"Go ahead," Jack said as he methodically…

Craig felt blood rush to his face. He wanted to turn and connect with Alexis, but he couldn't get himself to do it, not with the humiliation he was experiencing.

"Sustained! Counsel, stick to the facts without inflammatory embellishments until the witness testifies."

"Of course, Your Honor. It is just hard to rein in my emotion."

"You'll be in contempt if you don't."

"Understood," Tony said. He looked back at the jurors. "What you will hear testimony to is that Dr. Bowman's lifestyle had changed dramatically."

"Objection," Randolph said. "Private life, lifestyle — none of this has relevance to the issue at hand. This is a medical malpractice trial."

"Good lord!" Judge Davidson exclaimed with frustration. "Counsels, approach the bench!"

Both Randolph and Tony dutifully went to the side of the judge's box, out of earshot of everyone in the courtroom and, most important, beyond the range of both the court reporter and the jury.

"At this rate, this trial is going to take a year, for Christ's sake," Judge Davidson groused. "My entire month's schedule will have to be trashed."

"I cannot allow this farce to continue," Randolph complained.

"It's prejudicial to my client."

"I keep losing my train of thought with these interruptions," Tony grumbled.

"Pipe down! I don't want to hear any more pissing and moaning out of either one of you. Mr. Fasano, give me some justification for this excursion from the relevant medical facts!"

"It was the doctor's decision to go to the deceased's home on a house call instead of agreeing to the plaintiff's request to take his wife directly to the hospital even though, as the doctor himself will testify, he suspected a heart attack."

"So what?" Judge Davidson questioned. "I assume the doctor responded to the emergency without undue delay."

"We're willing to stipulate that, but Dr. Bowman didn't make house calls before he had his midlife crisis, or 'awakening', as he calls it, and before he moved into town with his lover. My experts will all testify that the delay caused by making the house call was critical in Patience Stanhope's death."

Judge Davidson ruminated on this. As he did so, he absently rolled his lower lip into his mouth such that his mustache reached halfway down his chin.

"Provider lifestyle and mindset are not the issues in medical malpractice,"

Randolph asserted. "Legally, the question is simply whether there was a deviation from the standard of care, causing a compensable injury."

"Generally you are right, but I believe Mr. Fasano has a valid point, provided subsequent testimony supports it. Can you say that's unequivocally the case?"

"To the letter," Tony said with assurance.

"Then it will be up to the jury to decide. Objection overruled. You may proceed, Mr. Fasano, but I warn you again about inflammatory language."

"Thank you, Your Honor."

Randolph returned to his seat, ostensibly annoyed. "We're going to have to weather the storm," he said. "The judge is allowing Fasano unusual discretion. On the positive side, it will add fodder for the appeal if there is ultimately a finding for the plaintiff."

Craig nodded, but the fact that Randolph, for the first time, was voicing the possibility of a negative outcome added to Craig's growing despondency and pessimism.

"Now, where the devil was I?" Tony said after regaining the podium. He shuffled through his note cards briefly, adjusted the sleeves of his silk jacket so that his shirt cuffs presented just enough and his clunky gold watch was just visible. He raised his eyes. "In the third grade, I learned I was terrible speaking in front of groups, and it hasn't changed much, so I hope you give me a little slack."

A number of the jurors smiled and nodded in sympathy.

"We will present testimony that Dr. Bowman's professional life changed dramatically almost two years ago. Prior to that, he had essentially a traditional fee-for-service practice. Then he switched.

He joined and has essentially taken over a successful concierge practice."

"Objection!" Randolph said. "This trial is not about style of practice."

Judge Davidson sighed with frustration. "Mr. Fasano, is Dr. Bowman's style of practice germane to the issue we discussed at the sidebar?"

"Absolutely, Your Honor."

"Objection overruled. Proceed."

"Now," Tony said, engaging the jury, "I'm looking at a number of faces here that look a little blank when I mention the term concierge medicine. And you know why? Because there are a lot of people who don't know what it is, including me before I took on this case. It's also called retainer medicine, meaning those patients who want to be included in the practice have to cough up some big bucks up front each and every year. And we're talking about some big money with some of these practices, upwards of twenty thousand dollars a head per year! Now, Dr. Bowman and his mostly retired partner, Dr. Ethan Cohen, don't charge that much, but they charge a lot. As you can well imagine, this style of practice can only exist in wealthy, sophisticated areas like some of our major cities and posh locales like Palm Beach or Naples, Florida, or Aspen, Colorado."

