“Well?” asked Jerry, staring at the glistening convolution of Bruce’s brain. “Do you two hotshots have any other bright ideas?”

“Not really,” said Cassi. “Maybe Robert will find evidence of a heart attack.”

“Even if I do,” said Robert, “it wouldn’t explain the cyanosis.”

“That’s true,” said Jerry, as he scratched the side of his head. “Maybe the nurse was wrong. Maybe the guy was just ashen.”

“Those nurses on cardiac surgery are awfully competent,” said Cassi. “If they said the patient was dark blue, he was dark blue.”

“Then I give up,” said Jerry, taking out a ten-dollar bill and slipping it into the pocket of Robert’s white jacket.

“You don’t have to pay me,” said Robert. “I was just kidding.”

“Bullshit,” said Jerry. “If it had been a pulmonary embolism I’d have taken your money.” Jerry walked over to where he’d hung his white jacket.

“Congratulations, Robert,” said Cassi. “Looks like you got case number eighteen. Compared to the number of open-heart surgery cases they’ve done over the last ten years, that’s getting close to being statistically significant. You’ll get a paper out of this yet.”

“What do you mean ‘me’?” asked Robert. “You mean ‘us,’ don’t you?”

Cassi shook her head. “No, Robert. This whole thing has been your idea from the start. Besides, now that I’ve switched to psychiatry, I can’t hold up my end of the work.”

Robert looked glum.

“Cheer up,” said Cassi. “When the paper comes out, you’ll be glad you didn’t have to share authorship with a psychiatrist.”

“I was hoping this study would get you to come up here frequently.”

“Don’t be silly,” said Cassi. “I’ll still come up, especially when you find new SSD cases.”

“Cassi, let’s go,” called Jerry impatiently. He had the door held open with his foot.

Cassi gave Robert a peck on the cheek and ran out. Jerry took a playful swipe at her as she passed through the door. Not only did she evade the blow, but she managed to give Jerry’s necktie a sharp tug as she passed.

“Where’s your woman friend?” asked Jerry as they reached the main part of the pathology department. He was still struggling to straighten his tie.

“Probably in Robert’s office,” said Cassi. “She said she needed to sit down. I think the autopsy was a little much for her.”

Joan had been resting with her eyes closed. When she heard Cassi she got unsteadily to her feet. “Well, what did you learn?” She tried to sound casual.

“Not much,” said Cassi. “Joan, are you all right?”

“Just a mortal wound to my pride,” said Joan. “I should have known better than watch an autopsy.”

“I’m terribly sorry…” began Cassi.

“Don’t be silly,” said Joan. “I came voluntarily. But I’d just as soon leave if you’re ready.”

They walked down to the elevators where Jerry decided to use the stairs since it was only four flights to the medical floor. He waved before disappearing into the stairwell.

“Joan,” said Cassi, turning back to her. “I really am sorry I forced you up here. I’d gotten so accustomed to autopsies as a path resident that I’d forgotten how awful they can be. I hope it didn’t upset you too much.”

“You didn’t force me up here,” said Joan. “Besides, my squeamishness is my problem, not yours. It’s just plain embarrassing. You’d think after four years of medical school I’d have gotten over it. Anyway, I should have admitted it and waited for you in Robert’s office. Instead I acted like a fool. I don’t know what I was trying to prove.”

“Autopsies were hard for me at first,” said Cassi, “but gradually it became easier. It is astounding what you can get used to if you do it enough, especially when you can intellectualize it.”

“For sure,” said Joan, eager to change the subject. “By the way, your men friends do run the gamut. What’s the story with Jerry Donovan? Is he available?”

“I think so,” said Cassi, punching the elevator button again. “He was married back in med school but then divorced.”

“I know the story,” said Joan.

“I’m not sure if he’s dating anyone in particular,” said Cassi. “But I could find out. Are you interested?”

“I wouldn’t mind asking him to dinner,” said Joan pensively. “But only if I could be sure he’d put out on the first date.”

It took a moment for Joan’s comment to penetrate before Cassi burst out laughing. “I think you sized him up pretty well,” she said.

“The macho medicine man,” said Joan. “What about Robert?” Joan lowered her voice as they got on the elevator. “Is he gay?”

“I suppose so,” said Cassi. “But we’ve never discussed it. He’s been such a good friend, it has never mattered. He used to rate my boyfriends back in medical school, and I used to listen until I met my husband because Robert was always right. But he must have been jealous of Thomas because he never liked him.”

“Does he still feel that way?” asked Joan.

“I can’t say,” said Cassi. “That’s the only other subject that we never talk about.”

“The patient is ready for you in No. 3 cardiac cath room,” said one of the X-ray technicians. She didn’t come into the office but rather just stuck her head around the door. By the time Dr. Joseph Riggin turned to acknowledge the information, the girl was gone.

With a sigh, Joseph lifted his feet off his desk, tossed the journal he’d been reading onto the bookshelf, and took one last slug of coffee. From a hook behind the door he lifted his lead apron and put it on.

The radiology corridor at 10:30 A.M. reminded Joseph of a sale day at Bloomingdale’s. There were people everywhere waiting in chairs, waiting in lines, and waiting on gurneys. Their faces had a blank, expectant look. Joseph felt an unwelcome sense of boredom. He’d been doing radiology now for fourteen years and he was beginning to admit to himself that the excitement had gone out of it. Every day was like every other day. Nothing unique ever happened anymore. If it hadn’t been for the arrival of the CAT scanner a number of years ago, Joseph wondered if he’d have quit. As he pushed into No. 3, he tried to imagine what he could do if he left clinical radiology. Unfortunately he didn’t have any bright ideas.

The No. 3 cath room was the largest of the five rooms so equipped. It had the newest equipment as well as its own built-in viewer screens. As Joseph entered, he saw that someone else’s X rays had been left up. If he’d told his technicians once, he’d told them a thousand times that he wanted his room cleared of previous films before he did a study. Then, as if that wasn’t enough, Joseph noticed there was no technician.

Joseph felt his blood pressure soar. It was a cardinal rule that no patients were ever to be left unattended, “Dammit,” snarled Joseph under his breath. The patient was lying on the X-ray table, covered by a thin white blanket. He looked about fifteen years old, with a broad face and close-cropped hair. His dark eyes were watching Joseph intently. Next to the table was an IV bottle, and the plastic tube snaked under the blanket.

“Hello,” said Joseph, forcing a smile despite his frustration.

The patient did not stir. As Joseph took the chart, he noticed that the boy’s neck was thick and muscular. Another glance at the boy’s face suggested that this was no ordinary patient. His eyes were abnormally tilted and his tongue, which partially protruded from his lips, was enormous.

“Well, what do we have here?” said Joseph with a wave of uneasiness. He wished the boy would say something or at least look away. Joseph flipped open the chart and read the admitting note.

“Sam Stevens is a twenty-two-year-old muscular Caucasian male institutionalized since age four with undiagnosed mental retardation, who is admitted for definitive work-up and repair of his congenital cardiac abnormality thought to be a septal defect…”