Her surprise was genuine, and it struck him again how intelligent people could be robbed of all ability to think rationally when it came to matters of the heart.

“I can try,” she said. She sat up. “Maybe today when I’m done reading the reports. You need to sleep now.”

She tried to roll out of bed, but he stopped her.

“Stay with me ten minutes,” he said.

With the light breeze from the window shifting over their damp skin, every nerve in his body still vibrating, he put his face to her scalp to draw in her scent, and fell asleep.

•   •   •

ANNA BEGAN TO drift off too, but five minutes later she sat straight up in bed with her hands pressed to her mouth.

“What?” Jack sat up too. “What?”

Her eyes were very round.

“Anna,” he said firmly. “What is it? A nightmare?”

“My cervical cap,” she said. “I completely forgot my cervical cap.”

Her eyes raced back and forth as if she were searching for something. Then she drew a deep breath and held it for three heartbeats.

“I think it will be all right. The timing is good.”

“Good? For what?”

“Ovulation. Or rather, the lack of it. I’m at the end of my cycle, not in the middle. Promise me we won’t lose our heads like that again.”

“Anna,” he said, brushing a curl off her damp cheek. “We’ll get carried away plenty, but I promise I’ll ask about the cervical cap first.”

She nodded, yawning. “Good,” she said. “I should get up now or you really will catch my cold.”

That made him laugh. He was still laughing when she slipped away, and left him to his dreams.

•   •   •

WHILE JACK SLEPT Anna read the postmortem reports, making notes and charts until she could no longer deny that there was a pattern. She had been so sure that Janine Campbell had tried to operate on herself, because she couldn’t imagine anyone, man or woman, purposefully injuring another human being in such a blatantly cruel way. She was no stranger to violence, to gunshots and stabbings, beatings and burns. Men were endlessly inventive when it came to hurting women, she understood this; and still here was the evidence that she was neither as worldly or cynical as she had believed herself to be.

It all made her miss Sophie more acutely. There was so much to miss about her cousin: the sound of her voice, the way she hummed when she went about some household chore, her dry sense of humor. Anna missed all those things, but just now, sitting with the autopsy reports spread out in front of her, she missed Sophie’s medical mind most. As diagnosticians they complemented each other, and Sophie would have had useful observations that Anna missed entirely.

•   •   •

IN THE AFTERNOON Jack got up to start his day, and Anna said as much to him. “As I have to do without Sophie, can I ask my cousin Amelie her opinion about the autopsies? She has more experience than Nicholas Lambert and I do, even put together. Something here might trigger a useful association.”

Jack liked the idea, so she wrote out a case-by-case summary along with her own observations, and put it all in an envelope that she addressed to her cousin.

“Ask Ned to mail it for you,” Jack had suggested.

Anna made a sound into her teacup that she hoped he would take for agreement. The truth was, she had a small plan. An innocent plan, really. One that was unlikely to turn up any new information and thus, she told herself, best kept to herself for the time being.

Except Elise came to call in the early evening, and Anna remembered there was another mind available to her. She lacked experience, but that might even work to their favor; clear-sighted and without prior assumptions, Elise might see something.

She debated with herself while Elise talked about what was going on at Roses: Mrs. Lee had declared the little girls to be healthy again, freeing them to bounce around the house and garden like frogs on a griddle for the entire afternoon. Margaret had predicted tears before bedtime and Aunt Quinlan had made a rude sound to that idea and called the girls to her.

“They wanted to come see you, but your aunt said they had to give you another day.”

Anna wanted to hear the stories Elise had to tell, but her mind kept turning back to the reports.

Elise was saying, “. . . reading a story by Mark Twain that had everybody laughing.” And then: “Are you tired, shall I go?”

“Not in the least. Really. How are things at the hospital?”

It was like offering water to a man in the desert. Elise told her about the surgeries she had observed in the last week, stopping to ask Anna questions and to consider the answers.

“Do you think you might want to take up surgery?”

Elise didn’t have to think about her answer. “I’m more comfortable on the other end of things, working with the patients directly. I like the challenge of . . . figuring out what’s really wrong. Diagnosis.”

Anna said, “That was the impression I had, so I’m wondering if you might find it interesting to read these postmortem reports I’ve been looking at.” She put her hand on the folder.

Elise’s whole posture changed. “I’ve never seen a postmortem.”

“That’s why I thought you might be interested.” She gestured to a chair. “Sit down, let me explain.”

•   •   •

ELISE TOOK AN hour to read through the reports, and then she sat looking out the window for a good while. The day hadn’t yet begun to wane, though it was already eight. People were drawn outdoors by the light and the fine weather, the silky touch of a warm breeze.

Somewhere in the city was a man who had caused the deaths of at least five women and maybe as many as eight, without anyone taking notice. He went about his business without interference because he showed an unremarkable face to the world. Unless he walked down the street with a bloody knife in his hand, he could go on just as he had started: an apple that looked solid until you bit into it to find your mouth full of worms.

She turned to look across the room. Anna was sitting in the corner of a sofa, her cheek against her hand while she read. She sensed Elise looking at her, and met her eye.

“Thoughts?”

“A few observations, but I doubt they’re significant.”

“Go on. Don’t leave anything out.”

This felt like a recitation in the lecture hall. Elise organized her thoughts and started.

“This doctor—I think he must be a doctor, given some of these details—started to perform these operations with two goals in mind. He wanted the patient to die in terrible pain, but he wanted the death itself to take place out of his sight.

“With Mrs. Campbell he was too violent, and with Mrs. Liljeström he was so fast that he damaged an artery and she hemorrhaged immediately and bled to death. So neither case satisfied him. But in the third, fourth, and fifth cases he had settled on a procedure that gave him the result he wanted, and then he was exacting. The incisions are all in the fundus between the uterine horns and spaced evenly, like tick marks on a tally sheet: one, two, three. All of them are angled to cut into the intestines to a depth of about two inches. The instrument was not sterilized, and it might even have been purposefully contaminated. That seems likely, given how quickly the infection took hold and spread.”

She looked up from the report in front of her. “Shall I go on? I have just a few more thoughts.”

Anna said, “It’s useful to hear someone else’s interpretation, so please do.”

“I was thinking of how a patient is prepared for surgery of this kind. If these women had marks on their arms and legs that indicated they had been forcibly restrained, would Dr. Lambert have noted that?”

Anna’s brows rose sharply. “Why do you ask?”

“Because if there were no restraints, he must have used anesthesia. The natural impulse would be to twist away from the pain. I’ll tell you what I think probably happened.”

She got up and walked back and forth for a moment to gather her thoughts.

“I think this person must be someone who is very well established. Or at least, has that appearance. He presents himself as a highly educated medical authority, with broad experience. He won’t be very young, and his fees will be exorbitant. Do you happen to know—”

“Yes, the fees were very high, between two hundred and three hundred dollars.”

It took a moment for Elise to make sense of such a large number.

“So these women would expect someone with a professional demeanor,” she went on, more slowly. “Someone severe, and a little frightening, but not unkind. I’m not being clear. Do you know what I mean?”

“The strict but benevolent father,” Anna said.

Elise was feeling a little more comfortable now, and she let the story come out in the way she imagined it.

“The patients will have high expectations. He must have some kind of medical office or clinic, treatment and operating rooms and the right equipment, everything in good working order and well maintained. A pleasant waiting room, and there must be an assistant or nurse, certainly. Someone to help the patients undress and dress again, and someone—maybe the same person?—to administer anesthesia.