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As she stood there, I felt ashamed. I’d rushed up there eager to tell her the truth, but the person I should have been confronting was Harry himself, not his wife. It wasn’t her fault that he’d fooled her. What had come over me, acting like an avenger to a woman whose life was already shattered?

“I’m sorry,” I said quietly. “You’re right. I don’t know your husband as well as you. I think I should leave now.”

Her eyes were closed and she stood rigidly, her muscles tensed, as if still tortured by my outburst. Finally, she relaxed slightly and sat down again, looking more desolate than I’d ever known her, even in her study in East Hampton.

“Perhaps you should,” she said.

She stayed seated as I walked out of the study and unlatched the front door to let myself out. The last sight I had of her was with her hands folded in her lap, gazing blankly at a bright acrylic, no doubt million-dollar, painting.

Once I’d endured the usual wait, Duncan appeared and beckoned me through. I’d never noticed personal touches in her office before, but as I sat down, I saw two photos framed by her desk. One was of a hulk holding an oar and the other of a teenager in braces.

“Yours?” I said, pointing at them.

“Louisa’s mine. That big guy is my stepson. He’s at Stanford,” she said. “You haven’t got children, have you?”

“Not even a wife, I’m afraid.”

There was a pause as we both smiled formally. I realized that she knew that already from having read my personnel file. There was nothing I could tell her about myself in small talk that she didn’t already know. That didn’t bother me, because I’d kept other things from her and was about to bring her up to date. After my shame at the way I’d confronted Nora, this was light relief. I didn’t care about upsetting Duncan.

“You asked to see me?” she said.

“I did. I wanted to let you know that I’ve thought over what you suggested when we last met, and I have an answer.”

“Which is?” she said icily, as if she didn’t appreciate me playing games. She wanted only silent obedience.

“No,” I said.

“No what?”

“No, I’m not going to keep quiet. It’s too late for that. I’ve informed the Suffolk County ADA about what happened when Mr. Shapiro was admitted to Episcopal and why I came to discharge him. I testified yesterday to a grand jury.”

“You did what?” Duncan said incredulously.

“Testified to a grand jury. In Riverhead.”

“What?”

She was all but gasping. Her face had turned puce with shock, and I was happy to have stunned her, even temporarily. She walked to the window with a view of the Queensboro Bridge, standing motionless as if she needed time to think. Then she recovered her bearings, and the rush of surprise turned to a blast of anger.

“This is the first I’ve heard of a grand jury, and you testify without even telling me? What the hell did you say?”

I savored that moment, for I had her fate in my hands and she had to wait for me to tell her. The truth was that I hadn’t told Baer about how she’d forced me to discharge Harry because he hadn’t asked. But I’d already made up my mind that when he did that, I would. I’d ceased to care about Duncan-nothing she did could save me.

“I’m under oath to keep my evidence confidential.”

That was childish, I admit-that’s what the subpoena said, but I could easily have told her if I’d wanted to or if I’d trusted her. Duncan naturally believed I wasn’t telling her because I’d implicated her.

“Dr. Cowper,” she said, “we talked about the importance of sticking together, that the hospital would stand behind you. It seems you have betrayed my trust.”

I’d done pretty well to keep my temper during all of our interactions, I thought, but that made me lose control.

“I didn’t ask to treat Mr. Shapiro. You were the one who wanted me to do it. My mistake was obeying you.”

“I don’t know what you mean,” she said firmly, looking down and pretending to smooth an invisible wrinkle in her skirt.

“Bullshit. You pressured me from the start to do what the Shapiros wanted and then you tried to keep it quiet.”

She stared at me as if unable to understand why I could be behaving this way: Why won’t he do what I say? What’s wrong with him?I didn’t fully understand that myself. All I knew was that I felt better for having defied her.

“All right, if you wish to destroy your career out of stubbornness, there is nothing I can do to prevent it. You may have relayed some fantasy to the grand jury about how you behaved and why. When the time comes, I will protect this institution by telling the truth.”

The purest rage I’ve ever felt erupted inside me. How dared she lecture me about the truth when she’d blatantly lied?

“You’ve never told the truth. You don’t even know the meaning of the word,” I shouted at her.

Duncan ignored my outburst. She walked to her desk and flicked a file shut as if it wasn’t any of my business anymore. In that moment, I knew that although I’d had some fun, I couldn’t defeat her. She ran this place, and Nora wouldn’t make her save me now that I’d turned on Harry. Episcopal would cast me aside just as Seligman had discarded him-the institution would protect itself.

“I await your resignation,” she said.

I hadn’t talked to Rebecca since she’d fixed my skull. I’d seen her in the distance in the hospital hallways, talking to someone or rushing somewhere, a blur of green scrubs and blue cap. Once I’d thought she’d noticed me from the corner of her eye and had turned to avoid a meeting. She finally turned up just after I’d left Duncan and was standing in my office, tallying how many boxes it would take to hold my possessions.

“Hey, you,” she said.

I turned, scanning her face again. Memory is strange: When someone we love leaves for a while, the image fades. Only when they depart forever is it etched permanently in the mind. I can picture my mother’s face more vividly than my father’s.

“Hey,” I said, half pondering a kiss on her cheek but not moving, a safe yard between us. The last time I’d seen her I’d been strapped to a gurney, but this time I had an awkward amount of freedom. “I’m sorting things out.”

“I can see that. You’re really shaking things up in here,” she said, sounding amused. “How’s that head of yours?”

“Pretty good, I think. You did a good job.”

“Sit down. I’ll take a look,” she said firmly.

I lowered myself obediently into my patients’ chair and felt her delicate fingers part my hairline to examine the skin closely. It felt comforting, like a tiny, unobtrusive massage, and my tight shoulder muscles unwound a little.

“Looks like the head’s healing nicely. How’s your mind doing? That’s your specialty, isn’t it?”

“Still in bad shape,” I said.

She sat opposite, in the chair I used during therapy. I found it unnerving to be observed from there, especially by her.

“I heard a rumor that the psych department was upset with you. You’re going to be okay, aren’t you? You’re not in trouble?”

For a split second, I thought of confessing the truth to her. It was the end of a long day, one on which I’d started out feeling resolved that I would tell the truth to power but had finished with power setting me straight. I felt alone, and she more than anyone else would understand. But I was lost in a maze of half truths and half secrets that Greene’s death had uncovered, and I couldn’t think of where to start.

“I’ll be fine. Don’t you worry about me. It’s been a bit of a palaver, but it’s all okay now,” I said. “It’s nice to see you. We should have a drink.”

“We should. Let’s do that,” she said as vaguely as I had proposed it, and slipped out of the room again.

I examined my shelves for a bit, pretending to be sorting out books, as if I could deceive myself with appearances in the same way I might fool someone else. Then I gave up and sat at my desk unhappily. Somewhere along the way, she’d let me go.