Chapter 19

Sela stirred beside Jerome in the bed, startling him, and he glanced over his reading glasses at her.

She turned to him and slowly lifted her hand to lay it on his arm, the effort so great that it seemed to him as if it took forever. "It's very late," she murmured, her words slightly slurred by sleep and the strong painkiller she was taking.

He nodded, glancing at the digital clock beside the bed, then back at her. "Almost three."

She sighed, closing her eyes, and pushing down on the mattress with both hands, trying to sit up.

His first impulse was to help her, but the rule was that she would ask for help if she needed it. "I'm sorry I've disturbed you," he said.

"Don't be ridiculous, Jerome." Leaning back on a pile of pillows, she kept her eyes closed for a moment and breathed deeply.

He knew she did it as a way to cope with the waves of pain that now washed over her with every movement.

"You're not disturbing me. It's this damned cancer in my bones that's disturbing me!" When she opened her dark eyes, they danced with defiance.

He couldn't help but smile.

"So what are you doing up so late?" She shifted, trying to find a comfortable position. "It's not like you to bring work home like this."

Jerome stared at the records in his lap. "A very disturbing case. My patient I call Blue."

She reached up to straighten her head scarf that had slipped askew while she slept.

He disobeyed the rules and put out a hand to help her, covering her hand with his.

"I hate you seeing me bald as a baby," she said, sliding the scarf down over the smooth, dark skin that was just beginning to get fuzzy. Once chemo was discontinued, even dying patients apparently began to grow hair again.

"I don't know why. I told you you're lovely bald. You have such a perfectly shaped head." He ran his hand over it.

She pushed him away with as much playfulness as she could muster. "Tell me about your case."

"You know I shouldn't."

She settled against her pillows and closed her eyes, folding her thin hands on her hollowed belly. "Tell me anyway. What are they going to do? Take away my license to practice?"

"They could take away mine."

She smiled, eyes still closed. "I'll never speak of the matter to anyone. I'll take it to my grave. Now tell me. It'll give me something to think about."

"You're hurting?" he asked, reaching out to rub her thin arm.

"Tell me," she repeated.

He returned his gaze to the file on his lap, hating this feeling of helplessness. And now that feeling was extending to his work. What he had read in the records transferred from a psychiatrist's office in Texas had been so disconcerting that he had been unable to sleep. After lying awake for more than an hour after Sela had drifted off, thinking about the patient, he'd gotten up and retrieved the file from his briefcase.

"Tell me what you know about someone born intersex," he said quietly.

Sela opened her eyes, startled. "Your patient is intersex? You're kidding. You didn't tell me that before."

"I didn't know. The patient appears quite normal—good-looking, even."

"Fascinating," she breathed.

"Now, I know the basics, but you're better at remembering these obscure conditions, Sela. You always were. What do I need to know?"

"Let's see. There are three variations of intersex," she began to recite, as if from a text. Then she looked at him, excitement in her eyes. "You know, this is remarkable. There are probably only three hundred and fifty known cases in the United States right now."

"So you think I'm in over my head."

"Certainly not, Jerome." She patted his hand beside hers on the bed. "Let's see, there are three kinds of intersex." She went back to her recitation. "A true, a male pseudo, and a female pseudo. A female pseudo is born with XX chromosomes and normal female organs, but with masculinized genitalia. They can appear more male or more female or a combination. Then there is the male pseudo with XY chromosomes and testes that are usually in the abdomen rather than descended. The external genitalia is usually female, although it can be ambiguous."

"How do you remember all this?" he asked.

"I went to class more than you did, remember?" She smiled slyly and then went on. "The last and the rarest is the true intersex. This person is born with both ovary and testicular tissue. The genitalia can appear to be all male, all female, a combination of both or ambiguous in appearance. What are interesting are the chromosome combinations, if I recall correctly." Sela pressed her finger to her lips in thought. "You know, not more than a year ago there was an article on this in one of the psychiatric journals. The karyotype can be XX, which is female, of course, XY, which is male or XX/YY which is called..." She snapped her fingers, trying to remember. "This damned morphine, Jerome—this is why I hate taking it. It clouds my memory." Her face lit up. "Mosaic!"

"Ah, mosaic, that's right," he agreed, scribbling a note on a legal pad beside him on the bed. "My patient is a true intersex. I haven't found it yet, if it's noted, what the chromosome makeup is." He paused. "What's the history of treatment of these individuals?"

