Chapter One

Peyton Shields could feel it coming. No one had tipped her off. No neon lights were blinking. But her sixth sense was in high gear.

Peyton was in her first year of residency in pediatric medicine at Children's Hospital, Boston, one of an elite thirty-seven interns chosen from premier medical schools around the world. She'd vaulted to the top through relentless drive, stellar academic credentials, and a mountain of debt to Harvard Medical School. Good instincts, too, were part of the successful package, and at the moment they were telling her that something strange lay ahead.

She parked her car in the space marked Physician outside the North Shore clinic, about thirty miles north of Boston in the city of Haverhill. Peyton was at that stage of her professional training where pediatric residents spent three or four days each month at an outlying clinic to broaden their experience. Haverhill was somewhat of a plum as far as clinical assignments went, situated in the affluent Merrimack Valley. Driving out in any direction, you were virtually guaranteed to run smack into a quaint, three-hundred-year-old town whose 98 percent white population earned more than double the state's median annual income. Though not the most charming in the valley, the city was an interesting mix of one of the finest Queen Anne-style streetscapes in America and blue-collar housing that had grown from the once-prominent shoe industry. With roughly 10 percent of its population living below the poverty level, the routine medical needs of its Medicaid children were served primarily by the clinic. Today, that meant primarily by Peyton.

"What are you two doing outside?" asked Peyton as she stepped out of the car.

It was a fair question. Even though it was a sunny fifty-six degrees --- a heat wave for late February --- it was highly irregular for Felicia and Leticia Browning to be caught chitchatting outside the front door at nine-thirty in the morning. The clinic's two full-time nurses were identical twins with polar-opposite personalities. Felicia was the more serious sister and a frequent pain in the neck.

"Power's out," said Leticia, giggling as usual.

"That's weird. All the traffic lights were working on my way over here."

"Cuz you was coming from the south," said Felicia. "Power's out from here north."

"What happened?"

"Earthquake," said Leticia. More giggles.

"Very funny."

"No joke," said Felicia. "We're on the southern edge of what they call the active zone, thirty miles north of Boston and on up to Clinton. Two dozen quakes in the last twenty-one years. Usually little bitty ones, like this."

"How do you know all that?"

"We'll always know more than you," said Felicia, only half-kidding. "We're nurses."

Leticia pulled a battery-powered radio from her sister's coat pocket. "They just interviewed a Boston College seismologist on the air."

"Shut up, fool," said Felicia.

"Ah," said Peyton, seeing they really weren't yanking her chain. "I take it there's no backup generator for this place."

Leticia just laughed. Her sister said, "Dr. Simons canceled his morning appointments and went home over an hour ago."

Good ol' Doc Simons. He ran the clinic, but hands-on he was not. To him, carpe diem meant "seize the day off."

The three women looked at each other in silence, as if soliciting ideas on how to keep busy. Peyton was about to walk inside when a car sped into the parking lot and screeched to a halt. The driver's-side door flew open and a teenage girl jumped out with a baby in her arms.

"Somebody --- help my son!" She looked barely old enough to drive and sounded even younger. Peyton ran to her and gathered the baby in her arms.

"How old is he?"

"Twenty-one months," she said in a panicky voice. "His name's TJ. He got stuck with a needle."

"Are you his mother?"

"Yeah. My name's Grace."

"Take him to Room A," said Felicia. "It's got plenty of sunlight."

Peyton hurried inside, stepping carefully through the dimly lit hall. The baby's cry was weak, as if he'd wailed to the point of exhaustion. They slid the examination table closer to the window to take advantage of the streaming sunlight, then laid the boy on it.

"Needle went in right there," said Grace, pointing at his leg.

Felicia aimed a flashlight. Peyton noticed a minor puncture wound inside the thigh. "What kind of needle was it?"

"Sewing needle. About an inch long."

"Did you bring it with you?"

"It's still in his leg."

Peyton looked closely but still didn't see it. "You sure?"

"The very tip was sticking out at first. I tried to work it out, you know, like a sliver. But it disappeared inside him."

Leticia slipped a small blood-pressure cuff onto the boy's right arm and pumped it. "You're sure it was a sewing needle, child?"

"What else would it be?"

Felicia grabbed the girl's wrists and rolled up her sleeves. "Show me your arms."

Grace resisted, but Felicia was much stronger. "I'm no druggy. Leave me alone."

The arms were trackless, but Felicia wasn't finished. "You shoot between your toes, girl? Or is it your boyfriend who does the drugs and leaves his needles laying around?"

"Nobody is on drugs, so just go to hell!"

Peyton was about to side with the girl, but then she noticed the marks on the backs of her legs just below the hemline of her skirt. "Is that blood behind your knees?"

Grace backed away. The nurse grabbed her and hiked up her skirt. The backs of her thighs were pockmarked with bloody needle holes.

"What is going on here, child?" said Felicia.

"My boyfriend did it."

"Did what?" asked Peyton.

"We got in a fight. He started jabbing me with this stick of his, so I grabbed TJ and ran out the door. He got TJ in the leg, and the needle broke off when I jerked away."

"What kind of stick has a sewing needle on it?"

Excerpted from LYING WITH STRANGERS © Copyright 2011 by James Grippando. Reprinted with permission by Harper. All rights reserved.