Karen looked over Alan’s shoulder. “It looks awful. Shouldn’t she be on antibiotics?”

The object of concern was Eden’s knee. The scrape had seemed innocent enough, but instead of healing it had become infected. With last year’s anaphylactic reaction now in Eden’s record, the nurse had convinced the camp director that it would be best to send her home.

“Polysporin is an antibiotic ― three, in fact,” he said, showing her the ointment he planned to apply after each hot compress, “none of them related to penicillin.”

“I meant a shot, or taking something by mouth.”

“I’d rather not give her anything internally.”

Karen had gone as far as she dared. She asked, “Do you have to take a culture?”

“It’s probably staph, and it’s covered.”

Lying around was not how Eden would have chosen to spend the afternoon. Once she was alone she disregarded Alan’s directive to do just that. By evening, though, she could not ignore the throbbing pain. Now she wanted comforting, so she called Josh. That, at least, she could do lying down. “For God’s sake!” he told her, “Do as your dad says. Do you want to get blood poisoning? We have a lifetime to think about!” It was both more and less than she’d hoped for.

Well, I asked for it, she told herself, and next day she did as she was told. All the same, the pain woke her in the night. “We’ll give it one more day,” Alan said when he saw it in the morning. “After that it’s IV antibiotics. Flat on your back now. You promise?”

“I promise,” she said, defeated. She had only herself to blame. She cried more out of mortification than pain. Where were her common sense and maturity now? What had she brought on herself?. . . What would Josh think of her?

By afternoon she felt ill, muscles aching and head pounding. Though she had neither eaten nor drunk anything since breakfast, she felt neither hunger nor thirst. She took two pain pills from the bathroom and was about to lie down again when a wave of nausea overcame her. She made it back just in time to vomit and have a loose bowel movement. After this she fell into a fitful sleep, only to awake an hour later to an overriding sensation of weakness and an inexplicable chilliness. This is July, she thought, how can it be so cold? Then the gooseflesh appeared on her upper arms and she began to shiver. Now she was frightened enough to call her mother. The first thing that struck Karen on seeing Eden was her flushed appearance and the warmth of her skin, as if she had fever. Her jaw dropped when she saw how right she was.

“A hundred and four,” she barely managed to say the words. “We’re going straight to the hospital. Enough of compresses and ointment.”

“It’s probably just a bad case of flu. Maybe the knee has nothing to do with it.”

“Maybe, and maybe not. We’re not taking any chances.”

“Oh God, I feel so miserable.” She allowed her mother to help her up. As she stood, she became lightheaded and almost fainted. Karen felt only mildly guilty for her remark about the compresses and ointment. But past and present were merging in her mind, and she was angry.

“Who’s her doctor?” the receptionist in the emergency room asked.

“Harmon.” Seeing the receptionist’s eyes widen, Karen added, “She’s not quite seventeen.”

“Ah, I guess she won’t be a pediatric patient much longer.” Karen was in no mood for small talk. “Would you call him please, or else let me?”

“Of course,” the receptionist said, all business now. “Here, I’ll dial for you.”

“Rick?” Karen related the details of Eden’s illness. “Do you think this could just be flu?”

“I don’t know, but you did right to bring her in. Nothing by mouth all day? She needs fluids, especially with that fever. The house staff’ll take care of her. Cathy Cross is very good. I’ll stay out of the way till they’re done.”

“Will you get back to me at home? I don’t want to be in their way either.”

The time was six-thirty. Karen accompanied Eden’s stretcher to the second floor, where she met the house physician. He was a young man only slightly taller than she, seemingly in his mid-twenties. He turned to Karen with a kind smile. “I’m Calvin McCrae, intern. You’re Mrs. Avery ? Eden’s going to room 226. I’ll see her as soon as they’ve got her in bed.”

“Is she going to be OK?”

“People her age bounce back fast. I’ll do a physical and order some lab tests. We’ll take blood cultures and start her on antibiotics. Most likely Prostaphlin and Garamycin.”

