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Julie realized she had been holding her breath. She let out a long exhale. Max’s eyes fluttered open, but he was groggy, completely out of it.

“BP is up to ninety,” the tech said.

Julie let herself relax a little only when Max began to move his extremities spontaneously and became somewhat responsive. Lisa set her hands on her hips and struck a pose as if to say that she’d filled her quota of excitement for the day.

“How did you know, Dr. Devereux?” Lisa asked. “Even the radiologist didn’t think of that when he put in those lines.”

“Well, maybe he doesn’t ride motorcycles,” Julie said.

When it was obvious that Max had stabilized, Julie went out into the hallway. To her surprise she found Trevor lurking nearby, with a clear view of the action. He looked at his mother with awe, a look Julie had not seen since her son was six years old. It erased all of her anger over his disobedience.

“That was pretty amazing, Mom. You saved his life, didn’t you?”

Julie just smiled.

CHAPTER 4

Roman Janowski-Romey, to everyone who knew him-sat at his expansive desk fingering the embossed invitation. The black-tie celebration would honor Charles Whitmore as the “Hospital Administrator of the Year.”

Anger and resentment rose in Romey’s throat. Whitmore was a fraud, the exact sort of asshole John Fogerty sang about in “Fortunate Son,” one of Romey’s favorite Creedence Clearwater Revival tracks. Whitmore got the job at Boston General because his family had been at the center of Boston’s illustrious medical history since the 1850s.

Big deal, Charlie, thought Romey as he gazed out his massive office windows at the green emerald square of the hospital quad five stories below. Daddy got you a job running an internationally renowned medical center with arguably the best medical staff anywhere and a patient service area that includes every millionaire in the world, and so you succeeded. Bully for you!

Romey knew he was the real deal. White Memorial had been a second-rate hospital before he took over. By instituting some unique and unusual methods, he had managed to make the hospital one of the best-run medical facilities in the state.

“Anybody can do a Whipple procedure on a sheik with pancreatic cancer who will die in a year anyway,” Romey had said during a board meeting. “The real trick, the reason you pay me so well, is because I can take the bread and butter of medicine-arthroscopy, gallbladder removal, and pneumonia-and create a margin of fifteen percent. Let the other hospitals battle to attract top doctors who want their egos affiliated with a worldwide organization. I’d rather have enough funds to give bonuses to my physicians so they will do what it takes to improve our bottom line.”

Heads nodded, and no one objected to Romey’s raise-a raise that pushed his salary into seven-figure territory and gave him another seven in bonuses. With that kind of income, Romey could be short and bald, with a noticeable belly and ears like radar dishes, and still attract plenty of leggy blondes, including the two who were his current mistresses. Nancy, his wife of thirty-five years, was willing to accept her husband’s indiscretions in exchange for her cushy lifestyle as long as he had the courtesy not to flaunt the girls in her face. Romey obliged happily. He would do anything to keep Nancy from making good on her longstanding threat to divorce him in the most costly way possible.

Romey folded the invitation in half, then tore it in two. The difference between Romey and Charles Whitmore, Romey knew, was flash and renown. The time had come for Romey to step out of the shadows and build his empire.

He looked at the pile of folders on his coffee table and knew where to begin. Romey slipped on his headset and dialed the direct line for the president of Suburban West Medical Center.

“Allyson Brock’s office,” said the friendly voice on the other end.

“Is Allyson in? It’s Roman Janowski from White Memorial.”

“Just a minute, Mr. Janowski, she’s just ending a meeting, but I know she will want to take your call.”

Of course she will. She’s drowning.

A brief interlude of insufferable elevator music followed before Allyson picked up the line.

“Romey, to what do I owe the honor of this call? You city boys rarely give us folks toiling in the hinterlands the time of day,” said Allyson, her voice almost dripping with honey.

“Not true, my dear. I always think that those who run small suburban hospitals have a lot to teach us all.”

“Well, what can I do for you, Romey?”

“Word on the street is that one has never played golf until they have played with you. A history with the LPGA, I understand.” In fact, Romey knew everything about Allyson’s brief time on the tour-just as he knew everything about her divorce; her two kids in college; her over-mortgaged houses in Wellesley, Martha’s Vineyard, and Loon Mountain; and her addiction to Nordstrom and Saks.

“I didn’t know you played.”

“Well, I am just learning, but I figure I might as well learn from the best, so I am hoping you might be able to find some time next Wednesday for a round with an old duffer.” Romey was sixty-five, hardly old, but Allyson was fifteen years his junior.

“Sounds like fun. I generally play at Beechwood.”

“Actually, Allyson, I want to show you my home course in Duxbury. Shall we say two o’clock?”

Allyson’s voice grew a bit tense as she agreed to Romey’s offer. She was shrewd enough to know Romey had something else planned. Why else would he want her at a club where she had never played before, and would know no one?

Romey moved to his couch, where a stack of files sat in front of him. He had a lot of homework to do before the round of golf, and none of it involved a ball, club, or tee. He opened the files to review the audited financial statements of Suburban West Medical Center, its Medicare cost report, IRS 990 forms, and notes from physicians who’d once worked at SWMC. Plenty of ammunition to guarantee the only one who would score an eagle on Wednesday would be Roman Janowski.

CHAPTER 5

Back again, for the second time in a week.

Tommy Grasso had become a regular at White Memorial. Bad luck combined with bad choices had turned the hospital into his version of Cheers, a place where everybody knew his name. Nobody wanted to boomerang in and out of the hospital, occasionally multiple times in the same month. Nobody wanted COPD either, but everybody wanted to breathe, so the hospital was where he had to go.

This was Tommy’s tenth trip to White Memorial since he rang in the New Year. Ten times Tommy had been processed through hospital admissions and wheeled into a bland and standard room where he would spend a few days, or maybe longer. Sometimes he was brought to the ICU and placed on BiPAP, a breathing apparatus that helped get air into the lungs. He was even placed on a ventilator a couple times. But they always sent him to rehab, then home for a short stint, only for the cycle to repeat.

What Tommy really needed was a new pair of lungs. What Tommy got was a spot on a waiting list that would probably never call his name because of his O-negative blood type. Even if they did find him a match-and that was a 7 percent possibility on the outside-he was saddled with an equally uncommon tissue type.

If smoking were not the single cause of Tommy’s health issues, it was certainly the star of the show. At one time Tommy could catch the eye of most any girl, including his beloved Gladys. He had been tall and fit, with a stomach flat as an ironing board, and blessed with a thick head of dark hair. A three-sport athlete in high school, Tommy could swim like a fish and still smoke like a chimney.

Over the years, Tommy’s dark hair turned gray and eventually fell out. His gut expanded as his lung capacity shrank, and a flabby chin overtook a jawline that once turned many heads. The two-pack-a-day habit that took away Tommy’s good looks had started back when Brownsville Station made smokin’ in the boys’ room sound like a cool thing to do. The habit continued until his college-bound son extracted a promise to quit that came too late.