He stepped around his desk and offered his hand. “Dr. Abe.”

  “Miami Jones,” I replied, although I was tempted to go with Mr. Jones.

  Abe directed me to a couple plush chairs by a round coffee table near the window. “Water?”

  “Sure, thanks.”

  He retrieved a filtered pitcher from a small refrigerator, poured out two glasses, then returned it.

  “So, I understand you are working on behalf of Mr. Cabrini.”

  “That’s right.”

  Dr. Abe put the water on the table and sat. “I should begin by saying that I can’t discuss the particulars of his case with you.”

  “HIPAA.”

  “Exactly. Plus, some of what we are studying with Mr. Cabrini is proprietary.”

  “Proprietary? Like work secrets?”

  “Research intelligence.”

  “So you’re a brain doctor, is that right?”

  “In layman’s terms, I suppose. I’m a board-certified neurosurgeon and research fellow at the Max Planck Institute.”

  “That’s at FAU?”

  “Yes. On the Jupiter campus.”

  “So you’re not treating Mr. Cabrini.”

  “Oh, yes, we are. See, I am leading a research project into the long-term effects of contact and combat sports on the human brain. All the participants in the study receive cutting-edge treatment for their conditions as part of our study.”

  “For free?”

  “That’s correct.”

  “And what are you hoping to show, that boxing is bad for the brain?”

  “No, that’s been proven. There’s no doubt. Being punched is a potentially concussive event, and repeated trauma over time leads to demonstrated negative outcomes.”

  “So what are you doing with Johnny?”

  “I can’t discuss specifics.”

  “What is it you are studying, in general?”

  “We are trying to establish the baseline for chronic traumatic encephalopathy and develop diagnostic tools for it.”

  “In English?”

  “Have you heard of CTE?”

  “Sure, repeated concussions leading to brain injury. Lots of NFL players get it.”

  “More or less. But currently, we can’t say definitively what it is, what exactly causes it, or who has it.”

  “Seriously? I thought it was about repeatedly getting hit in the head.”

  “It is, but what does that mean for an individual? Did you ever play sports?”

  “College football, pro baseball.”

  “Get injured?”

  “Not really. Niggles, sore shoulder, that sort of thing.”

  “But you knew players who did?”

  “Sure. Most.”

  “Take a knee injury,” said the doctor. “Say a cruciate ligament. What happens? You feel something in your knee, give it a rub, maybe a rest. But then it happens again. Is it worse? Is it the same part of the knee? What do you do?”

  “Get a scan.”

  “Right. A diagnostic tool to help determine the nature and severity of the injury, which then determines treatment. But imagine you can’t scan, you can’t know for sure. Then what do you do? Treat the best way you can. But repeated injury leads to a chronic condition. Years after you retire, your knees have degenerated to the point where you cannot walk. Imagine in this world that your knees are mission critical to your life function like your brain is. Now what? We do knee replacements these days, but we can’t do that on a brain.”

  He took a sip of water before he got going again. “So with head trauma, the challenge is that no two brains are the same. A light knock that does nothing to one person might concuss another. Two people might have a major collision and both suffer concussions, but one recovers that day, and the other might not recover for months.”

  “But we’re talking repeated hits over a long period of time, aren’t we?”

  “Yes, but how many is the baseline? Is ten too many? A hundred? A boxer might get hit in the head fifty thousand times in a career—most of those in sparring sessions, which is something we are trying to address—and that’s sure to be over any safe limit, but then how is it that some boxers don’t get CTE?”

  “They don’t?”

  “No.”

  “I thought the tests they did on those NFL players showed almost a hundred percent get CTE.”

  “The subjects tested had all exhibited signs of trauma when alive—depression, aggression, headaches. It was like selecting only people who limped and saying a hundred percent of them had bad hips. The fact is we don’t know. The numbers are clearly not good, but the data we have are flawed.”

  “So you can’t say what percentage of boxers get brain damage?”

  “Oh, I’d wager the answer to that is a hundred percent. But then you have to ask what is the extent of that injury? The brain is complex. It has a remarkable ability to repair itself, or to even reroute processes around damaged areas. But a concussion, by definition, is damage. The question is how bad and how much does it recover? Sometimes fully, sometimes not at all.”

  “But Johnny Cabrini has obvious symptoms, doesn’t he?”

