Gradually Kim responded to Tracy 's urging, and he visibly relaxed a degree. David took his hand away.

Kim nodded to Tracy. "Okay," he said. Then, turning back to Becky, he gripped her tiny arm. "Daddy will be right outside, Pumpkin."

"I don't want any needles," Becky said plaintively.

"They want to give you some fluid," Kim said. "But it will be only one stick. It will be over in a second. I know it's no fun, but you've got to be strong so you can get back to normal. Okay?"

"Okay," Becky said reluctantly.

Tracy gave Becky's hand a squeeze and told her that she would be with Kim and that they would be back in to see her in a few moments. Becky nodded but she clearly wasn't happy. She looked scared.

Tracy followed Kim out through the curtain surrounding Becky's gurney. She could hear that he was breathing fast. She didn't say anything until they had passed the nurses desk.

"Kim, you have to calm down," Tracy said. She put her hand gently on his arm. "You're so tense."

"David Washington drives me up a wall," Kim snapped.

"He's doing his job," Tracy said. "If the situation were reversed and you were taking care of his child, I'm sure you'd act the same way he has. You wouldn't want him giving orders."

Kim pondered this as he pushed through the swinging doors to the outside. The blast of cold air felt good on his face. He stopped on the platform and took a deep breath. He slowly let it out. Tracy still had a hold of his arm.

"I guess you're right," he said finally. "It's hard for me to see Becky lying there and so vulnerable."

"I can imagine," Tracy said. "It must be very difficult."

Their eyes met.

"You can understand?" Kim asked. "Seriously?"

"Absolutely," Tracy said. "You're a surgeon. You are trained to act. And who would you want to take care of more than your own child. For you the hardest thing in the world is to see Becky in need and not do something."

"You're right," Kim said.

"Of course I am," Tracy said. "I'm always right."

In spite of himself, Kim smiled. "Now, I'm not going to go that far. Frequently maybe, but not always!"

"I'll accept that, provided we go back inside," Tracy said with a smile. "I'm freezing."

"Sure, I'm sorry" Kim said. "I just needed a breath of cold air."

"Does the IV bother you?" Kim asked Becky.

Becky raised her left hand which was taped to a flat wristboard. A length of clear plastic tubing dove into the gauze covering the back of her hand. "I can't feel it at all," she said.

"That's the way it's supposed to be," Kim said.

"Does it feel cold?" Tracy said. "That's what I remember when I was in the hospital having you."

"It does feel cold!" Becky remarked. "I didn't know it until you said it. My whole arm is cold."

David had carefully examined Becky, had started the IV, had done routine bloodwork and urinalysis, and had a flat plate and an upright X-ray taken of her abdomen. Although he'd yet to see the X-rays since they were not yet available, the blood and urine results were all normal, suggesting the blood loss had been minimal. At that point, he'd sent for Kim and Tracy to keep Becky company while they waited for Dr. Claude Faraday.

The infectious-disease specialist arrived a few minutes later. He introduced himself to Kim and Tracy, and then to Becky. He was a slender, dark-complected man with an intense manner. He listened to a full recounting of Becky's problem, from the very first symptoms Saturday morning until the episode of hemorrhage that evening. He nodded every so often, especially when Becky herself added specific details.

"Okay, Miss Reggis," he said to Becky. "Would you mind if I looked you over a bit?"

Becky looked at Tracy as if she had to get permission.

"Dr. Faraday is asking you if it's all right for him to examine you," Tracy translated for Becky.

"It's okay," Becky said. "I just don't want any more needles."

"No more needles," Claude assured her.

Claude started his rapid but thorough examination by feeling Becky's pulse and checking the turgor of her skin. He looked into her mouth and ears. He used an ophthalmoscope to peer into her eyes. He listened to her chest and checked her skin for rashes. He gently poked into her abdomen, which was tender. He searched for enlarged lymph nodes.

"You seem okay to me, except for that slightly sore belly," he said at last. "Now, I'm going to step outside and talk to your parents. Okay?"

Becky nodded.

Tracy leaned over and gave her daughter a kiss on the forehead before following Claude and Kim out through the curtain. The corridor was busy, so the group drew to the side to avoid the bustle. David happened to see them and walked over. He introduced himself to Claude.

"I was just about to give a summary to the parents," Claude said to David.

"Mind if I listen in?" David asked.

Claude looked at Kim and Tracy.

"That's fine," Tracy said.

"All in all, she looks good to me," Claude began. "She's a little pale, of course, and a bit dehydrated. There's also some generalized abdominal tenderness. Otherwise, on physical exam she's quite normal."

"But the hemorrhage?" Tracy questioned. She was afraid Claude was about to dismiss the case.

"Let me finish," Claude said. "I also went over her laboratory work. Compared to last night, there is a slight drop in her hemoglobin. It's not statistically significant, but in view of the mild dehydration, it might be important, considering the history of the hemorrhage. There's also a slight drop in her platelets. Otherwise, everything is within normal limits."

"What's your presumptive diagnosis?" Kim asked.

"I'd have to say food-borne bacterial illness," Claude said.

"Not viral?" Kim asked.

"No, I think it's bacterial," Claude said. He looked at David. "I believe that was your feeling last night as well, wasn't it?"

"Yes it was," David said.

"But why no fever?" Kim asked.

"The fact that there has been no fever makes me think this has been more a toxemia than an infection," Claude said. "Which also goes along with the normal white count."

"What about last night's culture?" Kim asked. "Is there a preliminary twenty-four-hour reading?"

"I didn't see a culture," Claude said. He looked at David.

"We didn't do a culture last night," David said.

Kim shook his head in disbelief. "What the hell are you talking about?" he demanded. "I even gave you the sample."

"We don't do routine stool cultures for simple diarrhea here in the ER," David said.

Kim slapped his hand to his forehead. "Wait a sec! You just said you'd made a presumptive diagnosis of a bacterial infection. Why wouldn't you do a culture? It just stands to reason, much less being good medicine. How else could you treat rationally?"

"AmeriCare utilization rules proscribe routine cultures in this kind of case," David said. "It's not cost-effective."

Kim's face reddened. Tracy was the only one who noticed. She reached out and gripped Kim's arm. He pulled it free. "Cost-effective! What kind of screwball excuse is that? What the hell kind of emergency room are you running here? You're telling me that to save a few measly dollars you failed to do a culture?"

"Listen, you prima donna," David snapped. "I just told you, it's standard operating procedure not to do them. Not for you, not for anybody."

Losing control as he'd done the night before, Kim grabbed David by the lapels of his white jacket. "Prima donna, am I? Well, your goddamn screwed-up operating procedure has lost us a whole damn day!"

Tracy grabbed Kim's arm. "No, Kim!" she cried. "Not again!"

"Take your hands off me, you arrogant son-of-a-bitch," David growled.

"Calm down!" Claude said as he insinuated himself between the two much larger men. "It's okay. We'll run some cultures stat. We haven't lost that much, because I doubt we'd treat anyway."