“It’s been such a rush, my husband doesn’t even know. Do you know Doctor Avery ?”

“I certainly do. Would you like me to page him for you?”

“No, he’s in the office this afternoon. I’ll take care of it.”

“I’m sure he’ll understand, Mrs. Avery . You did exactly what you should have done. Leave your number at the station in case we need to call you. No need for you to stay.”

Her mind wandered back to her days of promise at F & D, when she would meet Alan, then a resident himself, at the hospital for dinner. How much had happened since then!  She felt comforted by Doctor McCrae. He seemed self-assured and sensitive.

~~~~~~~~~~

Calvin McCrae was less than two weeks into his internship, still savoring the letters M.D. newly added to his name. He smiled inwardly at his double life. At the hospital, he was the lowest of the low, trying to prove that he was more of a doctor now than he had been as a senior student. Things were different at home. To his parents he was now a doctor, transformed on one magic capped-and-gowned day from bleary-eyed student to knowledgeable healer. His new status in the neighborhood also brought challenges, in the form of curbside consultations by people he knew. These he fended off by insisting he was but an intern, thereby implying he wasn’t a real doctor yet. In time he’d be able to handle them with confidence.

Eden’s case was as straightforward as it was serious. He concluded in minutes that she had a life-threatening illness. Adding together chills, high fever, a heart murmur, and a skin lesion through which bacteria could have entered the blood stream, he diagnosed a staphylococcal infection on the aortic valve, which could destroy it in days. Accordingly he ordered two blood specimens drawn immediately for culture. On second thought, he drew them himself to save time. He then ordered intravenous oxacillin specifically for staph, and gentamicin in case other bacteria were involved. Like many doctors exposed to pharmaceutical advertisements and salespeople, he thought in terms of trade names, Prostaphlin and Garamycin, and ordered accordingly. He handed the chart to the nurse. “Get this started right away, Connie. It’s urgent.” He’d write the admission note later.

“How about the resident’s signature?” Connie asked.

“As soon as I find her. I don’t want to hold up treatment. The girl’s shocky.”

Connie hesitated briefly and set about her job.  “By the way, Cathy switched with Mort.”

“OK,” Calvin answered casually, “I’ll look for him.”

Nothing like a solid diagnosis ― acute bacterial endocarditis and septicemia ― and effective treatment to match, he thought. His decisive action made him feel good. By morning he would see grateful smiles on the faces of Eden and Mrs. Avery . Even Doctor Avery would be pleased. He looked forward to the morning.

By rights his treatment orders were not valid without a superior’s approval. It took a year of internship to qualify for a medical license, and he was barely two weeks into that year. But rules could get in the way of good medicine. Luckily, tonight’s nurse, whom he’d known since his high school days, was willing to bend the rules too. Mort would countersign later. He was probably at dinner. As soon as the infusion was running, Calvin made his way to the cafeteria.

He did not see Mort, but he did see Cathy Cross. Newly arrived in Philadelphia, she was two years ahead of him in training but ten years older, having worked as a nurse before going to medical school. He sat down at her table, noticing that the chair was warm.

“Feels like someone just sat here.”

“Mort. He just left.”

“Did he say where he was going? I had an admission. I need him.”

“I don’t know where he went,” she replied. “He was in a hurry ― made some remark about hoping things would stay as quiet as they’ve been all day.”

“He should be satisfied with his quiet day. It’s not quiet now. That girl is pretty sick.”

“Can I help?” she asked.

“I thought you were off tonight.  How come you’re still here?  It can’t be the food.”

Cathy screwed up her face.  “I was supposed to be on, so I didn’t make plans. Mort wants tomorrow off.  Mother’s birthday or something. I didn’t want to refuse, though it wouldn’t hurt if he remembered his ma a little sooner.  Anyway, here I am.  Can I help?”

“Not really. I’ve already started antibiotics.  Mort just needs to countersign the orders.”

