By Ethan’s fourth day in the hospital, I had also learned he was not the first patient Vance had treated this way. Mercy General could not hide the whispers from someone with the right contacts. In the previous eighteen months alone, there had been four formal complaints by patients or families alleging inadequate care. One case involved a young woman with chest pain whom Vance diagnosed with anxiety and discharged; she returned six hours later with a pulmonary embolism. Another involved a teenage boy with abdominal pain dismissed as gastritis who turned out to have a perforated ulcer. Both cases, I learned, had been settled quietly with nondisclosure agreements. No formal discipline. No real accountability. Just enough money and confidentiality to make the problem disappear on paper while the physician remained exactly where he was, still staffing the ER, still making decisions under fluorescent lights about who looked sick enough to deserve belief.