Saturday, July 5, 11:00 a.m. Buffalo, New York

Earl loved it when doctors decided to party.

For a few hours they sloughed off the demands on them from a never-ending maze of corridors filled with patients, pain, and loss to become as goofy as schoolkids let out for vacation. The decompression- extreme at the best of times, because all physicians believed if anyone had a God-given right to play, they did- felt even more of a release than usual. Out here, away from work, they also felt freed from the threat of SARS.

But the public didn't. Despite the makings of a perfect day for another successful St. Paul's Annual Hospital Bed and Bedpan Run for Fun- blue sky, a steady breeze off Lake Erie to cool the downtown core, the good turnout by staff and residents alike- the ranks of spectators lining the curb remained sparse. Hospitals had come to be seen as reservoirs of the virus. No one wanted to be around the people who staffed them.

"At least nobody tied bells around our necks," Sean Carrington quipped, referring to the historical treatment of lepers.

Rules for the event were simple. Contestants gathered at the starting line in Buffalo's so-called theater district- two playhouses, one multiplex- and chose a standard-issue, regulation-size hospital bed from a collection slated for the scrap heap. Divided into teams of five- one to ride, four to push- they attempted to safely transport their passenger and the contents of a half-full bedpan (apple juice being the fluid of choice) over a circuit comprising two complete city blocks.

Prior to the race, local politicians and business leaders backed their favorite teams, grandiosely presenting checks the size of air mattresses bearing five-figure amounts while the various competitors christened their chariots with flying banners intended to draw in the cash donors. The Go-Go Train was Urology's entry; the Cutting Edge carried the colors for Surgery; Janet's department would attempt to do itself proud on the Baby Bucket. Earl's crew had simply called their entrant ER, blatantly capitalizing on the popular TV show. But the favorite and champion for the last five years, Jimmy's Flying Angels, brought in the most bucks. Nobody minded, because he invariably divided up the loot with the fairness of a saint. "God bless St. Paul's," he called out to the small crowd after graciously receiving a check for fifty thousand dollars from a beaming, red-faced little man who ran a well-known pest extermination company called Hasta La Vista, Baby.

Then Jimmy rivaled the sun with a flashing grin and added, "For the course of the race, however, I will not be showing Christian kindness."

The other team leaders protested and strutted their feigned indignation in a show worthy of pro wrestlers.

"Hey, Father, unfair!"

"I'll tell your boss!"

"Divine tampering!"

But they evoked only strained laughter from the audience.

"Either our jokes are worse than ever," Thomas Biggs whispered to Earl, "or the few good citizens brave enough to show up aren't that happy to be here."

"Bit of both, I'd say," muttered Sean from behind them. "I tell ya again, we'll all be in cowbells before long."

As the presentations to other teams continued, Earl mugged for the hospital photographer, pulling deranged faces and using a grease gun like a syringe to lubricate the wheels of his team's bed.

"Set to get whipped?" Jimmy said with a sweet smile, sidling up to him.

Earl pretended to cower before him, and Jimmy flexed his muscles Atlas style, showing off a physique that most bodybuilders would die for. The photographer snapped away. "How about a quote?" she asked.

"In a two-K race, chaplains who run ten K a day ought to carry rocks as a handicap," Earl said.

"Nan, you're thinking of Hippomenes, and he was carrying golden apples to distract a woman he was chasing," Jimmy retorted. As soon as the woman left, his smile vanished and he glanced to where, a few feet away, Susanne Roberts, Michael Popovitch, Thomas, and J.S. were passing floppy straw hats to a half dozen spectators, enticing them to empty their pockets of small change.

"Can I have just a word with you in private?" Jimmy asked. "It won't take more than a minute."

Earl had already discovered that being VP, medical meant he'd never be lonely. He couldn't go to a hospital function without somebody collaring him for "just a word in private." But he'd hoped a zany affair where they all turned into clowns would somehow protect him from politics for at least a few hours. No such luck. And Jimmy, though on the side of the angels, could be a veritable Cardinal Richelieu when it came to exerting influence on the powers that be at St. Paul's.

"Sure."

They walked to a quiet alcove between a Starbucks and a wannabe Irish tavern with leprechauns painted on the windows.

Jimmy eyed the half-empty street. "Not the best turnout from our good citizenry."

"What's up?" Earl was impatient to dispense with whatever business the man had in mind so he could get back to his team. He'd few enough opportunities to shed his role as big boss and just be good old Earl with them.

"First let me say I thought you handled the Baxter case really well," the priest began. "That had to be the roughest case of that kind I've seen."

"Thanks, Jimmy."

"Are you going to use it for teaching rounds?"

"Of course."

"Will you invite the oncology department?"

"Anyone's welcome. Now, Where's this leading?"

"Just that seeing the way you were willing to sedate Baxter so he wouldn't suffer, I knew I could come to you without being accused of overstepping my bounds."

Earl bristled at being buttered up. "Cut the stroking, Jimmy. I know you're after something," he said, comfortable enough with the man to be blunt. Although they were not close friends- they only socialized in the context of hospital business- he liked Jimmy, and sensed that Jimmy liked him. But neither man offered to extend their relationship, as if they both knew intuitively to leave their friendship within boundaries where it could remain comfortable.

The priest's face sagged, and a sadness he rarely showed settled into his eyes. "You're going to get a complaint about me from some of our oncologist colleagues."

"What?"

"These last few days I've been holding up what you did for Baxter, or at least were prepared to do, as an example of what they might well emulate, and some of them got a tad upset about it."

"You didn't."

"I just wanted to warn you-"

"Jimmy, you know damn well not to interfere in how doctors practice."

"Who's interfering? When someone does the right thing, as you did, I simply make a joyful noise about it."

"A joyful noise?"

"Right. Jesus always went on about the need to make a joyful noise. I take him at his word."

"And which doctors, specifically, did you see fit to make this joyful noise to?"

"Well, Peter Wyatt, the chief of that bunch, for one. I always figure it's best to deal with the top man…"

Earl groaned. Wyatt personified the old-boy network at St. Paul's, though he himself hadn't yet reached sixty. But mentally Wyatt allied himself with those from an era where doctors were above mere mortals and not to be questioned, especially by underlings outside the medical hierarchy. "Jimmy, don't give me that naive crap. You knew going to him would stir up a hornet's nest."

"It needed doing."

"What did you say exactly?"

"That a dozen or so members of his department were dinosaurs who sucked at managing pain, and then I suggested an audit on the subject might be in order. I waited until today, of course, figuring it safer to express my opinion in a crowd, where he'd be forced to behave."

"You've got to be kidding."

Jimmy, now looking more defiant than sad, shook his head.

Earl's stomach did a pirouette at the thought of how Peter Wyatt would react, crowd or no crowd, to such a frontal assault, especially since the charge hit home. No greater hot-button issue existed in palliative care than proper pain management. The dilemma was, the more potent an analgesic and the bigger the dose, the more likely the medication would stop a person's breathing as well as the pain. Though some enlightened doctors advocated sufficient amounts to make a patient comfortable, even if they inadvertently hastened the person's inevitable death, some didn't. They administered instead rote, inadequate quantities rather than risk an accusation that they'd committed active euthanasia.