Laurie winced. Her secret was now quasi-public. Even though she had never met the secretary, the woman now knew a terribly private, intimate detail about her life that Laurie had not yet decided how she was going to handle. Difficult choices would have to be made.

"Congratulations!" the secretary continued. "Hold the line! I'm sure that Dr. Riley would want to say hello."

Without a chance to respond, Laurie found herself on hold, listening to music. For a brief moment, she thought about hanging up, but she decided she couldn't do it. To keep her mind in check, she looked down at the stack of death certificates and investigative reports from Queens. Anxious for a diversion, she picked up the first and began reading. The patient's name was Kristin Svensen, age twenty-three, who had been admitted to St. Francis Hospital for a hemorrhoidectomy. Laurie shook her head at the dimensions of the tragedy. It made her problems seem small compared to the death of a healthy young woman in a hospital after having her hemorrhoids removed.

"Dr. Montgomery! I just heard the good news. Congratulations."

"You can call me Laurie."

"Fair enough, and you can call me Laura."

"I'm not sure congratulations are in order. To be perfectly frank, this is an unexpected and rather an inconvenient surprise for me, so I'm not sure how I feel about it."

"I see," said Laura, reigning in her exuberance. Then, with sensitivity born of experience, she added, "We still have to make sure you and the conceptus are as healthy as possible. Have there been any problems?"

"A bit of morning sickness, but it's been very transient." Laurie found herself uncomfortable talking about the pregnancy and wanted to get off the line.

"Let us know if it gets any worse. There are lots of suggestions for dealing with it in the thousands of pregnancy books available. As for books, my advice is to stay away from the most conservative ones, because they'll drive you crazy, thinking you can't do anything, like take a hot bath. With that said, we'll see you next Friday."

Laurie thanked her and hung up the phone. It was a relief to get the call behind her. Picking up the computer printouts of the cases from Queens, she tapped them against the surface of her desk to align them. The motion caused an almost subliminal unpleasant sensation in the same location where she'd had the pain while down in the locker room. She wondered if she should have at least mentioned the feeling and pain to Laura Riley. She thought she should have, but wasn't about to call her back. Instead, she'd bring it up during her appointment, unless it became frequent or intense enough to warrant a call. She also wondered if she should have mentioned about being positive for the BRCA1 marker, but as with the discomfort, she decided it would be perfectly appropriate to discuss it on her first visit.

With the papers in one hand, Laurie reached for the phone again, but then hesitated with her hand on the receiver. She had it in her mind to call Roger for several reasons, not the least of which was feeling guilty about leaving him in the dark about what must have seemed strange behavior in his office. But she didn't know what she was going to say. She wasn't yet willing to tell him the whole truth for a number of reasons, but she knew she would have to say something. Ultimately, she decided she'd use the BRCA1 issue, as she'd already done.

Laurie picked up the phone and dialed Roger's direct line. What was really motivating her was her desire to take copies of the Queens materials over to him so she could talk with him directly about them. Despite the turmoil in her mind from her personal problems, she'd come up with an idea about the cases from Queens that might possibly solve the mystery of SADS.

fourteen

WHEN LAURIE GOT OVER TO the Manhattan General Hospital, she was ushered directly into Roger's office, where he was waiting for her. The first thing he did was close the door. Then he gave her a sustained, silent hug. Laurie hugged him back, but not with equivalent ardor. On top of the residuals from the marriage flap, she knew she wasn't going to be entirely forthright with him about her own situation, and it made her feel self-conscious. If he noticed her restraint, he didn't mention it. After the embrace, he turned his two straight-backed chairs around to face each other just as he had done the day before. He had Laurie sit in one, and he took the other.

"I'm glad to see you," he said. "I missed you last night." He was leaning forward into her space with his hands clasped and his elbows on his knees. Laurie was close enough to smell his aftershave lotion. His day was just beginning. His fresh shirt still had the telltale creases from the laundry box.

"I'm glad to see you, too," Laurie said. She reached out and handed him the investigative reports and the death certificates on the six cases from Queens. She hadn't had time to make copies, but it didn't matter. She could just as easily download them again. By giving him the material, she hoped to deflect the conversation away from her mental state, at least for the moment. Besides, she was eager to tell him her idea.

Roger scanned the pages quickly. "My word! They do seem similar to ours, even to the extent of occurring at around the same time in the morning."

"That's my take. I'll know more details when I get the hospital charts. But for the sake of the discussion, let's assume they are mirror images. Does that suggest anything to you?"

Roger looked down at the papers, thought for a moment, and then shrugged. "It means the number of cases has doubled. We now have twelve cases, not six. No, we have thirteen, including the death last night. I assume you've heard about Clark Mulhausen. Are you going to be doing the autopsy?"

"No, Jack is doing it," Laurie said. She had told Roger a little about Jack during their five-week courtship, including the fact that she and Jack had been lovers. When Laurie had first met Roger, she had described herself as "mostly unattached." Later, when she and Roger had gotten to know each other better, she had admitted that she had used that particular description of herself because of unresolved issues with Jack. She had even gone to the extent of confiding that the problem involved Jack's reluctance to make a commitment. Roger had accepted the news with great equanimity, which had enhanced Laurie's estimation of his maturity and self-confidence, and the issue had never resurfaced.

"Look at the dates on the Queens cases," Laurie suggested.

Roger again glanced through the papers then looked up. "They were all in the late fall of last year. The last one was in the latter part of November."

"Exactly," Laurie said. "They were clumped pretty close together, at a frequency of slightly more than one a week. Then they stopped. Does that suggest anything to you?"

"I suppose, but it sounds like you have something specific in mind. Why don't you tell me?"

"Fair enough, but first listen! You and I are the only ones who suspect we might be dealing with a serial killer, but we've been effectively gagged. I can't get the OCME to take a stand on the manner of death, and you can't get the hospital authorities even to admit there's a problem. What we're fighting here is institutional inertia. Both bureaucracies would rather sweep the issue under the rug until something forces their hand."

"I can't argue with that."

"What's held us so effectively in check from your side is that your hospital has such a good mortality rate that these deaths aren't appearing on the radar. From my side, it is the failure of toxicology."

"They still haven't found anything remotely suspicious?"

Laurie shook her head. "And the chances they might in the near future just took a nosedive. I'm afraid our crotchety laboratory director discovered my undercover effort this morning. If I know him, from now on he'll make sure that any further work on our cases will go to the very back of the queue. And even when he does get around to them, he's surely not going to do anything special."