"I don't know what to say," he repeated over and over, bowing to a growing sense that on this ward, bullshit would be even less forgivable than his ineptness with words. "But I'm sorry for your ordeal."

Still, he pushed on with the rounds. Despite the emotional suffering he'd discovered, he began to wonder if Jimmy hadn't exaggerated his claim about patients being undermedicated, as most seemed free of physical discomfort.

Then they approached the nearest of a string of rooms where the nurses had closed the doors. The sounds he'd heard earlier emanated from here.

He quickly scanned the chart of the patient they were about to see.

Elizabeth Matthews, fifty-eight, terminal cancer of the ovary.

What had sounded like whimpering turned out to be a continuous high-pitched cry once they were inside. The lights were off and the blinds were closed, so he could barely make out her form on the bed. But he could smell the acrid, sour aroma of her sweat.

Swallowing, he drew closer, and his eyes adjusted to the dark. She lay on her side clutching her knees, curled around the point where the tumor, grown from what had once been the source of her seed, would have maximally eaten through the contents of her lower abdomen and into her pelvis. She rocked back and forth, as if her belly were a cradle to the malignancy and her hideous keening could lull its ravages to sleep.

"Mrs. Matthews?"

The piercing sound from her throat never wavered.

A movement in the corner of the room startled him. "Doctor?" a man's voice said.

Earl turned to see a tall, asthenic figure rise from a lounge chair set well back from the bed.

"I'm Elizabeth's husband." He held out his hand. "Thank you for coming."

Earl took it, touched by the simple dignity of the gesture. Either the man had nerves of steel to remain so composed in the face of his wife's suffering, or witnessing it had left him numb. "Mr. Matthews, I'm so sorry."

"Nothing's helped, Doctor. She's been this way for the last two days. The residents tell me they're giving her the maximum amounts of morphine possible…"

As he talked, Earl flipped to the medication sheet and looked at the orders.

Morphine sulfate, 5 mg sc q 4 hrs prn.

Maximum, his ass. A medical student must have written it, copying word for word from the Physicians' Desk Reference, the bible of medications and their standard dosages. But Elizabeth Matthews didn't have standard pain.

He immediately felt back on his turf. "Get me ten milligrams of midazolam," he said to Yablonsky. This kind of suffering he could dispatch in seconds.

"But-"

"Now!"

One of her younger assistants darted out the door.

"When did she get her last dose of morphine?" he asked, walking over to check that Elizabeth Matthews's IV line remained functional. He opened the valve full, and it ran fine.

Yablonsky flipped to the nurses' notes. "At three this afternoon," she said, "during our usual medication rounds."

"And it's now nearly eight, five hours later. Her order says every four hours, as needed. I think we agree she needs it."

"Well, yes…"

"And you gave her only five milligrams?"

"Subcutaneous, as prescribed."

"You didn't request her doctor raise the dose, even though you could easily see she required more?"

"More is not what's on the chart, Doctor. Besides, we don't want her to get used to it so the drug no longer has an effect-"

"You call this an effect, Mrs. Yablonsky?" He gestured to the crumpled shape on the bed.

She fidgeted with the chart, fuming at being confronted. "No, but I-"

"What do you say we give her ten, then? And if that doesn't work, make it fifteen." He grabbed the file out of her hand and wrote the order, scrawling his signature with an angry flourish. "And once we find out how much is enough, we'll make it an IV infusion. Even street junkies know that popping narcotics under the skin doesn't hold a candle to mainlining."

Yablonsky turned scarlet all the way to the tips of her ears. "Really, Dr. Garnet, her oncologist says she could linger like this for months. She wi//grow tolerant to morphine, and-"

"Then we'll sedate her, just as I'm about to do now."

As if on cue, the young nurse who'd gone to fetch the midazolam returned and handed him a syringeful of the fast-acting sedative. He swiped the rubber portal at the side of Elizabeth's IV line with an alcohol swab, jabbed in the needle, and slowly pushed on the plunger. "Whatever it takes to make her comfortable," he continued, "especially if she's got months. My God, is that your policy, the longer a patient has, the longer they don't get sufficient morphine?"

Yablonsky's younger colleagues, standing behind her back, nodded tellingly.

Yablonsky snapped her head high and threw back her ample shoulders. "Of course not."

Earl wondered if she had once been an army nurse.

Elizabeth's cries lessened as he slowly injected the contents of the needle, keeping a sharp eye on the rise and fall of her chest.

Mr. Matthews walked over to the other side of the bed, leaned over, and stroked his wife's head. "It will be better now, Elizabeth. You'll get some rest." The fatigue in his voice weighted the words like rocks, but they must have fallen as gently as tears on her ears. She smiled, released her hold on her knees, and reached up to pat his hand.

A few seconds more, and she slept peacefully.

"Thank God," Mr. Matthews said, and pulled her mask from down around her neck back up over her nose. By the light from the hallway, his haggard eyes appeared gouged out by worry and exhaustion.

"Why not grab some shut-eye yourself?" Earl told him. "I promise you, she'll be fine for the night. Go home and get to bed." He put his hand on the old man's shoulder, and felt it slump in defeat. "Mrs. Yablonsky will sponge-bathe Mrs. Matthews and change her nightie and bedding." He turned to face the nurse. "And open the blinds, shall we? Let her see it's night should she wake up, right, Mrs. Yablonsky?"

She sucked in a mouthful of air. "Yes, sir."

"During the day, we'll continue to make sure they stay open and that there's natural light in here, so she'll be less confused. Agreed?"

The nurse nodded.

"And she gets her next morphine as soon as she starts to stir from the midazolam wearing off, which will be in about an hour…"

As Earl rattled off his instructions, tears rippled down the haggard circles beneath Mr. Matthews's eyes to where the crescent contours of skin bunched up by the top of his mask. From there wet marks spread through the material until it grew damp enough to stick against the hollow contours of his cheeks. He reached across his wife's sleeping form and held out his hand to Earl again, except this time it trembled slightly. "Thank you," he repeated, but much more softly than before.

Earl clasped it in his as he finished outlining to Yablonsky a regime that had more to do with simple human dignity than medicine. Yet he couldn't be sure she wouldn't screw it up somehow, to put him in his place.

"Yes, Doctor," she repeated over and over.

Her sullenness worried him. "And make sure the next shift gets it right as well. I want no more problems."

She bristled, almost standing at attention. "I'm doing a double and will be here until dawn."

Resentment had probably prevented her from adding a "sir" this time. Earl pegged her former rank as at least a sergeant.

He led Mr. Matthews to the door and delivered him to one of the younger nurses with instructions to give the man a taxi voucher.

Then he and Yablonsky wrapped up the rest of the rounds in an hour, during which Earl made similar adjustments to the medications of another seven patients, who all had little more than days, if not hours, to live. Still, there'd definitely be fireworks over what he'd done here tonight. One of the seven, unfortunately, belonged to Wyatt.