Tom looked down at Knox, who was gaping like a landed fish on the floor. To his surprise, he felt no urge whatever to save the man. Not even in Korea had he felt this emotion, or lack of it. Indeed, in Korea he had helped to save wounded North Korean and Chinese soldiers, despite seeing horrors they had inflicted upon American prisoners. But if what Viola said was true—and Tom had never been more certain of anything—then he wanted Frank Knox to die where he lay.

The sound of a distant siren pulled Tom out of his trance. He took hold of Viola’s wrist and held up the oversized syringe. “What’s this for?”

“Air,” she said. “Like those dogs you told me about, in medical school.”

Tom went dizzy for a moment. One of his worst memories from medical school was having to euthanize dogs with air injections after medical experiments. About a month ago, he had told Viola about that experience, and she had just used the information to murder Frank Knox. Tom wondered how much air it had taken to cause a vapor lock in the Klansman’s heart. At least 200 ccs, and probably more.

“We’ve got to get him up on the table,” he said in a detached voice.

“I’m not touching him.”

“We’re going to the gas chamber if you don’t help me get him up.”

“I don’t care.”

“Your brother will. Help me!” Tom was trying to communicate the idea that he was no longer working to save Knox, but Viola. “It has to look right when the ambulance men get here.”

At last Viola seemed to grasp the import of his words. Together, they wrestled Knox’s limp body onto the examining table. Tom put the stethoscope to his heart again. There was no heartbeat, not even a whisper of a pulse.

“He’s gone,” Tom said, grabbing the syringe from Viola’s hand and removing the needle. “Where did you inject him?”

“Twice internally. Once in the antecubital vein.”

“Christ.” Tom stuffed the syringe into the bottom corner of a cabinet. “Which arm?”

Viola pointed to the crook of Knox’s right elbow.

Tom opened a fresh syringe, drew two milligrams of adrenaline from a vial, then carefully injected it into the hole where Viola had injected the air.

The drug had no discernible effect on the prostrate man.

The siren was screaming now, just outside the clinic. Then the crew cut it and the wail began to drop in pitch, like a child’s top spinning down to stillness.

“When they come in,” Tom said, “we’re going to be working our asses off. Get a blood pressure cuff on him, and I’ll be treating him for a tension pneumothorax. Do you hear me?”

Viola made no sound, but she did turn and get the sphygmomanometer.