  “I can’t speak to a specific case.”

  “Okay, but if a subject had depression, anger issues, headaches, trouble holding down a job, that would be proof, wouldn’t it?”

  “You could say yes, but it isn’t definitive. Can a person who hasn’t experienced multiple concussions suffer from depression?”

  “Yes.”

  “Sure they can. Most people who have depression are not boxers or football players. And studies have shown that at any one time up to twenty percent of the population has a headache. Most of them will not have had concussions. And take a boxer who has been punched repeatedly over the years and another who has not. Maybe they each had some success in their heyday, made some money. Twenty years later, each is living in poverty, his glory days well behind him, maybe estranged from his family. Could that induce depression-like symptoms, substance abuse issues? Nothing more than life circumstance?”

  “Yes.”

  “Sure. So, CTE could be the problem, or not. What we know is that head trauma is bad, and it can lead to devastating outcomes later in life, but not in every case. So we search for a baseline above which we have some certainty of negative outcomes, and for a diagnostic tool to determine if a subject indeed is in the early stages CTE.”

  “How do you tell if they have it now?”

  “A neuropathologist cuts open the brain after death.”

  “Not so useful.”

  “Not for the individual.”

  “So the doctor who examined Johnny was right to deny him fund money?”

  “While I can’t speak on a specific case, I will say this: when you attempt to diagnose this kind of issue, you don’t just look for one marker, you look for a broad spectrum.”

  “Meaning?”

  “If the subject has severe headaches, one marker, that is not enough. But if a subject has multiple markers—headaches, depression, mood swings, anger issues—combined with a history of concussive trauma, like being a boxer, that would more likely lead to a CTE diagnosis. More markers, more likely it is.”

  “Johnny Cabrini has all that.”

  Dr. Abe lifted his eyebrow.

  “Have you seen the terms of the fighters’ fund?” I asked him. “Should a patient with a broad spectrum of markers be covered?”

  “It would seem the only reason to have such a thing. It’s not designed to cover getting cancer, is it?”

  “No. So you think the other doctor was wrong?”

  “I can’t speak to another neurologist’s diagnosis. I don’t know what data they’ve seen or what testing they’ve done.”

  “The other doctor isn’t a neurologist. He’s a primary care physician.”

  Abe frowned. “Then his first step should have been to make a referral.”

  “Would you share Johnny’s test results with the court if he asked?”

  “If that was the subject’s wish, then yes, of course.”

  I took a sip of water. It tasted smooth, whatever that meant. “Dr. Abe, you said subjects in your study were offered cutting-edge treatment. What would someone with symptoms similar to Johnny’s get?”

  “I’m afraid it sounds more impressive than it is. Mostly we treat the psychiatric issues using medications and some counseling. But we can’t treat the damage itself. That’s a ways off.”

  “So for a subject with symptoms like Johnny’s, you’re saying you can’t make them better?”

  “No, we cannot. When you treat symptoms and not the disease, all you do is buy time. How much time is anyone’s guess.”

  “So he won’t get better, the depression and so on?”

  “Mr. Jones, there is no cure for depression, and that’s without substantial damage to the brain. It can ebb and flow through a person’s life. It can often be managed with medications, counseling, and possibly lifestyle changes, such as fitness and eating behaviors, but it is never cured.”

  “One last thing. Johnny told me that you had said something about the right uppercut being the biggest problem. Is that correct?”

  “In a sense. What I meant was, the skull and the brain are designed to take front-on punishment, like a jab. It seems the worst damage is done when the force causes the head to rotate, to snap. In boxing that would be a cross—like a haymaker—or an uppercut. They cause the head to rotate, often resulting in damage to the brain stem—where the brain connects to the spine. But a good boxer usually sees a cross coming and prepares for it. The uppercut often hits unseen. If you watch enough matches, Mr. Jones, you’ll notice that many knockouts have something to do with an uppercut.”

  “Why the right uppercut?”

  “Most boxers stand left foot forward, so the right glove is the power shot. If it was a southpaw, I’d be watching for the left uppercut. Same principle.”

  “Doc, I’ve taken up enough of your time.” Abe walked me to the door. When we got there I stopped.

  “Dr. Abe, what’s going to happen to Johnny?”

  “Outcomes?”

  “Yes. I know you can’t get into case specifics, but he has a family.”