"Objection!" Randolph said. "Your Honor, concierge medicine is not on trial here."

"I disagree, Your Honor," Tony said looking up at the judge. "In a way, concierge medicine is on trial."

"Then relate it to the case, counselor," Judge Davidson said irritably.

"Objection overruled."

Tony looked back at the jurors. "Now, what do people in a concierge practice get for all this up-front moola besides getting kicked out of the practice and abandoned if they don't come up with the dough? You'll hear testimony for what they supposedly get. It's going to include guaranteed twenty-four-seven access to their doctor, with the availability of the doctor's cell phone numbers and e-mail address, and a no-wait guarantee for their appointments, both of which I personally think people should get without having to fork over retainer fees. But most important of all in relation to this current case, they get the possibility of house calls when appropriate and convenient."

Tony paused for a moment to let his comments sink in. "During the trial, you will hear direct testimony that on the evening of September fifth, 2005, Dr. Bowman had tickets to the symphony for himself and his live-in girlfriend while his wife and darling daughters were moping at home. With him currently back in the family manse, I'd love to have the doctor's wife as a witness, but I can't because of spousal confidentiality. She must be a saint."

"Objection," Randolph said, "for the very reason cited."

"Sustained."

"You will also hear testimony," Tony continued with hardly a break, "that the known standard of care when a heart attack is suspected is to get the patient to the hospital immediately in order to initiate treatment. And when I say immediately, I'm not exaggerating because minutes, maybe seconds,

count between life and death. You will hear testimony that despite my client's pleading to take his stricken wife to meet Dr. Bowman where she could be treated, Dr. Bowman insisted he make a house call. And why did he make the house call? You will hear testimony that it was important because if Patience Stanhope did not have a heart attack, even though from his own testimony you will hear that he suspected it, if she didn't, then he would be able to get to the symphony on time to drive up in his new red Porsche, walk in and be admired for his culture and for the young, attractive woman he had on his arm. And therein, my friends, lies — or lays, I'm never sure which — the medical negligence and malpractice. For in his own vanity, Dr. Bowman violated the standard of care that dictates a heart attack victim get to a treatment facility absolutely as soon as possible.

"Now, you will hear some different interpretation of these facts from the efforts of my more polished and experienced colleague. But I am confident that you people will see the truth as I believe the Massachusetts tribunal did when they heard this case and recommended it for trial."

"Objection!" Randolph called out, leaping to his feet. "And move to strike and request the court to admonish counsel. The tribunal's findings are not admissible: Beeler versus Downey, Massachusetts Supreme Judicial Court."

"Sustained!" Judge Davidson snapped. "Defense counsel is correct, Mr.

Fasano."

"I'm sorry, Your Honor, " Tony said. He stepped over to the plaintiff's table and took a paper offered by Ms. Relf. "I have here a copy of Massachusetts Laws, Chapter two thirty-one, section sixty B, saying the panel's findings and testimony before the panel are admissible."

"That was overturned by the case cited," Judge Davidson said. He looked down at the court reporter. "Remove the reference to the tribunal from the record."

"Yes, sir," the court reporter said.

Judge Davidson then engaged the jury. "You are directed to disregard Mr.

Fasano's comment about the Massachusetts Tribunal, and you are instructed that it will play no role whatsoever in your responsibility as triers of fact.

Am I understood?"

The jury all nodded sheepishly.

The judge glanced down at Tony. "Inexperience is not an excuse for not knowing the law. I trust there will be no more slipups of this sort, or I will be forced to declare a mistrial."

"I will try my best," Tony said. He returned to the podium slab-footed. He took a moment to gather his thoughts, then looked up at the jury. "I am confident, as I said, that you will see the truth and find that Dr. Bowman's negligence caused the death of my client's lovely wife. You will be then asked to award damages for the care, guidance, support, counsel, and companionship that Patience Stanhope would be providing today to my client if she had lived.

"So thank you for your attention, and I apologize to you as I did to the judge for my inexperience in this particular arena of law, and I look forward to addressing you again at the conclusion of the trial. Thank you."

Gathering his cards from the lectern, Tony retreated back to the plaintiff's table and immediately launched into a hushed but intense conversation with his assistant. He was flaunting the paper she had recently handed him.

