Dr. Kimberly Shiroma stood before her hospital room window staring out at the lush Hawaiian landscape.  The tropical splendor of her surroundings was lost on the doctor as she brooded over the past.  Twelve hours ago she had been caught in a nightmare; trapped on an airliner with a killer virus and no way down.  Part of her still had trouble believing the crisis was over.  But as time passed and no new emergency arose to demand her attention, she had finally accepted that it really was over.  She was safe and the virus contained.  Stuck in quarantine with little to do but think, Shiroma had found herself analyzing the events of the past day and the full import of her actions had finally descended upon her.  So here she stood, locked away in quarantine with only her guilty conscience for company.  She had killed a woman.  And if that was not horrible enough, she had turned right around and repeated her mistake, knowing the consequences.  She was a doctor, her job was to save lives not take them.  How could she have let Marcase talk her into taking such a risk?  They had concocted a drug using an enzyme extracted from cocktail nuts with fingernail polish!  If that wasn't ludicrous enough she had then without proper testing gone ahead and injected it into a living person.  It was madness, and she had gone along with it because she was scared and didn't know what else to do.  She was a scientist, she was use to methodical evaluation and testing of procedures, not jumping in with sketchy data and a prayer that all would be well.  She was not cut out for this "trench style" medicine.  This was not the first time they had gone in with only a vague hope that their proposed treatment would work.  Only this time their actions had not resulted in a miracle cure but in death.  She needed to seriously rethink her involvement with the bio-crisis team.  She was far more comfortable in the lab, working behind the scenes to find the answers.  In the past someone else had handled patient care.  Her job was to unravel the whys and hows of the disease not make the life and death decisions on the spur of the moment.  How Marcase handled making those calls was beyond her, she was nauseated just thinking about it.  Maybe it was time to get out, to go back to what she knew and was comfortable dealing with.  "Stop that Kimberly you are not a coward."  Since joining the bio-crisis team she had learned so much.  Her perceptions had been widened; she could no more go back then she could stop breathing.  She was a doctor and a scientist.  The team operated on the frontiers of medicine.  There were no rules or safe havens here.  Their work involved risk for themselves and those they treated.  Could she honestly turn her back on those who needed her skills and slink back to where it was safe?  Kimberly shook her head.  No she was her parents' daughter.  She could not quit.  On the other hand she didn't know if she could accept this cavalier treatment of people's lives.  No, that wasn't fair.  Both Marcase and Cassian cared about their patients.  Neither would risk a person's life needlessly.  But that was her problem, how did one determine when such a risk was the only viable option and when it was an unacceptable risk?   Shiroma continued to stare dejectedly out the window hoping that somehow she would find the answers she needed.  Her contemplation was interrupted by a soft tapping on her hospital room door.  Turning she was surprised to see her colleague Dr. Edward Marcase slip into the room.  "Edward what are you doing here?  We're supposed to be in quarantine."
     "Aw come on Kim, we both know that if we were going to get this bug we would be sick by now.  They're just keeping us here to be sure.  Besides I was going crazy staring at the walls.  Thought I'd come see how you were doing?"
     Shiroma couldn't help smile as Edward made himself comfortable in the room's only chair.  Obviously he wasn't planning to leave anytime soon.  And truthfully she was glad he was there.  She walked over and settled on the edge of the bed, giving him a tired smile.  "I'm not sure how I am.  Physically?  I agree with you.  If we haven't contracted the virus by now, we're clean.  Mentally?  I'm not sure."
     "This is about Darla isn't it?"  Marcase smiled at Shiroma's surprised look.  "No, I'm not a mind reader, but it wasn't hard to guess that now that the crisis is past you might be second guessing yourself."
     "You are way too astute Dr. Marcase."
     "No, Dr. Shiroma, I've just had way too much practice dealing with this type of thing.  Want to talk about it?"
     "How do you do it Edward?  How do you make split second decisions involving enormous risk?  And how do you live with the consequences of those decisions?"
     Marcase gave a weary sigh.  "It comes with the territory Kim and it never gets any easier.  I know it's been hard on you.  The type of work we do, the cases we've handled, I know that sometimes you feel I rush in without studying a situation fully.  That I take unnecessary risk, but that's the nature of front line medicine.  You don't always have the luxury of lengthy tests and trials."
     "But how do you know when it is necessity and when it is expediency?"
     "Have you ever played the 'What If' game?"  At Kimberly's blank look Marcase chuckled.  "I see you haven't.  In the 'What If' game you take a situation and project the expected outcomes of possible actions.  For instance, What if we had never boarded the airplane, what would have happened?"
