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July.
    Elliott is an odd duck. No one else in the department wears monogrammed shirts with cuff links, sports a Patek Philippe watch, or knows as much about pari-mutuel betting. He started in private practice and was such a good neurologist that we hired him into the academic group, where he had a meteoric rise from instructor to professor. Not one to gossip, he nonetheless seems to have a wealth of inside information. He knows what the residents are up to, what the administration is thinking, who is the next to be fired. He is a classically handsome man in the GQ sense, square-jawed, still maintaining awrestler’s build into his midforties. He went to a state university and to a less-than-name-brand medical school, and is unimpressed to the point of indifference by his current affiliation with Harvard University. He comes and goes as if he has something better to do, and apparently he did have something better to do than Chief’s Rounds, because when I turned to thank him, he was gone. The tickets were three rows behind the visiting team’s dugout. I would be wrapped up here by 5:00 p.m., I was thinking, unless something went terribly wrong. Which it did.
    Late in the afternoon, I was pushing the rolling cart with the patients’ charts around the semicircular nurses’ station on the tenth-floor ward. As I put the finishing touches on the last note in the last chart, a floor nurse rushed out of room 41 West and asked me if the team was going back in to see Mrs. G, the woman admitted last night from the intensive care unit, the very patient that Hannah and Elliott had been so concerned about. Mrs. G was Sofia Gyftopoulos, and her condition—hydrocephalus, also known as water on the brain, accompanied by a history of meningitis—was serious, but not critical.
    “No, we saw her an hour ago on our afternoon walk-rounds,” I said, “and she seemed fine except for a headache. Would you like me to take another look?”
    “Yes, I think her breathing is shallow.”
    If not for the unusually high number of admissions over the holiday weekend, I would have been home, resting up for the game. It would have been Hannah’s problem instead of mine. But I go where I’m needed.
    I walked in and briefly greeted Mrs. G’s husband Nick, who was sitting at the foot of the bed reading Entertainment Weekly , not looking at all concerned. Neither was Mrs. G, but then she wasn’t conscious, and her breathing was forced. I called her name and shook her shoulder, but was unable to rouse her. I checked her pulse, found it to be thready and barely detectable, and when I pried open her right eyelid, I saw that the pupil was enlarged and had lost its natural reflexof constricting in response to light. We call this a blown pupil, and it is a neurological sign that the brain is about to collapse. Nick was on his feet, Entertainment Weekly was on the floor, and the nurse was standing about three feet behind me when I turned to her and said in a loud but controlled voice: “Call a code!”
    Within the next two minutes, a dozen people would rush into the room, none of them having a precise idea of what was happening inside Mrs. G’s head, why her brain structures were shutting down one by one. While the code team focused on other things, like keeping her heart and lungs going, my job was to get to the root of the problem, and fix it. As for the Red Sox, they would have to start the game without me.
    In the clarity of hindsight, Mrs. G’s event was entirely predictable: not so much the when as the why , and the how . The stage had been set earlier in the day at morning report, when Hannah informed me that there were thirteen admissions to the neurology ward during the night and only three discharges. Two of our patients were sent to the ICU; one had coded three times overnight, and the patient list, usually no more than a page and a half, had lengthened to three full pages. Flavio, a second-year resident and a key member of the team, was stuck