Chapter 1

The Code Blue tone cut straight through Arthur Grant's quarterly report.

He didn't hesitate for even a second. His eyes came up off the page and landed on me. "Marcus. Go."

I was already turning before he finished the word. Diane Keller caught up with me in the hallway and gave me the handoff at a jog.

"Frank Delaney, fifty-four. Chest pain for an hour, arrested before the medics got him here. Looks like a big anterior MI."

The corridor to the procedure suite isn't a hundred yards. It felt like the whole distance between a man being alive and being dead.

I was halfway out of my white coat when someone stepped into my path. A young man, a wrinkled pharmacy printout in his hand.

Noah Grant. First-year resident, three months on the job.

"Dr. Hale." He'd pitched his voice so the whole corridor could hear it. "Your department signed out sixty ampoules of controlled anesthetic in March, and the count doesn't reconcile. Did you take them out and sell them?"

For a second I thought I'd misheard him. Behind us, the murmur in the waiting area cut off all at once, and then every head in it came around toward us.

Noah pushed another step closer.

"You're the chief of cardiothoracic surgery," he said. "Sixteen years in this hospital. I can't even imagine how much you've taken in kickbacks in that time."

I didn't have the spare energy to be angry.

The clock at the end of the corridor ticked over in hard red numbers. Fifteen minutes of a ninety-minute window, gone through my fingers already.

I pulled off the coat and threw it to Diane. My voice didn't move at all.

"Every unit that comes into this department is logged, electronically and on paper. I'll print the whole record myself when I'm out. Right now, move."

Noah's voice climbed.

"You're using your position to shut me up," he said. "You want to hide behind an emergency case and pull everybody's attention off what you did. I'm not moving. You explain it here, today."

The air in the corridor had gone solid. The doubt in all those faces was thickening into something with an edge of appetite to it — the pleasure of watching a thing come apart.

I looked at him. A kid a year out of medical school, and right now the most lethal obstacle between that door and the man behind it.

I took one breath and said it plainly.

"Dr. Grant. An acute MI has a ninety-minute window.

"Right now, that patient is seventy-four minutes away from being brain-dead."

My eyes came back to his stubborn face, and I spaced the words out for him.

"So you move now and I go save him.

"Or you keep standing there, and in an hour you go out and hand his family the death notice yourself."

Noah blew up on the spot, his voice jumping an octave.

"That's a threat," he said. "You're using a patient's life to threaten a doctor for having principles. Everybody look at this. This is what the head of our cardiothoracic department actually looks like. He'll hold a man's life up as a shield to cover the fact that he's selling anesthetics."

The patients and the families put their heads together and murmured. The looks coming at me had graduated from suspicion into something closer to a verdict.

I answered him calmly.

"Dr. Grant, this hospital has rules. Every ampoule of a controlled anesthetic — the requisition, the administration, the return of the empty — moves through a chain of custody a bank vault would recognize."