     Kim thought about the question.  She wasn't sure where Marcase was going with this but she was willing to play along.   "Well, if we hadn't been on the plane the virus would have still manifested."
     "But there would have been no one to warn the crew of the seriousness of the outbreak, no quarantine would have been initiated.  The disease would have spread unchecked and the flight crew would all have been stricken.  There would have been no one to fly the plane, it would have crashed with all on board."
     "All right I grant that it was fortuitous that we were on board and that we were able to access the lab module."
     "Now, what if we had not tried to extract the enzyme and modify the antiviral drug, what would have happened?" 
     "Darla would still be alive."
     "Would she?  Darla was the second person stricken.  The course of her disease was the most advanced.  We had at least three hours of flight time to Hawaii.  Darla might have lived another two hours at best.  She would not have lived to see a hospital.  If by some miracle she had managed to hang on for three hours, her condition would still have been beyond the hope of treatment.  Any way you look at it Darla would not have survived her exposure."
      "But Edward, I killed her."
     "Yes, the treatment killed her.  But what would have happened if you had not tried it on her?"
     "I'm not sure what you mean.  If I hadn't tried it on her she wouldn't have died of heart failure."
     "But then you wouldn't have had any idea about the drug’s dangers.  Without that knowledge the copilot might not have lived long enough to land the plane.  Darla didn't die in vain.  A lot of people are alive, thanks to her.  We're two of them."
     "And the copilot, what about him?"
     "We owe him our lives.  There was no way I could have landed that plane Kim.  After all our struggles we would have all died in a fiery crash if it hadn't been for him.  And without your treatment he would not have been able to fly.  However you look at it Kim there was no other choice but the one we made.  It was the only one that gave life a chance.  All other avenues led to certain death.  So yes, it hurt to make those calls but I couldn't in good conscience do anything else.  I'm a doctor; I have to always back the choice that favors life.  And there is one other thing you need to consider.  Both Darla and the copilot died knowing that they had made a difference.  Aside from the pain of her illness, Darla also had the pain of knowing that her and Rick's actions condemned an entire plane of people to death.  That is a heavy burden.  When the treatment began to work she had hope that those people were going to live.  She didn't have to die with their deaths on her conscience.  The copilot is similar; he died knowing he fulfilled his obligation.  He brought his people home."
     "I had never though of it that way.  So is that how you decide what harebrained ideas to try; you play the 'What If' game?"
     "Yep, of course I do it in my head and a lot faster.  It's almost instinctive, but believe it or not I do count up the possible costs of my actions before I rush in.  Well, at least where my patient's welfare is concerned.  Michael swears that I have no sense of self-preservation.  It seems my instincts only work when other people's lives are at stake."  Marcase leaned forward and grasped Shiroma's hand.  "There is something else you need to know Kim.  All the last minute miracles we've pulled out of the air since we have been a part of this team, well none of them would have been possible without you.  You are one hell of a doctor Kimberly Shiroma and there are a lot of people alive and well today because of you.  Thank you."
     For a few minutes Shiroma just stared, she did not even try to stop the tears running down her face.  Edward wouldn't care.  He didn't view emotions as a weakness and caring was not a crime.  No, the only thing Marcase viewed as a crime was not doing one's best.  He would never let someone die because he was afraid of taking a risk.  But she now knew that he wouldn't take that risk unless there was no other way to save the patient's life.  "Thank you."
     "You're welcome."  Further discussion was halted by a soft knock at the door.
     Shiroma smiled as Michael Hailey slipped through the door.  "Hello, Michael I see Edward's not the only one breaking quarantine."
     Hailey smiled.  "Someone had to make sure he didn't get caught."  He turned to Marcase.  "Which reminds me the blood patrol is on their way.  Time to go."
     Edward groaned as he climbed to his feet.  "Just what I need another blood test.  Why won't they believe me when I tell them we're all fine?"
     Hailey just shook his head.  "Can't imagine what they could be thinking.  Anyway this should be the last one.  Cassian has agreed to spring us if our blood work is still clean."
     "Hallelujah, OK Michael let's go.  See you later Kim, hopefully outside."
     Shiroma escorted the two men to the door.  As Hailey checked to make sure the coast was clear, Kimberly turned to Marcase.  "Thanks, I don't know how you knew but thanks."
     Edward reached out and gave his partner a quick hug.  "Like I said before, I've had way to much practice.  You'll be OK, Kim. See ya outside."  Then he was gone.
     Shiroma returned to the window, but this time instead of defeat she felt the first stirring of determination.  There was a great deal of work waiting for them out there and Kimberly Shiroma was ready to meet the challenge.