A three-inch swollen welt materialized almost instantaneously on Spielmann’s neck. Her eyes were the size of silver dollars. Within seconds, more hivelike bumps started popping up all over her face, arms, and legs. It was what Koller expected would occur in a systemic allergic reaction. Her lips and eyelids began to swell too and it was clear to Koller that the ball in her mouth wasn’t helping her breathing any. He waited a few minutes before taking it out. By then her airway had swollen closed, enough to make screaming impossible. Next, he undid her restraints. Then he watched as she rolled off the bed and landed hard on the Oriental rug. She was crawling on her hands and knees in a desperate attempt to get to the stairs leading to her kitchen.

“I wish I was a betting man,” Koller said, smiling down at her. “Because I would bet when you get to your refrigerator you won’t find your prescription allergy kit there. Then again, maybe you will.”

With her strength failing rapidly, Abigail Spielmann reached the head of the stairs. Then she fell, tumbling over and over before coming to rest twenty feet from her gourmet kitchen. Incredibly, she still managed to get to her hands and knees again. Inch by inch, as her body continued to swell and redden, she made it to her refrigerator. Pulling open the door required a Herculean effort. Her eyes were swollen shut now. Her breaths came in sporadic, wheezing fits.

Koller watched unblinking, absorbing her every move. There were no glass jars to crash on the floor and disturb the neighbors. Koller had already removed them and would break a few in a plastic bag to scatter about the kitchen floor before leaving. The only items to spill out in her frantic search for the kit, were those he put within her reach; a head of lettuce, a plastic bottle of ketchup, and two sticks of butter.

Spielmann collapsed face-first onto the cold tile floor, the cool air from the open refrigerator bathing her now lifeless body. Koller placed the prescription allergy kit a foot away.

Nicely done.

“Any moment can be our last, dear doctor,” he said. “Sadly, this is yours.”

Mr. and Mrs. Jefferson Collins arrived at the Singh Medical Spa and Cosmetic Surgery Center at precisely three. Earlier in the day, Daintry Calnan had called with the news that Dr. Paresh Singh had been called out of town for an emergency consultation. She tried to reschedule their appointment, but Jillian told her that for the time being, it would suffice if they were able to tour the facility.

“It will save us time when we do get to come in and schedule my surgery with Dr. Singh.”

The novelty of their plan had worn off and the reality was sinking in. Despite her theater background, Jillian had never had any talent for lying or deceit. Now, she used mental images of Belle and memories of their last conversation together to keep her focus under some modicum of control.

Nick was at least a seven on the SUD scale: Starting to freak out, on the edge of some definitely bad feelings. You can maintain control with difficulty. He had not shared the fact that he had suffered through another bad night. Restlessness, insomnia, nightmares, free-floating anxiety, even leg cramps-the works. Brain chemistry run amok. As usual, there was nothing transpiring in his personal life to correlate with the flare-up-nothing, of course, except the sudden arrival in it of Jillian Coates. As exciting as it was to feel himself falling for a woman, it was also as frightening as his PTSD episodes themselves. How could he ever even consider bringing someone into the bog that was his recurrent mental turmoil? Perhaps when-if-they caught up with Umberto. Perhaps then.

The receptionist, Daintry, was posted by the massive glass doors, watching their approach. She was a statuesque blonde in her early forties, although Jillian had trouble being certain about that fact due, she suspected, to the artistry of the woman’s employer. By the time they had exchanged handshakes, the receptionist had obviously sized them up and decided they were the stuff of which patients of the Singh Medical Spa and Cosmetic Surgery Center were made.

The combination lobby and reception area was even more imposing than the Web site had led them to expect. The vast space-nearly all marble-featured an eight-foot-high fountain in the center and huge, original artwork on three walls.

Seated behind a marble counter to one side of the lobby, wearing a dark suit tailored to show off his linebacker’s build, was a security guard with a square jaw and a plastic ID around his neck.

“That’s a Shelby Stone ID,” Jillian whispered to Nick. “I guess this place is directly affiliated with the hospital.”

Nick and Jillian were both wondering about Manny and Umberto. At this point, the connection between the two soldiers was tenuous-identical somewhat casual remarks made four years ago by each man regarding their return to the military, and their enrollment in a top-secret covert mission. In addition, Manny was much more of a candidate for plastic surgery than a product of it.

Still, both Nick and Jillian had seen Manny’s powerful reaction to the vista they believed he had seen from high up in this building. Looking around at the opulence surrounding them, it was hard to believe either Manny or Umberto ever had anything to do with the place. But now it was time to home in on that possibility.

“So,” Daintry said, passing a price list across to Jillian, “I will check once you have given me your insurance, but it is doubtful they will provide coverage for any of our procedures.”

“I’m sure that won’t be a problem,” Jillian said.

“Yes, yes, of course.” Daintry passed over a tastefully done brochure and encouraged the Collinses to visit any floors that were available by elevator. “I have a patient coming in for preadmission,” she said, “otherwise I would be glad to accompany you.”

“Can I please see one of the suites where I might be staying for my recuperation?” Jillian asked.

“The actual suites are locked or occupied, but I’ll unlock the sixth floor where some of them are located. Once you’re staying here, you’ll need a room key to access your floor. I can’t imagine you won’t be totally pleased with your suite. It will have all the amenities you could ask for, plus a spectacular view of the city. Some very famous Hollywood personalities have stayed there, and they have had nothing but praise for it.”

“I would like to see the operating room or rooms,” Nick said. “I once had a bad outcome with knee surgery, and I prefer to be as careful as possible around hospitals.”

“Our two operating rooms are not in use at this time, but the elevator will take you to the observation balcony one floor above them.”

There was something about the receptionist’s expression that made Nick uneasy-a look of mistrust, perhaps. Had they already said or done something wrong?

Jillian took his arm as they headed for the elevator. Her closeness did away with much of the anxiety he was feeling.

The two operating rooms were located underground-floor B-2. The button was at the bottom of a column that went down to B-2 and up through L to 6. A row of five keyholes across the base of the stainless-steel plate confirmed that some of the floors could be closed off or accessed only after being unlocked. The security measures were no surprise. Privacy was the watchword of the rich.

B-1 opened onto the observation balcony above the ORs themselves. Viewed through glass or Plexiglas from the overhead walkway, the rooms were gleaming spaces with state-of-the-art operating microscopes and monitoring equipment, along with screens most likely used to display projections of the befores and afters of noses, jawlines, chins, wattles, eyes, lips, and the like.