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The detective said, “Quail figured, given the patient’s brain damage, death would be attributed to natural causes without a full autopsy. She didn’t bother using a substance that would be hard to trace. It was a massive injection of Haldol, a tranquilizer.”

By the time Laura turned eight, she understood that her family wasn’t like others. A conscience had never been nurtured in her, not in the Farrel house, but nature had given her a strong moral sense.

Shame came easily to her, and everything about her family mortified her more deeply year by year. She kept to herself, taking refuge in books and daydreams. She wanted only to grow up, to get out, and to make a life that would be “clean, quiet, not a harm to anyone.”

The detective tried to console Noah with a final revelation: “The overdose was so large, death was immediate. That crap just shut down the central nervous system like a switch.”

By the time she was eleven, Laura wanted to be a doctor, as if she no longer felt able to cut free of her roots merely by doing the world no harm. She needed to give to other people, perhaps through medicine, in order to ransom her soul from her family.

When she was twelve, she morphed in her daydreams from physician to veterinarian. Animals made better patients. Most people, she said, could never be cured of their worst sicknesses, only of their body’s ailments. No one should have to learn that much about the human condition by the tender age of twelve.

Twelve years of striving to shape the future with dreams and seventeen more years of dreaming without purpose ended here, in this bed, where no more dreams waited beneath the pillows.

The detectives and the medical examiner’s people had stepped back, leaving Noah alone at the bedside, although they continued to watch in their capacity as guardians of the mortal evidence.

Laura rested on her back, arms at her sides. The palm of her left hand lay flat against the sheets, but her right hand was turned up and closed in a three-quarter fist, as if in the final instant, she had tried to hold fast to life.

Both the porcelain-smooth half and the ruined half of her face were revealed, God’s work and Crank’s.

To Noah, now that he would never see her again, both sides of her face were beautiful. They touched his heart in different ways.

We bring beauty with us into this world, as we bring innocence, and the ugliness that we take with us when we leave is what we’ve made of ourselves instead of what we should have made. Laura had moved on from this life with no ugliness at all. Only the soul leaves here; and hers was without stain or scar, as innocent at departure as it had been upon arrival.

Noah had lived longer and more fully than his sister, but not as well. He knew that when his time came to go, unlike her, he wouldn’t be able to leave behind all his ugliness with his blood and bone.

He almost began to talk to her, as he had talked so often over the years, hour after hour, with the hope that she heard him and was comforted. But now that his sister had traveled beyond hearing, Noah discovered he had nothing to say anymore — not to her, not to anyone.

He had hoped that the distant thunder in his head would stop rolling when he saw Laura and confirmed beyond doubt that she was gone. Instead, the roar gradually grew louder.

He turned from the bed and walked away. The air thickened and resisted him at the threshold, but only for an instant.

Across the hallway, the door opposite Laura’s was closed. On his last few visits, that room — also a single — had stood open for airing because no patient currently occupied it.

Although a new resident might have been admitted in the past few hours, instinct carried Noah boldly across the hall. He threw open the door and took one step past the threshold before men seized him from behind, restraining him.

Nurse Quail sat in an armchair, so petite that her feet barely touched the floor. Twinkling blue eyes, pink complexion, pert and pretty: as Noah remembered her.

Two men and one woman were with the murderess. At least one of them would be a homicide detective and at least one would be from the DAs office. The three were tough professionals, skilled at psychological manipulation, not likely to allow any suspect to hijack an interrogation.

Yet Wendy Quail clearly controlled the situation, most likely because she was too deluded to understand the real nature of her situation. Her posture and her expression weren’t those of a suspect facing a hard inquisition. She appeared to be as poised as royalty, like a queen granting an audience to admirers.

She didn’t shrink from Noah, but smiled at him in recognition. She held out a hand toward him as might a queen who saw before her a grateful subject who had come to kneel abjectly and to offer effusive appreciation for some grace that earlier she had bestowed on him.

Now he knew why he’d been required to check his pistol at the front door: just in case an unexpected encounter like this occurred.

Maybe he would have shot her if he’d had the handgun; but he didn’t think so. He had the capacity to kill her, the nerve and the ruthlessness, but he didn’t have the requisite rage.

Curiously, Wendy Quail failed to arouse his anger. In spite of the self-satisfaction that virtually oozed from her, and although her peaches-and-cream cheeks pinked with the warmth generated by a well-banked and well-tended moral superiority, she lacked the substance to excite anyone’s hatred. She was a hollow creature into whose head had been poured evil philosophies that she couldn’t have brewed in the cauldron of her own intellect; and if in her formative years she had been exposed to a gentler and humbler school of thought, she might have been the committed healer that now she only pretended to be. She was plates and platters of plights and pickles; she was ice cream therapy; but although she was worthy of being loathed and even of being abhorred, she was too pathetic to merit hatred.

Noah allowed himself to be drawn backward out of the room before the nurse could speak some witless platitude. Someone closed the door between them.

Wise enough to offer no commiseration or advice, two detectives escorted him along the corridor toward the lobby. Noah had never been a member of their department; his three years of service had been in another of the county’s many cities, which interlocked like puzzle pieces in a jigsaw of jurisdictions. Nevertheless, they were his age or older, and they knew why he no longer wore a uniform. They surely understood why he had done what he’d done, ten years ago, and they might even sympathize with him. But they had never straddled the line that he had crossed with both feet, and to them he was to be treated as politely as any citizen but with more wariness, regardless of the fact that at one time he had worn the tin and done the job just as they did. They spoke to him only to report how long the body would be held by the medical examiner and to describe the process by which it could be claimed and be transferred to a mortuary.

The care home’s residents had been asked to remain in their rooms with the doors closed, and had been issued sleep aids when they requested them. But Richard Velnod stood in his open doorway, as though waiting for Noah.

Rickster’s unnaturally sloped brow seemed to recede from his eyes at a more severe angle than previously, and gravity exerted a greater than ordinary pull on his heavy features. His mouth moved, but his thick tongue, always a barrier to clear speech, failed him entirely this time; no sound came from him. Although usually his eyes were windows to his thoughts, they were paled now by tears, and he seemed to be holding back some question that he was afraid to ask.

The detectives would have preferred that Noah leave directly, but he stopped here and said, “It’s all right, son. She didn’t have any pain.” Rickster’s hands moved restlessly, pulling at each other, at the buttons on his pajama top, at his low-set ears, at his wispy brown hair, and at the air as though he might pluck understanding from it. “Mr. Noah, wha… wha..?” His mouth went soft, twisted with anguish.