Cuddy found her residency interesting, educational but well within her capabilities. She enjoyed working with the different cases and getting more hands-on experience in her field. PPTH was living up to its reputation as a good hospital to study at.

It was also, to her disgust, more superstitious than expected. She quickly learned that Smithers had company in believing the place was haunted. She'd heard comments by several other assorted staff, too, taking routine things such as unexplained improvement or worsening of a patient, creaks in the night (all buildings creaked to some extent in temperature fluctuations, she tried to explain), and the occasional unsigned note that turned up with orders for a patient. A doctor could forget to sign or, with the ego common to many of them, assume the whole world knew their handwriting. Of course, an unsigned order would never be accepted without question, or shouldn't be, but those very rare notes had sometimes sparked a new direction on a case in discussion.

No, there were rational explanations for everything, including diseases, and she was determined to rationally and logically discover them.

Which is why this particular case was driving her crazy. It didn't seem to make sense, and she couldn't put the pieces together. To make matters worse, the head of endocrinology had said this morning, "So it's got you stumped, Cuddy?" His tone had been almost sarcastic glee, as if she could use taking down a peg or two.

She spent a few more hours going over test results, looking for anything she had missed, but finally, at a time when many physicians were heading home for the day, she found herself climbing the stairs to the roof. She had already discovered that it made a nice, private thinking spot. A couple of times, she had worked out a case up here, debating herself as if holding a single-person consultation with herself.

Dusk was settling rapidly over Princeton. She stood at the wall, looking out at the city, and then walked around the roof, at least the permissible parts. She wasn't pacing; Lisa Cuddy did not pace. She was simply thinking on her feet. She stopped at the fence, the one that divided the new from the old building, and looked across it into the forbidden territory. There was a lock on the gate that didn't appear to have been opened in years. Part of her wondered what actually was over there (in fact, not in superstition), but it was a minor part. That curiosity, after all, wasn't relevant to tonight's medical debate.

She walked off again, speaking to herself aloud. "All right, Cuddy. The patient has been hospitalized three times this year for pancreatitis. Insists he is a teetotaler, so alcohol isn't a factor. Insists he doesn't eat an unusual amount of fatty foods. What else that we haven't ruled out is a risk factor for chronic pancreatitis?"

"What about the labs?"

Cuddy nearly jumped out of her shoes. The voice was deep, rich, with a smoothness to it that sent a tingle up her spine. She spun around toward the door to the staircase, where the sound had come from. The light was fading now, but there was still enough to show her that absolutely no one was there.

She pulled herself up to her full height. "Whoever you are, don't come any closer. I've got mace, and I'm not afraid to use it." That was a lie; while she did have a can of mace, it was in her purse in her locker, not with her at the moment.

There was a soft chuckle, this time coming from just over the wall that looked out on the city. "Cuddy, Cuddy, Cuddy. I appreciate a show of spirit, but we're wasting time. I thought you were interested in diagnosing your patient."

"Who are you?" she demanded. "How do you know my name? If this is one of the doctors playing a trick. . ." She knew that it wasn't even as she suggested it. She had never heard that voice in her life before; of that much, she was certain.

"Of course I know your name," the voice responded, now coming from another shadow in another corner of the roof. She twirled around, trying to pin it down. "But again, we're wasting time. I did ask you a question."

She rewound mentally. "The labs?" This mysterious voice wanted not to harm her but to discuss the patient's labs? What kind of confrontation was this? And how did he keep switching locations?

"Ah, so you did hear me. Care to answer?"

She sighed. "Whoever you are, how do I know I can discuss patient care with you? Are you associated with the hospital?"

"In a way," he responded from yet another area of the roof. "Let's break this down: You're here, I'm here, and I don't see the HIPAA board at the moment. Don't see anyone else spying, either. So what's the harm in answering a simple question?"

She turned, still trying to pin down the location. This was ridiculous; nobody was this fast or silent. How did he keep changing corners? "Well," she began, "the labs show chronic pancreatitis."

"ZZZZTTT" He made a very effective buzzer sound. "You already said that. Don't repeat yourself, Cuddy. We're trying to figure out why. When you get stuck with a differential, try to head in new directions. Any new directions, even wrong ones, can work to shake you into a new way of thought. So what's unusual about his lab?"

