They say bad things come in threes, and that is often how it goes. For Susana Alvarez Lecter, bad things had indeed come in threes. The first, obviously, had been her arrest. The second had been the news of her mother. And now, this was the third. But Susana was calm despite her knowledge of what might happen. If she was careful, this might turn to her benefit.

Lt. Kelly McNeely eyed her prisoner and took a deep, calming breath. Susana certainly looked like dying was a possibility. She took a few steps up to where Susana sat and crouched down. This close, she could feel the heat radiating off the other woman's body and winced. That was one hell of a fever.

"Okay," she said calmly. "Nobody's dying. What's wrong with you?"

"My stomach," Susana said, and grimaced. "I think it's my appendix. It hurts."

Belatedly, Lt. McNeely remembered that Susana was a doctor herself, like her father. A Dr. Lecter for the new age. "How long has this been going on?"

"A few hours," Susana answered tiredly. "It's been getting worse and worse."

A long, exasperated hiss escaped from Lt. McNeely's lips. "All right," she said. She turned her attention to the other guards in the cell. "Get her on her feet and down to the infirmary."

"The infirmary can't help," Susana objected. "They'll give me a Tylenol and send me back here, and I'll be dead by morning." Her face was oddly blank, as if this idea meant little to her.

Of all the things Kelly McNeely would have disliked having to do, taking Susana Alvarez Lecter off the cellblock had to be one of them. But it was clear enough that it had to be done. The guards helped Susana to her feet. Up close, Lt. McNeely could feel a sick heat radiating off her: more like a bank of coals in a jail uniform than a human being.

There were no shortage of federal agents who would believe that death and pain were Susana Alvarez Lecter's just desserts. Kelly McNeely did not share this opinion. Her job had always been twofold: to maintain the security of the block, but also to make sure her inmates remained safe. Whatever Susana had done on the outside did not matter to her: her job was to keep Susana safely jugged. The lieutenant could be hard, when the situation demanded hardness. But not all situations did.

Kelly McNeely had never experienced the slaughter of lambs, but she understood the concept behind it perfectly well. She knew her duties. No one was dying on her watch. Not even Susana Alvarez Lecter.

She shook her head. "Nobody dies on my watch, Susana. If you need it, you'll get it. I promise."

So she got Susana on her feet and brought her down the hall to the heavy steel doors separating the pod from the rest of the building. Guards and inmates alike stopped and stared. Lt. McNeely glared at the guard at the gate.

"Open it," she snapped. The guard hastily complied. The heavy metal doors slammed open with a crash. And Kelly McNeely took Susana Alvarez Lecter off the cellblock for the first time since her arraignment. The doors crashed shut behind them.

Susana herself seemed no more threatening than Ana Castillo: she was hunched over as she walked and seemed to be in obvious pain. She was handcuffed, but her legs were free. That was probably for the best, McNeely thought. She seemed uninterested in misbehaving.

At the jail infirmary, there was only a skeleton crew. The doctor had gone home for the night, but there was a nurse. Carefully, McNeely allowed Susana to lie down on a gurney so the nurse could examine her. As she did, the lieutenant was close by, mindful that Susana might attempt to imitate her father. So far, she did not seem to be trying.

That wasn't surprising.

The nurse took an ear thermometer and put it to Susana's ear. A few moments later, the tiny machine let out a beep. The nurse seemed surprised at what she saw. Lt. McNeely glanced down at it. The digital display read 104.2.

"So what's the deal?" Lt. McNeely asked.

The nurse sighed. "Well…very high fever…tenderness in her abdomen…it could be appendicitis. She should really go to the hospital, but,…"

Kelly McNeely knew perfectly well what the but was about, but decided to ask anyway.

"But what?"

"I can't order a transfer," the nurse said timidly. "The doctor needs to do that. And he's not here, you'll have to page him."

Principles are all well and good to have, but it's in the clutch that principles are truly tested. It is easy enough to claim to love helping animals, for example, when the animals involved are harmless bunnies. The true test for an animal lover is when the animal needing help is not a rabbit but a wounded wolf. It wasn't the most flattering of analogies, but definitely applicable to Susana Alvarez Lecter.

The lieutenant eyed her prisoner, lowered her head for a moment or two, and thought. Susana Alvarez was a murderer many times over. She was highly dangerous and capable of great violence. She had killed law enforcement officers without a second thought.