With a sigh of relief that Tony had finished, Judge Davidson glanced at his watch before looking down at Randolph. "Does the defense counsel wish to make an opening statement at this juncture of the proceedings, or after the plaintiff's case in chief?"

"Most definitely now, Your Honor," Randolph replied.

"Very well, but first we will take a lunch recess." He smartly smacked the gavel. "Court's adjourned until one thirty. Jurors are instructed not to discuss the case with anyone or among themselves."

"All rise," the court officer called out like a town crier as the judge got to his feet.

3

BOSTON, MASSACHUSETTS

MONDAY, JUNE 5, 2006

12:05 P.M.

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Although most everyone else began to file out of the courtroom's gallery Alexis Stapleton Bowman did not move. She was watching her husband, who'd sunk back into his chair like a deflated balloon the moment the paneled door to the judge's chamber closed. Randolph was leaning over him and speaking in a hushed tone. He had a hand on Craig's shoulder.

Randolph's paralegal, Mark Cavendish, was standing on the other side of Craig, gathering up papers, a laptop, and other odds and ends, and slipping them into an open briefcase. Alexis had the impression Randolph was trying to talk Craig into something, and she debated whether to intervene or wait. For the moment, she decided that it was best to wait. Instead, she watched the plaintiff, Jordan Stanhope, come through the gate in the bar.

His face was neutral, his demeanor aloof, his dress conservative and expensive. Alexis watched as he wordlessly found a young woman who matched his behavior and attire like two peas in a pod.

As a hospital-based psychologist, Alexis had been to numerous trials, testifying in various capacities although mostly as an expert witness. From her experience, she knew that they were anxious affairs for everyone,

particularly for doctors being sued for malpractice, and especially for her husband, whom she knew was in a markedly vulnerable state. Craig's trial was the culmination of an especially difficult two years, and a lot was riding on the outcome. Thanks to her training and her ability to be objective, even about personal affairs, she knew Craig's vulnerabilities as well as his strengths. Unfortunately, in the current crisis she was aware that vulnerability trumped the strengths such that if he did not prevail in this very public questioning of his abilities as a doctor, she doubted he'd be able to pull together his life, which had splintered even prior to the lawsuit with a rather typical midlife crisis. Craig was first and foremost a doctor. His patients came first. She'd known that fact from the beginning of their relationship and had accepted it, even admired it, for she knew that being a doctor, particularly a good doctor, was in her estimation — and she had a lot of firsthand knowledge from working in a major hospital — one of the toughest, most demanding, and unrelenting jobs in the world.

The problem was that there was a good chance, at least on the first go-round, as Randolph had confided to her, that the case could be lost despite there having been no malpractice. In her heart of hearts, Alexis was sure of that from hearing the story and because she knew that Craig always put his patients first, even in those situations where it involved some inconvenience and even if it was three o'clock in the morning. In this instance, it was the double whammy of the malpractice claim and the midlife adjustment disorder that complicated the situation. The fact that they did occur together did not surprise Alexis. She hadn't seen many physicians in her practice, because seeking help, particularly psychological help, was generally not in the physician's nature. They were givers of care, not recipients. In this regard, Craig was a prime example. She had strongly suggested he seek therapy, especially considering his reaction to Leona's deposition and to the deposition of the plaintiff's experts, and she could have easily arranged it, but he had steadfastly refused. He'd even reacted angrily when she made the suggestion again a week later, when it was apparent he was becoming progressively more depressed.

As Alexis was continuing to debate whether to approach Craig and Randolph or stay where she was, she became aware of another person

who'd stayed behind in the gallery after the mass exodus. What caught her attention were his clothes, which were almost identical to the plaintiff's attorney's in style, color, and cut. The similarity of dress as well as their equivalently brick-like habitus and dark hair gave them the superficial appearance of twins as long as they weren't together, because the man in the spectator area was at least one and a half times the size of Tony Fasano. He also differed by being less swarthy, and in contrast to Tony's baby-bottom facial skin, he had the regrettable sequela of severe teenage acne. The residual scarring on his cheekbones was deep enough to appear like that of a burn.

At that moment, Tony Fasano broke off his conversation with his assistant, grabbed his ostrich briefcase, and stormed through the gate into the gallery on his way out of the courtroom. It was obvious he was chagrined about the error regarding the tribunal ruling. Alexis wondered why he was overreacting, since his opening statement from her viewpoint had been regrettably effective and was undoubtedly the reason Craig was brooding.

