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"See you soon."

A paying patient? That's always nice. Who doesn't like to operate on one of them? But that was none of Silverstein's business. And besides, in an emergency case I prefer not to know about the patient's payment arrangements. Let me do the case first. If he can pay—what a nice surprise, if not—bad luck. Nothing new. Most of my patients weren't insured or were on Medicaid, which paid peanuts. Paying cases were almost never allowed to reach me; they were filtered and skimmed by our in-house surgical Mafia.

Whatever. An emergency abdominal operation would bring a few thousand bucks, and that was definitely better than the few hundred Medicare would pay. I couldn't complain. I wasn't starving, but who wouldn't want to earn some extra money? It could be compensation for this early wake-up call and another missed breakfast.

I shaved fast, one direction only. I dressed quickly: A pair of khakis, white shirt, blue navy tie with the College of Surgeons' icon. Blazer in same color, cheap--bought at Macy's last year and already frazzling at the sleeves. Heavy black British shoes. A goodbye kiss for Heidi. She opened one sleepy eye. It followed me clumsily as I moved about the darkened room.

"An emergency operation for one of your poor patients?"

I grunted at first and then mumbled to myself. This was not a patient of mine. This was a new case, which was a relief. If I had to go back and perform an emergency operation on someone I'd already operated on, that could be devastating for both them and me! It could have meant I'd made a mistake during a previous surgery. It wasn't the case this time, and for that reason Heidi's black humor succeeded in lightening my mood.

I headed downstairs, gulped a glass of orange juice and stepped into the garage. I looked at my watch—fifteen minutes from bed to car. Not bad. I took a deep breath of the crisp morning air as the automatic garage door swung open.