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Faith winced as the needle pierced her skin.
"I want to feel useful again," Sara said, her voice taking on a confessional tone. "I want to feel like I'm doing more to help people than prescribing ointments for rashes that would probably go away on their own and patching up thugs so they can go back on the street and shoot each other again."
Faith hadn't considered that Sara's motivations might be so altruistic. She supposed it reflected badly on herself that she always assumed everyone approached life with selfish intentions. She told Sara, "Your husband sounded . . . perfect."
Sara laughed as she filled the test strip. "He left his jockstrap hanging on the bathroom doorknob, he slept around the first time we were married—which I found out for myself when I came home from work early one day—and he had an illegitimate son he never knew about until he was forty." She read the machine, then showed it to Faith. "What do you think? Juice or insulin?"
"Insulin." She confessed, "I ran out at lunch."
"I gathered." Sara picked up the phone and called one of the nurses. "You need to get this under control."
"This case is—"
"This case is ongoing, just like all the other cases you've worked and all the ones you'll work in the future. I'm sure Agent Trent can spare you for a couple of hours while you get this squared away."
Faith wasn't sure Agent Trent could spare anything at the moment.
Sara checked on the baby again. "His name is Balthazar," she said.
"Here I was thinking we had saved him."
She was kind enough to laugh, but her words were serious. "I'm board certified in pediatric medicine, Faith. I graduated at the top of my class at Emory University and I've devoted nearly two decades of my life to helping people, whether they're living or dead. You can question my personal motivations all you like, but don't question my medical abilities."
"You're right." Faith felt even more contrite. "I'm sorry. It's been a really hard day."
"It doesn't help when your blood sugar is out of whack." There was a rap on the door, and Sara walked over, taking a handful of insulin pens from the nurse. She shut the door and told Faith, "You have to take this seriously."
"I know I do."
"Postponing dealing with it isn't going to work. Take two hours out of your day to see Delia so that you can get yourself right and focus on your work."
"I will."
"Mood swings, sudden tempers—these are all symptoms of your disease."
Faith felt like her mother had just scolded her, but maybe that's exactly what she needed right now. "Thank you."
Sara put her hands on the bassinet. "I'll leave you to it."
"Wait," Faith said. "You deal with young girls, right?"
Sara shrugged. "I used to a lot more when I had my private practice. Why?"
"What do you know about thinspo?"
"Not a lot," the doctor admitted. "I know it's a word for pro-anorexia propaganda, usually on the Internet."
"Three of our victims have a connection to it."
"Anna's still very thin," Sara observed. "Her liver and kidney functions are off, but I thought that was because of what she'd been through, not anything she'd done to herself."
"Could she be anorexic?"
"It's possible. I really didn't consider the disorder because of her age. Anorexia is generally a teenage issue." Sara recalled, "Pete flagged up something similar during Jacquelyn Zabel's autopsy. She was very thin, but then again, she was starved and denied water for at least two weeks. I just assumed she had started out slightly underweight. Her frame was small." She leaned down to Balthazar and stroked the side of his cheek. "Anna couldn't have had a baby if she was starving herself. Not without serious complications."
"Maybe she got it under control long enough to have him," Faith guessed. "I'm never quite sure which is which—is anorexia where they throw up?"
"That's bulimia. Anorexia denotes starvation. Sometimes anorexics use laxatives, but they don't purge. There's growing evidence about genetic determinism—chromosomal blips that predispose them to the disorder. Usually, there's some kind of environmental trigger that sets it off."
"Like child abuse?"
"Could be. Sometimes it's bullying. Sometimes it's body dysmorphia. Some people blame magazines and movie stars, but it's far more complicated than just one thing. Boys are starting to get it more, too. It's extremely difficult to treat because of the psychological component."
Faith thought about their victims. "Is there a certain type of personality that's drawn to it?"
Sara considered the question before replying. "I can only tell you that the handful of patients I dealt with who suffered from the disease got extreme pleasure from starving themselves. It takes a huge amount of willpower to fight the body's physiological imperative for food. They might feel like everything else in their life is out of whack, and the only thing they can manipulate is whether or not they put food in their mouths. There's also a physical response to starvation—light-headedness, euphoria, sometimes hallucinations. It can duplicate the same type of high you get from opiates, and the feeling can be incredibly addictive."
Faith tried to remember how many times she'd made jokes about wishing she had the willpower to be anorexic for a week.
Sara added, "The biggest problem with treatment is that it's much more socially acceptable for a woman to be too thin than it is for a woman to be overweight."
"I have yet to meet a woman who is happy with her weight."
Sara gave a rueful laugh. "My sister is, actually."
"Is she some kind of saint?"
Faith had been joking, but Sara surprised her, answering, "Close. She's a missionary. She married a preacher a few years ago. They're helping AIDS babies in Africa."
"Good God, I hate her and I've never even met her."
"Trust me, she has her faults," Sara confided. "You said three victims. Does that mean another woman has been taken?"
Faith realized that Olivia Tanner's status hadn't yet hit the news. "Yes. Keep that under wraps if you can."
"Of course."
"Two of them seemed to take a lot of aspirin. The new one we found out about today had six jumbo bottles in her house. Jacquelyn Zabel had a large bottle by her bed."
Sara nodded, like something was starting to make sense. "It's an emetic in high doses. That would explain why Zabel's stomach was so ulcerated." She added, "And it would explain why she was still bleeding when Will found her. You should tell him that. He was upset about not getting there in time."
Will had a hell of a lot more than that to be upset about right now. Still, Faith remembered, "He needs your apartment number."
"Why?" Sara answered her own question. "Oh, his wife's dog."
"Right," Faith said, thinking the lie was the least she could do for Will.
"Twelve. It's on the directory." She put her hands back on the edge of the bassinet. "I should take this boy to his mother."
