"What about a primary-care physician?" Sue asked after a short pause. "Now that you are officially a subscriber, you're going to need one."

"How about you?" Laurie suggested. "Are you taking new patients?"

"I'd be honored," Sue replied. "But are you sure you would be comfortable with me as your doc?"

"Absolutely," Laurie said. "I'll also have to switch my gyno."

"I can help you with that as well," Sue said. "We've got some terrific people on staff, including the woman I use my myself. She's quick, gentle, and knows her stuff."

"Sounds like a good recommendation. But there's no rush; I'm not due for a yearly checkup for another six months."

"That might be true, but I think we should get it in the works. The woman I'm thinking of is awfully popular. For all I know, she has a six-month wait for a first appointment. She's that good."

"Then by all means," Laurie said.

For a few minutes, they both concentrated on eating. It was Laurie who broke the silence. "There's something else important that I wanted to talk to you about."

"Oh?" Sue commented. She put down her teacup. "Fire away!"

"I wanted to talk to you about SADS."

Sue's face screwed up into an expression of complete confusion. "What the hell is SADS?"

Laurie laughed. "I just made it up this second. You've heard of SIDS, sudden infant death syndrome."

"Of course! Who hasn't?"

"Well, I've coined SADS for sudden adult death syndrome, which is a good name for a problem that's been occurring over here at the Manhattan General."

"Oh?" Sue questioned. "I think you'd better explain."

Laurie leaned forward. "Before I do, I have to say that it has to be in strictest confidence that the information I'm about to tell you came from me. I had suggested to our deputy chief that some- one over here at the Manhattan General should be warned, but he blew his top, contending that it was all mere speculation with no proof, and as such, might hurt the hospital's reputation. Yet I feel like the researcher caught in the bind of conducting a double-blind study on a life-saving procedure, which has quickly suggested its worth. Even though I'd be destroying the integrity of the study, which might keep the FDA from approving the treatment, I've got to leak the results so the people getting the placebo can be saved."

Laurie leaned back and laughed at herself. "Wow! Am I getting melodramatic or what? But it is true that I have no specific proof concerning what I'm about to tell you, mainly because I haven't finished investigating the cases. I don't even have copies of their hospital charts yet. I just feel it strongly, and someone has to know sooner rather than later. Anyway, this kind of medical politics drives me up the wall. It's the one bad thing about my job."

"Now you've got my curiosity up. Way up! Come on! Spill the beans!"

Leaning forward again and lowering her voice, Laurie proceeded to tell the story in the chronology it had unfolded by starting with McGillan, then adding the two cases posted by Kevin and George, and ending with her case that morning. She talked about the ventricular fibrillation and the fact that the autopsies had been completely clean. She then told Sue that she felt that with no pathology on gross or microscopically, the chances of four cases happening by chance was about the same as the sun not coming up the following morning.

"What exactly are you saying?" Sue questioned dubiously.

"Well…" Laurie said with hesitation. Knowing Sue as well as she did, she was aware that what she was about to say was the figurative equivalent of slapping her friend in the face. "Although I suppose there is still a minuscule chance the cause of these deaths was accidental in the form of a late anesthetic complication or maybe an unexpected side effect of a drug, I sincerely doubt it. And when I say minuscule, I mean infinitesimally small, because our toxicology screens have so far been negative. Anyway, the bottom line is this: I'm concerned about the possibility that these deaths are homicides."

For a few minutes, neither Laurie nor Sue said a word. Laurie was content to let the information sink into Sue's brain. She knew Sue was enormously quick-witted and patriotic about the Manhattan General. She'd done all her residency training within its walls.

Sue eventually cleared her throat. It was obvious that what Laurie had said had troubled her greatly. "Let me get this straight. You think we have some kind of a grim reaper wandering around our wards at night?"

"In a way, yes. At least, that's my worry. Before you dismiss the idea out of hand, just call to mind those cases in the news over the last couple of years, where deranged healthcare workers were dispatching patients under their care. You remember them, don't you?"

"Of course I remember them," Sue said, seemingly taking offense at the comparison. She sat up straighter in her chair. "But we're not out in the boonies here or operating a fly-by-night nursing home. This is a major medical center with layers of oversight. And these patients you've been describing weren't bed-ridden or at death's door."

Laurie shrugged. "It's hard to argue with the facts that we have namely, no explanation for four deaths. And as I remember it, at least some of the institutions involved in those serial-murder cases were highly regarded. The double tragedy is that they went on for so long."

Sue took a deep breath and let her eyes wander around the room blankly.

"Sue, I'm not expecting you to do anything about this personally," Laurie said. "Nor should you feel defensive about the Manhattan General. I know it is a fine institution, and I'm certainly not trying to sully its reputation. What I was hoping is that you would know whom you or I should inform to try to keep it from happening in the future. Seriously, I'll be happy to tell this individual exactly what I told you, provided my identity can stay out of the picture, at least until the OCME officially gets involved."

Sue visibly relaxed. She gave a quick, mirthless laugh. "Sorry! I guess I take any criticism of the place to heart. Silly me!"

"Do you know someone like I described: someone on a clinical administrative level? Or what about the head of anesthesia? Maybe I should talk to him."

"No, no, no!" Sue repeated for emphasis. "Ronald Havermeyer has an ego as big as a tectonic plate, with the usual associated volcanic eruptions. He should have been a surgeon. Don't talk to him! He'd definitely take it personally and want to take revenge on the messenger. I know because I've sat with him on several hospital committees."

"What about the hospital president? What's his name again?"

"Charles Kelly. But he'd be as bad as Havermeyer, and maybe worse. He's not even a doctor, and he clearly thinks of this whole operation as a business. There's no way in hell he'd be sensitive to your situation, and he'd be looking for a scapegoat immediately. No, it has to be someone with a bit of finesse. Maybe a member of the mortality/morbidity committee."

"Why do you say that?"

"Simply because dealing with something like this is their mandate, and they meet once a week to keep tabs on what is going on."

"Who serves on it?"

"I served on it for six months. Someone from the clinical side serves on a rotating basis. The permanent members are the risk management officer, the quality-control chief, the chief counsel for the hospital, the president of the hospital, the nursing supervisor, and the chief of the medical staff. Wait a second!"

Sue lunged across the table and grasped Laurie's forearm so quickly that Laurie jumped. Laurie's eyes darted around the room, as if she expected an imminent physical threat.

"The chief of the medical staff!" Sue repeated with enthusiasm. She let go of Laurie's arm and gestured widely with her hands. "Why didn't I think of him before? Oh my gosh, he's perfect!"