Nate tried to shape his mouth into another complaint but had to focus on breathing so as not to throw up. The Jeep lurched to a stop in front of the emergency-room doors, and then Casper was barking as Jason clambered forward into the driver's seat. Janie appeared through Nate's window, her fingers at the handle, and then he was tumbling out into her arms.

They headed in, Janie bearing half his weight, the gla.s.s doors yawning open before them.

"Antibiotics?" Dr. Griffin flipped the chart. "Who the h.e.l.l put him on antibiotics?"

Janie looked across at Nate, who rustled on the stiff white sheets of the hospital bed and said, weakly, "She was ... ER doc."

"ER doc. Terrific. With his condition she didn't think it necessary to pick up the phone to his treating physician? Or at least to consult Epocrates on her iPhone? What's he taking?"

"Keflex," Janie said. "Five hundred mg's qid."

"What for?"

"I keep getting stabbed," Nate said.

Dr. Griffin shot him a look over the top of his perpetually slipping tortoisesh.e.l.l gla.s.ses. His brown eyes, nearly as dark as his skin, held a pinpoint focus that didn't match the saggy mien, the professorial potbelly, or the day-old scruff.

"We have an interaction?" Janie asked, getting the doctor back on task. Though Nate wasn't familiar with Dr. Griffin, Janie's working rapport with him was evident.

"Antibiotics raise the level of riluzole in the blood," the doctor said. "Not only do the liver enzymes spike-which can cause liver failure-but they increase the likelihood and severity of side effects. Which are-"

Janie cut in: "Weakness, fatigue, nausea, headaches, abdominal pain, dizziness-"

"-which in turn can exacerbate ALS symptoms."

Nate rolled his head on the pillow, keeping pace with the Ping-Pong match. An IV line pushed fluids steadily into his arm; already he was feeling a bit more clearheaded. As he untangled the medicalspeak, he felt a faint pulse of hope. "So it'll get better?" he asked. "The muscle weakness?"

"It should subside, yes, along with the dizziness and nausea once your blood levels drop."

Nate took a few cautious sips of air, relieved. "How long will that take?" he asked. His voice box felt feeble, no weight behind the words.

"Six to eight hours for Keflex to leave the bloodstream," Janie said. "Another six or so for the riluzole levels to back down to normal."

"But that's not the point." Dr. Griffin tugged at his jowls, which had surprising give. "You need supportive care. Fluids, rest-"

"Rest," Nate protested.

"You are sick, Mr. Overbay. I don't have to tell you that ALS is serious business. What you're doing to yourself-it's not tenable. You are dehydrated, hypoglycemic, suffering from lack of sleep. You can't do this given your condition." Dr. Griffin dropped the chart on the end of Nate's bed and turned to Janie. "Give your John Doe here another liter of saline and see if you can talk some sense into him."

Janie crossed her arms, shot a breath at the ceiling. "I've been trying for years."

The needle's pressure in his arm stayed constant, even when Nate dozed off. He surfaced from a brief sleep, blinking to consciousness, and focused on the tiny form at the foot of his bed. At first he thought it was a dream image hanging on, a vision from the spirit world. A painfully thin Hispanic boy, maybe six, with a bald, leukemic head that in combination with oversize eyes made him look vaguely alien. He wore black pajamas decorated with white bones-a skeleton costume-and clutched a starched pillowcase.

"Trick or treat," he said.

Nate sat up quickly. Charles he was used to, but this? He managed to say, "Uh..."

The boy shook the pillowcase imploringly. "It's Halloween."

Was it? Nate rewound the days, reorienting himself. It was. And the boy was real, or at least he appeared to be. The ceiling-hung dividing curtain had been partly drawn back so that Nate could see, above the unoccupied bed, dusk darkening the windows. Trick-or-treat time.

He glanced across at his food tray. "I have Jell-O."

"No. There." The boy pointed to a cup that had appeared on Nate's nightstand. "They leave you candy for us. See? So we can have Halloween even though we're stuck in here."

Nate reached into the cup, pulled out a miniThree Musketeers, and with a trembling hand dropped it into the boy's pillowcase. "Want more?"

"You hafta save it for the others."

"Others?"