But she was clearly sick, and could die without medical treatment. The largest thing for the lieutenant was this: she was Kelly McNeely's responsibility. That made the decision simple. There were those who would think death by ruptured appendix would be highly appropriate for Susana Alvarez Lecter, but she was not in their care and custody. Plus, the heat from a federal prisoner dying on Lt. McNeely's watch wasn't something she wanted to think about. Particularly when that prisoner was one the government wanted on trial so badly.

"I can, and I am," Kelly said. "Thank you for looking at her." She grabbed her radio and told them to call an ambulance. Then she reached down and helped Susana off the gurney.

"I'm going to take you down to Release now," she told her killer. "You're going to the hospital."

"Thank you, Lieutenant," Susana said tiredly.

"I'll be there with you. Don't try anything. Behave and you'll get through this."

Susana nodded.

Release was a section of the prison Susana had never expected to see. It proved to simply be a large property room where prisoners got their property returned to them, parallel to the Intake section. Prisoners entering the jail could not see prisoners leaving the jail. The lieutenant opened the heavy steel door and let Susana walk through it. For the first time since her arrest, Susana was outside.

Even despite her discomfort, it was good to be outside. It seemed vast and boundless after the tiny cell. Susana asked if she could sit down on the concrete steps and was allowed to. She looked up at the dark Virginia night sky and smiled, trying to ignore the stabbing pain in her stomach.

Not yet, Susana Alvarez Lecter thought.

The ambulance came, and Susana was loaded into it. The lieutenant remained with her in the back of the ambulance. Susana knew perfectly well that the lieutenant's presence was to make sure she didn't try to escape. A reasonable thing to do, but it wasn't time yet.

At the hospital, Susana was examined quickly in the ER. It was noisy and bustling, and the presence of an inmate was not uncommon. Susana expected this: during her own med school and residency in Boston, it was the same. A blood test revealed a high white-blood cell count, and an ultrasound supported the nurse's – and Susana's – original diagnosis of appendicitis. She was taken up to surgery and prepared. The lieutenant remained with her, and she remained handcuffed by one wrist to whatever gurney or bed she was in. She was freed only to change from the prison jumpsuit into the patient gown. Even in pre-anesthesia, where patients waited to be taken into surgery, Lt. McNeely remained over her.

Interesting, Susana Alvarez Lecter thought. She actually seems concerned. But it's not time yet.

The anesthesiologist came by and gave Susana her pre-op injection. She ran through her own mental checklist of what would happen. Pre-op anesthesia would make her drowsy. Then in the OR, she'd be put under. Then…well, then they would do the procedure. She had done it herself before, and wondered whether they would do it traditionally or laparoscopically. Traditional would give her a few days in the hospital, but lapo would give her only one. Either way, that was OK.

The drug took effect quickly. Dimly, she could hear Lt. McNeely saying something to her, but she couldn't grasp it. She heard metal rattle and felt her wrist yanked and turned: the cuff was being removed. Then she was taken into the OR, and a mask was placed over her face, and she fell into a deep sleep.

Lt. McNeely watched her go. She sighed. The rush and bustle of getting her admitted was over: now came the boring part. She checked her watch and cursed. She was supposed to be off an hour or so ago. She could always call for relief, but something in her was loath to leave. Susana was out cold in the OR now, but she would be up eventually. Kelly McNeely wanted to be there when she did.

Nice, she thought. She gets to sleep and I get to stay here and wait.

She made arrangements with the hospital for Susana to be housed in the jail ward, where she would be kept securely. She would have a private room, since the lieutenant was loath to house her around another inmate. She called the jail and updated them on the situation.

But after that, there wasn't much more she had to do other than wander the halls and drink the hospital coffee, which was almost on par with the jail's for sheer lack of taste. It was all there was, so she drank it anyway. Boring. She checked in with the surgical department occasionally, but mostly all there was for her to do was watch and wait. Oh well. The overtime would be nice.

Susana's operation was over in about three hours, and she spent another half-hour or so in recovery. Lt. McNeely accompanied her as she was wheeled to her room in the jail ward. Once there, she shackled Susana's right wrist to the rail of her bed and headed down the hall to determine what to do next. And get some more coffee.

