The lasting harm had been done to her work, the ordeal derailing her from the practice of medicine for nearly a year. Although she’d arranged for a temporary replacement, many of her patients worried that she would stroke out again despite her intention to return, and found new doctors. With each departure, the sense of purpose she fought so valiantly to regain shriveled a little more.

Then, just three months ago, while digging in her garden, her right side went numb. She tumbled to the ground, her arm and leg like deadwood for all the good they were to her. She lay there, her face pressed into the earth, dirt up her nose, and bugs crawling between her lips. A worm’s-eye view of the world, she thought, wondering if it would be the last thing she ever saw.

She’d had no pain, and knew this was the same kind of stroke as before, a blockage, not a bleed. If she got help fast enough, maybe the clot-busting enzymes that rescued her before could help again. Yet second by second, her time nearly ran out. When a neighbor spotted her and called an ambulance, she knew the three-hour window for treatment would soon close.

Once she got to the hospital, there had been no Melanie on hand to speedily diagnose and treat her.

“Since she’s already anticoagulated, it must be a bleed,” one of the ER residents, a sleepy-eyed kid, had said to her nurses as he methodically checked her reflexes.

No! she’d wanted to scream as she pawed feebly at his arm trying to get his attention.

He’d ignored her, and added, “Besides, we don’t know how long it’s been since she stroked out.”

Two hours, forty minutes, asshole! There’s still time.

“Send her for a CAT scan?” one of the women had asked, recording her vitals.

“Of course,” he said, and wandered out of the room.

No, don’t leave. Talk to the radiologist yourself. Bump me to the head of the line!

Three hours too late they’d made the correct diagnosis.

Her speech returned, but the delay cost her partial use of her right arm and her ability to walk normally. It also turned her into an old woman overnight.

“Hi, Bessie.” A pint-sized nurse with a GI haircut and a name tag that read NURSE TANYA WOZCEK pinned to her uniform bopped across to her bed. “All set for your meds?”

“As much as I’ll ever be.”

Everyone called her Bessie. It sprang from her insistence that she be registered as Mrs. Bessie McDonald, not Dr. McDonald, during her admissions. “Things go wrong when they know you’re a physician,” she’d repeatedly explained to the admitting office. “Doctors, nurses, techs – they all start doing what they wouldn’t normally do, second-guessing themselves. Leads to mistakes.”

But since the night of this most recent stroke, she’d had plenty of time to do some second-guessing herself. Had they known she was a doctor, would they have listened to what she was trying to tell them?

“Here, let me prop up your pillows,” Tanya said.

Bessie grew short of breath if she didn’t sleep partially upright. The result of heart failure. “Thank you, dear.”

“And here are your pills.” Tanya handed over a paper cup that had five tablets in it.

Bessie poured herself a glass of water from her pitcher, then downed the bunch of them in a swallow. She’d been on them for years: Digoxin to control her heart rate and increase its pump action; furosemide to keep water from accumulating in her lungs; rampril to relax her arterial tree and reduce the cardiac workload; warfarin, also known as rat poison, the anticoagulant that had led the resident off track; and a baby aspirin, to thin the blood and prevent more clots. As easy as one, two, three, four, five. Except having to take pills at all bored her, and the treatment, like all regimens, wasn’t perfect.

To control her angina, she had to take a spray of nitroglycerine under her tongue, in addition to wearing a patch of it on her skin. The latter could be worn anywhere, but most patients put it on their arm or chest. She stuck hers on her ass every morning just to be contrary, having precious few other ways to say, I’m here and I’ll do things my way.

“Skin’s skin,” she told the residents whenever they objected.

“You go right ahead and put it where you want, girl,” Tanya would say to her in private.

She liked Tanya. The woman always worked evenings, which led Bessie to try figure out what this nurse did during the days. She never talked about herself, and, of course, Bessie never pried. The fun lay in the guessing, not the answers. Bessie’s active mind grated against the hours of idleness and pounced on any puzzle for entertainment.

“I see you’ve been reading about Kelly McShane,” Tanya said, picking up a newspaper from the nightstand that lay open to the article. “The whole hospital’s buzzing about it.”

“I’ll bet. How’s Chaz Braden taking it?”

Tanya looked up from scanning the column. “Do you know him?”

“He was my cardiologist the first time I got admitted for my heart, about six months before his wife disappeared. Didn’t like him.”

The nurse’s expression slipped into neutral, and she glanced nervously at the doorway. “Can I get you anything? How about some juice?” Obviously, she wasn’t about to engage in a round of bad-mouthing the man, which, of course, was professionally correct.

But not fun.

Tanya leaned in close as if fluffing up the pillows a second time. “Our supervisor’s warned us not to gossip about it, but I bet you want to tell me every word of what went on back then, don’t you?” she whispered, dispatching propriety with a grin.

Nice girl, Bessie thought. “Of course I do.”

“Well, it’ll have to wait. You’re not my only patient, you know.” She gave a conspiratorial wink. “But maybe later, when I drop by with your needle.”

6:00 P.M.

St. Paul’s Hospital,

Buffalo, New York

Earl sat rereading the article for the tenth time when a quick rap on the door startled him.

Janet walked in. “Hi, love. Got a minute for me? It’s been a hell of a day in the case room.” She came up to him and pulled off her surgical cap, her short blond hair popping out from its confines like a golden star burst. She flipped the paper aside and pulled him to his feet, slipping her arms around him.

He felt his wife’s slim body beneath her OR greens, but returned the hug woodenly.

“Hey! That’s no way to treat a lady,” she said, pushing back and smiling up at him. Tall as he was, his six-foot frame outranked hers by only a couple of inches. Whatever she saw in his expression, she immediately knew that he was upset as hell. “Earl, what’s the matter?”

He sighed and handed her the article.

“Did you know her?” she said after skimming through it.

“She was in my class.”

“My God! That’s awful. I’m sorry. Were you friends?”

“She was in my study group. Along with Melanie Collins, Ronda Collins’s older sister, and, of course, Jack MacGregor,” he quickly added, giving her names he knew she’d recognize.

On hearing Jack MacGregor, Janet grimaced, and a pained expression crossed her face. MacGregor had died two years ago saving Earl’s life.

“There were a few others with us whom you don’t know,” Earl continued, feeling uneasy.

She read a little more of the column. “How creepy. Did you have any idea she’d been murdered?”

“No.”

“Even after she just disappeared without a trace?”

“We all thought she’d run away from her husband. It really wasn’t a happy marriage.”

“But no word from her, and you suspected nothing?”

“Of course we were worried. But you don’t know the man we thought she was escaping from. She’d told most of us she was going to leave him, yet insisted we not try and trace where she went. She was afraid he’d track her down by following us if we tried to contact her, so we figured that was why she just cut off all ties. After the police found no evidence of foul play, as far as I was concerned, no news meant she’d gotten away, free and clear.”