~~~~~~~~~~

Morton Friedman, M.D., enjoyed eating, and the cafeteria fare was much to his taste. Still, tonight he had eaten more as a matter of necessity than enjoyment. He was preoccupied. Under other circumstances he would have liked to flirt with his junior colleague, but on this occasion he excused himself as soon as he had finished. Expressing the hope that the evening would be as quiet as the day had been, he hurried out. Luckily Cathy asked no questions.

As senior resident, he was responsible for all patients on the pediatric service. Supervising two interns meant checking their physical findings on all new patients, approving lab tests and x-rays, and countersigning treatment orders. No drugs could be given without his approval. This early in the year, interns needed close supervision. Mort expected to be paged but hoped he wouldn’t. He had other interests to pursue. He was in his final year as resident. One of the privileges of seniority was time for research. The choice of a topic presented no problem, for he had long been fascinated by sleep, which renders healthy people unconscious for a quarter to a third of their lives. Luckily the chief neurologist was conducting research on this very subject and invited Mort into his laboratory, where he was now learning to analyze fluids from the spinal canal and brain cavities. His goal was to study the chemistry of dreaming, the molecular transformations connecting imagery, eye movements, and brain waves.

He had arranged to be on duty.  Last night he had needled the brains of his experimental cats. Tonight he would study computer printouts from the fluids he collected, looking for blips and squiggles that might point the way to chemicals not previously identified. He was unwilling to wait till his next on-call ― and even more unwilling to do his research on his own time ― so he had rescheduled his mother’s birthday to make sure Cathy would go along.

With a prayer to be left in peace, he hurried to the laboratory.

~~~~~~~~~~

“I assume they’re holding the antibiotics till Mort signs?” Cathy said.

“No, it’s too urgent,” Calvin answered. “She has acute endocarditis.”

Cathy tilted her head and arched her eyebrows. “You could have got an OK by phone.”

“It was straightforward textbook stuff.  I’m sure he’ll agree.”

“What did you order?”

“Prostaphlin and Garamycin.”

“Don’t they teach you to use generic names any more?” she asked with feigned disgust.

“OK, oxacillin and gentamicin. How’s that?”

“Better. We’re not in the business of promoting brand names. Anyway, it sounds like a reasonable choice. Unless, of course, she’s allergic. I assume you asked about that.”

Calvin frowned briefly. “Come to think of it, I didn’t. But most people aren’t.”

“True. But don’t bet your patient’s life ― or your own hide ― on the odds. Better get up there and make sure. I’ll see to it nobody steals your food.”

“Can’t it wait till I’ve eaten?”

“No.” She wagged her finger in the manner of a schoolteacher. “Now do as your resident says ― even if I am off duty.”

~~~~~~~~~~

After leaving Doctor McCrae to examine Eden, Karen turned to her next task ― notifying Alan. She found a pay phone and rang his office.

“Gilda, it’s Karen Avery . Is Alan available?”

“Afraid not, Mrs. A. I’ve been trying to reach you. You must not be calling from home. Alan’s at the hospital, with one of his patients. Emergency surgery. Alan’s watching.”

“That’s where I am. I just brought Edie in, with a fever of a hundred and four. She suddenly got sick this afternoon. Everything was such a rush I didn’t take time out to call.”

“My goodness! What is it?”

“I don’t know. Could be a bad case of flu, that’s what Edie thought. But she also has this infection on her knee. For all I know, it might have spread. I didn’t want to take any chances.”

“And right you are, too. Is she OK now?”

“She’s got an IV going and the intern sent me home so he could attend to her.”

“Alan’s patient ruptured an aneurysm. I bet he’s on the table this minute.”

“Can you reach him?” Karen asked.

“No. He told me he’d be scrubbed so he can get close. Gordon’s taking his calls.”

“Well, that’s no good to me. How long does this operation take?”

“I have no idea. I’m supposed to tell you it could get pretty late.”

Karen stamped her foot in frustration. “Why do these things always have to happen together? The one time you need a person you can’t reach him!”

