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Suddenly Pia knew what she could do to get herself centered, to regain some focus. George had been hanging around, offering to help. She thought there was something he could do for her, as he’d done a few times in the past. George wasn’t so different from any other man she’d ever encountered. But each time it had happened, when Pia thought George would have been put off by her needs, there he was, back again the next day.

Pia imagined that George would be on his lunch break, one of the benefits of a rotation in something predictable like radiology or pathology. There was a predictable schedule. She wanted to call him, but she couldn’t find her cell phone. And when she did find it, in the pocket of her coat, she saw that the battery was dead. She plugged the phone into the charger and called George, catching him as she had hoped on his way over to the cafeteria.

“I was going to swing by later to make sure you were okay,” George said. They hadn’t parted on the best of terms after meeting with the dean, and George’s perennial insecurity about Pia had surfaced again.

“You offered to help. Is that still the case or are you still mad at me for getting you in trouble?”

“I’m not mad at you, I’m just worried about you.”

Pia rolled her eyes.

“So you’ll help me?” This was awkward. Pia wanted George to say yes, I’ll be right over. Instead, he said, “Not if it means going back up to the lab.”

“No, George. What I’d like you to do is come over here for a few minutes.”

“Right now?”

“Right now, George! I assume you’re on lunch break?”

“Okay,” George said. “I’ll be right there.”

Pia prepared. Almost to the minute of his expected arrival there was a knock on Pia’s door. She pulled it fully open.

George’s eyes sprang open to their fullest extent. He was clearly taken aback. Nervously he glanced up and down the dorm hallway to make sure no one could see what he could. Pia was standing in the open doorway buck naked.

“This isn’t quite what I expected,” he managed, as Pia pulled him into the room. She was shockingly deliberate, as she had been on previous occasions, and again, as on those previous occasions, he didn’t resist. Under the circumstances she was a force greater than him, and he was powerless. Pia grabbed at the belt in George’s pants, and he obliged. She then pulled his sweater and T-shirt over his head. Pia pushed him onto the bed and handed him a condom just as she had on the other occasions. He was ready-achingly so-and Pia got up on him immediately. She closed her eyes and looked up, rocking herself rhythmically and hard against him. He knew it was simply sex, that she was looking for the endorphin rush, and she found it fast, shuddering slightly as she did so.

As soon as she was finished, Pia put her hands on George’s chest and slipped off him. She looked right at him, but it was like she didn’t see him. “Thanks. I needed that,” she said. She walked over to her bathroom, turned on the shower, and, after a couple of seconds, jumped in.

George put his hands behind his head and looked down at himself for a few beats. He then slipped off the condom, walked into the bathroom, and flushed it away. From a birth control perspective, it had been a waste. Pia had finished showering and was toweling off. George couldn’t help but admire her athletic body, exquisitely shaped breasts, and deep, flawless, honey-colored skin.

“Would it kill you to kiss me?” George was bemused; he didn’t know what to think. He was being used, he knew, and didn’t understand why.

“I don’t like kissing. Doesn’t do anything for me.”

George could tell Pia’s mind was already elsewhere. There was no point in him saying, “Well, what about me?” He could hear her reply: “What about you?” George didn’t know what else to say. Each time they had sex, George hoped it meant they’d made a breakthrough, that their relationship had climbed out of its curiously stalled state into a level of true intimacy. But it had never been the case. Nor was it now. She was a train running on a totally separate track. In many respects his role was irrelevant, as if it could have been anyone lying there.

“Thanks,” Pia repeated airily as she passed him coming out of the bathroom. There was no modesty, whether pretend or real. In her upbringing there had never been an opportunity for even pretense.

“What for? I didn’t do anything.”

“No, you did! Really. You’ve given me a reboot like what needs to be done with a modem once in a while. You’ve made it possible for me to see what I have to do, rather than sit here paralyzed.”

“Is that what it was? I want . . . I want us . . .” George felt like that hopeless teenager again. Pia was dressing quickly. George was standing naked and felt very self-conscious. He slipped on his boxers. “So tell me. What are you going to do?”

“Get in more trouble, I expect.”

“What does that mean?”

“You should just leave, George. My problem is I don’t think Rothman was treated correctly, whether people believe it or not. There was something wrong about how he got sick and there was something wrong about how he was treated. Chloramphenicol? It’s almost never prescribed these days. Third-generation cephalosporins are where it’s at now, so why give him something old that potentially causes truly catastrophic side effects?”

“You told me yourself. They used it because of Rothman’s own sensitivity studies.”

“That’s what they said. He shouldn’t have died, period, yet he was dead within what, fifteen, sixteen hours? He got sicker in the hospital-there was no delay in treatment, he was taken straight to the ward right after he showed the first symptoms. I think the treatment made him worse.”

“Okay, I understand you’re frustrated,” said George, “but the dean told you directly not to interfere. Not to play epidemiologist. Do you want to get kicked out of here in your fourth year?”

“I’ve got time off, I’m not sitting here, I’ll lose my mind. I’m going to talk to Springer about the treatment and why it didn’t work. No one said I couldn’t talk to him.”

“Springer! Everyone knows he hates med students. By reputation he was second only to Rothman. You pull him as a preceptor for your rotation in internal medicine and half the students try to switch within a week. And the other half are lining up on the roof to jump off the building. Not to mention the fact that you’ve already pissed him off.”

“Don’t worry, George, I’ll be my normal diplomatic self.”

“That’s exactly what I’m worried about.”

32.

COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY MARCH 24, 2011, 2:05 P.M.

As Pia sat and sat in the narrow waiting room of Dr. Helmut Springer, her determination to see him didn’t waver. Her tryst with George had succeeded in establishing in her mind what she needed to do. She had a burning need to know two things. The reason why Dr. Rothman became sick was one issue; another was why the vaunted and lauded Columbia medical staff had, in her mind, apparently screwed up his treatment. She knew she was only a fourth-year medical student, but from her perspective she couldn’t come up with a compelling reason why Dr. Rothman and Dr. Yamamoto should have died at all, let alone died less than a day after the men were admitted to the infectious disease ward at the hospital. It wasn’t as if they were in some backwoods operation-this was one of the absolute premier medical institutions in the world.

Though Springer probably wouldn’t be happy to see her, she was hopeful that if she talked with him he could aid her quest to find out what had happened. He was, after all, a world-renowned infectious disease specialist. She knew his reputation of not treating medical students with anything close to respect and she knew their meeting the day before had not ended well; still she was optimistic. If he didn’t know that she was the one who first recognized Rothman’s incipient peritonitis, she was going to tell him herself, thinking it should count for something.