Susana Alvarez Lecter rubbed her eyes. It was time now. She reached under the sheet and pulled up the hem of her gown. Across her abdomen were three small bandages. It would be one day's recuperation, which meant it had to be now. Susana glanced around and reached into the white cotton panties she had been obliged to buy from the jail commissary. She'd guessed that they wouldn't search her too thoroughly, and she had been right. When she pulled her hand out of her underwear, she held a small piece of plastic.

Susana had long heard of her father's escape from custody in Memphis, and she had found the story endlessly interesting. He had told her how he made the handcuff key, and Susana had determined to duplicate it once she ended up in custody herself. She wasn't able to exactly copy his method, but her own would work well enough.

Roughly three weeks after her incarceration, she had been on the phone with her attorney. Fortunately, she was allowed to go to the phone, unlike her father. She had politely asked one of the guards if she could borrow a pen. The guard had obliged her, warning her that it would be demanded back. The pen was a simple, standard-grade ballpoint, and it had a plastic ink tube in place of the metal one her father had once gotten access to. Even that was all right. Susana had quickly pulled the pen apart and bitten off the last inch or so from the open end of the ink tube. The stub she had bitten off she had hidden in her mouth. The rest of the pen she reassembled and gave back to the guard when asked. The pen still worked, so the guard suspected nothing. Her cooperativeness in giving the pen back when asked was duly noted.

After that, she had been stuck until her cousin's visit. The small radio Lisa Starling had given her cousin took AA batteries, and the small battery hatch that covered them once they were in had two small plastic prongs that extended under the body of the radio, to hold it on. Carefully, Susana had broken off a tiny piece from the end of one of the prongs. To make the necessary cuts was not convenient, as she had no tools at all in her cell. They could deny her tools, but she still had her teeth, and she had carefully rubbed the tiny edge of the ink tube against her upper teeth until she had worn a slit into it. Here it was fortunate that she had plastic to work with rather than metal: it was much easier to cut.

The piece of plastic from the prong took a bit of nibbling before it fit properly, but finally it did. She had forgone her time out of the cell in order to finish her key. The piece from the battery hatch sat neatly as a cross-piece, just a quarter-inch sticking out. She knew that the handcuff locks had small metal posts, and so she had carefully worn a slot in that too, so that the key would properly fit a handcuff lock. The key was easy to hide in the seams of clothing, the cheek, and other places. It had one other advantage over her father's design: a metal detector would not pick it up.

By that time, Susana knew she was sick, and would have to be taken to the hospital. Just what trick of fate had decided to inflict appendicitis on her the day after her mother died she did not know. To Susana, it was no more than a bad roll of the dice, snake-eyes, bad things come in threes. True, it was a rather hideous run of bad luck, but here she was, and here she might have the opportunity to escape. Her accomplice would doubtlessly ascribe more meaning to it, claiming that God had given her the opportunity, opened the door for her, set her free from the lions, bla bla bla. She'd hear plenty of that later tonight.

But there would be plenty of time for that.

The resulting key was improvised, and she doubted it would hold together for too long. In jail, Susana was required to wear both handcuffs and leg irons when out of her cell. Her key would probably not hold up to opening four locks, even if she ever had the opportunity to use it without guards flanking her. But here, in the hospital, there was only her one wrist handcuffed.

In a way, it was amusing. At the beginning of her confinement, it had occurred to her that they would never let her off the cellblock unless she was at death's door. Well, lo and behold. She'd behaved as they wanted her to, but she knew she'd stay in segregation for good. And here she was, one step closer to being free. Perhaps there was something to her accomplice's beliefs after all. At this point, it didn't matter. If he played his part, things would be fine. If not, she could still manage.

Carefully, Susana slid her key into the handcuff on her wrist and turned it slowly. She could feel the piece of plastic catch on the lock. Experimentally, she pushed on it. She could feel the plastic bend a bit in resistance, but the tumbler was moving too. Good. She felt the cuff roll open and fall away from her wrist, and carefully extracted the key.

She smoothed out the plastic as best she could and decided to try removing the cuff from the bed rail: it would make it easier to wield the handcuffs. Experimentally, she moved her body and was not pleased. She was sore and felt weak. But it would have to do. She would prefer death over prison.

The key unlocked it again, but she heard a snap and felt something slip. When she removed the key again, she had only the ink tube: the piece off the battery hatch was gone, fallen down into the guts of the lock.