“I’ll page him every half hour ― I can even do it from home ― and I’ll catch him the moment he comes out. That’s the best I can do short of sending someone after him.”

“No, that’d be overdoing it. If it turns out she just has the flu, he’ll be upset about being called out. He doesn’t like to make a production over little things.”

Gilda wondered what lay behind the sarcasm. “Will you be home?”

“I’m going home now.”

Seven o’clock. Karen went into room 226 to bid Eden goodnight, shrugged apologetically to Doctor McCrae, and went home to await Alan’s and Rick’s calls. Wondering which would come first, she made a cup of tea, but she had no appetite for food.

At nine o’clock the telephone rang.

~~~~~~~~~~

The encounter with Cathy had shaken him up. Behind the casual façade, he was angry at himself. How could he ask about allergy now that the drugs were already infusing?  He took the stairs three at a time. As he burst through the stairwell door, opposite the nurses’ station, he saw a woman in the blue uniform of kitchen staff speaking hurriedly to Connie. Connie’s mouth was hanging open and before Calvin could ask any question she had dashed off.

“What’s going on?” he shouted as he ran after her, but she was too absorbed to hear. They reached room 226 at the same moment, and there was Eden Avery , sitting up, face bloated, lips swollen, fighting a hopeless battle to breathe. As they stood, frozen by terror, the deep red of her face took on a purple tinge, and she slowly slumped over.

“Code Blue, quick!” he screamed. As fast as Connie had flown to the room she flew to the phone. Calvin instinctively attempted cardiopulmonary resuscitation, without stopping to feel whether Eden’s heart was beating. As he breathed into her mouth, he felt the tremendous airway resistance. He forced air in, but there was no way to get it out. When the code team arrived, he realized that his efforts had availed her no more than her own.

“Did anyone give adrenalin?” asked a small man in a green scrub suit. Guiltily Calvin remembered how he used to joke about that outfit ― referred to variously as monkey suit or pajamas ― which was the working garb of surgeons and anesthesiologists. Now he muttered a prayer of thanks for the life-saving skills of these doctors and vowed to be more respectful. He would have confessed on the spot, had he not been dismissed on answering no. Sensing his panic, the small man added: “Too many people and we get in each other’s way. We’ll be OK.”

But they were not. After twenty excruciating minutes, they emerged, grim and silent. Too numb to ask questions, Calvin watched as they made their way to the nurses’ station to record their efforts. He didn’t need to ask the cause of death. If the diagnosis hadn’t been obvious, Cathy’s last words would have made it for him. Don’t bet your patient’s life ― or your hide ― on the odds. He had not bet indifferently or recklessly. His motive, to treat a life-threatening infection with all possible dispatch, would have satisfied a conscience even more demanding than Calvin’s. But motive was not enough. It would have taken less than a minute to ask the life-sparing question, and give vancomycin instead. In his overconfidence he had committed the most egregious error. He was guilty of a young girl’s untimely and unnecessary death.

After the code team had gone, he turned to Connie, who met his gaze with solemn eyes.

“Has Friedman been told?”

“I’ve paged him,” she said. “He still hasn’t answered.”

“Keep trying. I’ve been looking for him too. He doesn’t even know she was admitted.”

~~~~~~~~~~

Constance Bader had a long association with the pediatric service at Cresheim Valley Hospital. For twelve years she had worked there full time. Now she filled in as needed. Connie knew most of the staff as well as the attending doctors. She also knew Calvin McCrae, the new intern ― had, in fact, known him since at thirteen he had paid daily visits to his injured friend Tim Haig on this very floor. She had met Calvin again some years later when he did volunteer work ― even knew the circumstances that brought him there. As a teenager he’d been bright, impetuous, and warm-hearted. He’d also had a crush on her, even though she was almost twice his age. Maybe, she fancied, she had even had a role in his becoming a doctor.

