Thirteen

Cassi had hoped that she’d become accustomed to the opthalmologist’s light, but each time Obermeyer examined her was as uncomfortable as the last. It had been five days since her surgery, and except for the insulin reaction, the postoperative course had been smooth and uneventful. Dr. Obermeyer had come by each day to peer into her eye for a moment, always saying that things were looking good. Now on the day of her scheduled discharge, Cassi had been escorted over to Dr. Obermeyer’s office for one last “good” look, as he called it.

To her relief, he finally moved the light away.

“Well, Cassi, that troublesome vessel is in good shape, and there’s no rebleeding. But I don’t have to tell you that. Your vision has improved dramatically in that eye. I want to follow you with fluorescein studies and at some point in the future you may need laser treatments, but you’re definitely out of the woods.”

Cassi was not certain what laser treatments involved, but it didn’t dampen her enthusiasm for getting out of the hospital. Convinced that her fear of Thomas had been imaginary and that a good deal of their problems were at least partially her own fault, she was anxious to get home and try to put her marriage back on course.

Although Cassi was entirely capable of walking, the green-smocked volunteer who came to escort her back to her room in the Scherington Building insisted that she ride in a wheelchair. Cassi felt silly. The volunteer was almost seventy and had a disturbing wheeze, but she wouldn’t give in, and Cassi had to allow the woman to push her back to the room.

After she was packed, Cassi sat by her bed and waited for her formal discharge. Thomas had canceled his office hours and was going to drive her home around one-thirty or two. Since she had been admitted, his loving attention had not faltered. Somehow he’d managed to find time to visit four or five times a day, often eating dinner in the room along with Cassi’s roommates, whom Thomas had charmed. He’d also completed plans for their vacation, and now with Dr. Obermeyer’s blessings they were to leave in a week and a half.

The thought of the vacation alone was enough to make Cassi feel enormously happy. Except for their honeymoon in Europe, during which Thomas had taken time out to operate and lecture in Germany, they’d never been away together for more than a couple of days. Cassi was anticipating the trip like a five-year-old waiting for Christmas.

Even Dr. Ballantine had visited Cassi during her hospital stay. Her insulin overdose seemed to have particularly unnerved him, and Cassi wondered if he felt responsible because of their talks. When she tried to bring up the subject, he refused to discuss it.

But what really made the rest of the hospitalization so pleasant was Thomas. He had been so relaxed the last five days, Cassi had even been able to talk to him about Robert. She had asked Thomas if she really had met him in Robert’s room the night Robert died or if she’d dreamt it. Thomas laughed and said that he indeed did find her there the night before her surgery. She had been heavily sedated and hadn’t seemed to know what she was doing.

Cassi had been relieved to know she had not hallucinated all the events that night, and although she still questioned certain vague memories, she was willing to ascribe them to her imagination. Especially after Joan made Cassi comprehend the power of her own subconscious.

“Okay,” said Miss Stevens, bustling into the room to see if Cassi was ready. “Here are your medicines. These drops are for daytime use. And this ointment is for bedtime. I also tossed in a handful of eye patches. Any questions?”

“No,” said Cassi, standing up.

Since it was a little after eleven, Cassi carried her suitcase down to the foyer and left it with the people at the information booth. Knowing that Thomas would be busy for at least another two hours, Cassi took the elevator back up to pathology. One of the vague memories she’d not wished to discuss with Thomas concerned the SSD data. She could remember something about the data, but it wasn’t clear, and the last thing she wanted to do was suggest to Thomas she was still interested in the study.

Reaching the ninth floor, Cassi went directly to Robert’s office. Only it was no longer Robert’s. There was a new name plate in the stainless steel holder on the door. It said Dr. Percey Frazer. Cassi knocked. She heard someone yell to come in.

The room was in sharp contrast to the way Robert had kept it. There were piles of books, medical journals, and microscopic slides everywhere she looked. The floor was littered with crumpled sheets of paper. Dr. Frazer matched the room. He had unkempt frizzed hair that merged into a beard without any line of demarcation.

“Can I help you?” he asked, noting Cassi’s surprised reaction to the mess. His voice was neither friendly nor unfriendly.