Oh well. It wasn't like it would be her wrists they would be on.

Susana covered up her free right wrist with the blanket and composed herself. She pulled out her IV. It bled a little, but it wasn't worth noting. She pressed on it with the bedsheet and the wound stopped bleeding quickly. When she called out, her voice was rusty and tired.

"Lieutenant?" she called out. "Lieutenant McNeely?"

The lieutenant came in a few minutes later. She stood in the doorway, not close enough for Susana to reach. She looked exhausted, heavy bags under her eyes. That was good: instead of a whole cellblockful of guards she would have to fight, it would be only one exhausted guard. Susana supposed tonight had been stressful for her too. It was about to get much worse.

"Yes, Susana?" she asked tiredly.

"May I use the bathroom, please?"

The lieutenant sighed and put a hand to her eyes, rubbing them to stay awake. "Yes, all right."

Lt. McNeely came forward, reaching in her pocket for the key. Outwardly, Susana looked as exhausted and tired as McNeely. Internally, she was watchful and tense. She choreographed what was about to happen in her mind three or four times while the lieutenant crossed to her bed. When she was in Susana's reach, Susana struck.

She came out fast with the handcuffs, the good cuff without the plastic blocking the lock in her hand. She slapped it on the lieutenant's wrist and then pulled her forward. The lieutenant gasped. Susana locked the other cuff onto the bedrail. She could feel the plastic working in the lock, but it went through well enough.

It was a battle of weakened women: Susana weakened from her illness and subsequent surgery, the lieutenant weakened by exhaustion and having only one free hand. Lt. McNeely groped for the pepper spray on her belt. Susana struck her hand savagely and was rewarded by hearing the can clack against the ground and roll across the room.

Then she grabbed Lt. McNeely's collar, high up and cross-handed. The sides of her hands pressed against the lieutenant's throat. Her fingers tightened on the shirt material and she pulled as hard as she could, neatly cutting off the blood supply to Lt. McNeely's brain.

It was a short fight and there was little sound. Lt. McNeely struck Susana on the side of the head. Susana grimaced, flicked her head to the side, and held on. The lieutenant grabbed her hair and yanked. It wasn't comfortable and it pulled her head back, but she kept her grip on McNeely's collar. Perhaps thirty seconds later, the lieutenant flagged, her hand sliding limp from Susana's head.

Susana kept up the pressure for another ten seconds, just in case her opponent was faking. She slid out from under the bed and closed the door. She pried open Lt. McNeely's eyes and peered into them for a moment or two. Despite herself, Susana liked the lieutenant and didn't want to kill her if she could avoid it. For the moment, Lt. McNeely was unconscious, but she looked stable. That was good. She'd showed Susana some kindness, and Susana supposed that giving her life back to her would be a suitable reward.

It didn't take long to swap clothes with the unconscious McNeely. The shoes were a little tight. She was perhaps two inches taller than the lieutenant and approximately the same build. The uniform fit acceptably well. Susana then arranged Lt. McNeely in the bed. She tore three strips off the bedsheet. One strip secured her free wrist. One went in her mouth, and the other Susana tied across her mouth.

"Sleep tight, Lieutenant McNeely," Susana said lightly.

She didn't know how much time she had or how many others there might be. McNeely's belt provided her with a baton, pepper spray, and a gun. She'd prefer not to use any of them if she had to – it would attract too much attention. So she opened the door and looked out into the hall.

She took some pleasure in noticing the outside of her door warned all and sundry that herein dwelled a violent inmate. That was good: perhaps they would ignore the lieutenant's first noises. She closed the door and strode down the hall. There were a few guards there, but none of them seemed to take any real interest in her. They saw the uniform and their brains turned off. All the better.

Her med school and residency years helped her navigate. The one end of the long hall led to a barred gate to the outside world. Operating it was a bored man in a uniform identical to hers behind a large sheet of Plexiglass. Susana strolled up to the gate and stopped, her hands in her pockets. She affected a bored mien, even though she was itching for the final gate to open.

"Hey," the man said.

"Hey," Susana returned. "I just need to get a form."

"You McNeely's relief?"

"Yeah," Susana returned. "But I gotta get…," she snapped her fingers as if trying to jog her memory. "You know. That form."