Tony's assistant sheepishly followed her boss. Without even a sideward glance or the slightest hesitation in his step, Tony called out, "Franco,"

while gesturing for the man dressed like himself to follow. Franco obediently did so. A moment later, they all had disappeared through the heavy double doors to the hall, which clanged shut with jarring finality.

Alexis glanced back toward her husband. He'd not moved, but Randolph was now looking in her direction. When he caught her eye, he waved for her to come join them. With an explicit invitation, she was happy to oblige.

When she got there, Craig's face looked as downtrodden as she'd assumed from his posture.

"You must talk to him!" Randolph ordered, venturing from his studied, patrician self-possession with a hint of exasperation. "He cannot continue to behave in this despondent, defeated manner. In my experience, juries have special antennae. I'm convinced they can sense a litigant's mind-set and decide the case accordingly."

"Are you saying the jury could decide against Craig purely because he's depressed?"

"That's exactly what I'm saying. You have to tell him to buck up! If he continues to comport himself in this negative fashion, there is the risk they will assume he's guilty of the alleged malpractice. I'm not suggesting they won't listen to the testimony or consider the evidence, but they'll do so only with the thought of possibly negating their initial impression. Such behavior turns a neutral jury into a prejudicial one and switches the burden of proof from the plaintiff, where it should be, to us, the defense."

Alexis looked down at Craig, who was now massaging his temples while cradling this head in his hands, elbows on the table. His eyes were closed.

He was breathing through an open, slack mouth. Getting him to buck up was a tall order. He'd been in and out of depression for most of the eight-month pre-trial period. The only reason he'd acted "up" at all that morning and in the days immediately leading to the trial was the prospect of getting the trial over with. Now that the trial had started, it was obvious that the reality of the possible outcome had set in. Being depressed was not an unreasonable response.

"Why don't we all go to lunch, and we can talk," Alexis suggested.

"Mr. Cavendish and I will have to skip lunch," Randolph said. "I need to plan my opening statement."

"You haven't planned it before now?" Alexis questioned with obvious surprise.

"Of course I'd planned it," Randolph said testily. "But thanks to Judge Davidson allowing Mr. Fasano such discretion in his opening statement, I must alter mine."

"I was surprised by the plaintiff's opening statement," Alexis admitted.

"And indeed you should have been. It was nothing more than an attempt at character assasination or guilt by association, since they obviously have no

evidence of actual medical negligence. The only good part is that Judge Davidson is already providing us with grounds for an appeal if needed, especially with Mr. Fasano's cheap trick of introducing the tribunal's finding."

"You don't think that was an honest mistake?"

"Hardly," Randolph scoffed. "I've had some of his cases researched. He's a plaintiff's attorney of the most despicable variety. The man has no conscience, not that I suspect one in his chosen field of specialty."

Alexis wasn't so certain. Having watched the attorney harangue his associate, if it were a charade, it was on Oscar level.

"I'm supposed to buck up, and you're already talking about an appeal?"

Craig sighed, speaking for the first time since Alexis has arrived.

"One must prepare for all eventualities," Randolph said.

"Why don't you run along and do your preparation," Alexis said to Randolph. "Dr. Bowman and I will talk."

"Excellent!" Randolph said crisply. He was relieved to be freed. He motioned to his assistant to leave. "We'll see you back here in a timely fashion. Judge Davidson is, among his other less desirable traits, at least prompt, and he expects others to be likewise."

Alexis watched Randolph and Mark make their way through the courtroom and disappear out into the hallway before looking back down at Craig. He was watching her gloomily. She took Randolph's seat. "How about you and I have some lunch?" she said.

"The last thing in the world I'd like to do at this moment is eat."

"Then let's go outside. Let's get out of this magisterial environment."

Craig didn't answer, but he did stand. Alexis led the way out of the bar area, through the spectator section, and out into the hallway and to the elevator lobby. There were small groups of people milling about, with some locked in furtive conversation. The courthouse oozed an aura of contention from every nook and cranny. Craig and Alexis didn't talk as they took the elevator down and walked out into a bright, sunny day. Spring had finally come to Boston. In sharp contrast to the oppressive, seedy courthouse interior, there was hope and promise in the air.