She finally stopped twirling; she was making herself dizzy and not coming any closer to pinning down this shadowy voice. "Well, he's got elevated amylase and lipase, of course. His ALT isn't that high, though, so we doubt it's caused by gallstones."

"Good so far. What else?"

Her mind was taking hold of the medical dilemma again. "Lipid panel is high. The patient insists that he doesn't eat much fat, though. Could be a genetic component for high cholesterol."

"So the lipid panel is high. Is it equally high?"

Her head came up as that anomaly reimprinted on her mind. "Actually, the triglycerides are by far the highest. The other levels are a bit elevated but not too bad."

"Bingo! Now you're thinking, Cuddy. So you have a patient who does not drink - allegedly, though remember that everybody lies - does not eat indiscreetly - ditto - and has had three attacks in a year of pancreatitis. His triglycerides are markedly high. Any history of pancreatitis in prior years, or did it just start?"

"It just started this year," she mused. She was thinking fiercely. Something, somewhere from a textbook was tickling at her brain.

"Any other non-abdominal symptoms that he's mentioned?"

"He's felt a bit down lately, but he did have a breakup recently. He thought it was due to that."

"Have you talked to his ex? What's her take?"

She faced the current location, if there was one, of that voice. "No, I haven't talked to the ex. He hardly gave us permission for that."

"Permission, smermission. There's a source of data there that could help you. For one thing, which came first, the chicken or the egg?"

"What?" She sorted through that. "You mean, did symptoms contribute to his breakup instead of his breakup causing symptoms?"

"Precisely. Now there's an interesting theory. But discarding the ex for the moment, since you would never do anything so rebellious as try to get information from her on the side, let's go back to that lab. Triglycerides are high. Very high. What does that remind you of, combined with chronic pancreatitis with no prior history before this year and with depression?"

Again, there was the feeling of something almost there, something she'd read somewhere. She tried fiercely to get it. "Help me out here," she said. "If you know, that is."

He chuckled. "Oh, I've got a theory. And you are slowly approaching it. You have potential, Cuddy; you just need some experience."

She sighed. "We're talking about the patient, not about me. If you think you know what he's got, why not say so?"

"Because this process is good for you. He isn't going to die in the next fifteen minutes, and you, if you push yourself, will become a better doctor. I assume you did a physical exam?"

She rolled her eyes. "Of course I did a physical exam."

"Notice anything? The eyes, Cuddy. Notice anything in particular about the eyes?"

The eyes? Most exams by all the residents had been focused on his abdomen, other than the standard neuro checks such as for uneven pupils. But wait a minute, there was an impression of something odd about his eyes. She replayed the latest exam mentally. The veins in the retinas might have appeared unusual. What was it about them that tickled her memory?

"Lipemia retinalis," she said as the light bulb went off. "I need to go do another exam and really look this time, but I think he might have familial chylomicronemia syndrome."

"Well done, Cuddy," the voice replied. "Like I said, you do have potential."

She turned for the staircase, eager to go test her new theory, then stopped. "Wait a minute. Who are you?"

"What does it matter? Just consider me a tutor, if you will."

"You have to have a name," she insisted.

There was a long pause, and his voice almost held a note of sadness when he finally replied. "My name doesn't matter now."

"But what do I call you?"

The sadness disappeared as quickly as it had come, leaving an almost playful note. "You may call me Maestro. Maestro of Medicine."

Cuddy shook her head. "Oh, come on. You have a name." Silence. She looked around, not that she had seen a thing so far. "Are you still here?" Silence. She sighed. "All right, although that's ridiculous. Thank you, Maestro."

"Anytime." That response seemed to come from the emerging stars above, not from a corner of the roof at all. She looked skyward, then gave up and turned for the door. She had to go check her theory on this patient.

It only occurred to her later, after verifying milky veins in the patient's retinas, that she might have bumped into Smithers' ghost.

Now that thought was ridiculous. Even the most imaginative of her colleagues had never described having full-length medical conversations with voices in the shadows. No, there had been somebody up there, someone possibly talented in ventriloquism as well as obviously brilliant in medicine. And sooner or later, she would find out what his name really was.