“She deserves a reprimand,” Meomartino said. “That old man has had it. With surgery we could only ease the pain of his last days. Because some bitch was too lazy to read the orders, he got two days of torture added to his sentence.”

Miss Fultz nodded in agreement. “When I started out, we wouldn’t have considered her a nurse. She’s a cow.”

“Then why do you defend her?”

“There’s a nursing shortage and we need every cow we can keep. If the reprimand goes through, she’ll quit, and she’ll have another job in half an hour.”

He stared at the paper in his hand.

“There have been evenings when I’ve found myself all alone in that ward,” she said quietly. “So far we’ve been lucky. We haven’t been caught short by an emergency. Don’t spit on our luck. The cow has a pair of hands and a pair of legs. Don’t deny my real nurses the use of those hands and legs.”

He ripped the paper twice across and dropped the scraps in a waste basket.

“Thank you,” Helen Fultz said. “I’ll make certain she reads every chart from now on before she serves the meals.” She smiled at him.

“Helen,” he said, “how would this place function without you?”

“The way it always does,” she said.

“You push yourself much too hard. You haven’t been sixteen years old for a long time.”

“Not very gallant today, are you, Doctor?”

“How old are you? Seriously?”

“What difference can that possibly make?” she said.

She was too close to the retirement age to want to discuss it, he realized. “It’s only that you look tired,” he said gently.

She made a face. “Age has nothing to do with it. I think I may be getting an ulcer.”

He saw her suddenly not as Helen Fultz but as a worn-out old lady who was a patient.

“What makes you think that?”

“I’ve nursed enough ulcers to know the symptoms. I can’t eat foods I used to. And I’m having a little rectal bleeding.”

“Get into the examining room,” he said.

“I will not.”

“Look, if Dr. Longwood had taken routine precautions he’d be a healthy man today. Just because you’re a nurse doesn’t relieve you of responsibility to yourself. The examining room. That’s an order.”

He grinned as he followed her in, aware that she was furious at him.

She was difficult to examine but contained no surprises. She was hypertensive, 190 over 90. “Have you had any chest pains?” he asked, listening to her heart.

“I’ve known about that basilar systolic murmur for nine years,” she said tartly. “As you said, I haven’t been sixteen years old for a long time.”

During the rectal examination, which she endured in mortified silence, he saw that she had hemorrhoids, undoubtedly the cause of the bleeding.