Something that had never happened before:

Jeremy forgot to turn off his pager, and it went off during a therapy session.

The patient was a thirty-year-old man named Josh Hammett, an electrician, undergoing a final set of skin grafts for deep-tissue burns suffered last year when a storm-snapped power line had scythed across his chest and severed his left arm.

Months after the amputation, phantom pain had set in, and when nothing else seemed to work, the plastic surgeon put in a psych consult.

This was the sixth time Jeremy had seen the young man. Josh had proved an excellent hypnotic subject, responding readily, even eagerly, to Jeremy’s suggestion that his arm had found a peaceful resting place.

Now, he reclined on a couch in the treatment room with Jeremy hovering near his head. Breathing slowly, regularly, the innocent smile of a dreaming toddler spread across his lips.

The bleating at Jeremy’s belt failed to rouse him. Deeply under. Jeremy switched off the beeper, let him stay wherever he was for a longer while than usual, finally brought him out gradually. When the young man thanked him and told him he felt great, really great, fantastic, actually, Jeremy turned it back on him: “You did all the work, Josh. You’re excellent at this.”

“Think so, Doc?”

“Definitely. You’re as good as it gets.”

Josh beamed. “I never thought it was something I could do, Doc. Tell the truth, when you first mentioned it I thought it was bogus-pocus. But that power-board idea ended being a great idea. The minute I visualize it, all the circuits in place, see all those lights blinking, everything working real smooth, I just go right under. Like that.”

He snapped the fingers of his only hand.

“Today,” he went on, “I really got into it. Pictured I was fishing, out off the sound. Hauling up pike and whitefish, so many it was almost too much for the boat. I tell you, I could smell those guys frying in the pan.”

“Set aside some for me.”

“You bet, Doc.”

Jeremy left the treatment room content. Angela’s number on the beeper brought a smile to his face.

“I’ve got half an hour,” she said, when he reached her on the thoracic ward. “How about coffee and Danish in the DDR?”

“I’m on my way.”

When he got to the doctors’ dining room, she was sitting at a table with Ted Dirgrove, the heart surgeon. Coffee and a chocolate cruller sat in front of her. Nothing in front of Dirgrove. He was out of his crimson scrubs, wore his white coat buttoned. In the exposed V was the curve of a black T-shirt.

Very hip.

He got up as Jeremy approached. “Hey, Jeremy.”

“Ted.”

Dirgrove turned to Angela. “I’ll be doing it on Thursday, so if you want to watch, no prob, just let my secretary know.”

“Thanks, Dr. Dirgrove.”

Dirgrove returned his attention to Jeremy. “I’ve been meaning to call you about the Saunders girl.”

“Everything okay?”

“Not quite,” said the surgeon. His spider fingers flexed, and his bony face turned rigid. “She died on the table.”

“God. What happened?”

Dirgrove rubbed an eye. “Probably a reaction to anesthesia, one of those idiopathic things. Her vitals went haywire- a peak, just what I was worried about- then a really deep trough. Everything just tanked. At first I was sure it was a typical, anesthesia screwup. Tube down the esophagus instead of the airway, because all of a sudden her oxygenation just plummeted. It stinks, but it happens, you spot it, you fix it. The gas-passer checked, and everything was in place. He just couldn’t stop her from losing function. I’d opened her, retracted the sternum, had just gotten to the heart.”

Dirgrove related the incident in a hollow voice, as if projecting through a bamboo tube. His eyes were weary, but he’d shaved closely this morning and looked well put together. “Everything was rolling along fine, then she was gone. It just stinks.”

Jeremy thought of the chubby young woman with the multipierced ears and the unruly hair. All that anger. Dirgrove picking her out as high-risk.

I come into this hellhole feeling fine and tomorrow I’m gonna wake up feeling like I got run over by a truck.

You’re an adult and it’s your body… so if you have serious… reservations…

Nah. I’ll go with the flow… what’s the worse that can happen, I die?

“Stinks bad,” said Jeremy.

“Stinks to high hell.” Dirgrove rolled his shoulders. “The autopsy results should come in shortly. No sense dwelling.”

He walked off.

“Poor man,” said Angela.

“Poor patient,” said Jeremy.

His tone was harsh, and she blanched. “You’re right, I’m sorry-”

“I’m sorry,” said Jeremy. “I’m on edge.” He sat down opposite her, reached for her hand. She offered her fingertips. Cold, dry. “It took me by surprise. When I didn’t hear from him again, I assumed…”

“Terrible,” she said. “Any other reason you’re on edge?”

“Too much work, not enough play.”

“Wish I could play with you, but they’re exploiting me, too.”

He looked at her cruller. She said, “Take it, I’m finished.”

“You’re sure.”

“More than sure.

Breaking off a piece, he chewed, swallowed. “I didn’t mean to snap at you.”

“It’s okay. He shouldn’t have dropped it on you like that. I guess I felt sorry for him because I identified with him. Losing a patient. It’s what we all dread, and sooner or later it’s going to happen. I’ve lost a few, already, but I wasn’t the attending, they weren’t really my patients. That’s one good thing about what you do, isn’t it? Patients don’t die. Not for the most part.”

“There’s always suicide,” said Jeremy.

“Yes. Of course. What was I thinking?” She drew back her hand, ran it through her hair. Her eyelids were heavy. “I’m not doing very well, am I? Too much work, not enough play. I did love that dinner, though. That was a great escape. I like the things you do for me, Jeremy.”

Her hand returned to his. The entire hand. Her skin had warmed.

“May I ask you something?” she said. “When it does happen- a suicide, or when a consult patient goes, like this one- how do you deal with it?”

“You convince yourself you did your best and move on.”

“Basically, what Dirgrove said. No sense dwelling.”

“Basically,” said Jeremy. “You can’t be a robot, but you can’t bleed for everyone, either.”

“So you learn to do that. Distance yourself.”

“You have to,” he said. “Or you wither.”

“Guess so.”

“Want coffee?”

“No, I’m fine.”

Jeremy got up, poured himself a cup from the doctors’ urn, and returned.

Angela said, “The girl who died. Do you think there could’ve been something to Dirgrove’s worries?”

“What, she scared herself to death?”

“Nothing that pat… yes, I suppose that is what I mean. Could there be something unconscious going on? Is there a death force that grows in some people and takes them down- causes their autonomic system to go haywire, poisons their system with stress hormone? Isn’t there some tribe in Vietnam that has a high rate of sudden death? Nothing’s predictable, is it? You go through all that basic science in premed, think you’ve got a handle on it. Then you see things: Patients coming in looking hopeless, but they recover and walk out on their own two feet. Others who aren’t that sick, end up on the wrong side of the M and M reports.”

Morbidity and Mortality. The right-hand column reserved for deaths. The M and M’s were the purview of Arthur’s department. The old man again… let him stay in Scandinavia, consuming lutefisk and pornography and whatever else they produced there…

Angela was saying, “What if the difference isn’t what I do? What if it comes down to psych factors? Or voodoo? For all we know, there’s the equivalent of a psychic virus that colonizes our basic survival instincts and bends us to its will. Merilee Saunders could’ve felt it taking her over. That’s why she was nervous.”