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A woman walked west on Sixty-fifth Street at 11:00 a.m. on a Wednesday morning, and a man, who happened to be going in the same direction, noticed her. He hesitated when he saw her, not to hide in the shadows, not to make sure that he wasn't seen, but to enjoy the lithe body as it walked by. To smile at the shining hair. He was just appreciating her. And the fact that he went in the same direction? Well, everyone on the street has to go either east or west, north or south. It was a meaningless encounter.

It was not the first time my overactive imagine was trying to turn an innocent moment on a lovely spring day into a portent of imminent danger.

"Where are you going? When are you coming back?” I would ask my mother, and she would smile and run her fingers through my hair and promise that she'd be back soon, leaving me, again, to wonder if this time my mother was telling the truth or a lie.

Until she went away for good.

Chapter Four

The officer who was supposed to meet me at the morgue wasn't there yet, so I sat in the anteroom, trying not to smell the antiseptic harbinger of death and mystery that hung in the air.

Before that spring, my patients didn't die.

While I deal with the heart, the head and the sex organs, I don't wield a scalpel or saw. I have never sliced through the top layer of skin, through fat and muscle, to discover the growth that does not belong, find the tear to sew up, or cosmetically alter an appearance. I have never immersed my hands in a human cavity to move aside a pulsing organ or feel the heat of blood spurting out of a wound.

Instead I probe with words for the secrets we learn to keep from others--and even more critical--the secrets we keep from ourselves, buried just as deeply as a bullet lodged in bone.

I have never signed a death certificate or had to walk out into a waiting room to find the expectant, anxious faces of a family member clinging past logic to the hope that I could save their ailing loved one.

My office is not in a cubicle in a hospital and does not smell of disinfectants. Rather I work in a turn-of-the-century building on the Upper East Side in New York City. Nothing about the building's elegant facade or classic lines suggests that past the Ionic columns and through the wrought-iron door is the most progressive sex clinic in the country.

There is a small brass plaque on the outside of the building, identifying it but giving little else away: "The Butterfield Institute."

The black cursive letters are etched deeply into the metal plate. Run your fingers over them and you feel the edges pushing into your flesh. Could you cut your skin on those edges and draw blood? Probably not, but even if you did, none of us inside could offer more than a Band-Aid.

There are only those three words on the bronze rectangle. We do not advertise. Not because we are ashamed of what we do--each of us could work twice as many hours and still not see all the patients who are waiting for an appointment--but because we respect our patients' privacy: their secrets are ours.

Inside the marble-floored foyer a glittering chandelier casts a sparkling light on the reception area. A young woman sits behind the ornate desk, complete with gilded lion's-claw feet. Behind her you can glimpse the marble fireplace, thick molding around the perimeter of the ceiling and another chandelier. One flight up the stairs are our offices.

That spring there were trees in bloom on the street outside my window, and I had seen them go from tight-pinked buds to lush, provocative blossoms to brown-edged and withering petals. It had been a glorious, slow seduction, but the trees had come into leaf and the show was over. And I was waiting at the morgue.

"What about Sheba Larcher's parole officer?" I asked Officer Dignazio as he escorted me into the cold tiled room. "Why didn't you call her?"

"Her parole officer is out of town. We wouldn't have asked you if we had any other choice, Dr. Snow."

A lab assistant in green scrubs pulled the metal drawer out. The mound under the pale blue sheet looked so small, more child-size than adult.

And then the M.E. lifted a corner and pulled it down.

I didn't look. Not at first. I had to force my head to turn, propel my feet forward, look down.

Sheba was only twenty. Only eight years older than my own daughter, but aged in ways I prayed my daughter would never be. This girl had still been beautiful, despite the hard edge. Hope could still leap into her eyes when we'd talked about how she was going to leave New York and find another way to make money.

I turned away. Not able to look at her anymore.

"Yes, that's her," I said to the M.E.

And then for just a second, under the antiseptic scent, I smelled something else. Not flowery like a woman's perfume, but heavy and almost a little sweet. And then the sharper astringent odor took over again.

I had seen her last in February. In prison. Four days before she was to be released. She had told me her mother had wired her the money to come home to a small town in West Virginia. That she was all right with giving up the dreams that had brought her to NewYork. But just in case, I gave her both my phone number and my address. An invitation to use either if she felt the need.

But she hadn't made contact. And obviously she had not made it home. The next contact I had had with her came from a police officer who called, asking me to come down and identify her body.

(This excerpt ended on page 35 of the paperback edition.)