"We've not done well by these troubled souls, I can tell you that. For years, of course, we didn't know a person could appear to be one sex and be another genetically—we just made the assumption that they were what they appeared to be. And as for those with a combination of both types of genitalia, we simply cut off anything that didn't look right and called that child a female." Sela shook her head. "We're learning now that these are the most tragic cases of all. The gender identity confusion can take a tragic toll on the psyches of these individuals." She turned to him. "I'm almost afraid to ask, but how was your patient treated?"

He shook his head, pulling off his glasses to rub his tired eyes. "I don't have any medical records, just psychiatric, but this patient has been disturbed for a very long time, I suppose as a result of the gender confusion. Apparently the patient's parents did not agree with the medical practice of altering the genitalia to make their child male or female, so the patient was forced to live with the idea of being neither... both, I suppose."

"Actually, true intersexes can be. You need to go on the Internet tomorrow and see what you can find out about the most recent treatment of true intersexes. I believe that some doctors are now beginning to take the position of doing no surgery and allowing the individual to develop as God... or nature"—she chuckled—"depending on where you stand, has created him or her. These individuals are a third sex, a combination of both male and female inside, and now, sometimes, outside as well." She closed her eyes, her facial muscles tightening in a spasm of pain.

"I'm sorry, sweetheart." Jerome dropped the file on the floor beside the bed and rolled toward her, trying carefully not to jostle her. "I shouldn't be troubling you with this."

"Don't be ridiculous," she said in a small voice. "You give me a reason to continue to live a while longer, Jerome."

He picked up her left hand in his. She had had him tie a string to her wedding band so she could wear it without having it fall off in the bed. "I think it's time for more pain medication. It's been more than four hours."

"I know, but I hate it," she said in an almost child-like voice. "It knocks me out. It steals from me much of the time I still have left with you."

Her words brought a lump to his throat. "I know." He rubbed her hand between his. Her skin seemed so thin now, and blotchy. She'd always had the most beautiful, rich ebony skin. "But at least you're not in pain. And at night, I'm asleep anyway."

She sighed. "I suppose it is time."

He placed her hand on the bed and climbed out, going around to her side. They had brought a small end table in from the living room and it was stacked with her many medications. He turned on the bedside lamp and grabbed a syringe and a bottle of diamorphine. Glancing down at her, he filled the syringe. "I think you need to consider an IV pump for this. You'd be more comfortable with a steady flow of medication."

She shook her head slowly. "Not yet. You know how that works—once you take that step, quality of life is severely reduced. Patients on diamorphine drips just mostly sleep."

"Maybe with a lesser dose—"

"Jerome, just give me the damned shot and get in bed. If you don't get some sleep you'll be cranky tomorrow and Mrs. Elright will blame me."

He wanted to tell her that Mrs. Elright would never blame her for anything. She worshiped Sela. Instead, he opened an alcohol prep package and removed the little square of gauze. "Left or right?"

She slowly rolled over to present her bottom to him.

Jerome slid her silky lavender nightgown up over her hip, wiped a spot of skin with the alcohol prep, and gave her the injection. As he rubbed the injection spot with his fingers, he tried not to think about how painfully thin Sela had become. She was nothing but skin and bones. Even her buttocks, which had always been so full and muscular and feminine, had lost its tone. He felt tears sting the backs of his eyelids and he fought it. "There you go, my love."

"Thank you," she whispered, not moving.

He slid her nightgown down and the sheet up. He then disposed of tile prep pad and popped the syringe into the red plastic hazardous waste container he'd had to pick up at the medical supply store. "You sleep now," he whispered, shutting the light off and leaning over to kiss her cheek. "I love you, Sela."

"Love you, Jerome," she breathed.

He walked back to his side of the bed and stepped over Blue's files on the carpet. Climbing into bed, he shut off his light and lay back, consciously pushing all thoughts of his patient from his mind. Tomorrow he'd do as Sela suggested and go on the Internet. Perhaps he'd even look up some colleagues. He was very concerned about whether or not he could treat Blue, and even more concerned about what the patient might do if he couldn't.

* * *

"Hey, I thought you'd gone home." M.K. walked around the wall of Adam's cubicle, a white cardboard box filled with files and her notepads in her arms.

"Just going back over Professor Connelly's statement." He pushed back in his chair, tucking his hands behind his head. "He's a weirdo, I'll give him that."

She propped the corner of the box on his desk to relieve her arms of the weight for a minute. "But he's not our killer."

Adam shook his head, staring at the notes on his desk. "I don't think so."

M.K. nodded. "Dr. Wood call? I'd really like to see Tiffany's autopsy report. The real thing, not the preliminary. Something might stand out to us that she didn't realize was significant"

"I was just getting ready to give her a call. She's been working nights, even later than we have. Some kind of big inspection coming up. Apparently she has to provide procedure manuals that haven't been written yet, plus the morgue has to be perfectly up to code, hacksaws and liver scoops in the right drawers, and so on."

