September 16, 2002. Harrington-Glasser Day School in Manhattan. Neil returned to his office after teaching a first-period Fundamentals of Art class to a group of freshmen and found the message light flashing on his telephone.

"I'm not feeling well," Caroline said. "I'm going home to bed. I'll see you there tonight."

She rarely left work simply because she wasn't feeling well. She hated the idleness of bed rest. She pushed herself in spite of coughs, colds, and fevers to get up and go down to the agency, or at least to plug in the laptop and work at home. What in the world would send her to bed in the middle of the morning?

He reached for the handset, dialed his home number. She picked up on the fourth ring, just before the answering machine kicked in.

"Hello?" Her voice was heavy, knocking against his ear like a rock.

"I'll come home," he said.

"No, no. It's just the flu. Nothing you can do. I have a pounding headache, and I can't think straight. I only want to rest."

"Are you sure?"

"Yes." A heavy sigh. "Yes, I'm sure."

"Maybe you should call the doctor, just to see--"

"No. Go back to work and let me sleep."

He hung up the phone uneasily, then pushed through the rest of the morning and afternoon with a sense of dread.

It was shortly after five o'clock when he finally reached Brooklyn. He got off the subway at the Bergen Street stop as usual and walked to Warren, where his and Caroline's house stood shoulder to shoulder with the row of other houses that straddled the block from Court to Smith. Normally he loved this path over the buckled treelined sidewalk, past the stoops of elegant old houses, aging like fine wine. This was where an artist should live, of course. It was part of the image that Neil had tossed easily about his shoulders when he'd first arrived in New York as a youth, green and destitute, talented and determined. "I am no longer a small-town boy," he'd said to himself. "I am a New York artist." And he'd slipped into the image like a man shrugging into a down jacket, and it fit him comfortably and at once.

But none of that mattered now, today, when Caroline was sick. Neil hurried up the steps to his front door and unlocked it. When he pushed open the door and stepped inside, he was greeted by an ominous silence and the stench of sickness. Upstairs, Caroline lay semiconscious on the bed in their darkened room, strands of her long hair caked with vomit. Neil rushed to her side and touched her cheek. Her skin was hot and moist, and she moaned against the weight of his hand.

"Caroline," he whispered.

She didn't open her eyes. He reached for the phone beside the bed, and in moments the expected siren split the air and Neil met the paramedics at the door. He pointed up the stairs. Though laden with their stretcher and equipment, the paramedics lumbered up swiftly, feet pounding against the hardwood floor.

When they saw her, they remained expressionless and moved quickly. Neil, the helpless spectator, hung back and watched from the doorway. What did he know of medicine and illness and emergencies?

They lifted her gently, carried her down the stairs and out the door to the ambulance double-parked there on Warren Street. Neil followed in a dazed numbness, unaware of the neighbors, the children who paused in their game of hopscotch, the mothers who, arms crossed, stood in open doorways watching the commotion, the whirling ambulance light a beacon of foreboding on their street.

Neil rode with Caroline in the ambulance the short distance to Long Island College Hospital. LICH, it was called: the "Litch." Four blocks away and he'd never even been inside. He gazed at Caroline's ashen face beneath the oxygen mask, listened dumbly to the paramedic calling ahead to the emergency room.

In only a moment they stopped abruptly and the ambulance doors flung open. Someone was shouting, "Come on, come on! Let's move it!"

Neil, feeling awkward and peripheral, tumbled out the back doors and watched as Caroline was whisked away by white jackets and pale green uniforms.

Once inside, he hurried to keep up but was intercepted by a woman at the desk.

"Are you family?"

"I'm her husband."

Neil felt a clipboard thrust into his hands.

"Please fill these out and return them--"

He cursed, shaken. "My wife is sick, and I have to sit here filling out forms?"

"We need the information," the woman explained with a look that said, "Let the doctors do their job, and you do yours." Aloud she said, "You'll be able to join your wife shortly."

He wanted to be at Caroline's side, but after all, what could he do? He would have to entrust his wife into the care of strangers. He took a seat in one of the vinyl chairs, one of the little black row houses in the city of the waiting room. He gazed dully at the clipboard on his lap. He rubbed his eyes, forced himself to read. Caroline's name, address, birth date, age, health history, insurance number. His hand trembled as he wrote.

He looked at his watch. 5:46 pm. Before he had even finished filling out the forms, a doctor was there, hand extended, introducing himself, looking grim.

"Your wife is very ill," he said. "We suspect meningitis."

"Suspect?"

"A spinal tap will tell us for certain. The important thing right now is to relieve the pressure on her brain. We did a scan which showed significant swelling...."

The doctor rambled on. Neil knew the man was talking; he could see his mouth move, knew that words were tumbling from it that made no sense at all.

"... highly contagious, so we will begin you on a round of antibiotics...."

