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Betsy blinked away the tears. She tried to focus again on the slide show, on the images of her son alive.

And then, just like that, a picture rotated into view that changed everything.

Betsy’s heart stopped.

The picture was gone as fast as it had come. More pictures piled over it. She put her hand to her chest, tried to clear her mind. The picture. How could she get to that picture again?

She blinked again. Tried to think.

Okay, first off. It was part of an online slide show. The show would repeat. She could simply wait. But how long until it would start up again? And then what? It would fly by again, staying in view only a few seconds. She needed a closer look.

Could she freeze the screen when it came back on?

There had to be a way.

She watched the other photographs swirl by, but they weren’t what she wanted. She wanted that other picture back.

The one with the sprained wrist.

She thought again back to that intramural game from seventh grade because she remembered something a little odd. Hadn’t she just been thinking about that moment? When Spencer wore the ACE bandage? Yes, of course. That had been the catalyst, really.

Because the day before Spencer’s suicide, something similar had happened.

He had fallen and hurt his wrist. She had offered to wrap it again, as she had back when he was in seventh grade. But instead, Spencer had wanted her to buy a wrist sleeve. She had. He had worn it the day he died.

For the first and-obviously-last time.

She clicked on the slide show. It brought her to a site,slide.com, and asked her for her password. Damn. It had probably been created by one of the kids. She thought about that. Security wouldn’t be great on something like this, would it? You were just setting it up and letting your fellow students use it to put whatever photographs they wanted into the rotation.

So the password had to be something simple.

She typed in: SPENCER.

Then she hit OK.

It worked.

The pictures were laid out. According to the heading, there were 127 photographs in here. She quickly scanned through the thumb-nails until she found the one she wanted. Her hand was shaking so badly she could barely get the mouse on the image. She did and then she clicked the left button.

The photograph came up full size.

She just stopped and stared.

Spencer was smiling in the picture, but it was the saddest smile she had ever seen. He was sweating; his face had the sheen of someone high. He looked drunk and defeated. He wore the black T-shirt, the same one he wore on that last night. His eyes were red-maybe from drink or drugs but certainly from the flash. Spencer had beautiful light blue eyes. The flash always made him look like the devil. He was standing outdoors, so it had to have been taken at night.

That night.

Spencer had a drink in his hand, and there, on that same hand, was the wrist sleeve.

She froze. There was only one explanation.

This picture had been taken the night Spencer died.

And as she looked around, into the background of the photograph, and saw people milling about, she realized something else.

Spencer hadn’t been alone, after all.

7

AS he had nearly every weekday for the past decade, Mike woke up at five in the morning. He worked out for exactly one hour. He drove into New York City over the George Washington Bridge and arrived at NewYork-Presbyterian’s transplant center by seven A.M.

He threw on the white coat and rounded on patients. There were times when this threatened to become routine. It didn’t vary much, but Mike liked to remind himself of how important this was to that person lying in the bed. You are in a hospital. That alone made you feel vulnerable and scared. You are ill. You may very well be dying and it seems to you that the person who stands in the way between you and greater suffering, between you and death, is your doctor.

How does your doctor not develop a bit of a God complex?

More than that, sometimes Mike thought it was healthy to have that complex, albeit benevolently. You mean a lot to your patient. You should act like it.

There were doctors who rushed through it. There were times Mike wanted to do that too. But the truth is, if you give your all, it only takes an extra minute or two per patient. So he listened and held a hand if that was required or stayed a little aloof-depending on the patient and how he read them.

He was at his desk by nine A.M. The first patient had already arrived. Lucille, his RN, would be working them up. That gave him maybe ten minutes to review the charts and overnight test results. He remembered his neighbor and quickly searched for the Loriman results in the computer.

Nothing posted yet.

That was odd.

A strip of pink drew Mike’s eye. Someone had stuck a Post-it note onto his phone.

See me

– Ilene

Ilene Goldfarb was his practice partner and head of transplant surgery at NewYork-Presbyterian. They had met during their residency in transplant surgery and now lived in the same town. He and Ilene were friends, Mike guessed, but not close ones, which made the partnership work well. They lived maybe two miles apart, had kids who attended the same schools, but other than that, they had few mutual interests, didn’t need to socialize, and totally trusted and respected the other’s work.

Do you want to test your doctor friend on his medical recommendation? Ask him this: If your kid was sick, what doctor would you send him to?

Mike’s answer was Ilene Goldfarb. And that told you everything you needed to know about her competence as a physician.

He headed down the corridor. His feet padded silently on the industrial-gray wall-to-wall. The prints lining the off-white hallway were gentle on the eyes, simple and with about as much personality as the artwork you’d find in a mid-scale motel chain. He and Ilene had wanted the entire office to whisper, “This is about the patient and the patient only.” In the offices, they displayed only professional diplomas and citations because that seemed to comfort. They did not keep anything personal-no pencil holder made by a child, no family photographs, nothing like that.

Your child often came here to die. You don’t want to see the image of someone else’s smiling, healthy children. You just don’t.

“Hey, Doc Mike.”

He turned. It was Hal Goldfarb, Ilene’s son. He was a high school senior, two years older than Adam. He’d made Princeton early decision and planned to go in premed. He’d managed to get school credit to spend three mornings a week interning for them.

“Hey, Hal. How’s school?”

He gave Mike a big smile. “Coasting.”

“Senior year after you’ve already been admitted to college-the dictionary definition of coasting.”

“You got it.”

Hal was dressed in khakis and a blue dress shirt and Mike couldn’t help but notice the contrast with Adam’s goth black and feel a pang of envy. As if reading his mind, Hal said, “How’s Adam?”

“Okay.”

“I haven’t seen him in a while.”

“Maybe you should give him a call,” Mike said.

“Yeah, I should. It’d be great to hang out.”

Silence.

“Mom in her office?” Mike asked.

“Yes. Go right in.”

Ilene sat behind her desk. She was a slight woman, small-boned except for her talonlike fingers. She wore her brown hair pulled back in a severe ponytail and had horn-rimmed glasses that nicely straddled the border between looking bookish and in vogue.

“Hey,” Mike said.

“Hey.”

Mike held up the pink Post-it note. “What’s up?”

Ilene let loose a long breath. “We got a big problem.”

Mike sat. “With?”

“Your neighbor.”

“Loriman?”

Ilene nodded.

“Bad tissue test result?”

“Weird test result,” she said. “But it had to happen sooner or later. I’m surprised this is our first.”