Set in a quiet side street in the heart of Moscow’s Meshchansky District, the Bekhterev Private Clinic occupied a five-story glass-and-concrete office building. Its namesake, Vladimir Bekhterev, born in 1857, was known chiefly as one of Russia’s most famous neurologists, a rival of Ivan Pavlov, and also for his probable murder on the orders of Josef Stalin. Asked to examine the dictator in 1927, Bekhterev had privately warned colleagues that Stalin was a paranoiac. He died suddenly and mysteriously the following day. After the fall of the Soviet Union, Russia’s new rulers reinstated him in the pantheon of national medical heroes. The Bekhterev Clinic had been sponsored by profit-seeking investors as part of that rehabilitation process. And now its cadre of highly trained doctors and neurosurgeons provided discreet and expensive medical services to Russia’s government and business elites.

One of those specialists, Dr. Viktor Obolensky, had his office on the clinic’s fourth floor. Delicate watercolors on its dark-paneled walls, the doctor’s elegant oak desk, comfortable leather chairs, and richly colored Oriental rugs created an aura of luxury that was a far cry from the dingy, run-down atmosphere of state-run medical offices and hospitals. His usual patients, men and women of influence and wealth, valued the difference.

Right now, Colonel Alexei Petrov didn’t give a damn about his surroundings. His whole attention was focused on the MRI images Obolensky had just shown to him to explain his diagnosis. Slowly, he looked up from the blue-tinted pictures to focus on the neurologist. “There is no possibility of a mistake?”

Apologetically, Obolensky shrugged his shoulders. He wore an expensive, immaculately tailored Italian suit under his regulation white coat. “I’m afraid not, Mr. Kuznetsov. The indications are unmistakable.”

Petrov took the blow in silence. The name Kuznetsov, the Russian equivalent of Smith, was the pseudonym he used for his visits to the clinic. He was also paying cash for these tests and consultations, since the last thing he wanted was a paper trail his Air Force superiors might be able to follow. Now, more than ever, he was glad that he’d taken precautions. “And the prognosis?” he asked at last, not sure if he really wanted an answer.

“Not good,” the doctor admitted bluntly. “A combination of radiation treatment and chemotherapy might slow the progression. At least to a degree. But the location and size of this malignancy make surgery . . . inadvisable.” The corners of his mouth turned down. “I wish I could give you better news. Unfortunately, this is not a case where there is even the slightest margin of doubt.”

Petrov took a short, sharp breath. “I see.” For a brief moment, darkness seemed to veil his vision. He cleared his throat uncomfortably. “And the likely time frame?” he asked, noticing with a trace of cynicism that he’d chosen a deliberately distanced, almost clinically sterile way to phrase his question. No doubt that was common for people in his position.

Again, Obolensky shrugged. “My best estimate would be anywhere from six months to a year. Perhaps eighteen months at the outside.” He nodded at the sheaf of MRI images still clutched in his patient’s hands. “The precise progression of tumors of this kind varies widely from individual to individual. Regular scans would let us track its growth more closely, of course.”