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“I’ll tell you where he should be,” snapped Thomas while he jabbed George in the chest with his index finger. “He should be on the medical floor in case something can be done about his immunological problem. Having already had pneumocystic carini pneumonia there’s a good chance he’ll be dead before he ever gets into a life-threatening cardiac state.”

George knocked Thomas’s hand aside. “As I said, you’re entitled to your opinion. I happen to think Mr. Jeoffry Washington is a good teaching case.”

“Good teaching case,” scoffed Thomas. “The man is medically ill. He should not be taking up a scarce cardiac surgical bed. The bed is needed for others. Can’t you understand that? It’s for this kind of nonsense that I have to keep my patients waiting, patients with no medical problems, patients who will be making real contributions to society.”

George again knocked Thomas’s hand away. “Don’t touch me like that,” he snapped.

“Gentlemen,” said Ballantine, stepping between them.

“I’m not sure Thomas knows what the word means,” said George.

“Listen, you little shithead,” snarled Thomas, reaching around Ballantine and grabbing a handful of George’s shirt. “You’re making a mockery of our program with the cases you’re dredging up just to keep the so-called teaching schedule full.”

“You’d better let go of my shirt,” warned George, his face suffused with color.

“Enough,” shouted Ballantine, pulling Thomas’s hand away.

“Our job is to save lives,” said George through gritted teeth, “not make judgments about who is more worthy. That’s up to God to decide.”

“That’s just it,” said Thomas. “You’re so stupid you don’t even realize that you are making judgments about who should live. The trouble is your judgment stinks. Every time you deny me OR space another potentially healthy patient is condemned to death.”

Thomas spun on his heels and strode from the room.

George took a deep breath, then adjusted his disheveled shirt.

“God! Kingsley is such a prig.”

“He is arrogant,” agreed Ballantine. “But he is such a damn good surgeon. Are you all right?”

“I’m fine,” said George. “I must admit I came close to slugging him. You know, I think he’s going to be trouble. I hope he doesn’t get suspicious.”

“In that sense his arrogance will be a help.”

“We’ve been lucky. By the way, have you ever noticed Thomas’s tremor?”

“No,” said Ballantine with surprise. “What tremor?”

“It’s on and off,” said George. “I’ve noticed it for about a month, mainly because he was always so steady. I even noticed it today when he was doing his presentation.”

“Lots of people are nervous in front of groups.”

“Yeah,” said George, “but it was the same as when I was talking to him about the Wilkinson death.”

“I’d rather not talk about Wilkinson,” said Ballantine, glancing around at the slowly emptying amphitheater. He smiled at an acquaintance. “Thomas is probably just tense.”

“Maybe,” said George, not convinced. “I still think he’s going to be trouble.”

Cassi dressed for her visit to Patricia as if it were the first time they were to meet. With great care she chose a dark blue wool skirt with a matching jacket to go over one of her high-necked white blouses. Just as she was about to leave, she noticed the atrocious state of her nails and thankfully postponed the visit while she removed her old polish and applied a new coat. When that was dry, she decided she didn’t like her hair, so she took it down and put it back up again.

Finally having run out of reasons to delay, she crossed the courtyard between the house and the garage. It was freezing out. Ringing Patricia’s bell, Cassi could see her breath in the crisp air. There was no answer. Standing on tiptoes, she looked through a small window in the door, but all she could see was a flight of stairs. She tried the bell again, and this time saw her mother-in-law slowly descend the stairs and peer out through the glass. “What is it, Cassandra?” she called.

Nonplussed that Patricia didn’t open the door, Cassi was silent for a minute. Under the circumstances she didn’t feel like shouting her reason for visiting. Finally she said: “I want to talk to you about Thomas.”

Even with that explanation there was a long enough pause for Cassi to wonder if Patricia had heard her. Then several bolts snapped aside and the door opened. For a moment the two women eyed each other.

“Yes,” said Patricia finally.

“I’m sorry to bother you,” began Cassi. She let her sentence trail off.

“You’re not bothering me,” said Patricia.

“Could I come in?” asked Cassi.

“I suppose,” said Patricia, starting up the stairs. “Be sure and close the door.”

Cassi was glad to close the door on the cold, damp morning. Then she climbed after Patricia and found herself in a small apartment sumptuously furnished in Victorian red velvet and white lace.

“This room is beautiful,” said Cassi.

“Thank you,” said Patricia. “Thomas’s favorite color is red.”

“Oh?” said Cassi, who had always thought Thomas partial to blue.

“I spend a lot of time here,” said Patricia. “I wanted it comfortable and warm.”

“It is that,” admitted Cassi, seeing for the first time a rocking horse, a kiddy car, and other toys.

Patricia, as if following Cassi’s glance, explained: “Those are some of Thomas’s old toys. I think they’re rather decorative, don’t you?”

“I do,” said Cassi. She thought the toys did have a certain appeal but looked a little out of place in the lavish setting.

“How about some tea?” suggested Patricia.

Suddenly Cassi realized that Patricia was as uncomfortable as she was.

“Tea would be very nice,” said Cassi, feeling more at ease herself.

Patricia’s kitchen was utilitarian, with white metal cabinets, an old refrigerator, and a small gas stove. Patricia put on the kettle and got out her china. From the top of the refrigerator she produced a wooden tray.

“Milk or lemon?” asked Patricia.

“Milk,” said Cassi.

Watching her mother-in-law search for a creamer, Cassi realized how few visitors the older woman saw. With a touch of guilt Cassi wondered why they hadn’t become better friends. She tried to bring up Thomas’s problem, but the rift that had always existed between them silenced her. It wasn’t until they’d seated themselves in the living room with full teacups that Cassi finally got the courage to begin. “The reason I came over here this morning was to talk to you about Thomas.”

“That’s what you said,” replied Patricia pleasantly. The old woman had warmed considerably and seemed to be enjoying the visit.

Cassi sighed and put her teacup down on the coffee table. “I’m concerned about Thomas. I think he is pushing himself too hard and…”

“He’s been that way since he was a toddler,” interrupted Patricia. “That boy was a hyperactive high achiever from the day he was born. And I tell you it was a twenty-four-hour-a-day job keeping him in line. Even before he could walk he was his own boss, and I had a devil of a time disciplining him. In fact from the day I brought him home from the hospital…”

Listening to Patricia’s stories, Cassi realized exactly how central Thomas still was to the older woman’s world. It finally made sense to her why Patricia insisted on living where she did, even though it was so isolated. Watching her mother-in-law pause to sip her tea, Cassi noted how strongly Thomas resembled Patricia. Her face was thinner and more delicate, but there was the same aristocratic angularity.

Cassi smiled. When Patricia put her cup back down, Cassi said, “Sounds like Thomas hasn’t changed much.”

“I don’t think he’s changed at all,” said Patricia. Then with a laugh she added, “He’s been the same boy all his life. He’s needed a lot of attention.”