Despite her decision not to date anyone, Jane had started to let her guard down with the guys in the department, hoping to fit in. Nothing serious, just played along with their lighthearted chatter and teasing in the way she would have with her buds back at Grand Forks. But then came the comments laced with sexual innuendos.

At first she'd taken offense. That kind of talk angered her. As early as high school she'd had to endure the "nice T and A" comments the boys whispered behind her back but loud enough for her to hear. It drove her to start dressing tough, all the while feeling far from it inside. Even now, being what her mother called "amply endowed," whenever she wore a swimsuit the old self-consciousness about her body remained. So when the males in ER cracked that J.S. had better not go near old men with pacemakers, she might have grinned good-naturedly, but the joke set her cheeks on fire.

"They're assholes," Susanne had told her in the nurses' lounge after the first incident. "Not one of them would know what to do with a gorgeous woman like you, and that's your weapon. Zing their kind right back, and they fold."

The next time some wit resorted to that same refrain, Jane had run her fingernail down the front of his lab coat, unhooking the buttons as she went, and looked him scornfully in the crotch. "No danger letting you near the female patients, with or without pacemakers."

He'd turned tomato red.

The others had oohed and laughed.

But she'd felt elevated a notch in how the males treated her after that.

And Susanne had become a combination older sister and aunt who watched over her without ever seeming to interfere.

"He says he doesn't want to do anything more about us right now," Jane found herself admitting to her. "That he couldn't stand the busybodies picking our lives apart."

"They won't if you don't let them," Susanne said.

"And how do I manage that?"

Susanne smiled and shook her head. "I suppose the same way you already have, silly- by continuing to keep your mouth shut. It's worked."

"But you knew."

"I'm different. What I picked up on had to do with seeing a kindred spirit, you might say. No one else is likely to find out."

Jane again wondered if Father Jimmy might not suspect the truth. "Yeah, right."

"Ask yourself why you know so much about who the people in this department are sleeping with," Susanne said.

Jane shrugged. "I don't know. Word gets around."

"Because most people, when they become lonely or down enough, brag about whom they love as a way to raise their confidence. I guess it somehow makes their being loved back feel more real. So far, honey, you've resisted that urge. As a result, you fall off everyone else's radar as soon as you walk out of here."

Susanne ought to know, Jane thought. Hardly anyone in the department ever gossiped about her private life. Oh, a few might have guessed at the possibilities of whom she might be with, but they didn't get far, there being no rumors to feed the mill. She wore no wedding ring, never discussed anything personal, and when sAewent out the door of ER, it might as well be into a black hole.

"So it beats me why he'd still be worried about gossip this stage of the game," Susanne continued. "You've both proven you can put up a good enough front to keep your business private. What's to stop the two of you from making plans for after next year?"

Hearing someone else articulate what she'd been telling herself, Jane felt something release deep inside her. Susanne, as usual, hadn't advised her what to do, but rather nudged her to see for herself what ought to be done. Not that she didn't already know. Anyone with half a brain could see that the time had come to press Thomas for the real reason he'd been stalling about their future. What held her back had to do with her fear of the truth and the practical prairie philosophy she'd learned from her mother: never ask questions when the answers might make you more miserable.

"You what?"

"I had to, Jimmy. Wyatt would have tried to kick you out of the hospital."

The priest jumped up from the visitor's chair in Earl's cramped ER office and started to pace. "But to have him lead a hospital audit on pain? That's as stupid as… as… as if you put bin Laden in charge of human rights at the UN."

"Or you telling the prickly fart how to practice medicine. Why'd you pull a boneheaded play like that?"

Jimmy froze and gave Earl a withering look. "Because I won't sit at any more bedsides and try to give spiritual comfort to poor wretches who die screaming."

"You're exaggerating-"

"Goddamn it, Earl, wake up. You see something that atrocious in ER, and you'd move in with morphine, ketamine, fentanyl- whatever it takes. I can't do that. For me it's beg the nurses, who ask the residents, who don't prescribe enough, then beg them to get their staff supervisor. Even then a third of them won't budge from the guidelines, but I beg them as well anyway, and all the time the screeching goes on. I tell you, there ought to be a court for medical atrocities, just like there is for atrocities of war, and this kind of torture by omission should be made a crime…" He seemed to run out of breath and simply stood there, panting as heavily as if he'd just completed one of his runs.

Earl sat stunned. He knew that crap happened, as hideously as described, and he condemned it whenever he could, but he'd never before seen it from so stark a point of view. At first he didn't know what to say. Finally he asked, "It's really getting to you?"

Jimmy nodded. "Sometimes." His eyes focused on something Earl couldn't see.

Judging from the pain reflected in the priest's gaze, Earl didn't want to see it. "You still could have come to me, Jimmy," he said softly. "Brought me patients' names and chart numbers. That's the kind of documentation that would have nailed Wyatt and others like him."

"Yeah, right. Case by case, committee by committee- it takes forever that way."

Earl exhaled long and hard. "But keep at it enough, and even the thickest-skulled dinosaurs change their ways in the end."

"Then why didn't you do it?"

"Me?"

"Yeah. You're a physician. Nothing stopped you from stepping up with charts and patient names these last twenty-five years."

Earl bristled. "Nobody dies like that in my department. Certainly not since I've been chief."

Jimmy's eyes narrowed into a hard, unjoking glare. "And that's the trouble with you, Earl. You hide in ER."

"Hide?"

"Yes, hide. It's a domain as black and white as any in the hospital. The sicker the patients, the easier your job. Stabilize 'em, medicate 'em, and ship 'em upstairs. Don't get me wrong, you're great at it- decisive, skilled, and courageous. But one of the reasons the job suits you isn't so noble. The patients don't hang around, and you like it that way. The ones who don't make it, you can honestly tell yourself they died while you were trying everything possible. The ones who do, their pain, fear, and despair are muted by shock or postponed by drugs. The long and short of it all is that you get to keep your losses more cut-and-dried. No having to deal with the long, messy aftermath that survival involves."

"Whoa. Now wait a minute, Jimmy. I find out how people did after they left ER. Their doctors tell me-"

"I'm not talking about the clinical results or satisfying your medical curiosity."

"Jesus, Jimmy, what the hell's the matter with you?"

"What's the matter is, you can't be VP, medical and bury yourself in a mentality that has a fix for everything."

Earl leapt to his feet. "That's not fair!"

"What's fair got to do with it? You want to face a patient's lingering, share in his or her long-term agony, witness their slow settling for a fraction of a former life, then watch your successes as they piece together what they lost from the heart attack or stroke or car accident that derailed them."