“Lenny, how are you?” I smile tightly at the long-faced, gray-eyed Doctor Lenworth. He’s in blue scrubs, and when we shake I feel the powder on his hands from recently-removed medical gloves. “Yeah, I’m still associated with the hospital as a consulting doctor, but I only show up here occasionally. I’ve got a clinic over by Lake Mead now.”

Lenny returns my tight smile. He’s aged in a way I haven’t, but it’s hard to tell whether that’s a good or bad thing. “Lake Mead? Nice. That’s pretty upscale. Mostly heart-disease and diabetes, I imagine. Diseases of the privileged. Folks living the good life.” He snaps on a fresh pair of purple medical gloves, glances past me to the ER, then flicks his judgmental gaze back to my face. “So why are you slumming it down here, Doctor Drake? Come to see how the other half lives?” He chuckles. “I mean the other ninety-nine percent. You just treat America’s one-percenters, right? Your own kind. Born into money, but still with that burning need to make more money.”

I gaze coolly into Lenny’s gray eyes. “You’re a senior physician at the UNLV Medical Center, Lenny. You must pull in, what, four hundred thousand a year, maybe half a million? And I’ll bet your speaking fees at all those medical conferences add up to another six figures a year. Pretty fucking sure you’re a one-percenter just like I am.”

“Except I earned it.” Lenny delivers the cutting remark with a matching smirk. “Excuse me while I get to work saving lives. Good luck getting your rich patients to stay off the caviar. Those are just fish eggs, right?”

“Fish eggs are actually great for the heart.” Muttering under my breath, I turn on my hand-crafted Italian-leather heel and storm down the tiled hallway towards the rear exit, towards where my black BMW 7-Series is parked around the block so the hospital cameras don’t pick up the license plates.

Not that anyone’s going to know it was murder, I remind myself as the tinted glass rear-exit doors slide open and a worried-looking middle-aged couple hurry into the hospital, their eyes wide with anxiety, gazes darting left and right like they have no idea what to do or where to go.

“Can I help you guys?” The words pop out of my mouth with a warm friendliness that surprises me. The last thing I need is for someone to remember seeing me here. But Lenworth already saw me, so I guess it doesn’t matter. Besides, the thug Dad asked me to silence was already close to the end. He’d been admitted for chest pains, was snoozing alone in his room when I flipped on my Wi-Fi-jammer to disrupt the room camera, entering like a masked ghost. Within seconds I’d plunged a syringeful of potassium chloride solution into the vein the nursing staff had conveniently pre-tapped for me, then I’d silently slipped out even as I heard the bastard gurgle out his final breath. Potassium chloride stops the heart and isn’t detectable in a toxicology report, so nobody is going to suspect a damn thing.

Still, I’m not part of this hospital’s permanent staff, and although I’m registered at all the Vegas hospitals, do my best to send a patient or two into each hospital every year for outpatient work or routine tests just so my name gets logged in the hospital systems as a visiting doctor, I shouldn’t get involved with patients I’m not treating.

But I’ve already offered my help to this worried-looking couple, and so I stand my ground and smile with a warmth that feels strangely genuine, just like that uncharacteristic offer to help was oddly forthcoming.

“Our daughter was admitted last night for an anxiety attack,” says the woman breathlessly. She’s a matronly-looking woman in her late forties, her anxious face etched with deep worry-lines that tell me she’s habitually highly-strung to the extreme. A glance at her overbitten nails confirms my first impression. “We drove down from Nebraska as soon as we could.”

“Her name is Wanda Turner.” The husband, a round heavyset man with bushy black eyebrows and his own worry-lines carved into a canyon of a forehead, blinks rapidly as he speaks, rubbing his lips feverishly, his fingernails also bitten down to stubs. “She’s a graduate student at UNLV.”

“Wanda’s getting her PhD in Psychology,” gushes the mother, almost falling over with anxious pride. “She’s in her sixth year. Her dissertation was due last year, but she delayed it by a year to get it absolutely perfect.” Mama Turner smiles to show white teeth whose edges are ground down smooth like pebbles. “Perfection is important.”

“Perfection is everything.” Papa Turner nods very seriously, squeezing Mama Turner’s hand, then gazing expectantly back at me. “She’s just trying to be perfect. But it makes her so anxious.”

“She’s on medication for the anxiety.” Mama Turner’s eyes go wide. “Maybe she stopped her medication!”

“That’s got to be it.” Papa Turner speaks firmly, but I can tell he’s trying to convince himself more than anyone else that it’s just a matter of popping more pills. Or fewer pills, as the case may be in this new world of over-prescribed drugs. “Where is she? Can we see her now?”

My throat tightens as I glance past the Turners towards the rear exit. An odd feeling of serendipity surges when I considerthat if I hadn’t stopped at the ER, I wouldn’t have bumped into Lenworth, and would have left the hospital before the Turners ever got here.

Taking a breath, I nod reassuringly at the Turners. My mind spins back to the scene in the ER, my razor-sharp memory recalling every patient instantaneously. It was mostly men—statistics show that men are overwhelmingly more likely to end up in the ER, thanks to an evolutionary predisposition to risky behavior and hostile aggression, tendencies which get supercharged when you add alcohol and drugs to the mix.

There were only two female patients in the ER, and neither looked young enough to be a graduate student. If Wanda Turner was a sixth-year PhD candidate, she’d be in her mid-twenties. The two women in the ER were both well into their golden years, probably victims of slot-machine fever or the blackjack-table blues, not PhD-thesis paranoia like Wanda Turner appeared to be stricken by.

“Follow me.” Again I speak with startling confidence, turning my lean, muscled body away from the exit doors and walking briskly down the hall towards the elevators. It’s been a while, but I still remember every detail about this hospital. Three years of sixteen-hour shifts tends to leave a mark. “We assign rooms alphabetically by last name, so your daughter will be up on the seventh floor.”

“Oh, no!” Mama Turner clutches her face like it’s about to fall off. “Seven floors is too high up!”

“Far too high up!” Papa Turner pales, then reddens. “Everything above the fifth floor is a death-trap. If there’s a fire, everyone above the fifth floor will burn.”

“You see, fire-truck ladders only reach the fifth floor of most buildings.” Mama Turner is still holding her cheeks, obviously to prevent them from exploding with anxiety or melting from madness. “That’s probably why our poor Wanda had the panicattack to begin with. Because she knew that if she was ever admitted to the UNLV Medical Center, they’d put her on the seventh floor, and the fire-truck ladders wouldn’t get to her if there was a fire! She knew she’d burn if there was a fire!”

Frowning, I rub the back of my neck and consider the possibility that I pricked myself with a needle containing a mind-warping chemical that makes everyone talk crazy. But a part of me sees the paranoid logic in that ludicrous conjecture, and I decide that these two are just worried parents who’ve driven here from Nebraska and are freaking out about their perfect little princess.

A princess I’m suddenly curious to meet, I realize as we get into the elevators and glide up to the seventh floor. With paranoid protective parents like these, no shit Wanda is a nervous wreck who probably eats her own fingernails for breakfast just like Mama and Papa. And although medication is often a vital and necessary part of treatment, it only fixes the symptoms.

And suddenly I want to fix the cause.

Because maybe it’ll fix something in me that’s broken.

Don’t kid yourself, comes the vicious thought. You’re going to hell for what you’ve done for Father and Family, for how you’ve betrayed the oath a doctor takes to do no harm. Suddenly feeling nostalgic for the early days when you were saving lives doesn’t mean you get a second chance. Those choices have already been made.

Choices that sealed your fate.

Decisions that doomed your destiny.

You can’t change a damn thing by whatever you think you’re doing here.