“Damn it,” Flann muttered. “We’ve got another half an hour before we can test the shunt. Pete can close after that. If they can set up another room, you can get started.”

“Dave says they can. I’ll get her upstairs.”

“You started her on bug killers?”

“As we speak.”

“Let me know as soon as she’s asleep, and I’ll put my head in if I’m not free yet.”

“Okay, no problem.”

Husband and wife fixed Glenn with anxious gazes as soon as she stepped through the curtain. “You’ve got an infection in your leg, you know that. The X-rays show air inside your tissues where it shouldn’t be. That indicates a certain kind of infection from strains of bacteria that can be harder to treat than the ordinary kind. It’s probably caused by whatever was on the old wire that you got tangled up in.”

“But you can treat it, right? With the antibiotics?” Todd’s voice was an octave higher than it had been and his face had gone from ruddy to gray. He swayed just a little.

“Sit down right there, Mr. Purcell, and I’ll finish telling you what we’re going to do.” Glenn pointed to the plastic chair next to the bed and Todd Purcell dropped into it with a thud.

Todd repeated, “You can treat it—”

“Todd,” Naomi said with gentle firmness, “let the doctor talk.”

Glenn didn’t bother correcting them. Almost everyone she took care of in the ER called her Doc. Everyone in Iraq had too. “We are going to treat you with antibiotics, and Cindy, the nurse you met earlier, will be starting them any minute. But that’s not going to be enough. We need to take you up to the operating room—”

Naomi’s husband gave a little groan. Glenn walked closer to the bed and gripped his shoulder, her gaze still fixed on Naomi, who held hers unwaveringly.

“You’re not going to have to amputate my leg, are you?” Naomi Purcell asked.

“No. We’re going to make an incision and wash out the deeper tissues to help stop the spread of infection. We might have to make several four-or five-inch incisions, but they’ll heal. You’ll have some scars, but it’s early yet, and chances are good your leg will be fine except for that.”

“All right,” Naomi said instantly. “When?”

“Right now. As soon as we can get the antibiotic started, we’ll take you upstairs to the OR.”

“Are you sure you have to do this?” her husband asked, looking like a frightened deer trapped in a thicket of briars.

“I’m sure. I talked to Dr. Rivers about it, and she—”

“Harper Rivers?”

“No, Flannery.”

“Harper takes care of our kids,” he said, some of the color coming back to his face. “Her sister—that’s the surgeon, right?”

“That’s right. She’ll be in charge upstairs.”

“But you’ll be with her, right?” Naomi said.

“Yeah, I will be,” Glenn said, thinking this would probably be her last case with Flannery Rivers.

Chapter Two

Mari had never lived anywhere without bus service. She’d never lived anywhere without malls and movie theaters and takeout. When she was thirteen, she’d gone to one of the big agricultural centers in LA County on a school-sponsored trip, but the miles and miles of row after row of green things had seemed foreign and boring at the time. Looking back, it had probably only been a few hundred acres of lettuce, but she’d been happy to get back to the concrete and city smells she’d grown up with. No buses meant driving, which she could do but had rarely needed to undertake back home when everything was a stop away on the subway, light rail, or bus. Who would drive in the insanity if they didn’t need to?

When she’d arrived at the Albany Airport lugging everything she planned to start a new life with in two suitcases and a taped-up carton of books, she’d rented a car and, following a printout from Google Maps, driven on increasingly narrow, twisting roads through countryside vaguely reminiscent of the fields and green valleys beyond the sprawl of Los Angeles. The farms she passed here, though, were so much smaller and the land so much hillier and the air so much cleaner. Maybe the East Coast seemed so alien because she’d never known anything other than LA. She’d rarely spent much time outside the city, because why would she? Everything that had seemed important growing up was there in the teeming streets—entertainment, shopping, school. Her parents almost never took a vacation—her father was always working in the store, her mother often joining him during the welcome busy stretches, and on the rare times when they weren’t both busy, there was always something going on with one or the other of Mari’s siblings. With barely a year and a half between them all, the after-school sports, clubs, and social events were a never-ending cycle that repeated year after year. Dances and finals and sports practice occupied everyone’s time, and when her mother was too busy with the younger ones, the older ones—the girls at least—stood in for her. Mari’s life had been the family, and she’d never imagined it any differently until everything had changed.

She’d dropped the rental off at the nearest return site as soon as she’d unloaded her belongings and the household essentials she’d picked up at a Target before leaving the city. She couldn’t afford to lease or buy a car, and so she would walk. She didn’t mind walking and it wasn’t very far from her studio apartment to the hospital. Or to anywhere else in the little village, either. Everything she needed in terms of food and necessities she could get at the grocery store she’d discovered just at the opposite end of town, its parking lot filled with pickup trucks and Subarus. She’d wondered on her first exploration of the village four days before if people drove anything else at all. Since then she’d found a surprisingly big pharmacy at the intersection of Main Street and the county road that ran through the center of town, a diner, a bakery that also served decent coffee and beyond-describable muffins and pastries, a pizza place, and a number of other shops. She could survive without a car, and walking felt good. Using her body felt good, and even after a week, her muscles seemed stronger.

And she’d better get her butt in gear now with just over an hour before she needed to start her new job. Her stomach squirmed with nerves. This wasn’t at all how she’d imagined her first day as a newly minted physician assistant. The silence of her tiny apartment reminded her every minute of all the voices that weren’t there, encouraging her, teasing her, quietly supporting her. Now there was only the voice in her own head telling her she could do this. She’d done much harder things. And she wanted to do it, needed to do it. Work gave her a reason to get out of bed in the morning, that and her stubborn refusal to be defeated.