Familiar as she was with the hospital, in one area she was at the same disadvantage as other substitute nurses. Her sporadic calls to duty gave her little time to get to know the patients. As she would reflect later, had Alice Brown, the regular nurse, not been ill, Eden Avery would not have died that night, because Alice would have caught Calvin’s mistake. And Alice would not have let old friendship blind her to proper procedure. She would have insisted on a resident’s OK for the orders.

Connie had ample reason to be frustrated.  As if the circumstance of Eden’s death wasn’t depressing enough, she had failed repeatedly to reach Doctor Friedman. He’d been unavailable to stop the lethal order; now he was unavailable to deal with the consequence.

Neither her supervisor nor Doctor McCrae, nor Doctor Cross, who had come up during the code, had any idea of Friedman’s whereabouts. Finally Connie called Doctor Harmon.

“This is Nurse Connie Bader at Cresheim Valley. Doctor, I don’t know how ― I can’t ― Doctor ― your patient Eden Avery, in room 226, died. Anaphylactic shock. About twenty minutes ago. I’ve been trying to reach Doctor Friedman, and he’s not answering his page.”

Doctor Harmon could not believe his ears. “My God! Did someone give her penicillin?”

“Oxacillin. But there’s nothing in the chart about allergies.”

“Who wrote the orders?”

“Doctor McCrae.”

“Didn’t he ask her, or her mother?”

“I don’t know. Should I read his history to you?”

“No, never mind, I’ll deal with that later. And where in the world is Friedman?” Then he remembered. “Wait a minute!  I thought Doctor Cross was on tonight.”

“She was scheduled, but they switched.”

Rick broke out in a cold sweat.  “Did Friedman countersign McCrae’s orders?”

“Doctor McCrae was unable to reach him and he thought it was urgent.”

“And you took orders from the intern without the resident’s signature?”

A moment of silence. “Doctor McCrae was sure Doctor Friedman would approve.”

“You should have called me. Where’s McCrae now?”

“He’s pretty crushed. I don’t think he’s up to calling.”

“I’ll be right over. Don’t call anybody. Let’s hope her mother doesn’t show up.”

Doctor Harmon lived twenty to forty minutes from the hospital, depending on traffic. The distance was short enough for a timely response in off-hour crises, long enough to think about what he would say and do when he reached his destination. He needed this cooling-off period, because he took his patients’ setbacks so personally. Never was this truer than tonight, for the victim had been a favorite of his and her parents were long-standing friends.

There was no shortage of scapegoats. The intern had committed a fatal error of omission. The nurse had carried out unauthorized orders. The supervising resident had abandoned his station. Every one of them could justifiably be held responsible.  But the real blame lay at his own doorstep. After hearing Karen’s account, he knew that Eden needed antibiotics, at least till the diagnosis was clear. McCrae would have been derelict not ordering them. And what choice did McCrae have but to insist they be given without delay? Were it not for the allergy, his decisiveness might have saved his patient’s life.

And Rick knew about Eden’s exquisite allergy. He would have ordered vancomycin.

Cathy Cross was one of Cora Hamilton’s appointees. Cora knew who was dedicated to the care of children and who was dedicated to his own advancement. Cathy would have been at her post. Of that he was sure. If he had known Friedman was on call, he would have known not to take anything for granted. It was his own fault for not asking.

McCrae was a brand-new intern, oscillating between insecurity and overconfidence. As for Connie Bader, her actions were typical for substitute nurses. Whereas the regulars often knew more than the house staff and weren’t afraid to make suggestions, substitutes tended to follow doctors’ orders without question. And the doctors could be intimidating.

