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She stepped up beside Rideout and shouldered him aside. It was easy. He was taller, but she had been turning and lifting patients for nearly half her life, and she was stronger. ‘Open your eyes, Andy. Open them right now. Look at me.’

Startled, Newsome did as she said. Melissa and Jensen (now with the lunchbox in his hands) looked alarmed. One of the facts of their working lives – and Kat’s own, at least until now – was that you didn’t command the boss. The boss commanded you. You most certainly did not startle him.

But she’d had quite enough. In another twenty minutes she might be crawling after her headlights along stormy roads to the only motel in the vicinity, but it didn’t matter. She simply couldn’t do this any longer.

‘This is bullshit, Andy,’ she said. ‘Are you hearing me? Bullshit.’

‘I think you better stop right there,’ Newsome said, beginning to smile – he had several smiles, and this wasn’t one of the good ones. ‘If you want to keep your job, that is. There are plenty of other nurses in Vermont who specialize in pain therapy.’

She might have stopped there, but Rideout said, ‘Let her speak, sir.’ It was the gentleness in his tone that drove her over the edge.

She leaned forward, into his space, and the words spilled out in a torrent.

‘For the last sixteen months – ever since your respiratory system improved enough to allow meaningful physiotherapy – I’ve watched you lie in this goddam expensive bed and insult your own body. It makes me sick. Do you know how lucky you are to be alive, when everyone else on that airplane was killed? What a miracle it is that your spine wasn’t severed, or your skull crushed into your brain, or your body burned – no, baked, baked like an apple – from head to toe? You would have lived four days, maybe even two weeks, in hellish agony. Instead you were thrown clear. You’re not a vegetable. You’re not a quadriplegic, although you choose to act like one. You won’t do the work. You look for some easier way. You want to pay your way out of your situation. If you died and went to hell, the first thing you’d do is try to grease Satan’s palm.’

Jensen and Melissa were staring at her in horror. Newsome’s mouth hung open. If he had ever been talked to in such a fashion, it had been long ago. Only Rideout looked at ease. He was the one smiling now. The way a father would smile at his wayward four-year-old. It drove her crazy.

‘You could have been walking by now. God knows I’ve tried to make you understand that, and God knows I’ve told you – over and over – the kind of work it would take to get you up out of that bed and back on your feet. Dr Dilawar in San Francisco had the guts to tell you – he was the only one – and you rewarded him by calling him a faggot.’

‘He was a faggot,’ Newsome said. His scarred hands had balled themselves into fists.

‘You’re in pain, yes. Of course you are. It’s manageable, though. I’ve seen it managed, not once but many times. But not by a rich man who tries to substitute his sense of entitlement for the plain old hard work and tears it takes to get better. You refuse. I’ve seen that, too, and I know what always happens next. The quacks and confidence men come, the way leeches come when a man with a cut leg wades into a stagnant pond. Sometimes the quacks have magic creams. Sometimes they have magic pills. The healers come with trumped-up claims about God’s power, the way this one has. Usually the marks get partial relief. Why wouldn’t they, when half the pain is in their heads, manufactured by lazy minds that only understand it will hurt to get better?’

She raised her voice to a wavering, childlike treble and bent close to him. ‘Daddy, it hurrr-rrrts! But the relief never lasts long, because the muscles have no tone, the tendons are still slack, the bones haven’t thickened enough to accommodate weight-bearing. And when you get this guy on the phone to tell him the pain’s back – if you can – do you know what he’ll say? That you didn’t have faith enough. If you used your brains on this the way you did on your manufacturing plants and various investments, you’d know there’s no little living tennis ball sitting at the base of your throat. You’re too fucking old to believe in Santa Claus, Andy.’

Tonya had come into the doorway and now stood beside Melissa, staring with wide eyes and a dishwiper hanging limp in one hand.

‘You’re fired,’ Newsome said, almost genially.

‘Yes,’ Kat said. ‘Of course I am. Although I must say that this is the best I’ve felt in almost a year.’

‘If you fire her,’ Rideout said, ‘I’ll have to take my leave.’

Newsome’s eyes rolled to the Reverend. His brow was knitted in perplexity. His hands now began to knead his hips and thighs, as they always did when his pain medication was overdue.

‘She needs educating, praise God’s Holy Name.’ Rideout leaned toward Newsome, his own hands clasped behind his back. He reminded Kat of a picture she’d seen once of Washington Irving’s schoolteacher, Ichabod Crane. ‘She’s had her say. Shall I have mine?’

Newsome was sweating more heavily, but he was smiling again. ‘Have at her. Rip and roar. I believe I want to hear this.’

Kat faced him. Those dark, socketed eyes were unsettling, but she met them. ‘Actually, so do I.’

Hands still clasped behind his back, pink skull shining mutedly through his thin hair, long face solemn, Rideout examined her. Then he said, ‘You’ve never suffered yourself, have you?’

Kat felt an urge to flinch at that, or look away, or both. She suppressed it. ‘I fell out of a tree when I was eleven and broke my arm.’

Rideout rounded his thin lips and whistled: one tuneless, almost toneless note. ‘Broke an arm while you were eleven. Yes, that must have been excruciating.’

She flushed. She felt it and hated it but couldn’t stop the heat. ‘Belittle me all you want. I based what I said on years of experience dealing with pain patients. It is a medical opinion.’

Now he’ll tell me he’s been expelling demons, or little green gods, or whatever they are, since I was in rompers.

But he didn’t.

‘I’m sure,’ he soothed. ‘And I’m sure you’re good at what you do. I’m sure you’ve seen your share of fakers and posers. You know their kind. And I know yours, miss, because I’ve seen it many times before.

‘They’re usually not as pretty as you’ – finally a trace of accent, pretty coming out as purty – ‘but their condescending attitude toward pain they have never felt themselves, pain they can’t even conceive of, is always the same. They work in sickrooms, they work with patients who are in varying degrees of distress, from mild pain to deepest, searing agony. And after awhile, it all starts to look either overdone or outright fake to them, isn’t that so?’

‘That’s not true at all,’ Kat said. What was happening to her voice? All at once it had grown small.

‘No? When you bend their legs and they scream at fifteen degrees – or even at ten – don’t you think, first in the back of your mind, then more and more toward the front, that they are lollygagging? Refusing to do the hard work? Perhaps even fishing for sympathy? When you enter the room and their faces go pale, don’t you think, ‘Oh, now I have to deal with this lazy slug of a thing again’? Haven’t you – who once fell from a tree and broke your arm, for the Lord’s sake – become more and more disgusted when they beg to be put back into bed and be given more morphine or whatever?’

‘That’s so unfair,’ Kat said … but now her voice was little more than a whisper.

‘Once upon a time, when you were new at this, you knew agony when you saw it,’ Rideout said. ‘Once upon a time you would have believed in what you are going to see in just a few minutes, because you knew in your heart that a malignant outsider was there. I want you to stay so I can refresh your memory … and the sense of compassion that’s gotten lost along the way.’