Chapter 1

Monday, July 1, 6:15 a.m.

When Michael Fuller’s phone alarm woke him with its insistent jangle, he literally leaped out of bed in a near panic while fumbling to turn the damn thing off. He’d been in the middle of a disturbing nightmare of being chased down endless yellow-tan corridors without the slightest idea of what or who was chasing him or why. All he knew was that he had been panicked out of his mind and as a result his heart was still racing.

With the back of his hand, he wiped his damp brow and took a deep breath to calm down. He’d never before experienced such a uniquely frightening dream. Certainly, he’d had his share of nightmares while growing up, but nothing like what he’d just endured. Although he’d had some minor difficulty getting to sleep the night before, due to his mixed emotions about the upcoming day, he certainly didn’t expect first-day jitters to have caused such a dream.

For twenty-three-year-old Michael Fuller, this first day of July was going to be momentous, marking the beginning of a whole new chapter in his life. Today was the first day of his surgical residency at Langone Medical Center, known colloquially as NYU, and he was going to be specifically starting at the renowned Bellevue Hospital. Although he’d felt definite anticipatory excitement, he’d also experienced a measure of anxiety. Certainly more than he realized, as was clearly evidenced by the bad dream. When he’d been on duty in the hospital as a medical student, there’d always been a resident available when an emergency happened. Suddenly now he was the resident, meaning from today on, there’d be no immediate backup. He would have to handle whatever emergency he might face when he was alone in the middle of the night on the hospital’s surgical ward, a circumstance that was very scary. His fear was that he wasn’t ready, that medical school hadn’t prepared him adequately.

But at the same time Michael felt uneasy, he also felt decidedly fortunate. As one of seven first-year NYU surgical residents, a position formerly known as an internship, he’d been chosen by chance to start at Bellevue along with another first-year resident, Andrea Intiso. Even being assigned with Andrea was a lucky twist of fate as far as he was concerned, because they were both graduates of Columbia University’s historic College of Physicians and Surgeons. There, purely by chance, they’d been teamed up as medical students for their clinical pathology, physical diagnosis, and internal medicine rotations. Consequently, he knew her to be a friendly, dependable, smart, and plucky woman, and he liked her.

The other five first-year surgical residents, three men and two women, had been assigned to the various other hospitals in the sprawling NYU Langone Health complex for their first two-month rotation. Mitt, a nickname Michael had been given as a toddler and still preferred, would also be assigned to these other hospitals in due course, after his first rotation at Bellevue. For him it was akin to having won a lottery because it was Bellevue Hospital that had attracted him to apply to NYU for his residency training for two major reasons.

The first reason was its distinguished history, including three centuries of fostering many major medical advances. He knew that Bellevue Hospital had even established the very first residency in surgery way back in 1883, which was still the model for surgical training worldwide.

The second reason was personal.

Mitt descended on his paternal side from a long and impressive medical pedigree. Way back in the seventeenth century a direct ancestor of his named Samuel Fuller had been on the Mayflower and served as the Plymouth Colony’s medical doctor. But more to the point from Mitt’s perspective, he was a direct descendant of four consecutive generations of celebrated Bellevue physicians, three surgeons—the latest of whom had also done a Bellevue surgical residency—and a psychiatrist. All four of these physicians had been contemporary leaders in their fields, particularly his closest relative, Dr. Clarence Fuller, his paternal great-grandfather. Mitt had made it a point to read a number of Clarence’s lauded research papers, in which he championed and helped develop methods of psychotherapy and even anticipated groundbreaking behavioral therapy.

Mitt had been impressed enough with what he’d read of Clarence’s Bellevue career to consider specializing in psychiatry himself, but Mitt’s father, Benjamin, a highly successful Boston-based hedge fund manager who was in secret a frustrated surgeon after deciding against medical school despite his own father’s encouragement, prevailed upon Mitt to follow in the renowned footsteps of his surgical forebearers, particularly Dr. Benjamin Fuller, Mitt’s father’s namesake.