But the boy was already at the door, heading to his next benefactor. "My bones glow in the dark," he announced. His little hand clicked the light switch. Sure enough, there it was, a cartoonish skeleton with a faint green tinge. The light came back on, Nate making sure to wipe the astonished expression off his face.

A little girl entered next with fuzzy angel wings and a burn savaging her chin and throat. Fighting the knot forming in his throat, Nate produced a gentle grin for her and a bite-size b.u.t.terfinger. Next, a preteen pulling her own IV pole. They kept trickling in, one after the other, with their tiny voices and heartrending costumes.

After the last child departed, Nate carefully extracted his IV line and stepped into the hall. There they all were in the corridor, a ragged parade, standing in rough a.s.sembly under the benign direction of an immense, soft-featured orderly. Nate's hand quaked and his ankle had again gone numb, yet he refused to tear his eyes from the spectacle and withdraw to his bed. With their glow-in-the-dark bones and angel wings, the children seemed to point the way to where he was headed. Pixie faces lit with delight, they showed off their costumes and compared their hauls. All that hope and promise, uneroded even here in a hospital ward on Halloween.

From the nurses' station at the far end of the hall, Janie looked on, too. Nate managed a nod, and she gave a smile and a little wave.

"Come on, now," the orderly called out to her brood, "time to hit the next floor up."

They followed her to the stairs like a row of ducklings, a diminutive Darth Vader wrestling off his mask and taking a few genuine asthmatic wheezes as he pa.s.sed from sight.

The tender display unlocked something inside Nate's chest, and all the anguish of the past week and a half rushed out, overwhelming him. Sagging against the wall, he pressed his thumb and forefinger to his eyes. But it was no use. The emotion came, swelling over him, and he hunched into himself, drawing halting breaths, struggling not to cry.

Janie was at his side, rubbing his back, somehow grasping the unexplainable, and, doubled over, he gripped her forearm. His mind spun, throwing out sense memories: his mother wasting away on that hospice bed in the dim air of the living room. The smell of decay on her breath. Abibas shading his eyes, staring back from the top of that dune. McGuire staring at his severed leg uncomprehendingly. Don't leave me don't leave me don't you leave me. Little girl with a burned face and angel wings.

For a time Nate and Janie held each other and breathed together, taking in the sounds and smells of the bustling medical ward in motion. A waft of iodine. Wobbly wheels on a gurney. A yielding cough, m.u.f.fled by a closed door.

A set of clogs tapped through Nate's field of vision, a nurse calling out, "Good to see you again, girl. You been on vacation?"

"Sort of," Janie said. "Good to see you, too, Renee."

"Oh, I logged you in."

Janie stiffened in Nate's arms. "Wait. You what?"

"You forgot to sign in. Can't get paid if you don't-"

"When? When?"

"Relax, girl. When I was coming back from my coffee run, I saw you in here with Dr. Suspenders. What's that-forty minutes ago?"

At the end of the crowded corridor, the elevator dinged. A flush of heat rolled through Nate's face, the premonition of something dire to come. He straightened up, lifting his head to see the lit circle announcing the car's arrival, flicking in and out of view between patients and doctors.

The doors peeled open, and Misha stepped out.

Chapter 49.

The security guard overflowing the folding chair next to the elevator glanced up from the L.A. Times, then returned his gaze to the print. Misha glided to the nurses' station at which Janie had been standing moments before.

"I am looking for Nurse Jane Overbay."

"I'm sorry, she's not working today."

Misha walked past the nurses' station, heading down the crowded hall. Still he didn't spot Janie and Nate, frozen in the bustling corridor.

"Sir, where's your visitor pa.s.s? I'm sorry, you can't go in here without a visitor pa.s.s. Sir!"

Without breaking stride Misha drew a handgun from inside his jacket, aiming over the counter as he pa.s.sed, and shot the nurse through the hip point-blank. The force blew her straight off the chair onto the floor, where she began convulsing. Behind him the security guard could barely wobble to his feet before Misha pulled a second gun with his free hand and fired twice, streaking the wall behind the man. A newspaper section fluttered down atop his body, soaking up blood.

A beat of stunned silence.

