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"I promised him I wouldn't hurt myself. But he still wanted the pills." Her face moved a few degrees toward sadness. "The bottle was in the side pocket of a carry-on we had taken with us to Aspen last year," she said. "I had a bad feeling about the whole thing. I thought about telling him the pills were lost." Her voice fell to a whisper. "But I gave them to him." She looked at Tess.

"Are you willing to tell North Anderson all this?" I asked.

"Yes," she said. She stared through me. "I gave Darwin the medicine he used to poison my baby. You begged me to keep her safe."

"She'll make it," I said.

"At the hospital on Nantucket they said she might have brain damage."

I knew Julia's statement was actually a question, but I didn't have the answer. Tess was at risk for neurological complications, but I didn't know how grave a risk. "Give her a little time," I said. "There's every chance she'll make a full recovery. She could look much better in a couple days-or a couple hours."

"I'm not leaving," she said.

"No one's going to try to make you. You can stay with her as long as you want." I walked over to her and crouched beside her seat, so that our faces were on the same level. "You do need to keep yourself well for her."

Julia looked at me directly for the first time.

"She's going to need a healthy mother more than ever," I said.

"Can you stay with us a little while?" she asked. She offered me her hand.

I took it. Her hand was trembling slightly, like a delicate, frightened bird, and holding it made me feel needed and strong. I thought of North Anderson's warning about getting too close to see the truth about the Bishop case, but, at that moment, it seemed to me that there were two clear-cut suspects-Billy and Darwin Bishop. "I'll stay here a while," I said. "I have another patient to visit in the hospital a little later, but I can stop back after that."

She caught her lip between her teeth in a sad and seductive, little-girl way. "I meant, will you stay with us when we leave here? I'm not going home."

"What's your plan?" I asked, sidestepping the original question.

"I'll take Garret and Tess to my mother's," she said.

I nodded.

"I want you to come with us," she said. "Just until I feel safe." She shrugged. "Who knows? Maybe we'll both end up feeling safer together."

Looking back, I heard those words with a part of myself injured in childhood and unhealed as an adult, despite the good work of Dr. James in trying to piece my psyche back together. Because the pull toward rescuing an unhappy woman-a wife and mother-who would simultaneously rescue me was nearly overpowering. It was a dream I had stored away in my unconscious for forty years. And it was all I could do to remind myself that Julia had had equal access to Tess-and to the nortriptyline-as Darwin. "I promise not to leave you in danger," I said, leaving the door open for any and every possibility.

I called North Anderson and told him about Julia's suspicions. He said he would have a detective from the Boston police force take her statement. "I got to tell you I'm being shoved toward the sidelines," he said. "I guess you got to be careful what you ask for. The state's pulling out all the stops to find Billy, but the resources come along with a State Police captain named Brian O'Donnell. He's hot to run the whole show."

"What sort of guy is he?"

"Nobody we'd want to have a beer…" Anderson said, stopping himself.

"It's okay," I said. "I can take a joke, without taking a drink."

"Let's just say he's by the book. Very focused. Very serious." He paused. "Megalomania is probably the right diagnosis, if that's a diagnosis at all."

"It's been replaced with Narcissistic Personality Disorder," I said.

"Sounds about right," Anderson said. "When are you back?"

"Early tomorrow. I'll check in with Claire and Garret, like you suggested."

"I'd do it as soon as you can. O'Donnell has the Governor's ear. He could pull the plug on both of us."

"Understood."

"Call me when you hit the island."

I headed to Lilly Cuningham's room and was surprised to find her sitting up in bed, reading the Boston Herald. Her leg was still packed with gauze, but it was out of traction. I walked closer and saw that the Bishop story had made it onto the front page of the late edition, under a massive headline that read: "twin terror." A photograph accompanying the story showed Julia and Darwin at a black-tie event. A smaller inset showed the Bishop estate. I tried to focus on Lilly. "You seem to be on the mend," I said.

She lowered the paper and smiled at me. "They finally found the right antibiotic," she said.

I glanced at the IV pole. It had been pruned down to one hanging plastic bag. "I guess so."

"I'm glad you came back," she said.

"I told you I would." I sat down.

"I've been thinking about my grandfather."

The way those words rolled off Lily's tongue made me wonder whether the antibiotics had done all the good work on her leg, or whether her mind had opened up enough to let some of the toxins drain. "What about him?"

"These thoughts I have," she said. "I don't think they're flashbacks-or some sort of delayed recall. I don't think Grandpa ever touched me."

"Okay," I encouraged her, "where do you think the thoughts are coming from?"

"My imagination," she said. "They're things I've dreamt up-nightmares during the day. Don't all little girls have funny feelings for their dads?"

Freud did believe that all young girls have unconscious sexual feelings toward the men in their families. But those feelings generally evaporate by adulthood and never fuel serious psychiatric symptoms. I wondered why Lilly's impulses had survived childhood and adolescence intact. Why did they surface on her honeymoon? And why were they so threatening that she had to resist them by doing something as distracting and destructive as injecting herself with dirt?

"Because she couldn't count on anyone else to resist them" the voice at the back of my mind said.

That seemed like the right path to journey down. "How would your grandfather have responded," I asked her, "if you had made the first move?"

"The first move?" she said.

"If you asked him for sex," I said.

A hint of a smile played across her lips. "I don't want to think about it," she said.

"That's always up to you," I said. "But if you choose to confront the thoughts, they may not sneak up on you anymore. You may find you can turn them on and off, without using a needle."

She looked as if she was on the fence about trying.

"Try it for ten seconds. No more," I said.

She looked at me to see if I was serious, then rolled her eyes and shook her head.

"Would he have been angry with you?" I led.

"No," she said. "He was an understanding man."

"Embarrassed?"

She shook her head.

"Shocked?"

She blushed, giggled. "God, I honestly don't know how he would have responded."

Those words, taken literally, sounded like they came directly from the heart of the problem. Lilly couldn't predict whether her grandfather would have taken her as a lover, had she asked him.

Healthy psychosexual development unfolds in an atmosphere in which children know the adults around them would never take them up on their sexual feelings. When a little girl asks her father whether he will marry her, a good answer is, "I'm married to your mother. I love her. Someday I know you'll meet someone who loves you that way." The father (or grandfather) should not respond with a suggestive wink or a playful pat on the backside-or with silence.

Unconsciously fearing that an offer of romance would be accepted by her grandfather, Lilly reacted by burying her sexuality. When it emerged on her honeymoon, it emerged with all the guilt and anxiety of a little girl trying to steal away the man of the house. Her sexual impulses were taboo. Worthy of punishment. Dirty.

"Did he have other women?" I asked.