“Ma’am? Ma’am?”

Two men in plainclothes stood by the instrument cabinet, frowning at her. The taller one crossed toward her, his paper shoe covers sucking against the sticky floor. He was in his mid-thirties, and he carried himself with that cocky air of superiority that all heavily muscled men exhibited. Masculine compensation, she thought, for his rapidly receding hairline.

Before he could ask the obvious question, she held out her badge. “Jane Rizzoli, Homicide. Boston P.D.”

“What’s Boston doing here?”

“I’m sorry. I don’t know your name,” she answered.

“Sergeant Canady. Fugitive Apprehension Section.”

A Massachusetts State Police officer. She started to shake his hand, then saw he was wearing latex gloves. He didn’t seem inclined to offer her the courtesy, in any event.

“Can we help you?” Canady asked.

“Maybe I can help you.”

Canady did not seem particularly thrilled by the offer. “How?”

She looked at the multiple streamers of blood flung across the wall. “The man who did this-Warren Hoyt-”

“What about him?”

“I know him very well.”

Now the shorter man joined them. He had a pale face and ears like Dumbo’s, and although he, too, was obviously a cop, he did not seem to share Canady’s sense of territoriality. “Hey, I know you. Rizzoli. You’re the one put him away.”

“I worked with the team.”

“Naw, you’re the one cornered him out in Lithia.” Unlike Canady, he was not wearing gloves and he gave her a handshake. “Detective Arlen. Fitchburg P.D. You drive all the way out here just for this?”

“As soon as I heard.” Her gaze drifted back to the walls. “You realize who you’re up against, don’t you?”

Canady cut in: “We have things under control.”

“Do you know his history?”

“We know what he did here.”

“But do you know him?”

“We have his files from Souza-Baranowski.”

“And the guards there had no idea who they were dealing with. Or this wouldn’t have happened.”

“I’ve never failed to bring one back,” said Canady. “They all make the same mistakes.”

“Not this one.”

“He’s only had six hours.”

“Six hours?” She shook her head. “You’ve already lost him.”

Canady bristled. “We’re canvassing the neighborhood. Set up roadblocks and vehicle checks. Media’s been alerted, and his photo’s been broadcast on every local TV station. As I said, it’s under control.”

She didn’t respond but turned her attention back to the ribbons of blood. “Who died in here?” she asked softly.

It was Arlen who answered. “The anesthetist and the O.R. nurse. Anesthetist was lying there, at that end of the table. The nurse was found over here, by the door.”

“They didn’t scream? They didn’t alert the guard?”

“They would have had a hard time making any noise at all. Both women were slashed right through the larynx.”

She moved to the head of the table and looked at the metal pole where a bag of I.V. solution hung, the plastic tube and catheter trailing toward a pool of water on the floor. A glass syringe lay shattered beneath the table.

“They had his I.V. going,” she said.

“It was started in the E.R.,” said Arlen. “He was moved directly here, after the surgeon examined him downstairs. They diagnosed a ruptured appendix.”

“Why didn’t the surgeon come up with him? Where was he?”

“He was seeing another patient in the E.R. Came up probably ten, fifteen minutes after all this happened. Walked through the double doors, saw the dead MCI guard lying out in the reception area, and ran straight for the phone. Practically the entire E.R. staff rushed up, but there was nothing they could do for any of the victims.”

She looked at the floor and saw the swipes and smears of too many shoes, too much chaos to ever be interpreted.

“Why wasn’t the guard in here, watching the prisoner?” she asked.

“The O.R.‘s supposed to be a sterile zone. No street clothes allowed. He was probably told to wait outside the room.”

“But isn’t it MCI policy for their prisoners to be shackled at all times when they’re out of the facility?”

“Yes.”

“Even in the O.R., even under anesthesia, Hoyt should have had his leg or arm handcuffed to the table.”

“He should have.”

“Did you find the handcuffs?”

Arlen and Canady glanced at each other.

Canady said, “The cuffs were lying on the floor, under the table.”

“So he was shackled.”

“At one point, yes-”

“Why would they release him?”

“A medical reason, maybe?” suggested Arlen. “To start another I.V.? Reposition him?”

She shook her head. “They’d need the guard in here to unlock the cuffs. The guard wouldn’t walk out, leaving his prisoner in here unshackled.”

“Then he must have gotten careless,” said Canady. “Everyone in the E.R. was under the impression Hoyt was a very sick man, in too much pain to put up a fight. Obviously, they didn’t expect…”

“Jesus,” she murmured. “He hasn’t lost his touch.” She looked at the anesthesia cart and saw that one drawer was open. Inside, vials of thiopental sparkled under the bright O.R. lights. An anesthetic. They were about to put him to sleep, she thought. He is lying on this table, with that I.V. in his arm. Moaning, pain contorting his face. They have no idea what is about to happen; they are busy doing their jobs. The nurse is thinking about which instruments to set up, what the doctor will need. The anesthetist is calculating the doses of drugs, while she watches the patient’s heart rate on the monitor. Maybe she sees his heart accelerate and assumes it’s due to pain. She doesn’t realize he is tensing for the lunge. For the kill.

And then… what happened then?

She looked at the instrument tray near the table. It was empty. “Did he use a scalpel?” she asked.

“We haven’t found the weapon.”

“It’s his favorite instrument. He always used a scalpel…” A thought suddenly raised the hairs on the back of her neck. She looked at Arlen. “Could he still be in this building?”

Canady cut in, “He’s not in the building.”

“He’s impersonated doctors before. He knows how to blend in with medical personnel. Have you searched this hospital?”

“We don’t need to.”

“Then how do you know he’s not here?”

“Because we have proof he left the building. It’s on video.”

Her pulse quickened. “You caught him on security cameras?”

Canady nodded. “I suppose you’ll want to see it for yourself.”

EIGHT

It‘s weird, what he does,“ said Arlen. ”We’ve atched this tape several times, and we still don’t get it.“

They had moved downstairs, into the hospital conference room. In the corner was a rolling cabinet with a TV and VCR. Arlen let Canady turn on all the power switches and work the remote. Controlling the remote was an alpha male’s role, and Canady needed to be that male. Arlen was secure enough not to care.

Canady shoved in the tape and said, “Okay. Let’s see if Boston P.D. can figure it out.” It was the verbal equivalent of tossing down the gauntlet. He pressed play.

A view of a closed door at the end of a corridor appeared on-screen.

“This is a ceiling-mounted camera in a first-floor hallway,” said Arlen. “That door you see leads directly outside, to the staff parking lot, east of the building. It’s one of four exits. The recording time’s at the bottom.”

“Five-ten,” she read.

“According to the E.R. log, the prisoner was moved upstairs to the O.R. at around four forty-five, so this is twenty-five minutes later. Now watch. It happens around five-eleven.”

On-screen, the seconds counted forward. Then, at 5:11:13, a figure suddenly walked into view, moving at a calm, unhurried pace toward the exit. His back was turned to the camera, and they saw trim brown hair above the collar of the white lab coat. He was wearing surgeon’s scrub pants and paper shoe covers. He made it all the way to the door and was pressing on the exit bar when he suddenly stopped.