicted him of a whole laundry list of crimes. He ended up with a total sentence of thirty years. He should have gotten even more.”
“So you’re safe now. Why not resume your true identity? Why not go back to Chicago?”
Adam laughed without mirth. “My life wouldn’t be worth ten cents. Charlie DeLuca was part of a big organization, not to mention his family members and people who owed him favors. As soon as his sentence was handed down, I’m certain the word went out to kill me.”
Carrie thought about this. “What brought you here to Jameson eight months ago, then?”
“After the trial one of the places the Witness Security Program—it’s usually shortened to WITSEC—had me working in was an office supply store in a small town in Iowa. One day a guy showed up with my picture, asking if anyone at work knew me. Apparently no one cared for the guy’s attitude, so they told him they had no idea what he was talking about. But the more I thought about it, the more convinced I was that my new identity wasn’t all that secret. After all, WITSEC has a lot of moving parts, and all Charlie DeLuca’s family, or hired gun, or whoever had to do was spread around enough money and they’d find me. It was time to find somewhere else, but this time, on my own.”
“So the program didn’t move you here?”
“No, I moved myself. No one knows where I am now . . . or, at least, I thought that was true. But if that shooting Saturday night wasn’t random, someone’s found me, and until I know for sure, I don’t want to talk with the police.”
“Why?”
“When I was working in Charlie DeLuca’s office, I learned he had contacts with cops on the take in police departments from California to New York. There’s no reason to think that doesn’t include Texas.”
Carrie was shaking her head before he stopped talking. “Why didn’t you choose a large town, like Dallas? Surely it would be easier to get lost there.”
“It is, but it’s also more likely that organized crime has a bigger presence in a large city than in someplace like Jameson. I’m close enough to Dallas to enjoy the benefits, but a smaller place like Jameson seemed a lot safer.”
“So you haven’t told anyone where you are?”
“Just one man. He’s a marshall, but this move is totally off the books. Besides, I’d trust Dave with my life.”
Carrie frowned. “Why?”
“He’s my older brother. He’s David Branson, Jr.”
Carrie thought about the story she’d heard. It revealed an Adam who had the moral fiber to do the right thing, even if it meant losing his identity, his family . . . and perhaps his life. True, he should have told her the story before asking her to marry him, but she could see by the pain in his eyes as he told the story how much it cost him to reveal it now. This wasn’t the Adam she thought she knew, but what she’d heard did nothing to erase her love for him.
Carrie was ready to say something to Adam when the crash of breaking glass made them both bolt from their chairs and hurry toward the front of the building. A large hole ringed with shards was all that remained of the plate glass window in the reception area. Smaller pieces of glass littered the carpet like diamonds. The drapes, one area of carpet, and two of the upholstered chairs in the room were on fire, sending tongues of flame licking outward, threatening a larger blaze. Wisps of acrid black smoke stung Carrie’s eyes and seared her lungs.
“Are you okay?” Adam yelled.
Carrie stifled her coughing long enough to say, “Just fighting the smoke. Is there a fire extinguisher here?”
“It’s in the hall,” Adam said. “I’ll get it. Call the fire department.”
As Carrie dialed 911, her first thought was for their safety. But her second was that despite Adam’s insistence on not being involved with the police, now he’d have to be. She wondered how he’d handle their questions—and where it might go from there.