“I was a friend of Robert Seibert,” said Cassi.

“Ah, yes,” said Dr. Frazer, rocking back in his chair and putting his hands behind his head. “What a tragedy.”

“Do you happen to know anything about his papers?” asked Cassi. “We’d been working on a project together. I was hoping to get hold of the material.”

“I haven’t the slightest idea. When I was offered this office, it had been completely cleaned out. I’d advise you to talk to the chief of the department, Dr. . . .”

“I know the chief,” interrupted Cassi. “I used to be a resident here myself.”

“Sorry I can’t help you,” said Dr. Frazer, tipping forward again in his chair and going back to his work.

Cassi turned to go, but then thought of something else. “Do you know what the autopsy on Robert showed?”

“I heard that the fellow had severe valvular heart disease.”

“What about the cause of death?”

“That I don’t know. They’re waiting on the brain. Maybe they haven’t finished.”

“Do you know if he was cyanotic?”

“I think so. But I’m not the one to be asking. I’m new around here. Why don’t you talk to the chief?”

“You’re right. Thanks for your time.”

Dr. Frazer waved as Cassi left the office, closing the door silently behind her. She went to look for the chief but he was out of town at a meeting. Sadly Cassi decided to sit in Thomas’s waiting room until he was ready to go. Seeing Robert’s old office already occupied had brought his death back to her with unpleasant finality. Having been forced to miss the funeral, Cassi sometimes had trouble remembering her friend was gone. Now she wouldn’t have that problem anymore.

When Cassi reached Thomas’s office she found the door locked. Checking her watch, she realized why. It was just after twelve and Doris was on her lunch break. Cassi got security to open the door to the waiting room and settled herself on the rose sofa.

She tried flipping through the collection of outdated New Yorker magazines, but she couldn’t concentrate. Looking around, she noticed that the door to Thomas’s office was ajar. The one thing Cassi had been effectively denying for the past week was Thomas’s drug taking. With the change in his behavior, she wanted to believe that he’d stopped. But when she was sitting in his office, curiosity got the better of her. She got up, walked past Doris’s desk, and entered the inner office.

It was one of the few times she’d been there. She glanced at the photos of Thomas and other nationally known cardiac surgeons that were arranged on bookshelves. She couldn’t help noticing that there were no pictures of herself. There was one of Patricia, but that was with Thomas Sr. and Thomas himself when he was in college.

Nervously, Cassi seated herself behind the desk. Almost automatically her hand went to the second drawer on the right, the same one where she’d found the drugs at home. As she pulled it out, she felt like a traitor. Thomas had been behaving so wonderfully the last week. Yet there they were: a miniature pharmacy of Percodan, Demerol, Valium, morphine, Talwin, and Dexedrine. Just beyond the plastic vials was a stack of mail-order forms for an out-of-state drug firm. Cassi bent over to look more closely. The firm’s name was Generic Drugs. The prescribing doctor was an Allan Baxter, M.D., the same name that had been on the vials she’d found at home.

Suddenly she heard the waiting room door shut. Resisting a temptation to slam the drawer, she quickly eased it shut. Then, taking a deep breath, she walked out of Thomas’s office.

“My God!” exclaimed Doris with a start. “I had no idea you were here.”

“They let me out early,” said Cassi with a smile. “Good behavior.”

After recovering from her initial shock, Doris felt compelled to inform Cassi that she’d spent the entire previous afternoon canceling today’s office patients so that Thomas could take her home. Meanwhile, she glanced at the inner office, then closed the door.

“Who is Dr. Allan Baxter?” asked Cassi, ignoring Doris’s attempt to make her feel like a burden.

“Dr. Baxter was a cardiologist who occupied the adjoining professional suite that we took over when we added the extra examination rooms.”

“When did he move?” asked Cassi.

“He didn’t move. He died,” said Doris, sitting down behind her typewriter and directing her attention at the material on her desk. Without looking up at Cassi, she added, “If you’d like to sit down, I’m sure that Thomas should be along soon.” She threaded a sheet of paper into her machine and began to type.

“I think I’d prefer to wait in Thomas’s office.”

