"Who are you? Why do this to me?" If he found he knew the person, understood the reasons, he'd know how to explain that there'd been a terrible mistake.

The last thing he remembered before a gloved hand had grabbed him from behind and rammed chloroformed gauze into his face had been the fumes. He'd turned only enough to glimpse a shadowy form before everything went black. He came to already bound and suspended from the overhead iron pipe, Tocco's leash looped around his neck. The powerful arms that locked him in their grip and held him up until his own legs could bear his weight were muscular, but he couldn't see the face.

"What are you doing?" he'd mumbled at first, still floating up from the no-man's-land of being anesthetized. "If Tocco's dead, goddamn you, I'm calling the police."

Then the realization he stood on a makeshift gallows had catapulted him awake.

Indifferent as an executioner, the person at his back had partially supported him until he stood entirely alone, straining up on his toes, winning some slack in the braided strap that choked off his air.

All to the tune of "Pretty Woman."

The present cramp in his right foot eased.

But the leash had again cinched tighter.

That's why the person had used it, why Jerome had used one, why so many did- handy, strong, effective.

His once magnificent brain began to plod for want of oxygen. He'd no means of measuring time or knowing how long he'd been dangling there. Questions that he might have reasoned through and disposed of in seconds grew impenetrable to his crippled flow of thought.

Who would do this to him? Jerome's wife? He couldn't remember her name, nor even recall her face. No, she'd dumped the man years before, hadn't even bothered to attend his funeral, didn't care enough.

He strained higher on his toes.

But why would anyone else who cared so much about Jerome have waited until now?

He felt his eyes bulge. He flexed his feet to push higher still. Goddamn it, he thought. This is a lynching.

Could it be the work of a more recent enemy? One who knew about what had happened at NYCH, yet wanted to get rid of him for another reason altogether? Somebody determined to make it look like he'd chosen suicide over being discovered as a fraud? Someone who'd set up a scene to make it appear he'd copied Jerome Wilcher, the man he'd discredited so many years before?

He lost strength in his legs, and the leash choked him harder.

Like a man inebriated, Stewart could still snatch seconds of clarity from a progressive swoon into darkness, enough to know that this scenario definitely widened the field as to who might have done him in.

Everyone who hated his guts.

He sucked in air as if inhaling it through a straw. Soon his windpipe would be squeezed smaller still, and his brain would shut down, seize, and die for lack of oxygen. He'd see for himself the greatest riddle that had preoccupied him these last few years. Would there be a tunnel, the bright light, and loved ones?

His thoughts began to shatter and drift apart. He fought to hold them together, but it felt like trying to make jagged shapes fit alongside each other.

What loved ones?

His daughter had stopped visiting years ago.

Two wives no longer saw fit to even talk to him.

Colleagues admired his skills, but who liked him besides Garnet? And even Earl suspected him of murder.

All he had were legions of grateful patients whose lives he'd saved.

Not the same thing at all.

"Who are you?" he shrieked again, outraged he wouldn't know his killer or the reason why he'd been targeted for murder.

This time spittle rather than noise bubbled out his lips.

He again pushed up on his toes and recovered some slack. With the arrival of more blood to the brain, his desperation to live revived. New terrors raced through his head, insane panic driving his thoughts at high speed with the frantic, illogical, futile clarity that visits a man about to die.

"Are you there? Tell me why you did this," he sobbed, not realizing he no longer made a sound. "Is it punishment for Jerome? Yes, that's it, isn't it? Ail the reminders are to make me think of the poor man's last agony. Yes. Please, let it be punishment. Because that means you must still be here in the basement. Because what good would punishment be without someone to witness it and see the torment? And there still might be time for me to explain, make you take pity and cut me down. You see," he tried to say, "I hadn't meant Jerome to kill himself…"

He became faint. His vision closed in around the edges again, but this time it was as if he were inside a black hood and someone were pulling it shut with a drawstring.

No! No hood! This needn't be. Not an execution.

The pain in his legs trebled.

And he felt himself get an erection.

He could explain that too.

Something to do with the blood supply being cut off to a certain level of the spine.

But he couldn't remember the specifics.

All from insufficient oxygen.

A new panic blasted through his delirium.

His lifetime of medical knowledge, his skill to bring people back from death, would slip away into oblivion, cell by cell, memory by memory.

That's my legacy, my entire worth.

This time both his legs curled into spasm.

The noose cinched tighter and crushed his larynx.

No more breath.

The darkness swept it all away.

No white light.

No loved one.

No peaceful floating above himself.

Only inexorable pain.

And one last thought: end it fast.

Except…

He wouldn't kick away the stool to let his full weight hurry the process.

He'd simply allow himself to sag and prolong the agony.

Something a suicide wouldn't do.

Something someone smart enough might notice and figure out.

Earl, for instance…

Chapter 15

That same evening, 8:27 p.m.

Damn," Janet said.

It had been the fifth time Earl heard the word coming from their study where she and Thomas were working.

Sounded like they weren't getting very far, he thought, putting away the last of the dishes from dinner.

Brendan steadied a stack of bowls under his chin and carried them toward their proper cupboard. "Is that the beaver kind of dam or the bad kind?" he asked, managing to set his load up on the counter, where it teetered precariously. Then he hoisted himself up beside them.

Earl tried not to smile. "Beavers."

"How do you know?"

"Because I do."

"How?"

"Just do. Now it's up to bed."

The familiar routine- bath, teeth, pajamas, story- unwound at its usual slow pace. Earl savored each step of it, the ritual having become an oasis for him at the end of each day.

Half an hour later he joined Janet and Thomas in the study only to hear her again mutter, "Damn."

"No correlations?"

"Not so far," she said. "But I'm trying a new approach."

He saw a printout of the New England Journal cluster study lying on the floor beside her chair and absently picked it up.

"I expanded the search to include the whole hospital," Janet continued, gesturing at the NO MATCHES FOUND message on her screen with one of Brendan's pencils. A tiny figure of Big Bird clung to the eraser end. "We thought we could save time by checking each staff category for a home run- namely, anyone who'd been on duty for eighty percent of the deaths in palliative care."

Earl saw in the article where she'd circled that number, it being the magic threshold in most cases where the study technique had actually unmasked serial killers.

She slumped back in her chair. "But I've checked every type of worker at St. Paul's I can think of- nurses, doctors, residents, orderlies, porters, cleaners, nursing aides, lab technicians, even secretaries and security guards. Who am I missing?"