Swiping my passcard, I let myself in to Cosima's lab, silently cursing the electronic lock's bleeping that seems abnormally loud in the deserted hallway. Catching the heavy door so that it whispers shut behind me, I pause for a moment to let my eyes adjust to the dimness. I can hear her breathing, the stertor and stridor making me wince; however distressing the sound, at least it is deep and even, telling me that she is asleep. The other sounds in the lab, the ever-present tireless rumination of its machinery — the hum of the sequencers, the subtle buzzing drone of the thermal cyclers, the whirring fans and occasional chirping of the mainframes — are constant enough to fade into the background, the high tech version of white noise.

I set my briefcase on her desk and slip out of my shoes and blazer. Clambering cautiously onto the narrow hospital bed to spoon her from behind, I wrap my arm around her too-slender waist, taking care not to disturb the pulse oximeter probe attached to her fingertip, the nasal cannula leashing her to the wall outlet and humidifier via the heated tubing of her high-flow oxygen circuit, and the PICC line dripping TPN into the basilic vein of her right arm. At least the Holter monitor is gone now, so I don't have to worry any more that I might accidentally pull off an electrode. Softly I press my lips to the side of her neck. Still deeply asleep, she makes a small murmuring sound. My heart turns over as her body instinctively conforms to mine.

Reaching for her paper chart, which contains the personal details and other identifying information that cannot be documented in her digital record, I skim the afternoon and evening nurses' notes. Marked hematuria, frequent hemoptysis, SpO2 at 92% and ABGs showing mild hypercapnia without oxygen supplementation. Her latest labs red-flag a worsening in her GFR and renal and hepatic function. A brief note from Nealon states that, based on this morning's survey films, he suspects that Cosima has new mets to her chest, though at least her aspiration pneumonitis appears to be responding well to antibiotics. Nothing out of the ordinary, beyond the observation that she had been given an injection of 68Ga-DOTATATE for her next PET/CT scan, which is scheduled for tomorrow afternoon.

I frown slightly and reach into my pocket for my phone, making sure to mute it before sending my text: Why the change in tracer?

Nealon responds within seconds in typically terse fashion: Less artifact from TPN

With a cold trickle down my spine, I realize that he is right. Not only would gallium-68 improve spatial resolution and sensitivity in lesion detection in her lungs compared with FDG, it would also be unaffected by the slight elevation in her blood glucose caused by the supplemental nutrients she has been getting every night in the week since her seizure.

No sense in berating myself for the oversight. I can dwell on it, which would be a pointless occupation, or I can accept that of late, I have found it more and more practical and necessary to rely on Nealon's experience and judgment. The recent increase in my workload and responsibilities had been yet another factor prompting me to reluctantly concede that I am out of my depth when it comes to clinical management of her case. To his credit, he has limited his involvement to keeping track of her progress, rarely offering unsolicited advice or stepping in without consulting me except under extraordinary circumstances.

Cosima is not even supposed to be aware of his existence, much less that I have consulted with him about her. I am still uncertain of his actual status in Dyad's convoluted hierarchy but despite the rumors of his rather Mengele-like reputation, I cannot dispute that he gets results. I had overstepped my bounds in telling her about his management of Jennifer Fitzsimmons' case, but thus far there have been no repercussions — or perhaps Dyad and Topside have simply decided to turn a blind eye to this relatively minor breach of protocol.

Both the director of nursing and the charge nurse had come by to see her this morning. According to the logs they had stayed for nearly half an hour but noted in the record only that After extensive discussion, patient was again adamant in refusing both a PEG tube and a port. I have to smile even as I despair at the thought of the mule-like obstinacy that must have provoked such carefully worded language. On the one hand, I understand why she is being so intransigent: consenting to a feeding tube and a longterm portacath means accepting the fact that she is an invalid, or rapidly becoming one, with all the ramifications that implies. On the other hand, I devoutly wish that I could knock some sense into her thick skull and hospitalize her for intensive supportive care. Cosima is frighteningly thin; even with the TPN on board in addition to whatever she manages to eat, she keeps losing weight at an alarming rate.

It is that same stubbornness that makes her refuse to be admitted to the hospital wing; hence the improvised setup in her lab. I have expressly forbidden her being disturbed while she sleeps — my clinical experience in a formal setting may be limited, but I have never seen the point of waking a patient to take vitals when what she needs most is to rest — and at least the lab is comfortingly familiar, almost her second home. But even with the call button affixed to the frame of her bed within easy reach and around-the-clock monitoring of her bio-metrics as well as of the lab cameras, the location is far from ideal if an emergent situation develops.

To that end, I have had the full trauma team on each shift run drills over and over again until they can all respond to a code in less than a minute and a half, which is at least marginally acceptable.

There were complaints in the beginning, I know, but Rachel had evidently made it clear to all Dyad's hospital staff that I had her tacit permission to carry on as I see fit where Cosima is concerned, quickly suppressing the grumbling and obviating the need to make threats. I am well aware of the newly guarded looks that dart my way, the hushed conversations that stutter to a halt when I pass through the hallways, the frankly sullen glares when I implement some new policy. I simply don't have the time or energy to care.

