"Good. We'll attempt to make a diagnosis in the meantime, but I sense something very serious is going on with the child."

"I'll be there as soon as I can." Laura hung up the phone and turned to the three concerned faces.

"There's something wrong with Patrick, my youngest son," she blurted. "He's in the hospital in Michigan. I have to get to him right now."

"Oh, Laura!" Carrie sprang up. "Greg, let's call Judge Potter, get an emergency hearing. With our new information, the D.A. might be willing to let her go. Compa.s.sion for a sick child and all."

"Get on it, Carrie," Greg agreed. "Laura, give us time to get you out of here."

"I'm going. Now. I'm not waiting for any permission to see my son. There's something really wrong with him, and I need to be there!" She started gathering her belongings.

"If you go now, they'll just arrest you. Give us time to get this thing settled legally this afternoon so you can leave tonight," Greg said firmly. "I'll go with you."

Thunder and lightning halted all air traffic all night in and out of Tampa - the lightning capital of the world. So it wasn't until Thursday morning with the twins safely at home with Marcy Whitman and the Whelans that Laura, accompanied by Greg, departed Tampa via a nonstop Delta flight to Detroit with a transfer to a small commuter twin engine to Traverse City.

Rob had met with Sandra Mulloy on Wednesday afternoon as planned. He'd convinced her not to object to his motion to allow Laura to leave Hillsborough County to travel to northern Michigan in the custody of her attorney, and Judge Potter had signed the order. Initially balking at testimony from a minor, Sandra had reluctantly agreed to evaluate Molly Palmer's affidavit and to look into matters of police protection for the child.

The next step, Greg hoped, would be immediate suspension of the charges against Laura. The P.R. machine in the D.A.'s office would then take over, obsessed with finessing the politically correct way to preserve Jake Cooperman's reputation. If a mob figure like Frank Santiago was ultimately convicted, the D.A. would come out a hero. In the meantime, Greg was charged with Laura's custody.

Calling from the Tampa airport, Greg breathed a sigh of relief when Celeste answered at the design site. "Darling, I'm so glad I got you. I tried the Peachtree, but you'd already left."

"Oh, Greg, it's so good to hear your voice. My client is making me crazy - a new fabric here, a new twist there. I need a break."

"Likewise. Listen, the judge has put Laura Nelson into my custody. I've got to escort her to Michigan to see her sick child, but I'll be back tomorrow night. It's a long story that I'd love to explain in person. Will you come home this weekend?"

"I'd better. I think I'm going through withdrawal here."

"Withdrawal? What kind?"

"Your kind. I miss you so much. I'll be home by seven."

"Ah, that's the best news I've heard all day. This weekend it's just you and me. And the sun and the moon and the stars. I miss you, darling."

"Glad to meet you, Dr. Nelson. I'm Dean Chambers." The rotund, balding man rose to greet Laura as she and Greg entered his cubbyhole office at Traverse City Community Hospital. He invited them to sit on the two wooden folding chairs positioned across from the ancient desk. This was the first time in almost six weeks that Laura had stepped into a hospital, and to be called "Dr. Nelson" evoked a sudden and sad recollection of her professional life before Kim Connor's death. For a split second she almost forgot that the patient she was here to see was her own son.

She quickly introduced Greg and the two men shook hands.

"Here, let me move these charts aside," Dr. Chambers suggested. "I'm behind, as usual, in my discharge dictations."

"Thank you for seeing us," Laura began. "What's the latest on Patrick? I'd like to go right in and see him."

"I thought it wise for us to talk first. He's a bright eight-year old and will surely hammer you with questions. Mainly, he wants to get out of here."

"Can't say I blame him," Greg murmured.

Dr. Chambers ignored Greg's comment. "Dr. Nelson, we did an ultrasound yesterday. The results are - disturbing."

"What do you mean?"

"We think he has some kind of a tumor. In his chest."

"Chest," she repeated. "Lungs?"

"We're not sure. Probably not. We think that it's in the heart, but we don't have the sophisticated equipment to be definitive. We've had consultations from pediatrics, cardiology and pulmonary."

Laura realized that Dean Chambers was a general pract.i.tioner with extensive experience but no specialty training that would equip him to manage much more than the day-to-day ailments of a small city practice. She found, however, that given his obvious candor she trusted him implicitly.

