Steeling herself against the pain, which was made worse with any movement of her abdominal muscles, Laurie began to inch herself down toward the foot of the bed. She wanted to get beyond the side rails and try standing. She'd only gotten halfway when Jazz breezed in.

"Hold on there, girl," Jazz said. "Where do you think you're going?"

Laurie stared at her with uncamouflaged scorn. "I need to find some nurses who will respond to the call button."

"Let me tell you something, dearie," Jazz said. "You are not the only patient on the floor, and you are hardly the sickest. We have to prioritize, which I'm sure you'd understand if you stopped to think for one lousy minute. What is it you want, pain meds?"

"I want a telephone," Laurie said. "The one on the night table has no dial tone."

"Getting your phone functioning is the mission of the day-staff communications department. This is the nursing night shift. We don't have time for that kind of stuff."

"Where are my belongings?" Laurie demanded. Everything could be solved if she could get her hands on her cell phone.

"Surgery must still have them."

"I want them down here this minute."

"You do have a lot of demands," Jazz ridiculed. "I have to give you that. But listen, sweetheart! Surgery happens to be very busy tonight, which means we're going to be busy. They will get to your crap when they have the time. Now, if you'll excuse me, I've got patients to see."

"Wait!" Laurie cried, before Jazz ducked out the door. When Jazz turned back to her, she added: "I want this IV out."

"Sorry," Jazz said with a shake of her head. She came back into the room, and coming alongside Laurie, she hooked a hand under Laurie's armpit. Without warning, she pulled Laurie back to where she had been in the bed. Laurie winced with the pain. She was also impressed with Jazz's strength. "You were in shock when you came into the emergency room," Jazz continued. "You need that IV in case you relapse. You need fluid, and you might need more blood."

"Another IV can be put in," Laurie contended. "I want this one out. If you don't take it out, I'll pull it out myself."

Jazz stared at Laurie for a beat. "You are a feisty one, aren't you? Well, you might have some trouble pulling that baby out. It's a peripheral central line, which sounds a bit contradictory, but it's a long catheter that's been stitched under that little bandage covering the entry point. You'd be pulling away a sizable hunk of tissue if you were to yank it out."

"I want my doctor called," Laurie said. "Otherwise, I'm going to take out this IV no matter what, get myself out of this bed, and walk out of here."

Jazz's wry, brazen smile that she had left with earlier reappeared. "You are too much. Seriously! I read that you practically bled out this evening, and now a few hours later, you're giving orders. I'll tell you what I'll do. I'll call the doctor and explain exactly what you just told me. How does that sound?"

"It would be better if I told her myself."

"Maybe, but that is problematic, since your phone is not yet set up. Anyway, I'll make the call, explain the situation exactly, including your refusal to have blood drawn for a clotting study, and then I'll be right back. How is that?"

"It's a start," Laurie conceded.

As Jazz walked out of the room, Laurie let her head fall back against the pillow. Her bed was cranked up about thirty degrees. Her heart was pounding in her temples, and the pain in her incision site was worse, and she now had the new concern that she might have torn a few stitches. Yet she felt as if her panic had peaked. She took a deep breath and let it out, trying to relax a degree. She even closed her eyes. Having Jazz get in touch with Laura Riley wasn't as good as getting Jack on the line, but as she had said to Jazz, it was a start.

twenty-three

ONCE AGAIN, EVENTS DIDN'T progress as Jack would have preferred. David Hancock was at lunch but due back any minute. At first, Jack thought this news was someone's idea of a joke, since it was in the middle of the night. That was before he remembered that people who worked the night shift lived in a completely opposite world time-wise, and for them, their middle-of-the-shift meal was lunch, no matter what the clock said.

Jack paced the room until David Hancock appeared. He was a slight man of indeterminate genealogy. As if in compensation for the scant hair on the top of his head, he wore a scraggly, graying goatee and mustache, giving him a decidedly devilish look. He listened to Jack's request without comment before taking the Post-it. While he looked at it, he noisily sucked his teeth.

"Are you sure this is a laboratory test?" David asked, raising his eyes to Jack.

Jack's optimism about getting an answer took a nosedive. "Reasonably sure," he said as he reached out to retrieve the note.

David moved the Post-it from Jack's reach as he continued to stare at it. "What made you think it was a laboratory test?"

"It was part of the preoperative orders on a number of patients," Jack said while looking over his shoulder at the door.

"It wasn't a preoperative order in this hospital," David said.

"No," Jack agreed, nervously shifting his weight, trying to make up his mind if he should just turn around and leave. "It was at the Manhattan General and at the Saint Francis out in Queens."

"Pshaw," David voiced disparagingly. "Two AmeriCare institutions."

Caught off guard by the lab supervisor's comment, Jack leaned forward to get a better look at the man's expression. "Do I detect a value judgment in your voice?"

"You'd better believe it," David said. "I've got a sister in Staten Island who works for the city, and she's had some medical problems. AmeriCare has given her the runaround. It's all a business with those people, and taking care of patients is the last thing on their mind."

"I've had my differences with them as well," Jack admitted. "Maybe someday we could share war stories. But right now I'm interested in learning what kind of test an MASNP is."

"Well, I have to admit I don't know what it is with a hundred percent surety," David began, "but my guess would be it is a medical genomics test."

Jack was taken aback. A half hour earlier Shirley Mayrand had made him feel old. Now he was afraid David was about to do the same thing in terms of knowledge. Jack was acquainted with the science of medical genomics, but his knowledge was limited to identity markers used in forensics. He knew the relatively new field, spurred by the decipherment of the entire human genome, was racing ahead at an exponential rate.

"My guess would be that the MA stands for microarray which is a high-throughput technology generally used for gene expression."

"Is it now?" Jack questioned innocently. He was already over his head and was embarrassed to admit it, although what David was saying was now relating to what Henry had said about the "positive MEF2A" on the other Post-it note.

"You've got a funny expression, doctor. I mean, you do know what a microarray is, don't you?"

"Well, not exactly," Jack admitted.

"Then let me explain. Microarrays are a grid or checkerboard of minute spots of a mixture of varying but known DNA sequences usually affixed to the surface of a microscope slide. And we're talking about a lot of spots. I mean thousands, such that they can give information on the expression of thousands of genes at any given moment."

"Really!" Jack said and then wished he hadn't. He knew he was sounding stupid.

"But I doubt the test you are questioning about is a test for gene expression."

"No?" Jack voiced meekly.

"No, I don't think so. My guess is that the SNP stands for single nucleotide polymorphism, which I'm sure you know is a point mutation in the human genome. Also as you know, thousands of SNPs have now been mapped so exactly throughout the human genome that they can be linked to specific mutated genes that are passed from generation to generation. Those SNPs that are so linked are called markers. They're markers for the bad, mutated gene."