"Or," I said, "to make him go after Billy instead of someone else."

The last Cape Air flight landed me back in Boston just after 8:00 p.m. Anderson and I had decided I would shuttle to New York the next morning, provided he could get me clearance that quickly to meet with Billy Bishop at Payne Whitney.

On my way back to Chelsea, I stopped at Mass General. I wanted to make good on my promise to see Lilly Cunningham after the incision and drainage of her leg abscess.

She was sleeping when I got to her room, but her bedside lamp was on. Even from her doorway I could see that the surgery had been more extensive than planned. Her leg was in traction, bent at the knee and suspended six, eight inches off the mattress. Her thigh was covered with a wet gauze dressing. Two thin steel rods had been screwed into each side of her femur.

I knocked on the door frame, but she didn't awaken. I walked into the room. I stood there half a minute, listening to the tired electronic beeping pulse of the ward at night, and watching Lilly breathe. I tried to imagine the emotions she might have experienced each time she buried a hypodermic needle in her flesh, soiling her insides. I didn't settle on rage or panic or even sadness. I thought she probably felt relief. Maybe even euphoria. For the moment, she could shed the pretense of normalcy. Her sham self-esteem and self-confidence could melt away, yielding to her real unconscious vision of herself as dirty and infected. Trash. Like someone finally allowed to drop her arms after holding them aloft for hours, she could give up the struggle to fend off her demons and, instead, let them spirit her away.

"Lilly," I said softly.

She didn't stir.

A little louder: "Lilly."

She slowly opened her eyes, but didn't respond.

"It's Dr. Clevenger," I said. "I told you I'd stop by after the procedure."

She took a dreamy breath, then closed her eyes again. "They gave me something for the pain."

"Would you rather sleep? I could try to stop back tomorrow."

She looked at me, squinting to focus. "No. Stay."

I walked the rest of the way to her bedside, pulled up a chair, and sat down. "How did it go?" I asked.

"Dr. Slattery says the infection had gotten into the bone. They had to take a piece of it."

I nodded, looking at the steel rods holding her leg together. "Opening the wound and letting the bad stuff out should prevent that from happening again," I said, picking up on the metaphor for her psychological trauma that I had started to build during our last meeting.

"Right," she whispered, obviously unconvinced.

I remembered telling her that I wasn't afraid to see the truth-even if it was ugly. I needed to prove that that was true in the physical realm, in order to coax her to reveal her emotional wounds. I leaned forward and touched one corner of the gauze bandage. "Do you mind if I take a look?" I asked.

She shook her head. Her gaze focused intently on my hand.

I gently pulled the gauze back far enough for me-and Lilly-to see the incision. She turned her head immediately and stared at the wall. I kept looking at the dissected layers of skin, fat, and muscle. Sterile gauze, soaked with bloody drainage, filled the base of the wound, which clearly went bone-deep. "Good," I said.

"Good?" she said bitterly.

"All the tissue they left looks healthy," I said.

She rolled her eyes.

"The last thing you'd want," I said, "would be a surgeon who wasn't willing to follow the infection all the way to its source." I noticed a tear start down Lilly's face. I grabbed a tissue from the nightstand and blotted her cheek dry.

She turned her head toward me, but said nothing.

"It's really no different than what I try to do," I said. "I have to help my patients trace the roots of their pain as deep as they go."

A few seconds passed. "What if your patient doesn't know what caused the pain?" she asked.

"Asking the question is half the answer," the voice at the back of my mind said. "She wants to take the journey. At heart, everyone wants the truth."

My breathing slowed. My eyes closed an instant, then reopened. "If you don't know, then we both have to find the courage to figure it out," I said.

Lilly blushed. "I have trouble talking about myself," she said.

"Why is that?" I asked.

"I guess I think it's safer to keep things inside."

"Safer?"

She didn't respond.

"What's the danger in opening up?" I asked.

"People who tell too much about themselves end up…" She stopped short.

"End up… what?" I asked.

"I don't know." Her brow furrowed. "Alone, I think."

That statement spoke volumes about Lilly. Fabricating an illness-lying-had brought her close attention from a team of doctors. Coming to terms with the real source of her suffering, especially if that source was abuse at her grandfather's hand, would end her relationship with him, and possibly with other family members as well. The risk of abandonment was real and had been with her since her childhood. There was no sense candy-coating the stakes. "I know how frightening it is for you," I said, "but you have to be willing to be alone, for a while. At the very least, you have to be willing to be alone with your own thoughts."

She nibbled at her lower lip, like a timid little girl. "I can't stand being by myself."

That was a pretty clear message. She needed something-someone-to count on, no matter what she divulged. I touched her thigh, just above the incision. "I promise to stay with you every step of the way," I said.

"But how can you say that?" she asked. "You don't even know me. How am I supposed to trust you?"

I could have come up with a platitude to sidestep that question, but only an honest response would count with a person whose life had become a lie. "You can't be sure that I'm trustworthy," I said. "You can never be certain-not with anyone. Eventually, you'll have to take a leap of faith. You'll have to go with your gut."

"I don't know," she sighed. "I'm so confused."

Another small victory; confusion is often the first sign of weakening in the mind's defense mechanisms. I didn't want to seem too eager to breach them. "Shall I stop back in a few days, then?" I asked.

She stared at me several seconds. "Okay," she said. "Yes."

I made it home just before 11:00 p.m. A message from North Anderson on my voice mail told me I was scheduled to interview Billy Bishop at 10:30 a.m. the next day. Judging from my experience flying to Manhattan on other cases, that would mean taking the 7:30 A.M. shuttle, planning for it to be late by a couple hours, which it pretty much always is.

I decided to hop on the Internet and learn what I could about Darwin Bishop. Yahoo! came up with 2,948 references, from sources like the Wall Street Journal, BusinessWeek, and CNN Financial News. The pieces told me Bishop had founded CMM with over $40 million of venture capital, that he had recruited engineers and metallurgists out of MIT, CalTech, and the University at St. Petersburg, and that his company had grown to one thousand employees within eighteen months. A mention in the New York Times noted Bishop's winning bid of $4.2 million for a Mark Rothko oil painting that had been predicted to bring $800,000 at auction at Sotheby's. His lavish lifestyle caught the eye of Vanity Fair, which published photographs of his vintage car collection and his nineteen-thousand-square-foot River House penthouse, as large as a quaint hotel. The property, located on 52nd Street, on a cul de sac between First Avenue and the East River, was also home to Henry Kissinger and Sir Rothschild. The penthouse had itself been owned by the Astor family before Bishop picked it up for a mere $13 million. And that was before Manhattan real estate really went through the roof.