The hotel in Brookline served the kind of breakfast that could be eaten at a desk while making a phone call. I made the call at seven-fifteen, with coffee in a paper cup at my left hand and a notepad I had not opened to my right.
"Records desk."
"Vasquez, Bureau of Medical Conduct. ID seven-three-two-eight. I need a hospitalization history for an inspector vetting file."
"Subject's name?"
"Vasquez."
A small pause, the kind a clerk takes to decide whether to ask. "Same Vasquez?"
"Yes."
I had run a check on myself once, in my first year. New auditors did. The result had been one record, eight years old, a city hospital trauma admission with the circumstances coded as assault. I had not run it since.
The keys at her end made the soft sound of a person who had stopped listening to what her own hands did.
"I have one record," she said. "Boston General, eight years ago this November. Twenty-three days. Coded blunt and sharp force trauma, unconscious on arrival, surgical intervention, postoperative coma. That's your full record."
"Any transfers in or out?"
"None."
"Anything from a private facility?"
"No private admissions. No referrals. ER intake paperwork right here. Boston General the whole way."
"Thank you."
I held the phone to my ear two seconds longer while she waited politely on the line. A four-centimeter crescent on the left clavicle did not appear on Boston General's record. Boston General had stitched me. The Bureau's record said so. The photograph in the desk drawer at Meridian said something else.
"Anything else, Inspector?"
"No. Thank you."
I set the phone down. The coffee was already cold.
I had not slept well, and I had slept anyway — there was nothing to be done before morning. My supervisor remained uncalled. The folder remained unopened. The Monday inspection log entry was a blank document, because the entry would have to include a sentence I was not yet willing to put on the Bureau's network.
The phone rang.
"Hollander."
"Garrett."
"How was the first day."
He used the verb in the past without a question mark, which was his way of asking. Garrett Hollander was sixty-two, kept three pens in his shirt pocket like a man who had been told to retire and had refused, and asked questions that did not require punctuation.
"By the schedule," I said.
The two words came out of my mouth in the pitch and rhythm in which I had spoken them every Tuesday morning of seven years. Beneath them sat the sentence I had not said, the one with the photograph in it, and the silence between the two was not visible from his end.
"Anything I should know."
"Halsey met me at the door himself. Whitlock is the compliance officer, capable. Three department heads — Ríos, Voss, Adler."
"Ríos."
"Cardiothoracic chief."
"Tall man."
"Yes."
"All right." Pen on paper at his end. "Send me the prelim by Friday. Don't let them feed you in the cafeteria."
"Garrett."
"Yes."
A two-count, while my mouth held the photograph and my voice did not.
"Nothing. Friday."
"Friday."
He hung up. The coffee cup made a wet ring on the laminate, and the wet ring on the laminate was the only honest thing about the conversation I had just had.
The drive to Meridian took fourteen minutes through the kind of sleet that made the dashboard heater the morning's first companion. I parked underground, walked up to the ground floor, unlocked my office, and did the one thing I had told myself in the elevator I did not need to do, which was open the top drawer of the desk.
The folder was where I had left it. The photograph was inside it. I closed the drawer and turned the key.
That was the audit before the audit.
Sebastián Ríos's office was on the second floor at the south end of the building, and the south end of the building had sun. By the time I knocked at nine, the radiator had been running long enough to make the room warmer than the corridor, and the corridor had been warmer than the lobby, and I was a degree closer to the temperature of a person rather than a coat by the time he said come in.
He was at the desk.
He stood — that part was the same as yesterday. The stand was less interrupted than yesterday. A night had assembled him.
"Inspector. Please." He gestured at the chair facing the desk, and then at the second chair, the one by the window. "Whichever's better for you."
"The desk is fine."
"Coffee. Tea. Water."
"Water."
He poured from a glass jug already on the desk, and his hand was steady, and the glass he handed across was cold enough to have come from the small fridge under his side table within the last fifteen seconds. He had timed it.
"I have eighty minutes," he said. "I cleared the morning."
"Forty should be enough."
"Take eighty."