"You want me to wait for you? We could grab something to eat. I'm just going home to go through some of these statements again. The interviews with the students' friends."

Adam wanted to say yes, but he knew he shouldn't. Couldn't. Not tonight. "Thanks, but I think I'll stick around here. Crackhow's on me to get those notes to him on the dock wiretaps. I should listen to a couple of them again."

She gave the box a heave, lifting it into her arms again. "Guess I'll see you Monday, then."

He thought she seemed disappointed and he felt bad. He didn't want to hurt her, but he was sure the best way to prevent that was not getting too close. He'd already hurt enough people.

When Adam heard M.K. step into the elevator, he picked up the phone and dialed Valerie Wood's office. She answered the phone on the second ring.

"Friday night, seven o'clock, and you're answering your phone yourself," he said, pushing back in his chair again and propping his feet on his desk.

"Adam."

He grinned. "How'd you know it was me?"

"Because you're the only smart-ass I know who is also working at seven o'clock on a Friday night. Besides, we've got caller ID."

He laughed with her. "Listen, I was calling—"

"I know, I know," she interrupted. "The autopsy reports. I'm sorry, Adam. I feel like I'm drowning in paperwork down here, and I've got this inspection coming and the county swears they're going to find a clerk for me, but right now it's just me and my deputy coroner and his wife's getting ready to have a baby and—"

"All right, all right. I get the picture." Adam chuckled. "A public servant's work is never done. I still can't believe you're not out on a Friday night. Don't you have a guy who wants to take you out, wine and dine you?"

She chuckled, her voice husky. "I wish. I can't remember the last time I went on a real date."

He chuckled, too. "I hear you."

"But actually, I'm starved," she went on. "I could definitely use a little dine, if not the wine. You want to get a bite to eat? I hate eating alone in restaurants, and I don't think any of my friends here in the cold-storage drawers are going to go with me."

Adam smiled at her sick sense of humor. He supposed you had to be that way to do what she did. "Sure," he heard himself say before he even thought about it. "I can meet you. I have to run by my ex's house in Ashview for a second, but then I'm free. Want me to come to Annapolis?"

"I could meet you in Ashview. There's this great little pub that has the best—"

"Grilled chicken sandwiches," he interrupted. "I know the place. College Park. I go there all the time."

"Great. Eight-thirty?" she said. "That will give me enough time to wrap something up here."

"Eight-thirty. See you then, Val."

* * *

Adam left the Baltimore office and, despite Friday evening traffic, was at Sophie and Mark's by seven-forty-five. On the ride over, he decided he wouldn't let himself feel guilty about not going out to eat with M.K. and then agreeing to meet Valerie Wood. Two entirely different situations, he told himself. Right now with M.K., he felt as if he were walking a tightrope. There was no denying the chemistry between them, and the fewer opportunities he gave himself, the better chance he had of not ending up in bed with her. Valerie was safe. While he liked her and certainly found her attractive, the tall, beautiful blonde just didn't hold a candle to M.K.'s more petite, subtle femininity. The coroner just didn't light his fire the way his partner did.

Walking up the sidewalk, Adam took note that the lawn needed mowing one last time before winter. It wasn't like Mark to let something like that go. He was always so fastidious about this lawn. The first thing he'd done after he moved in with Sophie was reseed the whole thing. Apparently he hadn't cared for the Kentucky fescue Adam had planted. He was fond enough of Adam's wife and child, though. Whatever.

At the door, Adam didn't knock, he just walked in. He found Sophie in the kitchen in fuzzy slippers, her ponytail to him, stirring a pot of spaghetti sauce that smelled great. "Hey, fatty," he called, walking up behind her to put one arm around her and give her a peck on the cheek.

"Hey." She turned to him, smiling.

He frowned and reached out to brush her temple. The area around her eye was a deep purple, beginning to turn green around the edges. "What happened to you?"

"Oh, that?" She laughed and turned away. "I'm getting so clumsy with this belly of mine. I swear there have to be two or three babies in here, but Dr. Ritter says it's just one."

He watched her as she went to the refrigerator and began to pull out vegetables for salad. "So you fell?"

"Ran into the corner cabinet" Without looking at him, she pointed to the end cabinet near the laundry room.

"Ouch."

"Yeah." She carried the vegetables to the counter.

"Well, I just came by to drop off the check. Sorry it's late."

She waved a cucumber in his direction. "You always pay, Adam. Who cares what day you give me the check so long as you give it to me and Liza Jane's tuition, room, and board get paid."