Mitt was the first to admit—with deserved appreciation—that his father’s generous economic inducements had played an outsized role in getting Mitt to apply to medical school and then choose a surgical subspecialty at NYU Grossman School of Medicine. One of the inducements was the fully furnished and professionally decorated apartment Mitt was now occupying on the fourth floor of 326 East 30th Street, which he knew was beyond anything a first-year surgical resident could typically afford. Same with the fancy Mercedes-AMG parked in a nearby garage.

After dashing into his posh, newly renovated bathroom, Mitt lathered himself in preparation to quickly shave. As he’d learned during the first week that he’d occupied the apartment to attend his NYU residency orientation, he had to scrunch down to take advantage of the magnifying shaving mirror. It had been positioned at a height significantly lower than appropriate for Mitt’s lanky six-foot-four frame.

With his coordination and considerable stature, which he’d reached at a youthful age, he’d been pressured as early as the sixth grade to play basketball. Mitt had declined and continued to do so through high school and college. He’d never appreciated what he labeled as the “marginal utility” of organized sports, much preferring to concentrate his extracurricular activities and attention on mental exercise rather than physical. His preferences leaned toward debating, playing chess, and music, particularly the piano. Ever since he could remember and maybe as early as age two, Mitt had been more cerebral than physical.

Working quickly to navigate the disposable razor around and over his angular and pale face, Mitt was conscious of the time. He was due in the fifteenth-floor surgical conference room at Bellevue Hospital at 7:30 a.m. sharp. Luckily the hospital was a mere five-minute walk away. After a quick rinse and dry, Mitt paused to study his reflection. He was worrying anew about how he was going to hold up under the stresses of being a newbie resident, especially if and when he had to face medical emergencies alone.

Although he had hardly been a polymath in high school and college, he’d done extremely well grade-wise, such that he was confident in his basic intelligence. Due to his interest in academics, Mitt had advanced more quickly than his peers and graduated high school at sixteen, college at nineteen, and medical school at twenty-three, making him the youngest of the current batch of first-year surgical residents at NYU. None of his academic accomplishments had been a surprise to his proud parents, who’d recognized Mitt’s precocity from an early age.

But there was more to Mitt’s intelligence than a high IQ. He wasn’t sure exactly when he first became aware of the capacity, but he had a kind of precognitive ability that he secretly labeled his “sixth sense.” It wasn’t constant, and he had no idea how to provoke it. When he’d applied to boarding school, college, and even medical school and then surgical residency, the moment he sent off his applications, he knew he would be accepted. He’d been so confident in his belief that he’d never experienced the anxiety that all his friends did, and on all four occasions, unlike his friends, he’d only applied to one school or program, not the usual dozen or more.

Adding to this unusual precognition, Mitt had on occasion the ability to sense what people were thinking. Again, it wasn’t a constant capability, and he didn’t know how to encourage its manifestation other than recognizing that it required concentrated mental effort and a clear mind. Curiously enough, when he was able to predict the future or tell what someone was thinking, it was almost always accompanied by varying degrees of tactile sensations along the insides of his arms or thighs, the back of his neck, or across the front of his chest. He likened these sensations, which he called paresthesia, the technical term, after taking neurology in medical school, to something like the “pins and needles” he’d feel when his extremities’ circulation was compromised.

In contrast to his precognitive faculty, which there was no way he could explain, he believed his ability to sense what people were thinking was probably based on an acute and unconscious sensitivity to a wide variety of idiosyncratic clues people unknowingly projected by their posture, expressions, and choice of syntax. Although the possibility that he possessed some rare psychic power had occurred to him on occasion, he’d dismissed the idea out of hand as being entirely anti-scientific. In college he had majored in math, physics, and chemistry and believed he could have pursued any one of those scientific fields if he’d been so inclined, which didn’t leave a lot of room for believing in the supernatural.

