The speed of the improvement startled her. Three days after she started radiation therapy, the pain in her back had begun to subside; within a week, she no longer felt it at all.

“I’d forgotten what it was like not being constantly aware of it,” she delightedly told her husband that night. “I feel like the Tin Man in The Wizard of Oz—like someone took an oil can to me and made all the stiffness disappear.”

Her husband, the President, took her in his arms. “That’s so wonderful, darling. Maybe the worst is over.”

“I hope so. They say so much of it is attitude. Well I’m going to test that theory—because no one’s going to top my attitude!”

Gregory Stillman knew not to be fooled, of course. They’d killed only a single, localized tumor—just a symptom, not the disease itself. Now it was a crap shoot. The distinctive cancer cells, born in the breast, could resurface almost anywhere, anytime: in thirty years, thirty months, or thirty days.

And this last was by far the most likely. By every indication, this was an exceptionally aggressive tumor.

Still, for the time being, there was no reason to disabuse the patient of her optimism—especially this patient. “Obviously, things are looking pretty good right now,” Stillman told her when the ten days of radiation were over. “The treatment’s done everything I hoped it would and more.”

“And now?”

“I’m going to want to keep a close eye on you, of course. There’s still disease there.”

“Isn’t that what we should be doing now, rooting out what remains of the disease?”

“It’s not that simple.” He opened his briefcase and withdrew a book—a copy of his own Basic Principles of Breast Malignancy. “Read this, I’d be pleased to discuss any questions you have then.”

She looked at him, incredulous. If he hadn’t just pulled off what she regarded as a minor miracle, she’d have been tempted to fire him on the spot.

“I would suggest an examination every two weeks,” he continued. “But, please, call me if you experience unusual physical symptoms of any kind.”

The first three exams were uneventful. When she arrived for the fourth, she once again reported nothing unusual. But it was impossible not to notice her cough.

“How long have you had that?” asked Stillman.

“Just a few days. I’ve always gotten a lot of colds.”

But there were no other cold symptoms evident. The cough was dry and rasping.

This was not necessarily cause for concern. Coughs are wildly nonspecific, they can be caused by a thousand things, nine hundred and ninety-eight of which are meaningless. And, in fact, when he took a chest X ray, it was clean.

Five days later, he reached her at the White House. “Just checking on that cough.”

Before she could respond, he heard it. “It’s no big deal,” she insisted. “Aside from that, I’m feeling strong as a horse.”

“How you’re feeling otherwise doesn’t interest me. I’d like you to come in tomorrow.”

“No!” Tomorrow truly was impossible. She had meetings all day and, with the Irish prime minister in town, a formal dinner scheduled for the evening. But more than that, she resented his peremptory manner. “It will just have to wait until next week. And frankly, Doctor, if we’re going to continue, I’d appreciate a bit more courtesy.”

That was the right button to push; like most bullies, he responded well to threats. “I’m sorry, Mrs. Rivers,” he instantly backed off, “I didn’t mean it as it sounded. My only concern is your health.”

“Believe me, Doctor, it concerns me also. But surely this can wait a few more days. Till next week.”

“Of course.”

The cough was still there the following week, perhaps even a bit stronger. But she resisted his suggestion of another X ray. “Look, I just had one last week. I know that’s not healthy.”

He smiled benignly, his mind brimming with contempt: This fucking moron’s just gotten dosed with three thousand rads and now she’s worrying about a twelth of a rad more! “Mrs. Rivers,” he said, in his best, concerned manner, “I really think this is pretty important. Knowing how you feel, I certainly wouldn’t suggest it otherwise.”

The new X ray showed it clearly: a streaky density, like a cirrus cloud, in the left lung. Studying it in his office while she waited in an adjoining room, he assumed the worst. The tumor was growing within the walls of the lymph vessels inside the lung. Radiation had taken them as far as it could. If this proved out, he’d have to begin a course of chemotherapy—and soon.

“Mrs. Rivers, I’m going to suggest you have a bronchoscopy. Just as a precautionary measure.”

“What’s that?”

“Well …” There was no way to make it sound anything other than gruesome, snaking a tube down the trachea and up into the lungs to take a look—but he tried. “I really think it’s something that must be done.”

“I’d like to discuss this with Dr. Burke. I value his opinion.”

“Absolutely. Of course.” He was coming to truly dislike this woman. He was the expert, Burke was a nothing! “If you can possibly arrange it, I’d like to schedule it for the day after tomorrow.”

“All right,” she suddenly relented, pain in her eyes, “since you seem to feel it can’t wait.”

This was a very sick woman. He knew it—and now she knew it too.

For the time being, at least, he suspected she wouldn’t be giving him much trouble.