After crossing a small, bricked courtyard wedged between the courthouse and one of Boston's Government Center's crescent-shaped buildings, Craig and Alexis descended a short flight of stairs. Crossing the busy four lanes of Cambridge Street took some effort, but they were soon able to stroll out onto the expansive esplanade fronting Boston City Hall. The square was crowded with people fleeing their confining offices for a little sun and fresh air. There were a few fruit stalls doing brisk business.

Without any particular destination, the couple found themselves near the entrance to the Boston T. They sat on a granite parapet, angled to face each other.

"There's no way I can tell you to buck up," Alexis said. "You're only going to buck up if you want to buck up."

"As if I didn't know that already."

"But I can listen. Maybe you should just tell me how you feel."

"Oh, whooptie do! Always the therapist ready to help the men-tally ill. Tell me how you feel!" Craig echoed mockingly. "How gallant!"

"Let's not be hostile, Craig, I believe in you. I'm on your side in this legal affair."

Craig stared off for a moment, watching two kids winging a Frisbee back and forth. He sighed, then looked back at Alexis. "I'm sorry. I know you are

on my side, letting me come back like a dog with his tail between his legs and pretty much no questions asked. I appreciate it. Really, I do."

"You're the best doctor I know, and I know a lot of doctors. I also have some insight into what you are going through, which ironically has something to do with your being such a superb physician. It makes you more vulnerable. But that aside, you and I have some issues. That's obvious, and there will be questions. But not now. There will be time for dealing with our relationship, but we have to get you through this ugly affair first."

"Thank you," Craig said simply and sincerely. Then his lower jaw began to tremble. Fighting off tears, he rubbed his eyes with the balls of his fingers.

It took a few moments, but when he felt he had himself under control, he looked back at Alexis. His eyes were watery and red. He ran a nervous hand through his hair. "The problem is this ugly affair keeps getting worse. I'm afraid I'm going to lose the case. Hell, when I think back on my social behavior back then when this happened, I'm embarrassed. And knowing that it's all going to come out publicly is a disgrace for both of us and a dishonor for you."

"Is the airing of your social behavior a big point of what's depressing you?"

"It's a part, but not the biggest part. The biggest humiliation is going to be the jury telling the world I practice substandard medicine. If that happens, I'm not sure I'll be able to practice anymore. I'm having a hard time as it is.

I'm seeing everybody as another litigant, and every patient encounter a possible malpractice case. It's a nightmare."

"I think it's understandable."

"If I can't practice medicine, what else can I do? I don't know anything else.

All I ever wanted to be is a doctor."

"You could do your research full-time. You've always had a conflict between research and clinical medicine."

"I suppose that's an idea. But I'm afraid I might lose my passion for medicine in general."

"So it's pretty clear you have to do everything in your power to win.

Randolph says you have to pull yourself together."

"Oh, Randolph, good grief!" Craig complained. He looked off in the middle distance. "I don't know about him. Having seen Mr. Fasano's performance this morning, I don't think Randolph is the right lawyer. He's going to connect with that jury like oil and water, whereas Fasano already has them eating out of his hands."

"If you feel that way, can you request another attorney from the insurance company?"

"I don't know. I guess."

"But the question would be, Is it wise at this late juncture?"

"Who knows?" Craig questioned wistfully. "Who knows."

"Well, let's deal with what we have. Let's hear Randolph's opening statement. In the meantime, we have to think of a way to spruce you up appearance-wise."

"That's easier said than done. Do you have any ideas?"

"Just telling you to buck up is not going to work, but what about concentrating on your innocence? Think about that for the moment. You were presented with the seriousness of Patience Stanhope's condition; you did everything humanly possible. You even rode in the ambulance so you could be there if she arrested. My God, Craig! Concentrate on that and your dedication to medicine in general and project it. Fill the whole damn courtroom! How could you be more responsible? What do you say?"

Craig chuckled dubiously in the face of Alexis's sudden enthusiasm. "Let me make sure I understand. You're talking about me focusing on my

innocence and broadcasting it to the jury?"

"You heard Randolph. He's had a lot of experience with juries, and he's convinced they have special senses about people's mind-set. I say you try to connect with them. God knows it can't hurt."

Craig exhaled forcibly. He was hardly confident but didn't have the energy to fight Alexis's zeal. "Okay," he said, "I'll try it."