Mitt had never told anyone about these special talents, not even his parents, even though as an only child he had a relationship with them that had been, and still was, particularly close. Knowing what his parents were thinking without them being aware was often to his advantage, although this was not always the case with his contemporaries. Especially during his teen years, it was usually disheartening for him to sense what girls thought of him, as it was often negative. Mitt was the first to admit that he was not a member of the “in crowd,” as he was decidedly bookish, hardly a positive in the teen value system he grew up in. On the other side of the coin, he did find his unique abilities helpful in giving him a leg up with his schoolwork. Before an exam, all he had to do was talk to his teachers or professors to predict what was going to be asked, eliminating any surprises. From an early age he developed a penchant for good grades.

After brushing his short, dirty-blond hair into a semblance of order, Mitt returned to his bedroom to dress. Casting an eye on the bedside clock, he was shocked by the raucous ring of his mobile phone. Curious and mildly unnerved at who could possibly be calling so early on a Monday morning, he snatched up the device. The answer was obvious, and he should have guessed. It was his father. Clicking on the phone and holding it up to his ear, Mitt said: “What in God’s name are you doing up at this hour? Are you ill?” He knew his father was an inveterate night person who usually remained in his home office until well past midnight to digest the early-morning European financial news to give him a jump on his workday.

“Ha ha,” his father fake-laughed. “As if I’d miss the big day. To be truthful, I’m jealous. At the same time, I couldn’t be any prouder. I hope you enjoy yourself!”

“Ditto that,” his mother, Clara, voiced in the background.

“I’m not sure ‘enjoy’ is the right word,” Mitt said. “To be honest, I’m a bit nervous.” In the back of his mind, he quickly banished the thought of his nightmare. “It’s an awful lot of responsibility. Going from medical student to resident is a big step, like going from day to night with no twilight.” After another glance at the time, he put his phone on speaker, placed it on the top of his bureau, and continued dressing.

“You will do fine!” Benjamin said with conviction. “You excelled in medical school, so you couldn’t be better prepared.”

“We’ll see,” Mitt said noncommittally. He didn’t want to get into a discussion about the deficiencies of current undergraduate medical education, which were looming in the back of his mind. “But thanks for calling. I’ll let you know how the day went as soon as I can. It might not be until tomorrow. I sense I’m going to be on call tonight, but I don’t know for certain. Andrea and I haven’t been given our schedules, but since there are only two of us, the chances are fifty-fifty.” He actually already knew he would be on call that night, but he didn’t want to get into a discussion about how he knew. As for Andrea, his parents had met her at their recent medical school graduation. They also knew from a previous phone call that both she and Mitt had been assigned to Bellevue to start their residencies together.

“Our illustrious surgical ancestor Dr. Benjamin Fuller has to be tickled pink that you are following in his footsteps.”

“I hope so,” Mitt said. He’d thought about his ancestor on multiple occasions, including the night before. Benjamin Fuller was his most esteemed surgical forebearer, born just before the Civil War in 1860. He earned his formidable reputation at Bellevue, serving first as an intern, then a resident, and finally as an attending physician. He’d worked with the internationally famed surgeon William Halsted and also with William Welch, the father of modern pathology, until both men switched from Bellevue to the newly formed medical school at Johns Hopkins. For Mitt, it was daunting to follow such a legend, as it undoubtedly raised expectations for his performance with the powers that be. Was he up to it? Mitt had no idea, but he was soon going to find out. For him the situation was like jumping into the deep end of a pool with only a rudimentary knowledge of how to swim.

“I’m convinced you are going to become more famous than my namesake,” Benjamin said as if sensing Mitt’s insecurities and wanting to be supportive. “I can feel it in my bones.”

“Famous or not,” Mitt responded, glancing again at the time, “I have to get a move on here. I’m due at the hospital at seven thirty sharp.”

“Of course,” Benjamin said. “Call us when you can. Good luck!”

“Yes, good luck,” Clara called out in the background.

Mitt disconnected the call and quickly ran the knot he’d made in his tie up under his chin and folded down the collar of his shirt. Donning the short white coat and white pants he’d been given during his brief orientation at NYU Grossman School of Medicine, plus the lanyard he’d been given with his hospital ID, he checked himself in the mirror. At least in his all-white outfit he looked like a surgical resident, even if he didn’t feel like one.