By mid-morning on Tuesday, February 4, 2003, Nina Pagonis was running about 20 minutes late, which didn't concern her much because the people sitting in her office were the kind of people who would wait. Nina's assistant always showed her visitors into the public part of her office at precisely the moment of their appointments, whether or not Nina herself was present. It was simply good manners. If it proved a bit disorienting to some of her guests, well that could be useful, too.

When Nina finally did arrive that morning, her assistant told her that a couple was waiting for her inside.

"A man and a woman. Regarding the treatment you took home last night."

"Which one?" said Nina.

"The Meek Shall Inherit," said her assistant.

"Oh, good," said Nina. "The one about Bertha of Savoy. Have you read it?

"Of course," said her assistant. "Very juicy. Strange, but juicy. Much stranger than these two."

"What are they like?"

"Used car salesmen," said her assistant.

"Hmm," said Nina. "Could you put these on a nice plate?"

A few moments later, Nina walked into her office, full of energy, apologies, and solicitude, and carrying a plate of Greek cookies.

"It's Renee, right? And you must be Bradley! Do you have enough water? Coffee? You must try one of these--we call them koulourakia--kind of a Greek biscotti--I've found a little bakery that makes them just the way--"

But just then, Nina's cell phone buzzed. She looked at it. Her mother's doctor.

Nina took the call. The doctor told her the time had come for a tracheostomy. Just to make her mother more comfortable. Nina asked the doctor to slow down. She demanded more details. As she talked, pacing behind her desk, her two guests chewed their koulourakia, pretending not to listen. The doctor explained the difference between a tracheotomy and a tracheostomy. It all sounded horrible to Nina. She knew how much her mother would hate this procedure, how vigorously she would protest, if she weren't intubated. But that was the point: her mother had tubes down her throat, she couldn't talk. Nina asked the doctor if this was desperate measure, just something to needlessly prolong... She trailed off. The doctor said No, not at all, it's very routine, we'll get through this episode, your mother will be be fine.

After a few more questions, Nina gave her approval.

She closed her phone and apologized to her waiting guests. "Sorry, I had to take that. My mother's in the ICU. I have power of attorney."

It occurred to Nina, as she gathered herself together, sat down and started the meeting, that even though the phone call was very real, it also worked as a kind of performance. It wouldn't be a bad idea to enter every meeting talking about surgery. Making tough decisions about life and death.