"Good. And another thing. Try to tap into your physician's ability to compartmentalize. I've seen you do it time and time again in your practice.

While you're thinking about how grand a doctor you are and how you gave your professional best with Patience Stanhope, don't think of anything else.

Be focused."

Craig merely nodded and broke off eye contact with Alexis.

"You're not convinced, are you?"

Craig shook his head. He gazed up at the boxy, postmodern Boston City Hall building that dominated the esplanade like a crusader castle. Its brooding, distressed bulkiness seemed to him like a metaphor for the bureaucratic morass that ensnared him. It took effort to pull his eyes away and look back at his wife. "The worst thing about this mess is that I feel so helpless. I'm totally dependent on my assigned insurance company attorney.

Every other hurdle in my life called for more effort on my part, and it was always the additional effort that saved the day. Now it seems like the more effort I make, the deeper I sink."

"Concentrating on your innocence like I'm suggesting takes effort.

Compartmentalizing takes effort also." Alexis thought it ironic that what Craig was voicing was exactly how people in general felt about illness and their dependency on doctors.

Craig nodded. "I don't mind making an effort. I said I'll try to connect with the jury. I just wish there was something else. Something more tangible."

"Well, there is one other thing that passed through my mind."

"Oh? What?"

"I've thought about calling my brother, Jack, and seeing if he would come up from New York and help."

"Oh, that would be helpful," Craig said sarcastically. "He won't come. You guys haven't been close over the years, and, besides, he never liked me."

"Jack has had understandable difficulty with us being blessed with three wonderful daughters when he tragically lost both of his. It's painful for him."

"Maybe, but it doesn't explain his dislike of me."

"Why do you say that? Did he ever say he didn't like you?"

Craig looked at Alexis for a beat. He'd cornered himself and couldn't think of a way out. Jack Stapleton had never said anything specific; it was just a feeling Craig had had.

"I'm sorry you think Jack doesn't like you. The reality is, he admires you, and he told me so specifically."

"Really?" Craig was taken aback, convinced that Jack's assessment was the opposite.

"Yes, Jack did say you were the kind of student in medical school and residency that he avoided. You are one of those people who read all the suggested reading, somehow knew all the trivial facts, and could quote at length from the latest issue of The New England Journal of Medicine. He admitted that awe did breed a certain contempt, but it was actually inwardly directed, meaning he wished he could have dedicated himself as much as you did."

"That's very flattering. It really is. I had no idea! But I wonder if he feels the same after my midlife crisis. And even if he were to come, what possible help could he provide? In fact, crying on his shoulder might make me feel worse than I do now, if that's possible."

"In Jack's second career as a medical examiner, he's had a lot of courtroom experience. He travels all over as an expert witness for the New York ME's office. He's told me he enjoys it. He strikes me as very inventive, although on the negative side, an inveterate risk-taker. As despondent as you are about how things are going, maybe his impromptu inventiveness could be helpful."

"I truly can't see how."

"I can't either, and I suppose that's why I hadn't suggested it before."

"Well, he's your brother. I'll leave that decision up to you."

"I'll think about it," Alexis said. Then she checked her watch. "We don't have a lot of time. Are you sure you don't want to grab something to eat?"

"You know, now that I've gotten out of that courtroom, my stomach has been growling. I could use a quick sandwich."

After they stood up, Craig enveloped his wife in a sustained hug. He truly appreciated her support and felt even more embarrassed about his behavior prior to his legal problems. She was right about his ability to compartmentalize. He'd totally separated his professional life and his family life and put far too much emphasis on the professional. He prayed he'd have a chance to balance the two.

4

BOSTON, MASSACHUSETTS

MONDAY, JUNE 5, 2006

1:30 P.M.

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"All rise," the court officer called. Judge Marvin Davidson whisked out of his chambers with a swirl of black robes at the exact moment the second hand of the wall-mounted, institutional clock swept past the number twelve.

The sun had moved in its diurnal trajectory, and some of the shades over the story-tall windows above the six-foot-high oak paneling had been raised. A bit of cityscape could be seen, as well as a tiny patch of blue sky.

"Be seated," the court officer called out after the judge had done so.

"I trust you all had a refreshing bite to eat," the judge said to the jury. Most jurors nodded.

"And as I instructed, I trust no one talked about the case in any capacity."

All the jurors shook their heads in agreement.

