Contents

      Chapter One

      Chapter Two

      Chapter Three

      Chapter Four

      Chapter Five

      Chapter Six

      Chapter Seven

      Chapter Eight

      Chapter Nine

      Chapter Ten

      Chapter Eleven

      Chapter Twelve

      Chapter Thirteen

      Chapter Fourteen

      Chapter Fifteen

      Chapter Sixteen

      Chapter Seventeen

      Chapter Eighteen

      Chapter Nineteen

      Chapter Twenty

      Chapter Twenty-One

      Chapter Twenty-Two

      Chapter Twenty-Three

      Chapter Twenty-Four

      Chapter Twenty-Five

      One

      The End

      I read a poll in the newspaper once that said the number-one fear of Americans aged eighteen to sixty-five is public speaking. Spiders are second, and death a distant third. I’m afraid of all these things. But most of all, I’m afraid of failure.

      I’m no coward. I want to make that perfectly clear. But my life turned from nearly perfect to a horror movie in a matter of days, so I take fear a lot more seriously now.

      I’d followed my life plan almost to the letter, with very few detours. I’d gone from plain old Ms. Carrie Ames to Dr. Carrie Ames just eight months prior to the night I now refer to as “The Big Change.” I’d broken away from the sleepy, East Coast town I’d grown up in, only to find myself in a sleepy, mid-Michigan city. I had a great residency in the E.R. of the public hospital there. The city and surrounding rural communities provided endless opportunity to study and treat injuries inflicted by both urban warfare and treacherous farm equipment. Living my dream, I’d never been more certain that I’d found the success and control over my destiny that had always seemed to elude me in my tumultuous college years.

      Of course, sleepy mid-Michigan towns get boring, especially on frozen winter nights when even the snow won’t venture out. And on a night exactly like this, after only having been home for four hours from a grueling twelve-hour shift, I was back at the hospital to help deal with a sudden influx of patients. The E.R. was surprisingly busy for such a forbidding evening, but the approaching holiday season seemed to affect everyone with a pulse. Thanks to my rotten luck, I was charged with attending trauma cases that night, patients with serious injuries and illnesses that put them in imminent danger of death. Or, more specifically, carloads of mall-hoppers who showed up in pieces after hitting black ice on 131 South.

      After I’d admitted three patients, I found myself in great need of a nicotine fix. While I felt guilty for sticking the other doctors with a few extra cases, I didn’t feel guilty enough to forgo a quick cigarette break.

      I was heading for the ambulance bay doors when John Doe arrived.

      Dr. Fuller, the attending physician and most senior M.D. in the hospital, ran alongside the gurney, barking instructions and demanding information from the EMTs in his no-nonsense Texan accent.

      Distracted by the fact that Dr. Fuller’s smooth, Southern speech had been replaced by an urgent, clipped tone, I didn’t notice the patient on the gurney. I had never seen my superior lose his unflappable calm before. It scared me.

      “Carrie, you gonna give us a hand here or are you on a one-way trip to Marlboro country?” he barked, startling me. The cigarette between my fingers snapped in half when I jumped, reduced to a fluttering shower of dry tobacco. My break had been officially canceled.

      I brushed my hands clean on my lab coat and fell into step beside the gurney. It was only then that I noticed the state the transport was in.

      The sight of the patient paralyzed me as we entered the cubical and the EMTs were squeezed out to make way for the R.N.s who rushed in.

      “Okay ladies, I want splash guards, gowns, goggles, the whole space suit. Quickly, please,” Fuller snapped, shrugging off his blood-smeared white coat.

      I knew I should do something to help, but I could only stare at the mess on the table in front of me. I had no idea where to start.

      Blood might be the one thing I’m not afraid of. In the case of John Doe, it was not the blood that made working on him, touching him, even approaching him unthinkable. It was the fact that he looked like my dissection cadaver on the last day of Gross Anatomy.

      Puncture wounds peppered his chest. Some were small, but four or five were large enough to fit a baseball in.

      “Gunshot wounds? What the hell was he shot with, a goddamned cannon?” Dr. Fuller muttered as he probed one of the bloody holes with his gloved finger.

      It didn’t take a forensic-science degree to tell that what had caused the wounds in John Doe’s torso had not caused the wounds in his face. His jaw, or what was left of it, hung skinned from the front teeth to the splintered end, where it had been ripped from the joint to dangle uselessly from the other side of his skull. Above the gaping hole in his cheek, one eye socket stood empty and crushed, the eye itself and optical nerve completely missing.

      “I’d say someone used an axe on his head, if I thought it were possible to swing one with enough force to do this,” Dr. Fuller said. “We’re not going to get a tube down this way, his trachea’s crushed all to hell.”

      I couldn’t breathe. John Doe’s remaining eye, clear and bright blue, fixed on mine as if he were totally alert.

      It had to be a trick of the light. No one could endure this kind of trauma and remain conscious. No one could survive injuries of this magnitude. He didn’t cry out or writhe in pain. His body was limp and completely void of any reaction as the attending staff made an incision in his windpipe to intubate him.

      He never looked away.

      How can he be alive? my mind screamed. The concept destroyed the carefully constructed logic I’d built over three years of medical school. People did not live through something like this. It wasn’t in the textbooks. Yet, there he was, staring at me calmly, focused on me despite the flurry of action around us.

      For a sickening moment, I thought I heard my name from the mangled hole of his mouth. Then I realized it was Dr. Fuller’s frantic voice cutting through the haze of my paralyzed revulsion.

      “Carrie, I need