Neil started, forced himself to become engaged in this absurd conversation. "Me?" he cried. "Forget about me! It's my wife--I want my wife to get better!"

"Of course. We're doing everything we can."

"Is she going to be all right?"

"We're doing everything we can."

Is there nothing else he can say? Neil wondered. "I want to see my wife."

"Of course. She's been moved to intensive care. I'll have a nurse show you to the room."

A walk down a long corridor of bright lights and dull colors. Then, Caroline in the ICU, a figure shrouded in white linen, intubated, monitored, her slumbering body the tiny battleground of a microscopic war. One plastic tube entered her sloping mouth and disappeared down her throat. Another tube snaked down her nose while a tangle of IV bottles dripped medications--Neil didn't know what--directly into a spot under her collarbone. She was surrounded by machines that kept tabs on the numbers, spewing out the war news: heart rate, respiratory rate, temperature, oxygen saturation, blood pressure.

Neil sank into the chair beside the bed and took Caroline's hand.

"Caroline," he whispered, "can you hear me? I'm here, sweetheart."

There was no answer, no indication at all that she was aware of his presence.

Neil stared at his wife uncomprehendingly. He had seen her walk out the door just that morning. He had seen her leave for work less than twelve hours ago. What was she doing here with all these monitors, these tubes, these substances running into her body, trying to keep it functioning when last he saw her it had been functioning just fine on its own? Only last night the two of them had been remembering their time in London, said they really ought to go back, yes, let's think about going back next summer....

Neil didn't know that something like this could happen, that it was even possible. But no, that wasn't true. He knew of course, at some level. He knew such things happened; he read about them, saw them, shook his head at them. A person didn't have to live long before he knew. There was that time he caught the F train at Bergen Street, and by the time the subway stopped again, two minutes later, he'd seen the man across the car from him crumple to the floor, dead of a heart attack. Another time, that young woman crossing the street, jaywalking on Atlantic Avenue, was struck by a car, blood everywhere. And only a year ago he and Caroline had stood on the roof of their house and looked out toward Manhattan, saw the smoke rising into an empty sky where, just hours before, two towers had stood.

He knew, of course. He knew. But what man lives in the day-to-day with the expectation of disaster?

At some point a spinal tap was done. "Yes," the doctor said, "she has bacterial meningitis. Meningococcal meningitis, the most serious kind. Not necessarily fatal--"

"Not necessarily?"

"Some people do survive."

But, Neil understood him to mean, most people don't.

Their objective right now was to push the antibiotics and fluids, to keep the blood pressure stable, to avoid the collapse of the circulatory system, the shutting down of the body's systems.

Neil, left alone once more with Caroline, wondered what to do and was horrified to think there was nothing at all he could do. If she lived, it wouldn't be because of him, and if she died, it wouldn't be because of him. He had no control at all. He could only watch and wait.

Evening sank down to night, and Neil didn't move. The night grew dark, and the nurses came and went, and after an eternity a sliver of gray dawn touched the window, but still Neil didn't move. He didn't eat or sleep. He simply kept vigil, waiting and watching, his terror so deep it sometimes left him breathless.

Another shift change, a new face at the bedside. "Why don't you go home and rest awhile, Mr. Sadler?"

"No, I have to stay."

She slunk away on squeaking shoes. He didn't notice, didn't care.

"Open your eyes, Caroline."

The day wore on. Later Neil would learn that his students at Harrington-Glasser sat waiting for him, wondering why he didn't show up for class. But for now, for Neil, they didn't exist. He forgot to call the school, forgot to call the ad agency where Caroline worked. Everything that had mattered yesterday didn't matter today. He watched Caroline's face, waiting for a flicker of movement, a sign of life.

Finally his own eyes began to close; in his exhaustion he drifted into a place of strange dream images. He fought to stay awake but nodded, reluctantly, into sleep. And for that reason, when the alarm went off on one of the monitors, it was all the more jolting, sending Neil into a panic.

A sudden rush of people spewed into the room. Someone grabbed Neil by the arm, moved him away from the bed. He swayed on his feet, watching in horror. Another dream image, or were these voices, these people, real?

"Blood pressure?"

"Ninety over fifty-eight."

A white blur of movement ...

"Heart rate?"

"Fifteen and dropping."

"Get the line moving!"

"The fluids are--"

"We're losing her!"

"Blood pressure?"

"Eighty-two over forty."

"Stay with us, stay...."

"Dropping."

"Try again!"

"I can't get a--"

"Blood pressure? Blood pressure!"

A distant murmuring, then human voices giving way to the slow and steady whine of the machine.

Flat line.

Forever Neil would remember how his own heart was beating wildly at the very moment Caroline's heart stopped.

Excerpted from THINGS WE ONCE HELD DEAR © Copyright 2011 by Ann Tatlock. Reprinted with permission by Bethany House Publishers, a division of Baker Publishing Group. All rights reserved.