"Good. Now you will hear the opening statement by the defense. Mr.

Bingham."

Randolph took his time standing up, walking to the podium, and placing his notes on the angled surface. He then adjusted his dark blue suit jacket and the cuffs of his white shirt. He stood ramrod-straight, using every inch of his six-foot-plus height while his long-fingered hands gently enveloped the lectern's sides. Every single silver hair on his scalp knew its assigned place and had been snipped to a predetermined length. His necktie, with its sprinkling of Harvard veritas shields set in a crimson field, was tied to perfection. He was the picture of inbred, refined elegance and stood out in the middle of the shabby courtroom like a prince in a brothel.

From Craig's perspective, he couldn't help but be impressed, and for a few moments he'd gone back to thinking that the contrast with Tony Fasano might be favorable. Randolph was the father figure, the president, the diplomat. Who wouldn't want to trust him? But then Craig's eyes moved to the jury and went from the muscular fireman to the plumber's assistant and on to the inconvenienced businessmen. Every face reflected a reflex ennui that was the opposite of their reaction to Tony Fasano, and even before Randolph opened his mouth, Craig's brief flash of optimism disappeared like a drop of water on a sizzling fry pan.

Yet this rapid flip-flop realization wasn't all bad. It gave validation to Alexis's advice about mind-set, so Craig closed his eyes and conjured up the image of Patience Stanhope in her bed when he and Leona charged into the woman's bedroom. He thought about how shocked he'd been by her cyanosis, how quickly he'd reacted, and everything he'd done from that moment until it was apparent she was not going to be resuscitated. Over the course of the last eight months he'd gone over the sequence numerous times, and although on a few other cases over the years, he could second-guess himself and believe he should have done something slightly different, with Patience Stanhope he'd done everything absolutely by the book. He was confident that if he were confronted with the same situation that very day, he would not do anything differently. There had been no negligence.

Of that he was absolutely certain.

"Ladies and gentlemen of the jury," Randolph said slowly and precisely.

"You have heard a unique opening statement from someone who admits he

has had no experience in trying medical malpractice cases. It was a tour de force with clever, initial self-deprecations which made you smile. I didn't smile because I saw the ploy for what it was. I will not debase you with such oratory tricks. I will merely speak the truth, which I'm certain you will come to understand when you hear the testimony that the defense will present. In contrast to the opposing attorney, I have had more than thirty years' defending our good doctors and hospitals, and in all the trials I have participated in I have never heard an opening statement quite like Mr.

Fasano's, which in many ways was an unfair character assassination of my client, Dr. Craig Bowman."

"Objection," Tony shouted, leaping to his feet. "Argumentative and inflammatory."

"Your Honor," Randolph interjected. With annoyance, he made a small, dismissive gesture with one hand toward Tony as if shooing away gnats.

"May I approach the bench?"

"By all means," Judge Davidson snapped in return. He waved for the attorneys to come to the sidebar.

Randolph strode up to the side of the judge's bench with Tony fast on his heels. "Your Honor, Mr. Fasano was allowed wide discretion in his opening statement. I expect the same courtesy."

"I only described what I intend to substantiate with witnesses, which is what an opening statement is supposed to prove. And you, Mr. Bingham, objected about every ten seconds, interrupting my train of thought."

"Good God!" Judge Davidson complained. "This isn't a murder-one trial,"

the judge said. "It's a medical malpractice trial. We're not even through the opening statements and you're at each other's throats. At this rate, we'll be here for months." He allowed what he said to sink in for a beat. "Let this be a warning to you both. I want to move things along. Hear me? Each of you are experienced enough to know what is appropriate and what the other will tolerate, so rein yourselves in and stick to the facts.

"Now to the objection at hand. Mr. Bingham, what's good for the goose is good for the gander. You did object to Mr. Fasano being inflammatory. He has every right to object to you doing the same. Mr. Fasano, it is true you were given wide discretion, and God help you and your client if your testimony doesn't support your allegations. Mr. Bingham will be allowed the same discretion. Do I make myself clear?"

Both attorneys dutifully nodded.

"Fine! Let's continue."

Randolph returned to the podium. Fasano sat back down at the plaintiff's table.

"Objection sustained," Judge Davidson said for the court reporter's benefit.

"Continue."