His reading glasses lay on the desk where they had lain yesterday, lenses turned up. The detail did not need to be in the Bureau's notes, and it went into the Bureau's notes anyway. A man's glasses were a man's hand on his profession, and I wanted that on record before the conversation began.
I asked him the questions an auditor asks a department chief.
He answered them in order.
He answered like a man describing a country he loved without making you ask for the next sentence — the procedures of his unit, the number of theaters, how scheduling was negotiated with anesthesia, the points at which he had had to argue for resources and the points at which he had not. His voice stayed at the lower register I had heard yesterday. He named his residents one at a time, each name precise, as if he could pull that resident out of a crowded room from across the room. For forty-five minutes he spoke without making me ask the same question twice.
There was no policy he had ever broken.
He had lost no patient outside the parameters that medicine accepts as the parameters of losing patients. He had documented no colleague in a way that compromised them. In eight years of his chiefship, every surgical event in his department had been resolved through standard internal channels. He told me this without telling me, the way a man with nothing to declare goes through customs. The ease was the answer.
I waited for the answer's edge.
When he reached the end of the question I had asked about cross-departmental cases (the cases where his unit shared a table with another service), he stopped, and the stopping was specific. He had not run out of material. He had reached the place where the material had to be chosen.
"Inspector."
"Yes."
"Have you been here before."
The pen continued for a half-word and stopped.
"Before."
He said the word again as though the first one had not landed where he intended. There was a pause the length of a breath he did not take.
"Specifically."
I set the pen down at the angle at which I always set pens down when my hands needed to be free of a small task.
"This is the first scheduled audit of Meridian on my end," I said. "It's in the materials."
He nodded.
He nodded the way someone nods when he has not received the answer to the question he asked and has accepted that he is not going to. The nod was not disappointed. It was the small inclination of a person who had been told something he already knew, told in a form that confirmed the limit of what the conversation was going to be today.
"Of course," he said.
He put his hand on the reading glasses on the desk and did not pick them up.
"Your next question, Inspector."
I asked the next question, and he answered it, and we finished at fifty-two minutes, twelve under what he had cleared. When I stood, he stood. He did not extend his hand. He had not extended it yesterday either. Twice was a decision.
"Thank you for your time, Dr. Ríos."
"Inspector."
I was at the door when he spoke again.
"It's a good audit when a department chief can answer the questions you brought him. It's a better one when he can answer the ones you did not."
The doorframe took my weight a second longer than the polite second.
"I'll let you know if I have any."
"Please do."
I worked the rest of the day in the office without a window. The shape of work was the shape it always was. I read documents and made notes on the documents and made notes on the notes. The folder in the drawer stayed in the drawer. The not-opening was a discipline, like the small disciplines of my morning.
At seven I drove back to Brookline. The hotel was the kind a Bureau per diem paid for: clean, beige, without a smell. The room had two queen beds and one I used. The bathroom door was the kind that stuck on the carpet; it always took two pulls to close.
I closed it.
I undressed efficiently — blouse on the hanger, pants folded across the chair, slip and bra and the small adjustments of a woman who had been wearing a costume all day. The mirror over the sink reached to my hips. The light over the mirror was clinical — hotel-clinical, designed for shaving and for makeup and not made to forgive either.
I looked at the scar.
I had looked at it in mirrors for eight years. The looking had been the looking of a person passing a piece of furniture that had been in the room since she had moved in. The looking had never been the audit. Tonight was the audit.
The scar was a crescent. Approximately four centimeters along its long axis. The convex side was inferior; the concave side rose toward the suprasternal notch. Slightly displaced left of midline. The line was clean. It was not the line of an injury. It was the line of a closure.
The pads of two fingers found the place they had been finding for eight years without either of us — fingers, hand, woman — admitting that finding was what they had been doing.
A scar of this shape, on this part of the clavicle, was the closure left by a particular kind of incision. The incision was the one a surgeon made when the structures underneath needed to be reached without losing the cosmetic line. The structures underneath were the great vessels, the apex of the lung, the upper mediastinum.
The thought arrived at the bathroom mirror in the language of the Bureau's training manuals because the language of the Bureau's training manuals was the only language I had for the thought.
I had no language for the next sentence. The next sentence was a question, and the question was not what.
The question was where.