"Dr. Brown," Tony Fasano said, gripping the sides of the lectern with his short, thick fingers. "Before we get to Patience Stanhope's unfortunate and avoidable death -"

"Objection," Randolph said emphatically. "There has been no establishment that Mrs. Stanhope's death was avoidable."

"Sustained!" Judge Davidson declared. "Rephrase!"

"Before we get to Patience Stanhope's unfortunate death, I'd like to ask you if you've had previous contact with the defendant, Dr. Craig Bowman."

"I have."

"Can you explain the nature of your contact to the jury?"

"Objection, Your Honor," Randolph said with exasperation. "Immaterial. Or if it is material in some unfathomable way, then I object to Dr. Brown as an expert witness for bias."

"Counsels approach the bench, please," Judge Davidson said.

Tony and Randolph dutifully grouped at the side of the judge's bench.

"I'm going to be very upset if we have a repeat of Monday," Judge Davidson said. "You're both experienced lawyers. Behave as such! You both know the rules. As to the current line of questioning: Mr. Fasano! Am I to assume you have a relevant rationale for your current line of questioning?"

"Absolutely, Your Honor! The core of the plaintiff's case revolves about Dr. Bowman's attitude toward his patients in general and Patience Stanhope in particular. I call to the court's attention the deprecatory 'PP' classification. Dr. Brown has the ability to provide some insight into the development of these traits during Dr. Bowman's critical third year in medical school and during his residency training. Subsequent testimony will relate them directly to the case of Patience Stanhope."

"Okay, I will allow this line of questioning," Judge Davidson said. "But I want it related quickly to establish its relevance. Am I clear about that?"

"Perfectly clear, Your Honor," Tony said, unable to suppress a slight smile of satisfaction.

"Don't look so goddamned pained," Judge Davidson said to Randolph. "Your objection has been recorded. My judgment, provided Mr. Fasano is being totally honest about relevancy, is that the probative value will outweigh the prejudicial. I admit it is a judgment call, but that's why I'm here. In return I will grant the defense wide leniency on cross-examination. As for the question of bias, there's been ample opportunity to determine that during discovery, and it wasn't. But the issue can be examined on cross.

"And I want the pace to pick up," Judge Davidson said. "I've allocated this week for this trial, and here it is Wednesday already. For the sake of the jurors and my schedule, I want it to conclude on Friday unless there are some particularly extenuating circumstances."

Both lawyers nodded. Randolph repaired to his seat at the defense table while Tony returned to the podium.

"Objection overruled," Judge Davidson called out. "Proceed."

"Dr. Brown," Tony said after clearing his throat. "Would you tell the jury the nature of your contact with Dr. Craig Bowman?"

"My first contact was as his preceptor at Boston Memorial Hospital on his internal-medicine rotation during his third year of medical school."

"Could you explain what this means, since no one in this wonderful jury went to medical school?" Tony made a sweeping gesture down the line of jurors, some of whom nodded in agreement. Everyone was paying rapt attention, except for the plumber's assistant, who was focusing on his nails.

"Internal medicine is the most important rotation and the most demanding during the third year, and perhaps for the entire four years. It is the first time the students have prolonged contact with the patients from the patient's admission to their discharge, and they participate in the diagnosis and therapy under strict observation and supervision by the resident house staff and by the preceptor."

"Was this preceptor group that included Dr. Bowman a large group or a small group?"

"A small group: six students, to be exact. The teaching is intense."

"So you as the preceptor see the students on a regular basis."

"Every day."

"So you can observe the overall performance of each student."

"Very much so. It is a critical time in the student's life, and it marks the beginning of the individual's transformation from a student to a physician."

"So that attitudes that are observed or develop are important."

"Exceedingly so."

"And how do you rate your responsibility as a preceptor vis-a-vis attitudes?"

"Again, exceedingly important. As a preceptor, we have to balance the explicit attitudes toward patients as promulgated by the medical school versus the implicit attitudes often exhibited by the overworked and -stressed house staff."

"There's a difference?" Tony questioned with exaggerated disbelief. "Can you explain the difference?"

"The amount of knowledge medical trainees must assimilate and have immediate recall of is staggering and increasing every year. As pressed as residents are, they can sometimes lose sight of the ultimate humanistic aspects of what they are doing and which form the basis of professionalism. There are also defensive coping mechanisms in the face of suffering, dying, and death that are not healthy."

Tony shook his head in bewilderment. "Let me ask you if I have this correct. In simplified terms, there can be a tendency on the part of medical trainees to devalue individual people, like losing sight of the trees by paying too much attention to the forest."

"I suppose," Dr. Brown said. "But it is important not to trivialize this issue."

"We'll all try," Tony said with a short chuckle, which brought a few tentative smiles from the jurors. "Now, let's get back to the defendant, Dr. Craig Bowman. How did he do during his rotation in third-year internal medicine?"

"Generally excellent. In the group of six students, he was far and away the most knowledgeable and the most prepared. I was often astonished at his recall. I remember one episode of asking what a patient's BUN was."

"The BUN is a laboratory test?" Tony asked.

"Yes. I asked it more as a rhetorical question, to emphasize that knowledge of kidney function was key in the treatment of the patient's condition. Dr. Bowman rattled if off without hesitation, making me wonder if he had made it up, a frequent medical student ploy to cover unpreparedness. Later, I looked it up. It was exactly right."

"So Dr. Bowman got a good grade for the course."

"He got an A."

"Yet you qualified excellent by saying 'generally excellent.'"

"I did."

"Can you tell us why?"

"I had a nagging feeling, which I again got while supervising Dr. Bowman when he was a resident at the Boston Memorial Hospital."

"And what was this feeling?"

"I had the impression that his personality -"

"Objection!" Randolph called out. "Foundation: The witness is neither a psychiatrist or psychologist."

"Overruled," Judge Davidson said. "As a physician, the witness has had exposure to those fields, the amount of which can be challenged on cross. The witness may proceed."

"It was my impression that Dr. Bowman's desire to succeed and his lionization of our then chief resident made him view patients as a means to compete. He actively sought out the most difficult patients so his presentations were intellectually the most interesting and achieved the widest acclaim."

"In other words, it was your impression Dr. Bowman saw patients as a way to further his career?"

"Essentially, yes."

"And that kind of attitude is not consistent with the current concept of professionalism?"

"That's correct."

"Thank you, doctor," Tony said. He paused and looked from one juror to another, making eye contact with each, allowing the testimony to sink in.

Jack leaned over toward Alexis and whispered, "Now I understand what you said about Tony Fasano; this guy is good. Now he's putting academic medicine and its inherent competitiveness on trial along with concierge medicine."