As Cassi passed behind her desk, Doris’s head shot up. “Thomas doesn’t like anyone in his office when he’s not there,” she protested with authority.

“That’s understandable,” returned Cassi. “But I’m not anyone. I’m his wife.”

Cassi went back through the door and closed it, half expecting Doris to follow. But the door didn’t open, and presently she could hear the sound of the typewriter.

Going back to Thomas’s desk, she quickly retrieved one of the mail order forms, noting that it was not only printed with Dr. Baxter’s name, but also his DEA narcotics number. Using a direct outside line, Cassi placed a call to the Drug Enforcement Administration. A secretary answered. Cassi introduced herself and said she had a question about a certain physician.

“I think you’d better talk with one of the inspectors,” said the secretary.

Cassi was placed on hold. Her hands were trembling. Presently one of the inspectors came on the line. Cassi gave her credentials, mentioning that she was an M.D. on the staff at the Boston Memorial. The inspector was extremely cordial and asked how he could be of assistance.

“I’d just like some information,” said Cassi. “I was wondering if you keep track of the prescribing habits of individual physicians.”

“Yes, we do,” said the inspector. “We keep records on computer using the Narcotics and Drugs Information Systems. But if you are looking for specific information on a particular physician, I’m afraid you can’t get it. It is restricted.”

“Only you people can see it, is that right?”

“That’s correct, Doctor. Obviously we don’t look at individual prescribing habits unless we are given information by the board of medical examiners or the medical society’s ethics committee that suggests there is an irregularity. Except, of course, if a physician’s prescribing habits change markedly over a short period of time. Then the computer automatically kicks out the name.”

“I see,” said Cassi. “There’s no way for me to check a particular doctor.”

“I’m afraid not. If you have a question about someone, I’d suggest you raise it with the medical society. I’m sure you understand why the information is classified.”

“I suppose so,” said Cassi. “Thanks for your time.”

Cassi was about to hang up when the inspector said, “I can tell you if a specific doctor is duly registered and actively prescribing, but not the amount. Would that help?”

“It sure would,” said Cassi. She gave Dr. Allan Baxter’s name and DEA number.

“Hang on,” said the inspector. “I’ll enter this into the computer.”

As Cassi waited, she heard the outer door close. Then she heard Thomas’s voice. With a surge of anxiety she stuffed the drug order form into her pocket. As Thomas came through the door the inspector came back on the line. Cassi smiled self-consciously.

“Dr. Baxter is active and up-to-date with a valid number.”

Cassi didn’t say anything. She just hung up.

 

Thomas was both talkative and solicitious as he drove Cassi home. If he’d been angry at her presence in his office, he’d hidden the fact beneath a welter of questions about how she was feeling. Although Cassi insisted she felt fine, Thomas had made her wait by the hospital entrance so that he could run and bring the car around.

Cassi was thankful for Thomas’s attentiveness, but she was so upset by what she had just learned from the Drug Enforcement Administration that she remained silent most of the way home. She now understood how Thomas managed to procure his drugs without detection. He’d supply Allan Baxter’s narcotics registration. All he had to do was fill out a form every year and send in five dollars. With the number and some idea of the level at which Dr. Baxter had been prescribing before he died, Thomas could obtain plenty of drugs. Probably more than he could consume.

And the fact that he had resorted to such deception made it clear that his problem was more extensive than Cassi had allowed herself to believe. His behavior had been so normal this last week she let herself hope that he had already begun to control his abuse. Perhaps they could talk further when they were away.

“I have some bad news,” said Thomas, breaking into her thoughts.

Cassi turned. She saw his eyes flick over at her for the briefest instant as if to make certain he had her attention.

“Before I left the OR today I got a call from a hospital in Rhode Island. They’re bringing in a patient for emergency surgery tonight. I tried to get someone else to take the case because I wanted to be with you, but there was no one available. In fact, after I make sure you’re comfortable, I’ll have to be on my way.”

Cassi didn’t respond. She was almost glad Thomas would stay over at the hospital. It would give her a chance to decide what to do. Maybe she could document the amount of drugs Thomas was taking. There was still the chance he’d stopped.

