This consummation at dawn was his high tide, his lifetime-best surf, a perfect set of double overhead swells, and it was not in his nature to imagine that what came thereafter would be not more of the same and soon a new life with a new healthy heart, but instead error, disorder, terror, anguish, and loss.

The storm.

Ryan sailed through the psychological testing and was added to the heart-recipient list of the United Network for Organ Sharing.

Following the diagnosis of cardiomyopathy and his revelation of his condition to Samantha, he was spared the dreams that had plagued him for a week. The city in the sea, the lake of black water, and the haunted palace had been deleted from his nightly itinerary.

No other dreams arose to trouble him. He slept well each night and woke rested or at least rested enough.

In lonely moments, he no longer heard the curious rapping that-at windows, at doors, in bathroom plumbing, and from a plasma TV-had insisted upon his attention.

His sense of being watched, of being the object of a sinister conspiracy, blew away with the dreams and with the phantom knocker. A fresh air came into his life, and cleared from his head the stale miasma of unreason as if he had merely been suffering from a pollen allergy.

He experienced no further episodes of deja vu. Indeed, he suspected that if he returned to Denver and located the small park with the aspens, that place-and the church adjacent to it-would not affect him as it had before.

As for knowing, before he saw it, what the crucifix would look like above the altar at St. Gemma’s…

Over the years, he had been inside a few Catholic churches, attending weddings and funerals. He didn’t remember any of those altars, but he assumed that perhaps a crucifix in one Roman church was much like that in another. Uniformity might even be required. He must have known what he would find in St. Gemma’s only because he had seen the identical crucifix-or one nearly like it-at one of those weddings or funerals.

He attributed the calm and clarity that purged his paranoia to the medications that Dr. Gupta prescribed, including a diuretic to control heart failure and an antiarrhythmic drug to correct abnormal heart rhythms. His blood was better oxygenated now than it had been, and toxins once dangerously retained were being flushed from his system more efficiently.

Irrationally, he had feared that a scheming poisoner, a modern-day Medici, might be among his household employees. Ironically, the only poisoner had been the very heart within his breast, which by its diminished function had clouded his mind and fostered his delusions, or so he concluded.

Through October and November, Ryan’s greatest problem proved to be impatience. As others awaiting transplants received their hearts or perished, he moved up the list, but not fast enough.

He remained acutely aware that Samar Gupta had given him at most one year to live. A sixth of that year had passed.

When he saw TV news stories about traffic accidents involving fatalities, he wondered if the deceased had signed organ-donor cards when getting their driver’s licenses. Sometimes the knowledge that most people did not donate would inspire an angry rant. This was not fair to those against whom he railed, because during all the years that he’d been in good health, he never signed such a card, either.

Now enlightened, through his attorney he arranged to donate what organs, if any, might be of use to others after his body succumbed to the ravages of cardiomyopathy or, alternately, if he received a transplant but died anyway.

By December, Dr. Gupta had to adjust Ryan’s drugs and add two more medications to his regimen in order to prevent the return of the frightening and debilitating symptoms.

The cardiologist used arcane medical terminology to avoid words like deterioration. But Ryan had no doubt that his condition was deteriorating.

He did not feel much different from the way he had felt in September, except that he tired more easily now, and he slept longer than he had in those days.

When he looked in a mirror, he noticed only small changes. A slight bloat. Sometimes a persistent unhealthy flush in his cheeks, at other times a gray-blue paleness of the skin under his eyes.

He became impatient not only with his progress up the waiting list but also with Samantha. Sometimes she tested his forbearance.

For one thing, he felt that she had too much confidence in the organization that compiled the list and selected the recipients.

If Ryan had managed his business with the kind of unwarranted assumptions and the tolerance for bureaucratic inertia that he saw in this particular medical community, he would not have become a wealthy man. Since lives were at stake here, he argued that these gatekeepers should be more-not less-efficient than he had been while building a social-networking empire on the Internet.

She would listen to little complaining on the subject before reminding him that he had promised to weather this waiting period with a relaxed attitude. He had pledged not to try to handle what in truth he could not control, but to let it unfold as it would.

“Dotcom, you worry me,” she told him now. “This restlessness, these spells of anger. This isn’t good. It doesn’t help you. You’re wound too tight.”

Week by week, Ryan developed more exotic strategies to survive, investigating all manner of alternative-medicine treatments that might supplement what any cardiologist could do for him, everything from rare substances obtained from the spores of rain-forest ferns to psychic healing.

With sympathy, reason, and humor, Samantha provided a reality check to each treatment scheme that he considered adopting. Although he knew she was right, sometimes her acerbic humor seemed to be cold sarcasm, her reason mere pessimism, and her sweet sympathy insincere.

Ryan suspected that his sour moods and his frequent spells of restlessness and agitation were caused by his medications. A review of the side effects listed for each drug confirmed his suspicion.

“I’m sorry, Sam,” he told her more than once. “It’s these damn drugs. I’m not myself. Next thing, I’ll be growing hair on my palms and howling at the moon.”

He knew that he was exhausting her, that her work on the novel had come almost to a halt. He began to give her more time to herself, though she protested that she would be there for him all day, every day, until he was restored to full health, with a new heart.

On December 12, they had dinner in a restaurant where white tablecloths, Limoges china, crystal, and waiters in white jackets set both a mood and a standard.

This wasn’t one of those Newport Beach high-end meat markets that layered on the style but catered to upscale singles who chose their dinner companions from the opportunities at the bar. Here the clientele was older, quieter, with at least a veneer of class, often with that old-money charm and grace that made even true class seem somewhat tacky by comparison.

Between the appetizers and the entrees, Ryan told Samantha about Dr. Dougal Hobb, a prominent cardiologist and cardiovascular surgeon with offices in Beverly Hills.

“I think I might switch to him,” he said.

Surprised, she asked, “What’s wrong with Dr. Gupta?”

“Nothing. He’s fine. He’s all right. But Dr. Hobb is so highly regarded. He’s really at the top of his profession.”