When the lawyers got hold of this ― Rick could hardly imagine they wouldn’t ― he, as attending physician, would be at the head of the lineup. Deservedly so. But the prospect of a lawsuit was trivial compared with Eden’s death and her parents’ bereavement.

~~~~~~~~~~

Calvin walked to the end of the hallway. He looked at the street and the homes on the other side. How often he had gazed on this scene as a student. How restful to watch the traffic after a day of examining patients, trying to impress his professors, cramming ever more data into his reluctant brain. How inconsequential the fatigue of those days seemed now.

He was no stranger to mistakes, reckless ones even. But with the help of caring friends he had survived the consequences and continued his climb. Now he tasted defeat as he had never known it. He thought of the condescension with which he had dismissed Eden’s mother, his cockiness as he went to dinner, the certainty of tomorrow’s smile. “Oh doctor, I feel so much better.”  He thought of his parents’ pride and his modesty in belittling his stature by insisting on being called intern. Modesty, indeed! He didn’t deserve even that title. What right, for that matter, did he have to his degree, Doctor of Medicine? The patient goes to the doctor for help, and the doctor prescribes death. Yes, that is what he had done, prescribed death. For Eden Avery , the antibiotic had been an agent of death as certain as arsenic, only faster.

Overcome by despair, Calvin wept: for his patient, who would never again enjoy life, family, and friendship; for those who would miss her; and for himself. How utterly his self-image as healer had been crushed. How would he face his next patient? “Hi there, Annie! Hi, Mrs. X. I killed the last girl I admitted. Not deliberately, just careless. But don’t worry. I’m sure it won’t happen to Annie.” And his career? Would he even last out the year? My God, less than two weeks! Next day there’d be morning report, where tonight’s events would be dissected for the instruction of all.  Then the monthly mortality conference.  How would he survive that? . . . And where, dammit, was Friedman?

He felt an arm on his shoulder. He turned and looked into the face of Cathy Cross.

“I began to worry when you didn’t come back. Then I heard the code.  I’m so sorry.”

“You told me, but it was too late. It’s so awful.”

“I wish I could make you feel better. Who among us hasn’t made mistakes and gotten away with them by sheer luck? Would you feel better if I stayed around the rest of the night? You shouldn’t be on service alone anyway, and I can’t imagine what’s happened to Mort.”

“But you’re off duty.”

“Right now there’s nothing I’d rather be doing, and I have other evenings off coming.” He welcomed her embrace and gave himself up to his grief.

~~~~~~~~~~

By the time Rick reached the hospital, an eerie quiet had descended on the nurses’ station. There sat Connie Bader; Martha Vinton, the nursing supervisor; Calvin McCrae; and Cathy Cross. Except for Cathy, all looked as if they expected a reprimand.

“It’s been a bad evening, hasn’t it?” Rick said.

“Yes,” they replied as a group, trying not to show their relief. Rick was popular with the nurses and house physicians. He had been associated with Cresheim Valley more than thirty years and knew the stresses facing those on the front lines. This was not the time for criticism. “I thought when Mort was on duty you were off,” he said to Cathy.  “Isn’t that what’s meant by switching?”

“I heard the code in the cafeteria, so I stopped by.”

“It was good of you. Can you fill me in?”

~~~~~~~~~~

The call was from the hospital. “Mrs. Avery ? This is Flo Decimo, circulating nurse in the OR. Your husband asked me to call. This aneurysm is taking longer than they thought, and he wanted me to tell you he could be very late, and not to wait up or worry.”

Karen thanked Nurse Decimo, poured herself more tea, and sat down to wait. An hour later her patience gave out. The telephone rang again just as she got up to call Doctor McCrae.

“Karen?” The voice sounded like Rick’s, but why did it have such a strange intonation?

“Yes? Who’s calling?” A cold fear gripped her. She cursed the silence of the house and her solitude in it. Why couldn’t Alan be here tonight of all nights?

“It’s Rick. I went to see Edie. All hell had broken loose. The code team was there in her room, with their emergency equipment, the drugs, the crash cart.”

Karen screamed: “No! Oh God, no! Please don’t let it be . . . !”

Rick knew it was futile to beat about the bush. “She had a reaction to oxacillin and they couldn’t bring her out.”

“What is oxacillin?” she cried hysterically. “Doctor McCrae never mentioned that.”

“Maybe he used the trade name, Prostaphlin. It’s a kind of penicillin for staph.”

“But McCrae should have known. Everybody knows she’s allergic to penicillin. . . . And Alan isn’t home.” She was crying uncontrollably. “He’s been watching some stupid operation all night. He doesn’t even know she’s in there. I’m all alone. What shall I do?”

“You’d better come to the hospital. I’ll get Alan out of the OR.”

Rick took a deep breath and steeled himself. The power of denial! First, he himself. It hadn’t happened the way he told her. Went to see Edie, indeed! He was home, reading the newspaper while his patient lay dying. They’d called him. Now Karen. A mother who has this minute been told she has lost her only child, and she takes time out to quibble about the name of the antibiotic. As if the enormous truth could be diminished by this delaying tactic.

