Bryan's foster mother, who took in foster children so she wouldn't have to work, needed assurance only that his Medicaid would cover the cost of the surgery.

"I don't have to stay with him at the hospital, do I?" The heavyset black woman finished buttoning Bryan's shirt before she set him down in her ancient umbrella stroller.

"No, but does his biological mom want to talk to me? I can explain the procedures to her over the phone." Alexandra didn't want to meet Bryan's mother in person.

"She don't care." The foster mother clipped the frayed lap belt around Bryan's waist. The boy, who should have been bouncing with energy, huddled to one side and parked his thumb in the distorted sneer that was his mouth. "She pregnant again."

Bryan's mother had already had five other kids taken away from her. Like him, all of his siblings were born addicted to heroin. The last two were born HIV positive.

Alex watched the boy's cleft dilate as he closed his eyes and held his thumb loosely in his mouth; his damaged palate wouldn't even allow him the comfort of suckling. "Someone needs to sterilize that woman."

"Only fix she want is the kind she can stick in her arm." The foster mother pushed Bryan out of the exam room.

After Alex picked up her messages and told Grace to call HRS about Bryan's mother, she headed over to the hospital.

Construction that never seemed to end had worked traffic into a nasty knot, so she used the delay to return some calls.

"Dr. Charles Haggerty, please. This is Dr. Keller." While she was on hold, she inched her Jeep to the far left side of her lane to see beyond the furniture delivery truck in front of her. Road construction and a fender bender blocked off three of the four eastbound lanes. A good mile of bumper-to-bumper traffic stretched out ahead.

"Al? Where are you?"

"On the road between my office and surgery." The sun came out from behind some clouds, so she slipped on her shades. "What's up?"

"I've got a six-year-old boy, Down's kid, and I'd like you to look at him for a partial glossectomy. Hang on." To someone else he said, "Get me a throat swab and a CBC on four, thanks, Amanda." There was noise: a child's angry screech and a woman's startled yelp. "Oh, shit. My patient just bit my nurse. Can we do this over dinner, Al?"

Alex laughed. "Charlie, the last time you invited me out to eat, we ended up having peanut butter crackers in bed." After an extended period of shoptalk and some slow, comfortable sex, both of which she had enjoyed.

"I wanted to order takeout," he reminded her. "You were the one who had to argue about laparoscopic nerve reconstruction until after the Thai place closed. Amanda, can you—yes, thanks—here, Melinda." The sound of a sobbing child grew louder. "Would you like to say hello to Dr. Keller? No? Don't try to bite the phone, baby—she's not as pretty as you." The child's crying slowed, and there was some sniffling and a thick, muttered question. "Oh, no. Dr. Keller can't wear Blue's Clues sneakers. Her feet are too big. She only fits into Donald Duckwear."

Alexandra liked Dr. Charles Haggerty for a lot of reasons, and not just because he was a great specialty pediatrician who adored his mostly handicapped patients. He laughed at her more radical ideas, but he always listened, and he never gave her any sexist or competitive crap. Doctors were usually in terrible shape and/or lousy lovers, but Charlie had a nice body and, when they weren't too tired, actually put some effort into using it to please hers. He hadn't pushed marriage or moving in with her, either, two more big gold stars in her boyfriend book.

But Charlie had always been more of a friend than a lover, and Alex knew she should turn him loose.

"I need a wife who'll take care of me," Charlie had told her more than once, "and so do you."

"Here's your mom, Melly." A shuffle and a grunt as Charlie passed his burden to other arms. "Be right with you, Justina." He released a breath. "What do you say, Al? Be my Calgon dream girl and take me away from all this."

Alex was honestly tempted to accept his invitation to dinner, whether it be Thai takeout or crackers in bed. She had Luisa today, though, and from experience she knew all she'd feel like doing tonight would be listening to Chopin while she nursed a headache and a glass of dry white wine. "Maybe next week, okay?"

"Seeing Lopez again?" His voice softened. "You've got to stop beating yourself up over her, sweetheart. With some of them, you just do what you can and pray."

"I know." If Alex had still believed in God, she might even agree with him. A break opened in the lane next to hers and she darted into it. "Gotta go, Charlie. Send over your glossectomy tomorrow morning. I'll work him in."

"Appreciate it. Get some sleep, and I'll stockpile some more saltines and Skippy for next time."

