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COLUMBIA UNIVERSITY MEDICAL CENTER NEW YORK CITY FEBRUARY 28, 2011, 7:23 A.M.

The girl, twelve, awakens with a start. She’s lying on a thin mattress on a low, narrow bed and circling around her is a pack of girls. They’re older-sixteen, seventeen-and as they shuffle along, they’re staring down at her with obviously sinister intentions. Some are suppressing giggles, others are smiling, but these smiles aren’t signs of happiness, they’re smiles of anticipation. It’s still nighttime. There are other cots in the long room and the girl knows the other occupants are awake but they won’t move to help her because they know what’s about to happen.

Transfixed with terror, the girl is unable to react as the mob falls upon her. As she’s being dragged off the bed she sees her chief tormentor, the ringleader’s face twisted in a manic grimace. Still, she knows better than to scream for help. Somewhere in the dormitory, there’s suddenly a loud banging sound. And again.

Pia Grazdani, twenty-six, woke up in a panic and a cold sweat, unsure for a second of where she was. She breathed out with relief when she realized she was safe and in her dorm room at Columbia University Medical Center. Someone was banging on the door.

Taking another deep breath, Pia leaped out of bed in her flannel pajamas, took three quick strides to the door, flipped the dead bolt, and pulled it open. As she expected, it was George, her fellow fourth-year medical student.

“Pia, do you know what time it is? This isn’t a day you want to be late.” His tone was not as strident as the syntax suggested. At six-one, George Wilson had seven inches on Pia, but somehow he always felt smaller when he was in her presence. As he explained it to himself, she had what he called a tough, plucky personality and could at times be rather volatile.

Pia held the door open and George took a couple of steps into the small dorm room. Pia let the door close and turned and hurried past George, pulling her pajama top over her head as she did so. George looked at Pia’s bare back, at the cut of her shoulder blades framing her flawless olive-brown skin. She stood in front of her low dresser and pulled out some clothes for the day. As she did so she caught George’s stare in the mirror.

“Sorry, George, I couldn’t sleep and then when I could sleep I was dreaming. You go ahead, I’ll catch up with you later today.”

With that said, Afrodita Pia Grazdani turned her full attention to getting ready. When she pulled down her pajama pants, George turned his head and looked out the window. He would have preferred to watch her but was afraid to do so. Instead he concentrated on the dramatic view that he and the other medical students had learned to take for granted. He could see the giant George Washington Bridge connecting Manhattan with New Jersey. Its usual morning rush-hour traffic was at a standstill in both directions.

“It’s okay, Pia,” said George, “I’ll wait.” Then, searching for something to say, he added, “I guess you still haven’t figured out how to use that alarm clock I bought for you. I can’t get you up every day-you’ve got to do something about being on time. You could always use the alarm on your cell phone if you’d prefer.”

George stopped talking. He’d turned his attention back to the room and was immediately transfixed by the sight of Pia brushing her jet-black hair. He felt an immediate crushing sadness. The few times Pia and George had slept together, four exactly, Pia had asked George to leave before he fell asleep. And each time she’d stood at that same dresser with her back to him brushing her hair, just as she was doing now. Over the course of time George had become painfully aware they hadn’t truly slept together at all those four precious times, they’d just had sex: Wham bam thank you ma’am, in reverse.

George was athletically inclined and good-looking in a preppy, stereotypical fashion with an unruly shock of blond hair and a ready smile. During his Ivy League college days it had drifted back to him that many preppy women found him to be a “hunk.” There had never been a shortage of willing girlfriends. But George had set his sights early in life on becoming a doctor and did not want to become involved. As a consequence, George’s romantic life had been a string of one-night stands and short flings with little emotional commitment. He’d hurt people, he knew, especially now that the tables had been turned and he was the “hurtee” rather than the “hurter.” With Pia it was completely different. She truly didn’t seem to care, and it drove him crazy. Numerous times he had told himself to forget her, that she was damaged goods, but he couldn’t. Instead he’d become obsessed to an extent. George desperately wanted to have a romantic relationship with this woman, but he had no idea what she wanted and why it hadn’t happened. He’d been trying during three and a half years of medical school.

“Come on, what are you waiting for?” Pia barked when she popped out of her tiny bathroom still applying a pale lipstick that was more for lip protection than color. She grabbed her medical student white coat, pulled it on, and draped her medical center ID around her neck. She held open the door behind her as if she were the one waiting.

Emotionally flummoxed, as per usual, George awakened from what could have been considered a petit mal seizure and followed her out through the door. He had to practically run to catch up to her as she hurried down the hall toward the elevators.

Pia continued to walk quickly as they made their way out of the dorm and turned right toward the medical center complex. Columbia University Medical Center lies in Washington Heights on Broadway as it runs north along upper Manhattan’s spine. Even at this time of the morning, the place was busy. The more purposeful people in the varying-length white coats making their way along 168th Street were the doctors, students, and staff of the hospitals and research facilities. The patients and their relatives who were arriving were more hesitant, trying to figure out where they needed to be and clearly apprehensive of why they were there and what the day might bring.

George turned up the collar of his jacket against the sharp wind that came off the Hudson River and was funneled into 168th Street by the curve of Haven Avenue. Tomorrow, it would be March, the month in which any day the temperature might be in the sixties or it could snow. At that moment it wasn’t particularly cold, but the wind was a reminder that winter still had some kick.

George and Pia were heading for different buildings to start their fourth-year month of elective. Fourth year of medical school was a series of monthlong rotations in various specialties, which included an elective period where the individual students could choose something of their particular interest. That month Pia was to do research, as she’d done during her month of elective in her third year. George was to work in radiology, as he too had done the previous year. These choices were particularly apropos since three weeks earlier, George, Pia, and the rest of the class of 2011 had learned the results of the residency matching program. Both Pia and George had been awarded positions there at Columbia University Medical Center, thanks to their superb academic records and strong faculty recommendations: Pia in internal medicine and George in radiology. By special dispensation, Pia would also be starting a concurrent Ph.D. program in molecular genetics, which would allow her to continue her lab work while fulfilling her requirements as a medical resident.

Awaiting Pia that morning at the William Black Medical Research Building was the noted molecular geneticist Dr. Tobias Rothman, winner of both a Nobel Prize and a Lasker Award. In addition to being known for his accomplishments, Dr. Rothman was even better known around the medical center for being a difficult person to work with, thanks to his renowned total lack of social graces. Rothman did not suffer fools. In fact Rothman did not suffer anyone except his long-term research assistant, Dr. Junichi Yamamoto. Originally Rothman’s reputation had made George nervous for Pia when she started her third-year elective in the man’s lab, but his concern had been tempered by his personal knowledge that she herself was a handful. From direct experience he knew that she could be counted on to hold her own in most any situation. As it had turned out, to everyone’s surprise, even Pia’s, she had gotten along famously with the famed and feared researcher. In fact it had been Rothman’s suggestion that Pia do a Ph.D. program at Columbia with her practical work taking place in his lab. Until Pia had come along, Rothman had never mentored anyone. For a while it had been a major point of gossip in the entire medical center as people wildly hypothesized what on earth was going on between the exotically attractive medical student and the universally disliked but respected curmudgeon who was the center’s major research celebrity.

“Pia! Wait up!” George called out. In her typically self-absorbed fashion, Pia had gotten ahead of George in the crowd. Dodging the phalanxes of medical students in their white coats who were all converging on the Black building, George scuttled ahead to catch Pia just before she entered the building. He pulled her aside. Pia looked up

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