“You do understand?” asked Thomas. “I didn’t have any choice about it.”

“I understand,” said Cassi.

Thomas drove up to the house, insisting on getting out and opening the car door for Cassi. It was something he hadn’t bothered to do since their first dates.

As soon as they were inside, Thomas insisted that she go directly up to the morning room.

“Where is Harriet?” asked Cassi when Thomas followed her with a pitcher of ice water.

“She took the afternoon off to visit her aunt,” said Thomas. “But don’t worry. I’m sure she made something for you to eat.”

Cassi wasn’t worried. She could certainly make herself dinner, but it seemed odd not to have Mrs. Summer bustling about.

“What about Patricia?” asked Cassi.

“I’ll take care of everything,” said Thomas. “I want you to relax.”

Cassi lay back on the chaise and allowed Thomas to settle a comforter over her lap. With her backlog of psychiatric reading at her fingertips, she had plenty to do.

“Can I get you anything else?” asked Thomas.

Cassi shook her head.

Thomas bent and kissed her forehead. Before he left he dropped a travel folder in her lap.

Cassi opened it and found two American Airlines tickets.

“Something for you to look forward to while I’m gone. Meanwhile, get a good night’s sleep.”

Cassi reached up and put her arms around Thomas’s neck. She hugged him with as much force as she could muster.

Thomas disappeared into the connecting bathroom, being careful to close the door quietly. Cassi heard the toilet flush. When he reappeared, he kissed her again and told her he’d call after surgery if it wasn’t too late.

After a quick stop in the study as well as the living room and kitchen, Thomas was ready to go.

With Cassi back home from her stay in the hospital, Thomas felt better than he had for many days. He even looked forward to surgery, hoping it would be a challenging case. But before he could be on his way, he had one more job: to see his mother.

Thomas rang her bell and waited while Patricia came down the stairs. She was pleased to see him until he told her he was returning directly to the hospital.

“I brought Cassi home today,” he said.

“Well, you know Harriet’s off. I hope you’re not expecting me to look after her.”

“She’s fine, Mother. I just want you to leave her alone. I don’t want you going over there tonight and upsetting her.”

“Don’t worry. I certainly won’t go where I’m not wanted,” said Patricia, contrary to the last.

Thomas walked away without saying anything more. A few minutes later, he climbed into his car and, after wiping his hands on the rag he kept under the front seat, started the engine. He looked forward to the drive back to Boston, knowing there would be very little traffic. Carefully he eased the powerful car out into the crisp afternoon air.

Arriving at the hospital. Thomas was pleased there was a spot next to the attendant’s booth. He called a loud hello as he climbed from the car. He went into the hospital and took the elevator directly up to surgery.

 

As evening approached, Cassi let the pale, wintry light fade without turning on the lamp. She watched the windswept sea change from pale blue to gunmetal gray. The airplane tickets still in her lap, she hoped that once they were away she and Thomas could honestly discuss his addictive problem. She knew that recognition and acknowledgment were more than half the problem. Trying to take a positive attitude, Cassi closed her eyes and conjured up visions of long talks on the beach and the beginning of a whole new relationship. Still tired from her ordeal in the hospital, she fell asleep.

It was completely dark when she awoke. She could hear the wind rattling the storm windows and the steady beat of the rain on the roof. True to form, the New England weather had made another about-face. She reached up and snapped on the floor lamp. For a moment the light seemed glaringly bright, and Cassi shielded her eye to look at her watch. She was surprised to see that it was almost eight o’clock. Irritated at herself, she tossed off the comforter and got to her feet. She did not like to be so late with her insulin.

In the bathroom, Cassi noted that she was showing two-plus sugar. Returning to the morning room, she went to the refrigerator and took out her medicine. Carrying the paraphernalia over to her desk, she meticulously drew up the correct amounts, fifty units of the regular and ten units of the Lente. Deftly she injected herself in her left thigh.

She carefully broke off the needle and dropped the syringe into the wastebasket, then put the insulin containers back into the refrigerator. Cassi kept the regular and Lente insulins on different shelves just to make sure she did not confuse them. Then she unpacked her eye medication, removed her eye patch, and managed to put the drops in her left eye. She was on her way down to the kitchen when she felt the first wave of dizziness.

