envelope—plain, self-sealing, available at a hundred stores—addressed in block capitals. This one bore only a single stamp. She squinted to read the smudged postmark—mailed from the central post office on Monday evening.
Elena ripped the flap and pulled out a single sheet of plain paper. The same block capitals, written in blue ballpoint, spelled out a new message:
THAT'S TWO STRIKES. WILL THERE BE THREE?
Elena made it through the morning on autopilot. Clinic was mercifully light. At noon she took her bowl of soup to a quiet corner of the cafeteria. The bowl was empty when she returned her tray to the moving belt, but she had no recollection of what she'd eaten. All she could think about was "two strikes."
This changed everything. The person who made the phone calls was connected with the circumstances of Chester Pulliam's death. Maybe they were the same person, maybe not, but they were certainly connected. Did Lillian's reach extend to the hospital? Could she know the effect of the cloud cast over Elena's professional reputation by recent events in the ICU? And if Lillian was behind this, how had she managed it?
Elena consulted the large clock that hung over the door of the cafeteria. She had half an hour before she was due in the neurosurgery department's monthly M&M conference. She'd been in medicine so long she no longer thought of candy when she heard those initials. No, this was the Morbidity and Mortality Conference, the meeting where the menu centered on complications and death, neither a sweet subject.
One of the "mortality" cases was that of Chester Pulliam. Matney promised that her possible role in the termination of his life support wouldn't come up, but although her attendance was pro forma, it was necessary. Now she had twenty-five minutes to make it across campus for the conference. Ten minutes to the shuttle bus stop, ten or more for the ride to the building that housed neurosurgery, another five to make it to the conference room. No, there was no time for what she wanted to do.
Elena started for the door. First the conference, then the phone call. She promised herself she wouldn't forget it. She dreaded making it, but she had to know. This had to come to an end.
Twenty-seven minutes later Elena opened the door of the neurosurgery conference room a cautious six inches and peered inside. A huge conference table occupied at least two-thirds of the room. A mixture of faculty and residents filled the chairs around it, with Matney at the head. Dr. Clark sat immediately to his right with the department vice chairman, Dr. Bruce Mickey, on Matney's left. The chairman whispered something, and the three men laughed. Elena took the opportunity to ease into the room and slide into a vacant chair along the back of the room.
Two junior faculty members were seated to Elena's right. She wasn't particularly trying to eavesdrop, but their whispers came through as though channeled through a megaphone.
"Did you hear about Dr. Matney?"
"Yeah. Dunston's leaving, and Matney's the prime candidate to succeed him as dean. The Search Committee's giving him the once-over right now."
The first doctor looked around. Elena casually directed her gaze to the bound journals lining the walls. Satisfied, he continued. "Matney's already given the word to the faculty. He wants this department squeaky clean. Anything that might look bad, sweep it under the rug or deep-six it some way. If it could bring attention, don't do it."
"I know. He caught me in the surgeon's lounge and told me to stop giving a particular IV med to patients with cerebral edema because that was off-label usage."
"Man, I'll be glad—"
"Let's get started." Matney's eyes swept the room. All conversation stopped as though someone had hit a "mute" button. The chairman leaned back in his chair, apparently relaxed and comfortable.
"Gershon?" This was a first-year resident, who presented the case of a patient who'd developed an infection at the operative
Elena ripped the flap and pulled out a single sheet of plain paper. The same block capitals, written in blue ballpoint, spelled out a new message:
THAT'S TWO STRIKES. WILL THERE BE THREE?
Elena made it through the morning on autopilot. Clinic was mercifully light. At noon she took her bowl of soup to a quiet corner of the cafeteria. The bowl was empty when she returned her tray to the moving belt, but she had no recollection of what she'd eaten. All she could think about was "two strikes."
This changed everything. The person who made the phone calls was connected with the circumstances of Chester Pulliam's death. Maybe they were the same person, maybe not, but they were certainly connected. Did Lillian's reach extend to the hospital? Could she know the effect of the cloud cast over Elena's professional reputation by recent events in the ICU? And if Lillian was behind this, how had she managed it?
Elena consulted the large clock that hung over the door of the cafeteria. She had half an hour before she was due in the neurosurgery department's monthly M&M conference. She'd been in medicine so long she no longer thought of candy when she heard those initials. No, this was the Morbidity and Mortality Conference, the meeting where the menu centered on complications and death, neither a sweet subject.
One of the "mortality" cases was that of Chester Pulliam. Matney promised that her possible role in the termination of his life support wouldn't come up, but although her attendance was pro forma, it was necessary. Now she had twenty-five minutes to make it across campus for the conference. Ten minutes to the shuttle bus stop, ten or more for the ride to the building that housed neurosurgery, another five to make it to the conference room. No, there was no time for what she wanted to do.
Elena started for the door. First the conference, then the phone call. She promised herself she wouldn't forget it. She dreaded making it, but she had to know. This had to come to an end.
Twenty-seven minutes later Elena opened the door of the neurosurgery conference room a cautious six inches and peered inside. A huge conference table occupied at least two-thirds of the room. A mixture of faculty and residents filled the chairs around it, with Matney at the head. Dr. Clark sat immediately to his right with the department vice chairman, Dr. Bruce Mickey, on Matney's left. The chairman whispered something, and the three men laughed. Elena took the opportunity to ease into the room and slide into a vacant chair along the back of the room.
Two junior faculty members were seated to Elena's right. She wasn't particularly trying to eavesdrop, but their whispers came through as though channeled through a megaphone.
"Did you hear about Dr. Matney?"
"Yeah. Dunston's leaving, and Matney's the prime candidate to succeed him as dean. The Search Committee's giving him the once-over right now."
The first doctor looked around. Elena casually directed her gaze to the bound journals lining the walls. Satisfied, he continued. "Matney's already given the word to the faculty. He wants this department squeaky clean. Anything that might look bad, sweep it under the rug or deep-six it some way. If it could bring attention, don't do it."
"I know. He caught me in the surgeon's lounge and told me to stop giving a particular IV med to patients with cerebral edema because that was off-label usage."
"Man, I'll be glad—"
"Let's get started." Matney's eyes swept the room. All conversation stopped as though someone had hit a "mute" button. The chairman leaned back in his chair, apparently relaxed and comfortable.
"Gershon?" This was a first-year resident, who presented the case of a patient who'd developed an infection at the operative
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