The frail form in my embrace stirs. She inhales sharply, the muscles of her abdomen, ribs and back reflexively contracting and winding up the tension in her body to culminate in an all-too-familiar series of rattling coughs. Gently I coupage her, then reach for a nearby emesis basin so she can spit out a large glob of blood-tinged mucus and rinse her mouth with dilute salt water. "Never let it be said," she says raspily, stroking her fingers over my arm wrapped around her, "that I don't know how to show a girl a good time."

Kissing her below her ear, I smile against her skin, breathing in her scent, which is only faintly sour. I make a mental note that I will need to find some way to wash her hair soon; perhaps the hospital hairdresser can lend us his portable sink. "Tell me who is slandering you in this way and I will avenge your name."

"My hero." Cosima chuckles, a coarse wet sound that turns into another productive cough; the humidified oxygen/air mix is definitely improving her mucociliary clearance. "You would look good with a sword, like Uma Thurman in 'Kill Bill.'"

"Too messy and gory. Can't I just shoot them in the kneecaps? That would be just as effective, and I could use the target practice."

"There's no honor in knee-capping someone, Uma. Besides, that's a dirty tactic, like something a terrorist or a mafioso would use, not my gorgeous French knight in shining armor." Turning cautiously and moving aside tubing and the mass of her dreads so that she can face me, she gives me a little crooked happy smile. "Hello, you."

"Hello, yourself." Cupping the curve of her cheek, I lean in to kiss her, avoiding the prongs of her cannula. Carefully I shift us around on the narrow bed so that she is draped over me in a more comfortable position. Holding her snugly with her head burrowing into my neck, I press my lips to her forehead, nuzzling at the tiny fine curling tendrils at her hairline.

"You're pushing yourself too much," she murmurs into my shoulder. "Go home, get some rest."

Fighting the tightening in my chest and gut, I hug her to me as closely as I dare. "I will. I just had to see you first. And make sure you're not giving the staff too hard a time. Besides, you know I don't sleep well unless you're trying to warm your ice-cold feet between my legs." Though tonight the temperature in the lab is turned up so high that for once her feet are actually warm; it's hot enough in here that I am beginning to sweat.

"That's me, professional grade A blue-ribbon-prize-winning pain in the ass." I can feel her smile as she nibbles at the base of my throat, making me sigh. "Hey, you didn't forget to feed Hubert, did you? Little dude's probably wondering why I haven't been bringing him dinner."

I slide my hand beneath her sweater and knit shirt and scritch the very tips of my nails in slow circles over the warm satin of her back, careful to barely skim the far too prominent knurls and ridges of her spinous processes and ribs. "I almost did," I confess. "But I actually stopped by a pet supply store the other evening. You should have seen the look on the cashier's face when I said I wanted to buy one mealworm."

She laugh-snorts against my neck. "That'll hold him for at least a week. You keep that up, he's going to be the world's fattest spider by the time I get back home."

If you get back home, supplies the voice in the back of my mind before I can firmly quash it. "Would it be okay if I found him a new place to live? The Christmas tree is so dry now that it rains needles all over the floor even when I just walk by it; I'm going to have to take it down soon. It does smell nice, though."

"Yeah, that's cool. Thank you for indulging me about letting me keep it up. When I was a kid my parents always insisted on getting rid of our tree on New Years' Day, so ever since I've been living on my own I've always hung onto mine until they're like total fire hazards." Deftly she slips four fingers of one hand between the buttons of my blouse, stroking my belly lightly; my abdominal muscles twitch in response to her touch. "Where are you going to move him? It's too cold to put him outside. Anyway, he's a domesticated house spider now, used to getting his meals catered in. He's probably too lazy and too soft to survive in the wild any more."

"I was thinking of bringing him to Marcus. He likes spiders and seemed very keen when I mentioned Hubert to him."

"Dr. Marcus Nilssen, you mean," she corrects; we cling to one another, giggling like guilty schoolchildren. Tipping up her head, she kisses me softly. "That's fine. You've got enough on your plate without having to worry about orphaned and soon to be homeless spiders." Drawing little designs over my skin with her fingertips, she gives me a rueful smile. "You'd better get going, Dr. Cormier. Not gonna do anyone any good if you wear yourself out. Besides," she says, kissing me again, "wearing you out is my job."

I smile against her lips, hoping she cannot see the tears that are threatening to spill over in my eyes. "Yes, it is. And the sooner you get better, the sooner you can resume doing your job." Moving gingerly, I slide out from beneath her, settling her on her side and arranging the various wires and tubes so they are not in her way. Bending to kiss her again, I caress the incredibly silky skin at her temple. "Do you need me to bring you anything from home?"

The corner of her mouth curls slightly. She turns her head to place a kiss on my palm. "Got everything I need right here, babe."

My suddenly thickened throat makes it difficult to swallow. "Sleep well, chérie. I'll see you in the morning."

"I'll be sure to tell my butler to show you into the front parlor right away," she mumbles, already half asleep.

I manage to keep my face stone-calm as I walk through the corridors, barely acknowledging the few people I pass, and all during the ride in the company car back to my flat. Only after I have mechanically put away my things and undressed for bed do I let myself fall apart, sobbing and wailing as I clutch futilely at her pillow.