What could it be? Something related to the congenital heart defect that had worried her so before he'd had the rea.s.suring cardiac catheterization as an infant? Not likely. A tumor in an eight-year-old with normal blood work? Lymphoma? Sarcoma? Tuberculosis? Laura's mind recycled the differential diagnosis. What type of tumor could this be? Something very rare.

"We'd like to send him to Ann Arbor for evaluation," Dr. Chambers continued. "Of course, we need parental consent, and arrangements have to be made."

"Is Steve here?" Laura asked.

"Not at the moment. He went home for a nap after spending the night in a chair in Patrick's room."

Laura sank back against her own chair. "Oh, this is all too much."

Dr. Chambers smiled kindly. "Do you want to see Patrick now?"

"Of course. I guess I'll tell him that he has to go to another hospital."

"You'll find him resting comfortably, but we do have oxygen running with nasal p.r.o.ngs. We're keeping him in bed, giving him Lasix for congestive failure, and a lidocaine drip as prophylaxis for ventricular tachycardia."

"What does that mean in English?" Greg asked.

"It means that Patrick has a serious heart problem. A tumor that's blocking the normal blood flow," Laura explained.

"Like a heart attack?"

"No, but with the same complications," Dr. Chambers offered. "Heart failure, arrhythmias."

Greg's eyes were wide. "But he's just a little kid."

Laura walked shakily beside Dr. Chambers to the small pediatric ward, Greg trailing behind. There were only five beds and two were empty. Patrick was propped up, working on a puzzle laid out haphazardly on his tray. On each side of him was a crib with a baby. One about three months old lay quietly sleeping, the other older, red faced, crying furiously as he struggled to free his left arm which was securely connected to an IV board.

"Patrick!" Laura ran toward him.

"Mom!" A huge smile spread across his face.

"Am I ever glad to see you!" She threw her arms around his small body, taking care not to disrupt the IV catheter taped to his left arm and the EKG leads that she knew were connected to electrodes on his chest.

"You too, Mom." He looked tentatively at Greg. "How's it going?"

"Good, honey," she said, tousling his chestnut brown hair. "What about you, how are you feeling?"

"I wanna go home. Can you tell them to take all this stuff out of me? They won't even let me get up and walk around." He took several short breaths. "I missed the All Stars game last night."

"You didn't answer my question, honey," Laura said. She held his face in her hands. "How do you feel?"

"Good. Get me outta here, Mom." He lowered his voice. "These babies are driving me crazy."

Laura smiled. "Here, let me check you out." She gestured toward the stethoscope in Dr. Chamber's pocket and he silently handed it to her.

"Shush for a minute, honey."

" 'Kay, Mom."

Laura pulled up the child's blue hospital gown, careful not to disturb the electrodes taped to his chest. She moved the stethoscope across his thin frame, pausing at the pulmonic area in the right upper chest, the aortic area, left upper chest, and the apical area on the left side below the nipple, listening for irregular heart rates and abnormal heart sounds.

Laura tried to steady her hands as she auscultated his lungs, calmly asking her son to take big breaths in and out. His struggle to do so was more than evident. Laura's hands trembled as she silently handed the instrument back to Dr. Chambers.

"Just one more thing, but I'll have to crank your bed up a little." Laura carefully inspected Patrick's neck, looking for and finding marked distension of the jugular veins. Then she palpated his abdomen, taking special care to note with escalating concern the enlarged liver as it sank too far beneath the rib cage on the right side, but also to see with some relief the absence of a distended spleen.

"New murmur, grade four, systolic," she said, looking to Dr. Chambers for confirmation. "Normal rhythm on lidocaine, definite signs of CHF."

"Right. Full-lead EKG and ultrasound reports in the chart."

"What's CHF?" Patrick demanded as Laura cranked the bed back to a sitting position and plumped his pillows.

"Oh, just doctor talk. You've heard me talking funny like that about my patients, right?"

"Yup." He gulped air. "Mom, what's wrong with me?"

"Well, Patrick, we still have to do more tests and stuff, but first we're thinking about taking you to another hospital. We have to make some phone calls first."

"No way. I hate hospitals. I wanna go home."

"Soon, honey. Listen, my friend here, Greg, is going to stay and talk to you a while when I talk to your doctor. He's from Florida, and his favorite thing is sports - baseball, football, you name it." She hoped she was right and that Greg wasn't one of the minority of males who hated sports.

Greg nodded. "You bet."