"Yeah, the damn forms," the man said morosely. "All that paperwork, you know? Here. Sign out." He pushed a clipboard through a hole in the Plexiglass partition towards her. Susana took it and signed a name to it and then smiled brightly at him.

"How's her inmate doing?" the guard asked, and scratched himself.

"Just fine. A little sore," Susana said truthfully. "She's a nasty one, though. Tell the others, they don't want to open that door if they can avoid it." She chuckled. "She's a biter, you know. Leave it up to me."

"Yeah, I heard," the bored door guard said. He pushed a button and the door opened with an electric buzz. Susana tried to control her elation as she headed out of the jail ward into the free world.

The uniform would get her out the door, but she needed something less conspicuous once she was out. She headed out of the ward and looked for the signs. Finding her way to the hospital parking garage was not terribly difficult. She had the walkie-talkie on and was listening for signs that her escape had been discovered. Nothing so far. Her stomach still ached, but she was stable, and that was what mattered.

Even this late, there were people moving in and out: the families of ER patients, mostly. She saw a family heading back to their minivan and passed them up. Then she caught sight of a well-dressed middle-aged man walking alone back to his Audi, a bandage over his cheek. He was speaking into his cell phone, his eyes firmly elsewhere. In his other hand he held his keys, fumbling for the remote control to his car alarm. She slipped up behind him as quietly as she could, but she needn't have bothered. All of his attention was focused on the person he was talking to. He was assuring someone that he was all right, just a couple of stitches, nothing to worry about.

The first blow from the baton hit him on the back of the neck and he dropped to his knees as if axed. The cell phone dropped from his hand. Just to be sure, Susana tromped on it and it broke apart with a plastic crunch. Electronic guts spilled over the concrete of the parking lot. He screamed once, and Susana shut him with with a blast from the pepper spray. Now he was blinded and already hurt. Even weakened and in pain as she was, it was easy to beat him to death with five more judicious blows from the baton.

She hauled him over to a nearby pickup truck, grimacing all the while. The pickup truck had a piece of canvas stretched tight across the bed. Susana undid some of the snaps and dumped him inside. That hurt her stomach incision something awful, and she had to hold the side of the pickup and bend over and breathe until the nausea went away. Then she snapped it back up, neatly hiding the body.

She pressed the button on the car alarm remote and followed the chirp. The car wasn't far away. It was a black Audi A6. Not too bad. Probably a midlife-crisis car. Even better, there was a tan trenchcoat in the back which would serve well to hide the guard uniform. It was much too big for her and she had to roll up the sleeves, but it would do for the car.

In the rearview, she noticed her face was speckled with blood and she wiped it off with some tissues she found in the center console of the Audi. As she studied her face in the mirror, she smiled suddenly, sadly.

"I did it, papa," she said. She thought he would have been proud. But he also would have understood that there was little time for sentiment right now.

The man had conveniently left the parking ticket on his dashboard. Susana adjusted Kelly McNeely's gunbelt on her hips and checked the pockets of Kelly McNeely's uniform. She was rewarded with a crumpled five-dollar bill in the right shirt pocket and two quarters in the right pants pocket. She started the car and drove away. The walkie-talkie occupied the passenger seat, turned all the way up. She paid the parking garage attendant and drove away into the night.

A few blocks down the street from the hospital was a convenience store. Susana pulled into the parking lot and walked around to the side of the building. A pay phone hung there. She took the phone, dropped Kelly McNeely's change into the phone, and dialed a number from memory.

A voice answered, "Hello?"

"Hi," Susana said. "It's me. You told me you wanted a sign, right?"

The voice seemed startled. "You mean…,"

"That's right. I'll be over in twenty minutes. Did you get the things I asked you to get?"

"Of course I did."

"Good," Susana said, her tone clipped. "I don't mean to be rude, but I'm in a bit of a rush here."

The voice chuckled. "Then we'll talk when you get here. I'll be waiting."

Susana hung up the phone. She decided she didn't need the walkie-talkie anymore – once they found it missing they could use it to home in on her. So she dropped it under the Audi's rear tire and backed over it with an audible plastic crunch. The walkie-talkie was built to take more abuse than the phone had been, but was not engineered to survive being driven over.

Susana Alvarez Lecter dropped the Audi into first gear, pulled out of the parking lot, and headed out into the late Virginia night to meet her accomplice.