She showered in the miniscule pocket bathroom, barely able to dry off without bumping her hip on the corner of the sink. She blow-dried her hair, thankful again for the natural waves that required little more than a decent cut to look acceptably stylish, and put on the minimum of makeup to cover the smudges beneath her eyes. Sleep was sporadic still, and she hadn’t quite gotten over the jet lag. She’d never been very good at traveling on the few occasions she’d visited her father’s distant relatives in Mexico or interviewed for PA-training positions. She always missed her pillow. The one she’d slept with forever, it seemed, shaped to her arms and the curve of her cheek.

She smiled at her weary image in the mirror and admitted what she really missed. The smell of coffee floating up from the kitchen in the morning along with her mother’s voice reminding Joseph of some errand he had to do after work or calling to Raymond to get out of bed before he missed the bus or singing snatches of some old song as she fixed breakfast and packed lunches. Even with four of the kids gone, the house had still felt full with her and the two boys and Selena still living at home. The house always felt full of life.

Her tiny apartment was neat and airy and sunny, but oddly sterile, as if the silence scoured it clean. Getting to work and occupying her mind was exactly what she needed to remember she was damn lucky to be able to complain about anything—including a nice, clean, quiet place to live and a job she’d wanted all her life. Self-pity was an unbecoming pastime, and she needed to be done with it.

Feeling better for the mental scolding, she dressed in tan pants, brown flats, and a dark green cotton polo shirt, gathered the necessities into her favorite buttery soft leather shoulder bag, the one Selena had given her for Christmas two years before, and made sure to lock the door on the way out. The hospital was at the other end of town up a hill, a twenty-minute walk from the short street a few blocks off Main where she’d found an apartment in what had once been a grand mansion but was now carved up into small odd-shaped apartments. Hers was on the second floor in the back, overlooking a plain fenced yard shaded in one corner by a big tree she thought was a maple, but wasn’t sure. No one seemed to use the yard, although someone cut the grass.

Traffic was heavier than she expected at a little after six, mostly those pickup trucks again, almost all filled with men and carrying logos on the side saying floor repair, general contractor, plumbing, or some other trade. The café was open, and she treated herself to a scone and a cup of very good espresso and still approached the hospital twenty-five minutes before she needed to be there. The hospital was the only building on the wooded hillside, and as she passed through the stone pillars flanking the entrance to the winding, crushed-gravel road and climbed past tall cast-iron lampposts and taller pines, she felt as if she was walking back in time.

At the top of the approach road, Mari stopped. She’d only had glimpses of the hospital through the trees that surrounded it on her walks through the village, although she’d been aware of its presence, perched above the fray like a watchful bird. It even looked a little like a bird, with its wings stretching out to either side. She’d seen pictures of it online and even found an old historical society talk about it that someone had posted along with photos, some of them decades old. She tried to imagine, looking at the faded sepia images of young women in long dresses with white aprons and frilly caps, and stern-faced men in high-collared white shirts and tailored coats with narrow lapels and high-waisted pants, what it had been like practicing medicine before the modern era had brought such astounding progress and devastating commercialization. Before the days of vast medical consortia and insurance companies and all of the other agencies that had crowded in and relegated so many of the hospitals like this to memory.

This hospital was undergoing a major transition, adding an Emergency Medicine residency program and joining with the regional medical school’s PA training program. She was about to become one of the faculty of that new program. A year ago she thought she’d never have the chance to treat a single patient, and now this. Everything had happened so quickly. A job and a new life.

No one had congratulated her and no one had tried to stop her from leaving. Of course, in so many ways, she’d already been gone.

A siren wailed, drowning out her thoughts, and she jumped onto the green grassy shoulder well to the side of the curving road as an EMS van rolled around a corner and swept past. Perhaps whoever rode inside would be her first patient. Fifteen minutes from now, she’d know.

From the turnaround in front of the hospital, she took one more second to appreciate the soaring majesty of her new home—as she somehow thought of it. A fountain centered the grassy expanse in the middle of the circular drive, clear water draped in rainbows gushing into a scalloped cast-iron basin from beneath the feet of a life-sized metal sculpture of a woman with a child by her side, their hands clasped together. The hospital itself was anchored by the central structure, a brick edifice six stories high, ornate white columns surrounding the broad entrance, and wings extending from either side like arms clasping the forested hills towering behind it. She turned and looked at the village down below, dappled in sunlight and shrouded by tree branches—seeming so peaceful, as if nothing could ever disturb its tranquility. She knew she was only wishing such a place existed, a foolish wish. The past could not be undone or relived. Harsh words could only be forgiven and someday, she hoped, forgotten.

And none of that mattered now. She turned back to the hospital and took a deep breath of the cleanest air she thought she’d ever experienced. So fresh her lungs actually tingled. Smiling at the thought, she followed the drive in the direction she’d seen the ambulance take and found the emergency room entrance without any trouble. At six forty-five in the morning, it was already busy. Several people stood in line at reception, waiting to sign in with the woman sitting at the counter. A line of gurneys waited along the wall on either side of big double doors that stood open at the entrance to the treatment area. An orderly pushed a woman in a wheelchair around a corner, and an elevator dinged. The murmur of voices drew her down a short hall to the nurses’ station. She stopped by the desk and waited until a middle-aged man with thinning brown hair wearing khaki pants and a camo scrub shirt adorned with Snoopy looked up at her and smiled.