She stopped, thinking it would pass quickly. But it didn’t. Cassi felt perspiration break out on her palms. Confused as to why eyedrops would cause such a rapid systemic effect, she returned to the morning room and checked the label. It was an antibiotic as she’d suspected. Putting the eye medication down, Cassi wiped her hands; they were drenched. Then her whole body began to sweat, accompanied by a rush of unbelievable hunger.

Cassi knew then that it wasn’t the eyedrops. She was having another insulin reaction. Her first thought was that she’d misread the calibration on the syringe, but retrieving it from the wastebasket proved that to be false. She checked the insulin bottles, but they were just as they’d always been, U100. Cassi shook her head, wondering how her diabetic balance could have been thrown off so much.

In any case the cause of the reaction was less important than treating it. Cassi knew she’d better eat without delay. Halfway down the hall to the kitchen, she felt streams of perspiration began to run down her body and her heart began to beat wildly in her chest. She tried to feel her pulse, but her hand was shaking too much. This was no mild reaction! This was another overwhelming episode like the one in the hospital.

In a panic Cassi dashed back to the morning room and threw open the closet. The black leather doctor’s bag she’d gotten in medical school was somewhere there. She had to find it. Desperately she pushed the clothes to the side, searching the shelves in the back. There it was!

Cassi pulled the bag down and ran over to her desk. Undoing the catch, she dumped out the contents, which included a container of glucose in water. With shaking hands, she drew some up and injected herself. There was little or no effect. The shaking was getting worse. Even her vision was changing.

Frantically Cassi snatched up several small IV bottles of fifty-percent glucose which had also been in the doctor’s bag. With great difficulty she got a tourniquet around her left arm. Then with a spastic hand managed to jam a butterfly needle into one of the veins on the back of her left hand. Blood squirted out of the open end of the needle, but she ignored it. Loosening the tourniquet, she connected the tubing from the IV bottle. When she held the bottle above her head, the clear fluid pushed the blood slowly back into her hand, then started to run freely.

Cassi waited for a moment. With the glucose running she felt a little better and her vision immediately returned to normal. Balancing the bottle between her head and shoulder, Cassi put a few pieces of adhesive tape over the site where the butterfly needle entered her skin. The adhesive did not stick too well because of the blood. Then, taking the IV bottle in her right hand, she ran into the bedroom, lifted the telephone receiver, and dialed 911.

She was terrified she would pass out before anyone answered. The phone was ringing on the other end. Someone answered, saying “911 emergency.”

“I need an ambulance . . .” began Cassi, but the person on the other end interrupted her, saying, “Hello, hello!”

“Can you hear me?” asked Cassi.

“Hello, hello!”

“Can you hear me?” screamed Cassi, her panic returning.

Cassi could hear the person on the other end of the line say something to a colleague. Then the line went dead.

Cassi tried again with the same result. Then she dialed the operator. It was the same maddening problem. She could hear them, but they couldn’t hear her.

Grabbing the second IV bottle in her left hand and carrying the running bottle above her head, Cassi ran on wobbly legs down the corridor to Thomas’s study.

To her horror his phone also wasn’t working. She could hear the other party vainly saying hello, but it was obvious they couldn’t hear her. Bursting into tears, she slammed the phone down and picked up the second IV bottle.

Cassi’s panic mounted as she struggled to descend the stairs without falling. She tried the phones in the living room and kitchen without success.

Fighting against a powerful drowsiness, she ran back through the hall to the foyer. Her keys were on the side table, and she clutched them along with the unused IV bottle. Her first thought was to try to drive to the local hospital, which wasn’t far—ten minutes at most. With the IV running, the insulin reaction seemed to be controlled.

Getting the front door open was an effort that ultimately required Cassi to put down her IV bottle for a moment. Blood backed up into the IV but cleared again when she raised the bottle over her head.

The cold, rainy night seemed to revive her as she ran for the garage. Juggling the IV, she managed to open the car door and slide behind the wheel. Tilting the rearview mirror, Cassi slipped the ring of the IV bottle over it she pushed the key into the ignition.

