“A panic attack?” Alice stared at her twin, unable to absorb the words. “That can’t be right. Nick’s so easygoing.”

“I know! It makes no sense. But they’ve ruled out a chest infection, an MI, pericarditis, a dissecting aneurysm, cholelithiasis—”

“You know I don’t understand any of that doctor talk.”

“Sorry.”

The blue water of the lake glowed a silvery pink in the dawn light and the twins watched the view from a bench in the Pelican House back yard. Libby had texted Alice earlier asking if they could talk—just the two of them—before she went home to the girls. The request had surprised Alice given Jess was sleeping at Libby’s house and Libby usually debriefed with her best friend, but she hadn’t second guessed it. Instead, she’d embraced a rare twin moment and met Libby at the gate with coffee and blankets. Even in the half-light, Alice could make out shadows under her twin’s eyes that couldn’t be confused with smudged mascara. Libby wore exhaustion like an ill-fitting coat.

“They’ve ruled out all the big things and it doesn’t leave much else as the cause. They told me they still had some tests to run this morning, but I read the referral to the psychiatric intern.”

“Just fell in front of your eyes, did it?” Alice couldn’t believe Libby had read it—her twin was a stickler for confidentiality.

Libby grimaced. “Fine. I used my admitting rights to access Nick’s history, but I’m desperate. I can’t imagine what’s upsetting him so much that it’s making him sick. Or why he hasn’t told me. We tell each other everything!” She suddenly gripped Alice’s arm so tightly, Alice flinched. “Is anything going on at Pirellis’? Have you noticed anything strange at the office?”

“No. I mean, he was a bit grumpy the other week when J—” She tripped over her tongue, remembering her promise to Nick and quickly recovered. “When Jannick was late with his visa paperwork.”

Libby make a dismissive sound as if the information was irrelevant. “Some of my patients are complaining that tourist numbers were down this summer. Do you think it could be the business?”

“The boats were booked solid, Libs. I know. I cleaned all of them. A lot.”

“Then what can it be?” Libby’s hands tore through her hair. “I mean, surely if he had an addiction, I’d know.”

“An addiction? Libs, I really don’t think Nick’s doing drugs.”

“Of course he’s not. I know he’s not. His behavior’s not erratic …” Libby’s frantic gaze sought hers. “When I told Jess he was making himself sick, she asked me if I thought he might have a gambling problem.”