Southeast Chicago Hospital was a fortress of modern medicine, which over the years had collected a small village of specialty clinics, outpatient services, and rehab centers around its two-thousand-bed central building. Alex parked in the private, underground physicians' lot and signed in with reception before she took the staff elevator up to the fourteenth floor.

She had been to Luisa's room a hundred times, and still she had to force herself to punch the number fourteen button. The higher the elevator rose, the more she felt the invisible weight on her shoulders increase.

Luisa Lopez had been born in the projects on Chicago's west side, and had lived there all her life. Pregnancy at sixteen entitled her to welfare and her own apartment, but the building she had moved to was much older than her mother's. The tenants were so vicious that cops would not even enter the building without backup. But Luisa was determined to live on her own and do better for herself and her child. She moved in and started taking GED classes at night.

"She live for that baby," Sophia Lopez had told Alex when she'd first interviewed her. "Todo el mundo, the world to her."

Mrs. Lopez had shown her a tenth-grade school photo of her daughter. Luisa had been rather plain and a little overweight, but she'd taken care of her chocolate-colored skin and pretty white teeth, and kept her thick black hair in neat corn-rows. She'd gotten one bit of beauty by inheriting her Puerto Rican father's large, hazel eyes.

Luisa, who was quiet and bothered no one, always took the bus home from class at night, but young women on their own get noticed. One night, someone either followed her home or broke into her apartment and waited for her to arrive.

Whoever it was also brought three friends with him.

The police reconstructed what they thought had happened from the crime scene and some reluctant witnesses. Four intruders ransacked the apartment and, when they found nothing of value, took out their frustrations on Luisa.

Alex remembered reading the initial ER intake report. It had taken five pages, front and back, to complete the list of injuries Luisa had endured. It had been too much for her unborn baby, which she had miscarried.

Police believed that Luisa's attackers had set fire to her apartment to hide their crimes, but someone on the same floor had smelled the smoke and called 911. Alex had spoken to the firefighter who had found Luisa curled up on the floor, her clothes on fire, in active labor, still cradling a teddy bear she had saved for her new baby. The firefighter, a seasoned veteran, had wept while describing how he'd doused the flames and yet still had been forced to pry the toy from Luisa's burned, clutching arms.

The men who had attacked Luisa were still at large.

Aside from the chapel, the burn ward was the quietest place in the hospital. Alex kept her voice low as she checked in with the charge nurse. "How's she doing?"

"Bad night, ripped out her IV twice." The nurse handed over a metal-cased chart. "Got her catheter out, too. Pissed all over the cradle and called me or my mother a bunch of nasty names when I rolled her after breakfast."

"That's my girl." Alex noted how much morphine Luisa had been given, and then wrote up a script for Valium. "If she gets feisty tonight, tranq her."

Because the fire had left Luisa with third-degree burns over forty-five percent of her body, which had already been brutalized beyond belief, she had not been expected to live. Alex had been called in on the case by her mother, who had been infuriated by the other staff physicians' apathetic treatment. In broken English, Sophia Lopez told her that she'd do whatever it took to keep her daughter alive.

And every time Alex looked at Luisa, she wondered what kind of life that would be.

Today there was a big man dressed in black sitting next to Luisa's burn cradle. He was reading Psalms from the Bible in a quiet voice while the patient stared at the window on the other side of the room.

Alex considered turning on her heel and walking out. This makes my day complete. Instead she forced her lips into a professional smile. "That doesn't sound like the latest Linda Howard novel."

The priest stopped reading and set aside the Bible. "Hello, Alexandra."

Father John Keller, Alex's only brother and all that was left of her family, did not rush over to give her a hug. She couldn't remember the last time they'd touched, but she thought maybe it had been before he'd gone to the seminary. Back then, Alex had been a skinny fifteen-year-old who adored him and tagged after him because he was the greatest big brother on the planet. Even when he talked about becoming a priest, she had been convinced it wouldn't change things. John had loved her more than anyone.

But John had changed. He had picked his God over her, and Alex had been made to understand that there was no competition between her and the Almighty.

"What a terrific surprise." No, it wasn't; she needed John and Luisa all at once as much as she needed to jump in the middle of a WWF cage match. "I thought this was feed-the-junkies day over at St. Luke's."

"Mondays and Wednesdays." John glanced at Luisa. "Today I visit shut-ins and hospitals."

"Kind of a trip for you." St. Luke's, the Chicago parish where her brother had worked for the last five years, was on the other side of town. Alex could think of at least two hospitals that were closer than hers.