The engine turned over and over, but it would not start. She took out the key and closed her eyes. She was shivering violently. Why wouldn’t the car start! She tried again with the same result. Looking at the IV she realized the bottle was almost empty. Shaking, she removed the cover, from the second bottle. Even during the few minutes it took to make the exchange she could feel the effect. There was no doubt in her mind that when the glucose ran out, she’d most likely lose consciousness.

She decided her only chance now was Patricia’s phone. Emerging from the garage into the rain, Cassi rounded the building and ran to Patricia’s door. Still holding the IV bottle above her head, she rang the buzzer.

As on her previous visit, Cassi was able to see Patricia descend the stairs. She came slowly, warily peering out into the night. When she recognized Cassi and saw her holding aloft an IV bottle, she quickly fumbled with the door and threw it open.

“My God!” said Patricia, noticing Cassi’s pale, perspiring face. “What happened?”

“Insulin reaction,” managed Cassi. “I have to call an ambulance.”

Patricia’s face registered concern, but seemingly paralyzed with shock, she did not get out of the way. “Why didn’t you call from the main house?”

“I can’t. The phones are out of order. Please.”

Cassi blundered forward, pushing clumsily past Patricia. The movement caught Patricia by surprise and she stumbled back. Cassi didn’t have time to argue. She wanted a phone.

Patricia was incensed. Even if Cassi wasn’t well, she didn’t have to be rude. But Cassi had turned a deaf ear to her mother-in-law’s complaints and was already dialing 911 when Patricia caught up to her in the living room. To Cassi’s relief, this time she could be heard by the emergency operator. As calmly as she could, she gave her name and the address and said she needed an ambulance. The dispatcher assured her that one would be there immediately.

Cassi lowered the receiver with a trembling hand. She looked at Patricia, whose face reflected confusion more than anything else. Exhausted, Cassi sank to the couch. Patricia did the same, and the two women sat quietly until they heard the sirens coming down the drive. The years of unspoken antagonism made communication difficult, but Patricia helped Cassi, who was now nearly unconscious, down the stairs.

As Patricia watched the shrieking ambulance race back across the salt marsh, she had a moment’s real sympathy for her daughter-in-law. Slowly she went back upstairs and called Boston Memorial. She felt her son should try to meet his wife at the local hospital. But Thomas was in surgery. Patricia left word that he should call as soon as possible.

 

Thomas glanced down at the clock on the instrument panel. It was 12:34 A.M. The charge nurse had given him Patricia’s message the moment he came out of the OR at 11:15. When he’d spoken to his mother she’d been very upset, telling him what had happened. She chided him about having left Cassi alone and urged him to go to the local hospital as fast as he could.

Thomas had called Essex General, but the nurse hadn’t been able to say yet how Cassi was doing. She just told Thomas that she’d been admitted. Thomas didn’t need any urging to hurry. He was desperate to find out Cassi’s condition.

At the red light the block before the hospital, Thomas slowed but did not stop. When he reached the hospital grounds, he turned so sharply the wheels of his car squealed in protest.

The front desk of the hospital was deserted. A small sign said INQUIRIES GO TO EMERGENCY. Thomas sprinted down the hall.

There was a tiny waiting area and a glassed-in nurses’ station. A nurse was having coffee and watching a miniature TV set. Thomas pounded on the glass.

“Can I help you?” she asked with a strong Boston accent.

“I’m looking for my wife,” said Thomas nervously. “She was brought in here by ambulance.”

“Would you mind sitting down for a moment.”

“Is she here?” asked Thomas.

“If you’ll sit down, I’ll get the doctor. I think you’d better talk to him.”

Oh God, thought Thomas as he turned and obediently sat down. He had no idea what was coming. Luckily he didn’t have to wait long. An Oriental man in a crumpled scrub suit appeared, blinking in the bright fluorescent light.

“I’m sorry,” he said, introducing himself as Dr. Chang. “Your wife is no longer with us.”

For a moment Thomas thought the man was telling him Cassi was dead, but then the doctor went on to say Cassi had signed herself out.

