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The atmosphere went flat.

Earl had long since stopped trying to figure out Stewart's mood swings, having concluded years ago that the man had a narcissistic personality to go with his prodigious talent. But diagnosing him didn't render him any less annoying. He could take the simplest inquiry as a personal affront, as if whoever questioned him questioned his competence. Yet everyone also excused this prickly side of him, just as they did his tendency to yell a lot, again because of his extraordinary ability to pull off miracles. Thank God, he would usually apologize afterward when he did lose his cool and pull one of his snits. "I'm just not used to anyone challenging me," he'd once told Earl. "Most of my patients have tubes down their throats." But sometimes he could prolong holding a grudge, and over the stupidest things.

Jimmy, a muscular man wearing the same protective gear as everyone else, stepped up on the stage. His square jaw stood out beneath the covering of his mask, and not even layers of green could hide his well-proportioned physique. "Top o' the mornin' to you," he began when he reached the microphone, sweeping the audience with intense black eyes that had a magnetic pull to them. "Oh, I bet you're thrilled t' hear from a preacher. The ones fresh out of medical school, having never found the human soul in all those studies, are always the most skeptical that it exists." His lilting Irish brogue and mischievous squint instantly reanimated the room. People leaned forward to hear what he had to say. "So I'll keep it short. The Pastoral Services Department is here to serve the emotional and spiritual needs of patients, family, and staff. To learn more, give me a call. I want to stress we're open to all, whether a person has a formal religious affiliation or not. Remember, people of all stripes get scared in here, and even if we just provide a sympathetic ear…"

But Earl kept his gaze on Stewart, then glanced back at Thomas. Presumably Stewart's display had to do with Thomas's question. Understandably the resident remained oblivious to any wrongdoing on his part, and chatted easily with the R2s immediately to either side of him, both female. No surprise there. He had a way with the ladies.

Yet Stewart kept scowling toward the young man, as if trying to catch him in some other act of inexcusable insolence. After a few seconds, however, the ridges in his forehead flattened, and his expression softened.

Good, Earl thought.

Stewart's pique over imagined slights occasionally grew to the point that it interfered with work. One time the tension in ICU had gotten so bad that Earl slapped a notice in red ink above the entrance: PROS LEAVE THEIR GUNS AT THE DOOR. The job of setting him straight usually fell to Earl because no one else in the hospital would dare criticize Stewart about anything. Earl figured he got away with it because of the year he'd been Stewart's chief resident at New York City Hospital twenty-five years ago. That kind of seniority over a junior can stick for life.

"… in other words, don't be shy about using our help," Jimmy said, sounding as if he'd concluded his remarks.

Janet bent forward to whisper into Earl's ear. "It's not fair, the good looks on that man. Even covered up, they might give a woman ideas."

Earl turned and raised an eyebrow at her. "You'll be making me jealous," he murmured out of the corner of his mouth.

"I'm glad I still can." She leaned back and clasped her round belly with both hands again.

"Now I have one other announcement," Jimmy continued, "but first, such a serious bunch as yourselves will frighten the sick into a relapse, so here's a joke to lighten the mood." He lifted the microphone off its stand and walked free of the podium. "Did you hear the one about the priest, the minister, and the rabbi who went to Disneyland together?"

Everybody waited for the answer.

"They got in a fight about where to go first. I mean, it got loud. The priest shouted, 'Fantasylandl' The rabbi, 'Tomorrowlandl' The minister, 'Frontierlandl' They even started pulling on the map, pushing and shoving each other, kicking up the dust. Grown men, squabbling like you wouldn't believe. Then Goofy walks up. 'Hey, Mickey,' he says, 'look! It's Holyland.'"

Groans filled the air again, but this time they were good-natured.

Jimmy continued to walk the stage. "Sorry, but when I entered the seminary, it was a toss-up between that and being a stand-up comic. I'm still working on my act, in case I get the call. What'd'ya think?"

"Don't give up your day job," someone shouted.

A few people chuckled.

Jimmy pointed to the heavens and shook his head. "You know, that's what He keeps telling me."

This got him a round of applause.

"Make your point, Jimmy," Earl muttered none too quietly. He was impatient to say his own piece so he could get the hell back and reassess the man he'd left in ER.

The chaplain gave him a nod. "Not to take up any more of your busy morning, but I'm here to invite you all to our annual Run for Fun this Saturday. That's when you, healthy, young, and strong, get to put your professors, weak, old, and flabby- well, some of them, anyway- to shame by humiliating them in a two-K jaunt through scenic downtown Buffalo, entirely in the name of charity. Oh, by the way, the lot of you will be pushing hospital beds, each complete with a simulated patient and half-full bedpan from which you must not spill a drop. Thanks for your time."

Earl joined in the clapping, ready to take the stage, when the overhead PA crackled to life.

"Drs. Garnet, Deloram, Biggs- ER; Father Jimmy Fitzpatrick- ER stat!"

Artie Baxter, the stockbroker, lay on his stretcher frowning and blinking furiously. He couldn't speak because of the tube in his throat, and he breathed thanks to a respiratory technician who kept ventilating his lungs with an Ambu bag, twelve squeezes to the minute. J.S. provided the chest compressions, five at a time, strands of her thick black hair slipping from under her cap and flopping over her forehead as she worked. A cloying scent of singed flesh hung in the air despite the gobs of contact gel that glistened in the tight curls on Artie's chest, and his cardiac monitor showed the zigzag line of a fibrillating heart.

"We were on him so quickly when he arrested, he never lost consciousness," Susanne whispered to Earl.

At her side stood a heavyset, pear-shaped man with worried, tired-looking eyes and the edges of a salt-and-pepper beard sticking out the bottom of his mask. Dr. Michael Popovitch was a longtime friend, director of the department's residency program, and acting chief of ER during Earl's many absences. He'd once shared the fire in the belly that's a prerequisite for long-term survival in emergency medicine, but lately the cases seemed to weigh heavily on him. Each month his gaze grew a little sadder. "We've maxed him with epi, Lidocaine, procainamide- every antiarrhythmic we have," he said, terse and to the point, "and shocked him silly. Bottom line, nothing's worked."

The causes of refractory V-fib. automatically flashed through Earl's mind. "How's his potassium, sugar-"

"No metabolic problems," Michael cut in, "other than a slightly high glucose after the bolus you gave him-"

"An overdose, maybe?" Stewart Deloram interrupted, inserting himself as part of the huddle. "Tricyclics, aminophylline, speed…" He rattled off the drugs that might precipitate this kind of arrest.

Thomas Biggs stood a little off to one side. He watched the proceedings but offered no suggestions.

Earl found his own attention drawn to Artie's eyes as they blinked more furiously than ever. Leaning directly over his face, he said, "Close your eyes once if you can hear me, Mr. Baxter."

The fluttering stopped. The lids closed and opened.

"Do you see me?"

They closed and opened again. Then he stared at Earl, his pupils wide with fright, seeming to want an explanation.