Suddenly the man who calls himself Defield changes. Like watching a cloud-shadow rapidly pass over a landscape. He visibly relaxes, and the lack of tension alters his expression. “Okay, good,” he says with a tight smile, and a kind of dreamy look in his eyes. “Time to meet my sons, Dr. Munk. Time to meet my beautiful boys.”

“Sons?” Munk asks, confused. “Boys?”

Defield opens the rear door of the vehicle, revealing two slender, unconscious bodies strapped to a pair of matching gurneys. One fitted with a respirator, the other breathing on his own.

“My God,” says Munk. “Identical twins.”

Suddenly, it all makes sense. And he knows why Defield is so confident of a tissue match. A glance tells him that the twins are not Defield’s progeny, not his children by birth, but there’s no doubt about the man’s paternal connection. Munk doubts the man’s sanity, but not his bond as a father, which informs and explains everything he has done so far. All that he has risked, and all he is about to sacrifice.

“Welcome to my tragedy,” says Defield. “I’ve had to choose. Who lives, who dies. You know what that means? Do you? Can you imagine?”

The surgeon shakes his head.

“Means I go to hell,” the man who calls himself Defield says quite affably. “Maybe I’ll see you there.”

As Munk helps unload the first gurney, he can’t help thinking that when the man smiles, he looks like a grinning skull.

44 what would shane do?

Rush hour starts early on the 287, and by the time we get to the Scarsdale exit it’s almost six-thirty. Fortunately Mr. Yap has been left at home, or else he’d be going nuts, because I’ve been playing backseat driver and Connie’s been pushing the Beetle for all its worth. Weaving in and out of traffic, using the breakdown lane, scooting through traffic lights with a blaring horn at my urging.

Should I be concerned about risking lives other than my own? Yes, but I’m not that good a person. All I can think about is Tommy, and what might be happening to him. What might already have happened. How every fiber of me wants to be with him right now, this instant, but I can’t. All because every truck in the world has decided to converge on this particular highway, at this godforsaken hour of the morning.

“What do we do when we get there?” Sherona wants to know. “You got a plan?”

“I don’t know,” I tell her. “Rush in the place and shout the medical equivalent of ‘stop the presses,’ I guess. If we even have the right place.”

“I feel good about it,” says Connie, trying to keep my spirits up as she hunches over the wheel like a NASCAR driver. “The ambulance was on 287, the clinic is just off 287, where else could he be going?”

“Could be heading to the Sawmill,” I fret. “From there he could go anywhere.”

“We’ll get there, check it out,” Connie promises. “One more light, and then we turn left on Fennimore, then the second right.”

After what seems an eternity—I’m debating whether to get out and run—at last we’re on a boulevard that isn’t clotted with commuters. Professional offices and plazas, all beautifully landscaped.

“It’s here somewhere,” Connie says as I crane my neck, searching.

Sherona spots the sign before I do, and Connie screeches into the tree-shaded parking lot of the Scarsdale Transplant Clinic, an ultramodern ground-level concrete structure with darkly tinted windows, the whole structure painted in shades of pastel that fail to make it welcoming. In the center of the wide swath of perfectly manicured lawn, a heliport pad with a shiny gold MedEvac helicopter strapped down with what look like silver bungee cords.

At this hour there are only a few vehicles in the lot—a matched pair of Mercedes coupes and a Lexus sedan—taking up the slots assigned to staff. The place is utterly quiet, no sign of life. Except for the telltale doctor cars, it doesn’t even look open for business.

“What now?” Connie asks, sounding much less confident than she did while fighting us through traffic.

“Sherona, how about you try the front desk,” I suggest. “Use your powers of persuasion. Tell ’em what we know, see if it does any good. Connie and I will circle around the back, see if we can find a back way in.”

“‘Powers of persuasion,’” says the big woman as she eases her weight out of the tiny Beetle. “I like that.”

She struts away like a drill sergeant looking for troops to rally.

Around the back we find a hospital loading dock with an ambulance in the slot.

My heart slams and my mouth goes dry.

“Jersey plates,” says Connie, sounding thoroughly discouraged.

“Doesn’t mean anything,” I tell her. “Plates can be swapped. You notice the doors?”

“What about them?”

“See where it says Beacon Medical Transport? Those are magnetic signs.”

I vault out of the car, approach the ambulance. It’s a big, boxy vehicle with orange-and-white stripes that look very familiar. A quick inspection reveals that the magnetic stick-on signs cover the logo for Hale Medical Response.

We’ve found it. Against all odds, we managed to track the monster to this very place.

My heart lifts. At the same time my anxiety level spikes so high it feels like my head is about to explode. And my knees, well, they seem to have dissolved, leaving me with legs like limp spaghetti.

This is it. Somewhere inside this building, my son is waiting. Alive or dead, I’m going to find him in the next few minutes.

“Where are you going?” Connie wants to know, hurrying to catch up.

“He’s here,” I say.

“We should call,” Connie suggests. “Alert the cops.”

My hands shake as I hand her the cell phone.

The loading doors, I soon discover, are bolted from the inside. Pounding with my fists produces nothing but a dull thump. Running around the corner of the building, I’m confronted by mirror-tinted plate-glass windows that extend from the roofline to the ground. Crazy with fear, I search the ground for a rock. Wanting to smash the hateful glass. Finding nothing but grass and imbedded paving stones.

What would Shane do?

“Connie! Your keys!”

Without a word, Connie hands me the keys to the Beetle.

“Stand back,” I tell her, and run to the car.

The engine starts instantly, but the little car has a standard transmission, and the first time the clutch is popped the engine stalls. Grinding the starter, begging it to go. The engine chugs to life and I ease it into first gear and run up over the curb, onto the pristine lawn. Gathering speed across the lawn, I’m in third gear by the time the building looms. Somewhere in my peripheral vision, Connie is raising her arms, her mouth as round as that Munch painting of The Scream, either cheering me on or shouting for me to stop, or maybe both.

What I’m thinking, as the little car crashes through the plate glass, is that my friend Connie will be mad at me, and then the rear wheels catch and I’m thrown hard into the steering wheel.

Then nothing, blackness.

When I come to, bells inside the building are ringing like a giant alarm clock. The windshield has been reduced to diamonds that litter the dash. I can feel them in my hair, particles of shattered glass, and my face is hot and wet. The front air bags have deployed, pinning me to the back of the seat, which is now in the rear of the vehicle. Can’t move. Can barely breathe, a great pressure on my chest and lungs.

And then Connie is there, frantically reaching through the broken side window and trying to pull the air bags away from me.

“The door is jammed,” she informs me in a strangely calm voice. “You’ll have to scrunch through the window.”