“What?” shouted Thomas.

“She was a doctor herself,” apologized Dr. Chang.

“What are you trying to say?” Thomas tried to stifle his fury.

“She arrived suffering from an insulin overdose. We gave her sugar and she stabilized. Then she wanted to leave.”

“And you allowed her to.”

“I didn’t want her to leave,” said Dr. Change. “I advised against it. But she insisted. She checked out against medical advice. I have her signature. I can show you.”

Thomas grabbed the man’s arms. “How could you let her leave! She was in shock. She probably wasn’t thinking clearly.”

“She was lucid and signed a release form. There wasn’t much I could do. She said she wanted to go to the Boston Memorial. I knew she’d get better care there. I’m not a specialist in diabetes.”

“How did she go?” asked Thomas.

“She called a taxi,” said Dr. Chang.

Thomas ran back down the corridor and out through the front door. He had to find her!

Thomas drove recklessly. Luckily there was almost no traffic. After a brief stop at home, he headed back into Boston. When he pulled into the parking garage at the Memorial it was just before 2:00 A.M. He parked and ran into emergency.

In contrast to Essex General, the ER at the Memorial was flooded with patients. Thomas ran straight to the admitting office.

“Your wife hasn’t come into the ER,” one of the clerks told him.

The other clerk punched Cassi’s name into the computer. “She hasn’t been admitted either. It shows she was discharged this morning.”

Thomas felt a sinking feeling in the pit of his abdomen. Where could she be? He had only one other thought. Maybe she’d gone up to Clarkson Two.

Although he’d never stopped to wonder why, Thomas did not like to be on the psychiatry floor. It made him feel uncomfortable. He didn’t even like the sound the heavy fire door made when it closed behind him with its airtight seal.

As he walked down the dark corridor, his heels echoed loudly. He passed the common room where the TV was still on although no one was watching. At the desk a nurse who’d been reading a medical journal looked up at him as if he were one of the patients.

“I’m Dr. Kingsley,” said Thomas.

The nurse nodded.

“I’m looking for my wife, Dr. Cassidy. Have you seen her?”

“No, Dr. Kingsley. I thought she was on medical leave.”

“She is, but I thought she might have come in here.”

“Nope. But if I see her I’ll tell her you’re looking for her.”

Thomas thanked the woman and decided to go to his office while he tried to figure out what to do.

As soon as he opened the door he went to his desk to get several Talwin. He took them with a splash of Scotch, then sat down. He wondered if he were getting an ulcer. He had a boring pain just below his sternum that he also felt in his back. But the pain he could live with. What was worse than the pain was the pervasive anxiety. He felt as if he were about to shatter into a million pieces. He had to find Cassi. His life depended on it.

Thomas pulled over the phone. Despite the hour, he called Dr. Ballantine. Cassi had spoken to him before, and there was a chance she’d approach him again.

Dr. Ballantine, groggy with sleep, answered on the second ring. Thomas apologized and asked if he’d heard from Cassi.

“I haven’t,” said Dr. Ballantine, clearing his throat. “Is there some reason I should?”

“I don’t know,” admitted Thomas. “She was discharged today, but after I took her home I had to come back to the hospital for an emergency. When I got out of surgery there was a message to call my mother. She told me Cassi had apparently given herself another overdose of insulin. An ambulance took her to the local hospital but by the time I got there she’d signed herself out. I have no idea where she is or what state she’s in. I’m worried sick.”

“Thomas, I’m so sorry. If she calls, I’ll get in touch with you immediately. Where will you be?”

“Just call the hospital. They’ll have my number.”

As Dr. Ballantine replaced the receiver, his wife rolled over and asked what the trouble was. As chief of service, Ballantine got few emergency calls at night.

“It was Thomas Kingsley,” said Ballantine, staring into the darkness. “His wife is apparently very unstable. He’s afraid she may have tried to kill herself.”

“The poor man,” said Mrs. Ballantine as she felt her husband throw off the covers and get up. “Where are you going, dear?”

“No place. You go back to sleep.”

Dr. Ballantine put on his robe and walked out of the bedroom. He had an awful feeling that things were not happening the way he’d planned.