~~~~~~~~~~

One of the endearing institutions at Cresheim Valley Hospital, in Mort Friedman’s eyes, was midnight supper. Actually it was served at ten-thirty, but by that time those on duty could readily believe it was midnight. Mort, not one to miss a meal, stowed his printouts and helped himself to a trayful of food more suitable for an athlete than a student of sleep, and sat down to work it over. His appetite was fired up; he’d had a rewarding evening in the sleep lab. Basking in visions of glory, he almost failed to notice Cathy Cross sitting down opposite him. “What’s a nice ― uh ― person like you doing in a place like this on her night off?”

“I’m hungry and the food’s free.”

“Touché. Well, I only hope your next night on is as satisfying as mine. Would you believe it, not a single call. Not even an admission. That’s the way I like them. Gives me a chance to study sleep. And please note, I said ‘study.’ ”

When his wit failed to elicit even a weary ha-ha, he looked at Cathy, ready to ask if she was feeling all right. He stopped cold, mouth open, fork poised in midair. She was looking at him with an expression he had never seen before, a mixture of accusation, disgust, and hate.

“What’s the matter? Am I talking with my mouth full? Sorry, I’ll watch my manners.”

“You were in the lab all evening?”

“Yes. Why? For God’s sake, what’s going on?”

“You didn’t answer your page.”

“Page? There was no page. Who paged me?”

“Just about everybody. In your absence a patient was admitted, worked up, treated, and pronounced dead.”

Mort slowly rose and deliberately placed his fork on his plate next to the remaining food.

“Either you’re a fantastic actress or you’re telling me something I don’t want to hear.”

“It’s true, every word. This girl came in febrile and shocky. Heart murmur. Possible acute endocarditis. Cal took blood cultures and ordered oxacillin and gentamicin. He was looking for you to countersign, but he didn’t think the girl could wait. I thought he’d done the right thing, except he’d forgotten to ask about allergies. I sent him back up, but by then she was in anaphylactic shock, and the code team couldn’t bring her round. Harmon’s here.”

Mort’s legs turned to rubber. “Harmon’s patient? Endocarditis? Penicillin allergy? Was this a readmission?”

“Yes. The old chart’s flagged all over the place. ‘Allergic to penicillin.’ Her last admission was for anaphylaxis. Bicillin. She had rheumatic heart disease.”

“Oh God, I know that girl. They had a big conference about her. Eden Avery ?”

“That’s her. You would have stopped that order. I’m sorry to be so blunt.”

“You’re being remarkably tactful,” he said bitterly. “What you’re saying is the patient died because I wasn’t there to supervise an incompetent intern. Right?”

“He’s not incompetent. He responded to an urgent situation and overlooked a caution. We’ve all made mistakes. He’s new. Things you and I do without thinking take a conscious effort on his part. Please try not to be too hard on him. He’s suffered a great deal tonight.”

“I’m sorry. I shouldn’t be passing the buck to him. But I still don’t understand why I didn’t hear the page.”

“Checked your beeper lately?”

“I put in a new battery just last week.”

“Look at it now to be sure.”

The display panel was blank. He jiggled the switch but it made no difference.

“Shit,” he muttered and ran from the cafeteria. The remainder of his precious food grew cold on the tray.