Jack immediately noticed the man’s nervous tics, which involved slight twists and nods of his head. Dr. Levitz gave no indication he was aware of these movements. He shook hands stiffly with Jack and then retreated behind the vast expanse of his desk.

“I’m very busy,” Dr. Levitz said. “But, of course, I always have time for the police.”

“I’m not the police,” Jack said. “I’m Dr. Jack Stapleton from the Office of the Chief Medical Examiner of New York.”

Dr. Levitz’s head twitched as did his sparse mustache. He appeared to swallow. “Oh,” he commented.

“I wanted to talk to you briefly about one of your patients,” Jack said.

“My patients’ conditions are confidential,” Dr. Levitz said, as if by rote.

“Of course,” Jack said. He smiled. “That is, of course, until they have died and become a medical examiner’s case. You see, I want to ask you about Mr. Carlo Franconi.”

Jack watched as Dr. Levitz went through a number of bizarre motions, making Jack glad the man had not gone into brain surgery.

“I still respect my patients’ confidentiality,” he said.

“I can understand your position from an ethical point of view,” Jack said. “But I should remind you that we medical examiners in the State of New York have subpoena power in such a circumstance. So, why don’t we just have a conversation? Who knows, we might be able to clear things up.”

“What do you want to know?” Dr. Levitz asked.

“I learned from reading Mr. Franconi’s extensive hospital history that he’d had a long bout with liver problems leading to liver failure,” Jack said.

Dr. Levitz nodded, which caused his right shoulder to jerk several times. Jack waited until these involuntary movements subsided.

“To come right to the point,” Jack said, “the big question is whether or not Mr. Franconi had a liver transplant.”

At first Levitz did not speak. He merely twitched. Jack was determined to wait the man out.

“I don’t know anything about a liver transplant,” Dr. Levitz said finally.

“When did you see him last?” Jack asked.

Dr. Levitz picked up his phone and asked one of his assistants to bring in Mr. Carlo Franconi’s record.

“It will just be a moment,” Dr. Levitz said.

“In one of Mr. Franconi’s hospital admissions about three years ago, you specifically wrote that it was your opinion that a transplant would be necessary. Do you remember writing that?”

“Not specifically,” Dr. Levitz said. “But I was aware of a deteriorating condition, as well as Mr. Franconi’s failure to stop drinking.”

“But you never mentioned it again,” Jack said. “I found that surprising when it was easy to see a gradual but relentless deterioration in his liver function tests over the next couple of years.”

“A doctor can only do so much to influence his patient’s behavior,” Dr. Levitz said.

The door opened and the deferential receptionist brought in a fat folder. Wordlessly she placed it on Dr. Levitz’s desk and withdrew.

Dr. Levitz picked it up and, after a quick glance, said that he’d seen Carlo Franconi a month previously.