"Ladies and gentlemen of the jury," Randolph said, "motivation is not usually part of medical malpractice proceedings. What is normally at issue is whether the standard of care has been met such that the doctor possessed and used that degree of learning and skill in treating the patient's condition that a reasonably competent doctor would employ in the same circumstance. You will note that in his opening statement, Mr. Fasano said nothing about his experts suggesting that Dr. Bowman did not use his learning and skill appropriately. Instead, Mr. Fasano must bring in the concept of motivation to get his allegation of negligence to be substantive.

And the reason for this, as our experts will testify, is that from the instant Dr. Bowman knew the gravity of Patience Stanhope's condition, he acted with commendable speed and skill, and did everything possible to save the patient's life."

Alexis found herself nodding in agreement as she listened to Randolph. She liked what she was hearing and thought he was doing a good job. Her eyes switched to Craig. He was at least sitting up straight. She wished she could see his face from where she was sitting, but it was impossible. Her eyes then went to the jury and her evaluation of Randolph's performance began

to erode. There was something about the jurors' posture that was different from when Tony Fasano was speaking. They seemed too relaxed, as if Randolph wasn't sufficiently engaging their attention. Then, as if to confirm her fears, the plumbing assistant gave a long, sustained yawn, which spread through most of the others.

"The burden of proof lies with the plaintiff," Randolph continued. "It is the defense's job to rebut the plaintiff's allegation and the testimony of the plaintiff's witnesses. Since Mr. Fasano had indicated that motivation is his key stratagem, we, the defense, must adjust accordingly and present with our witnesses an affirmation of Dr. Bowman's commitment and sacrifice throughout his entire life, beginning with a doctor kit given to him at age four, to be the best doctor and to practice the best medicine."

"Objection," Tony said. "Dr. Bowman's commitment and sacrifice during his training has no bearing on the particular case at hand."

"Mr. Bingham," Judge Davidson asked. "Will your witnesses' testimony relate Dr. Bowman's commitment and sacrifice to Patience Stanhope?"

"Absolutely, Your Honor."

"Objection overruled," Judge Davidson said. "Proceed."

"But before I outline how we plan to present our case, I'd like to say a word about Dr. Bowman's practice. Mr. Fasano described it as 'concierge medicine' and suggested the term had a pejorative connotation."

Alexis glanced back at the jury. She was concerned about Randolph's syntax and wondered how many of the jurors could relate to the words connotation and pejorative, and, of those who could, how many would think they were pretentious. What she saw was not encouraging: The jury looked like wax figures.

"However," Randolph said, raising one of his long, manicured fingers into the air as though he was lecturing a group of naughty children. "The meaning of the word concierge in its usual sense is help or service, with no

negative connotation whatsoever. And indeed that is the reason it has been associated with retainer medicine, which requires a small, up-front fee. You will hear testimony from a number of physicians that the rationale for such a practice format is to spend more time with the patient during appointments and during referrals so the patient enjoys the kind of medicine all of us laypeople would like to experience. You will hear testimony that the kind of medicine practiced in a concierge practice is the kind of medicine all doctors learn during medical school. You will also hear that its origins have come from the economic bind in traditional-practice settings that forces physicians to crowd more and more patients in a given hour to keep revenues above costs. Let me give you some examples."

It was reflex rather than conscious thought that propelled Alexis to a standing position in reaction to Randolph's foray into dull medical economics. Excusing herself, she moved laterally along the church-like pew toward the central aisle. Her eyes briefly met those of the man who was dressed identically to Tony Fasano. He was sitting in the aisle seat directly across as Alexis exited her row. His expression and unblinking stare unnerved her but then immediately dropped out of her consciousness. She headed to the door to the hall and opened it, trying to be as quiet as possible. Unfortunately, the heavy door made a click heard all around the courtroom. Momentarily mortified, she stepped out into the hall and then walked out into the large elevator lobby. Sitting on a leather-covered bench, she rummaged in her shoulder bag for her cell phone and turned it on.

Realizing she had poor reception, she took the elevator down to the ground floor and walked back out into the sunlight. After being indoors, she had to squint. To avoid the smog of cigarette smoke from the nicotine addicts sprinkled around the courthouse entrance, she walked a distance until she was by herself. Leaning on a railing with her bag over her shoulder and tucked safely under her arm, she scrolled through her phone's electronic address book until she came to her older brother's entries. Since it was after two in the afternoon, she used his work number at the Chief Medical Examiner's Office in New York City.