He laid the check on the small counter near the refrigerator that served as a desk. "You okay?" he asked, not entirely sure he believed she'd run into a cabinet. It looked to him like someone had punched her.

"Sure." She was peeling the cucumber. "Why wouldn't I be?"

"I don't know. You look tired."

"I'm forty-three and eight months pregnant Adam." She began slicing the cucumber into a large wooden salad bowl. "I am tired."

He stood there for a minute. "Okay. Well, you ought to take it easy. Mark here?"

She turned to him, a smile lighting up her face. "He's been sticking close to home for days. Just work and home. He's out in the backyard with Savannah. She wanted to show him how well she could swing all by herself now."

He crossed the kitchen toward the French doors that led out onto the deck. "Little dark and chilly for swinging in November at eight at night, isn't it?"

She rolled her eyes. "We have coats and lights here. She wanted to show her daddy."

Adam walked out onto the deck and closed the glass door behind him. In the shadows beyond the lamplight coming from two sconces he'd wired on either side of the doors himself, he spotted a hunched figure in a dark jacket sitting on the steps. Across the yard, illuminated by a large security lamp, Savannah sailed on a swing.

"Adam!" she shouted excitedly. "Liza Jane come?"

"'Fraid not," he called. "Sorry. Just me." He walked over to the step and sat down beside Mark, who didn't look at him. "Hey, buddy, how's it goin'?"

"Goin'," he answered flatly.

Adam nodded, watching Savannah swing higher and higher for a moment.

"Look at me, Daddy," she squealed with delight. "Look, I fly!"

Mark raised one hand. "I see you."

"How was your week?" Adam asked.

"Fine."

Adam reached down and buttoned up his jean jacket. It was chilly tonight. Winter was definitely on its way. It smelled like rain. "I saw Sophie inside. Brought the support check. She looks beat"

"She works too hard." Mark's tone remained without emotion. "She's doing inventory at the store."

Adam turned the ball of his foot back and forth on the step. "Saw her eye. Pretty nasty."

"She's gotten clumsy with this pregnancy. I tell her she needs to slow down."

Adam hesitated. He hated to voice what he was thinking, but he'd hate himself even more if he didn't ask, and there was something to his concern. "So that's what happened? She ran into the cabinet?"

Mark turned to look at him. "What are you asking me, Adam? Did I hit my wife?" he growled.

Adam glanced out over the dark yard. He'd always loved this yard. Once upon a time, he'd sat here on these steps and watched Liza Jane swing. "Did you?"

"I can't believe you would ask me such a tiling."

Mark's bitterness was plain in his voice, and the bitterness wasn't about Sophie or her eye. It was about what had happened. About Laura. About how Adam had failed her. Failed Mark. Mark. He'd never been able to forgive Adam. Not any more than Adam could forgive himself.

"Of course I didn't hit her."

"Sorry, buddy." Adam rested his hand on Mark's shoulder for an instant. "I know you're having a rough time." He sighed, wishing now he hadn't asked. Of course Mark hadn't hit Sophie. He would never do such a thing.

Mark was watching Savannah again, or maybe he was just staring out into the dark.

"So how have you been doing? I mean it, man." Adam rubbed his hands together to warm them up. "I've been worried about you. You get some help like we talked about? A lot of people do. It's nothing to be ashamed of. Hey, if a guy like me—"

"I'm getting some help." He stood up abruptly. "Savannah, dinner." He walked up the steps, across the deck, and into the house.

Savannah leaped off the swing in midair and raced toward Adam, all bundled up in a pink coat and hand-knit gloves. In the dark like this, she looked so much like Liza Jane had at this age that it was eerie. What was really eerie was that they weren't even related by blood.

"You stayin' for dinner?" Savannah demanded. "We're havin ' pasghetti."

He put out his hand, catching her smaller one. "Can't." They crossed the deck and he opened the door for her.

"Mama, Adam says he can't stay for dinner. I told him we was having pasghetti."

"We were having spaghetti," Sophie corrected. "Hang up your coat and wash your hands." She looked to Adam. "You sure you don't want to stay? There's plenty."

"Can't."

She set the salad bowl on the table. "Date?"

"Sort of." Adam halted in the doorway to the front hall. "Where'd Mark go? I should take off."

"Bathroom, I guess." She gave him a quick smile, opening the refrigerator to get something. "I'll tell him you said good-bye."

Adam took one more look at her black eye, but he didn't say anything. "Okay. Catch you later." He followed the sidewalk out to his Jeep, ignoring the too-tall grass that he sometimes wished still belonged to him.