"Be right back." Laura pulled up the lone visitor's chair, and with her eyes pleaded with Greg to sit down before she and Dr. Chambers left the ward.

Patrick took the bait. "What about basketball? Did you think that Washington would beat the Sonics for the championship?" He grabbed the plastic p.r.o.ngs going into his nose and pushed them down around his neck. "I hate these things."

"Yeah, I did. Did you?"

"Naw. Anyway, baseball's my favorite. I like Sparky Anderson." He paused, struggling to breathe. "I got his autograph once when my dad and grandpa took us to see the Reds for spring practice. You like baseball a lot?"

"Oh, man. How about Pete Rose and his three thousandth hit?"

"Yeah! Pete's one of my favorites." Patrick was gasping.

"Hey, buddy," Greg said, "don't you think you should put those things back in your nose? I think they help you breathe."

"Yeah, okay," said Patrick. He struggled to put the nose straps in place again.

"How do you think the Bucs are gonna do next season?'

"I'm for the Dolphins," Patrick said. "Bob Griese is the best quarterback in the -"

CHAPTER TWENTY-FOUR.

What to do? Where to turn? Laura potentially had access to any medical expert, any medical center, but where to start? Where should she go to get the best medical care for her son? First she called the local pediatrician and adult cardiologist who had seen Patrick at Dr. Chamber's request. They reiterated Patrick's presentation: irregular, rapid heartbeat; runs of ventricular tachycardia, which could result in sudden death; an unusual cardiac outline on his chest X-ray; some kind of a ma.s.s on two dimensional echocardiography, most likely in the heart itself; a loud heart murmur typical of severe aortic stenosis with obstruction; obvious clinical signs of congestive heart failure presenting as easy fatigability, the shortness of breath on exertion that Steve had described. Could any of this be related to the preexisting patent foramen ovale?

Where would they have the most experience in cardiac tumors in kids? Of course, she'd fly him anywhere. Then she remembered a name from the past. A surgical resident with whom she'd trained back in med school in Detroit. He'd gone on to pediatric cardiac surgery at Children's Hospital in Philadelphia. He would know where to turn.

Laura had Tim Robinson paged during post-op rounds at Children's Hospital.

"Laura? Is this the ravishingly beautiful Laura Nelson I'm talking to?"

"Hi, Tim. Yes, it's me, but things aren't too good."

"Tell Uncle Tim all about it. Better make it snappy though. I've got a bunch of residents waiting on me. I'm an a.s.sociate professor here, if you didn't know. Miracles do happen."

"I'm glad. Listen, Tim, my youngest son has some kind of a cardiac tumor. He's eight. I need help."

"I'm sorry, Laura." Tim's characteristic frivolity gave way to grave professionalism. "Tell me all about it."

Laura explained what she knew. Patrick's symptoms, his past medical history, the EKG, the echocardiogram. "What could it be?"

"Several possibilities. A tumor? An aneurysm? Hypertrophic subaortic stenosis? Infectious disease? Like tuberculosis, ecchinococcal cyst? Doesn't seem related to the PFO. h.e.l.l, Laura, I can't tell from here."

"They think it's a tumor. What can you tell me about cardiac tumors?"

"First, they're rare and they present much like your son's story - arrhythmias, signs of congestive heart failure. Eighty percent are benign. They're usually attached to the left ventricular wall or septum. Somewhere about three to five centimeters in diameter. They can compress the endocardium causing arrythmias and block the aortic outflow. Usually operable." He paused for a breath.

"What about sarcoma, rhabdomyosarcoma, or some kind of metastatic malignancy?"

"Eighty percent are benign, rhabodmyomas, myxomas, fibromas. Where are you anyway? In Tampa? Shands, in Gainesville?"

"No, I'm in Traverse City, Michigan."

"Oh boy, out in the sticks, medically speaking. Listen, here's what we'll do. I'll get on a plane tonight and find my way to Traverse City. Never been there. Bet it's beautiful this time of year. Don't they have lots of cherries up there? If your son needs surgery, there's no better place than CHOP. We have the best, I mean, the best, pediatric facilities and surgeons anywhere."

"What about the University of Michigan? Ann Arbor is so much closer."

"They're great, but I'm telling you, Children's Hospital here in Philadelphia is where you want to be. I'm here, but more importantly, so is George Kamen. He's the best surgeon in the world for this kind of situation. "

"Okay, Tim, I trust your judgment. But please, hurry up and get here."