And then the medical ward erupted. Patients shouting, wheelchairs overturning, bodies stampeding for the stairs. As Misha powered down the hall, kicking aside gurneys and toppling IV poles, Janie shoved Nate through the doorway into his room. He scrambled across the bed and grabbed his jacket, flipping it around, looking for the pocket, willing his weak hands to work faster.

Footsteps. Screams. Another gunshot, followed by a primal howl.

"He's just shooting people," Janie said.

Nate had the gun out finally, in his trembling grasp. He pushed Janie behind the dividing curtain and tugged it. In the ceiling track, the nylon wheels gave a screech, the sound lost beneath the crash of a cart overturning in the hall and more shouts of panic.

The boom of a door being kicked in up the hall. A startled shriek. Then a matching screech of a curtain being raked back.

Seconds later another boom. Another screech.

Janie's panicked breaths against Nate's ear. "He's going room to room."

They waited, the scrubs-green sheet rippling before their faces. With an unsteady thumb, Nate pushed the safety off his Beretta.

Heavy footsteps-probably boots. The complaint of a desiccated voice, a crash, then a faint moan. Boom. Screech.

Dr. Griffin's voice, right outside in the corridor. "Don't, just don't-"

Gunshot.

Janie gave out a faint cry, pressed both hands across her mouth. They could hear Dr. Griffin's wet, labored breaths.

Now right next door. Boom. Screech.

Janie's whisper came again, a rush of hot air. "We should run."

Nate firmed his hands around the stock and mouthed, No time.

The door to Nate's room was open; they'd get no benefit of a warning. But the footsteps neared.

Tap tap tap.

Pause.

Somehow, even through the opaque curtain, Nate sensed a change in the quality of the air. A presence. Misha was in the doorway. One brisk pace into the room. Another.

Nate willed his forearms still. He took a silent step back and raised the gun. The barrel wavered ever so slightly in his weak grip.

Janie leaned against the wall, her face tense with antic.i.p.ation. Nate aimed at the curtain, chest high, ready for the burst of movement.

A scream came from down the hall, then feminine footsteps skittering toward the stairs.

Misha stopped.

He must have been debating whether to continue on toward the curtain or go after the footsteps in the hall. Was he pondering whether the fleeing woman was Janie? They could hear him drawing breath. Calm and steady. The guy's heart rate probably hadn't ticked north of sixty.

Nate sighted on the rubbery part.i.tion curtain, knowing that Misha was a few feet beyond but unsure where. A missed shot would be answered with a barrage.

The woman's footsteps in the hall grew louder.

Misha set down his boot again, the faintest scuff against the tile. Nate shifted the gun toward the noise and felt it slip soundlessly through his weakened fingers.

With all his focus, he willed his hands to clamp, but the muscles wouldn't obey. The gun spun in slow-motion rotation, the checkering on the handle grazing his fingertips. And then it was free, in the air, tumbling toward the hard tile.

He tried to suck in a breath but found his lungs already full. Bending, he lunged for the gun, missing, but then Janie's hand shot into sight and caught it two inches off the floor. She had made not a noise.

Crouching, they stared at each other, wide-eyed, neither daring to breathe. A squeak of Misha's boot on the tile, just beyond the curtain.

In the stillness they heard the woman's footsteps veer up an adjoining corridor, the sound starting to fade. And then another noise chimed in, that of distant sirens.

Misha retreated now, sprinting off, presumably after her.

Nate and Janie exhaled together, an explosion of relief. Moans reached them from the hall-Dr. Griffin, in agony.

Janie inched the curtain aside, and they peered through the still-open door. Dr. Griffin lay in the corridor, hands across his thigh, blood spurting through his fingers at heartbeat intervals and painting thin lines on the floor.

"Arterial bleed," Janie said, pushing the pistol into Nate's hands. "I'll stabilize him and be right back. A minute, tops."

She started up, but Nate grabbed her shoulder. "Misha's still out there."

She pointed at Dr. Griffin. "He will die if I don't go."

The frantic look between them couldn't have lasted a second, but it stretched to an eternity, one objection after another shuffling through Nate's mind. The determination on Janie's face told him he didn't really have a say anyway. He removed his hand from her shoulder.