  “I wouldn’t put it like this to the family, Mr. Jones, but with you, I will be blunt. Subjects with Mr. Cabrini’s markers don’t get fairytale endings. The depression will likely get worse, as will the mood swings and the anger issues. Subjects find it increasingly difficult to work or to be around people. We can up the medications, but all that does is dull the pain. These drugs, like all drugs, have side effects that must be managed. Such subjects often descend into alcohol and substance abuse. An alarming number end up dying by suicide.”

  “That’s pretty bleak.”

  “Yes, Mr. Jones, it is.”

  “So what can we do?”

  “The best we can. This is why we research. This is why Mr. Cabrini comes here. Once upon a time, prostate cancer killed most men who developed it. Now five-year survival rates are in the high nineties, and most of the deaths that do occur are because men of your age don’t go to the doctor until it’s too late. We may not be able to save Mr. Cabrini, but Mr. Cabrini may be able to save those who come after him.”

  I shook the doctor’s hand and thanked him, then walked back through the halls that felt more like a brokerage firm than a medical clinic. I nodded at the receptionist as I strode by but didn’t stop, walked swiftly to my Jeep, and started it before I even closed the door. I laid rubber and got far, far away.

  CHAPTER SEVEN

  I spent the day at loose ends. Ron was working at home on the island, digging up what he could on this fund and handling a few insurance client cases. Lizzy was doing her thing, whatever that was. I paced for a while, then I sat at my desk and thought about whatever flapped its way into my mind. I ended up daydreaming: I was on the field with my high school baseball coach, Coach Dunbar, except I was only a child, maybe six years old. I threw the ball to him behind home plate, and he tossed it back. This went on and on, and I was only pulled from it by the sound of police cars speeding down Olive Avenue, sirens screaming.

  I went for a walk down Clematis Street and perused the lunch places but bought nothing. As I got near the water, I saw E.R. Bradley’s Saloon, which made me think of Longboard Kelly’s. I tossed around the idea of one of Mick’s fish sandwiches, but something kept me from going. It was as if my professional life and my private life had collided at Longboard’s. The notion made little sense since clients often came and found me underneath the palapa, and Ron and I habitually talked through cases while sitting at the bar. Those compartments had breached and intermingled a long time ago without causing me any stress, but now I didn’t know what I was thinking or where I should be. The axis of my planet was tilting, and it was all I could do to hang on.

  So I walked. Down Flagler Drive past the bridge named after the same man, until I got to Providencia Park, where I did a loop and then headed back the other way. I walked straight by Clematis Street and the amphitheater and along the water until I reached the long boardwalk out to South Cove Islands.

  The nature area on the biggest of the islands was nothing more than hardy mangroves and sand and rocks, and there was nothing natural about it. It was manmade, an attempt to resurrect the estuary habitat that had existed before Flagler and his trains arrived. It was Florida all over. It looked like how the state had been two hundred years ago—scrub and sand—but it wasn’t real. It gave a sense of natural peace within earshot of the traffic on Flagler Drive, and egrets and herons stood with me looking at the skyline of West Palm Beach.

  When I got back to the office, Lizzy glanced up but went straight back to work. I grabbed my car keys and told her I was heading out. The traffic had built as the afternoon had beckoned the evening, but the slow pace along Route 1 suited my mood. I wasn’t in any hurry. Getting to where I was going later was just as good as sooner.

  I crawled down toward Lake Worth until I reached 10th Avenue, then I headed west. I had an address that my phone’s GPS found shortly before Congress Avenue, but I had no idea what I was searching for. It looked like any old two-level strip mall: glass storefronts at street level and windows on the second floor that suggested office space—the kind of place you might expect to find a private investigator’s office, at least if you were reading a Dashiell Hammett novel.

  I saw a barbershop that was closing up, and a payday lender and a dollar store still open, but nothing that looked like a club. Someone behind me sounded their horn, so I scanned for a place to park.

  A second horn blared. I moved forward and turned down the side street, where I pulled into a parking lot behind the stores. I eased along the rear of the building, just solid doors on this side, turned left at the cinder block wall, and parked in the rear. I wandered over to the building. It was after five, and the lot was about a third full, but I saw no one around. At the dollar store, a note taped on the steel door said they were open and to come on in for bargains.

  I left the bargains behind and walked the sidewalk along the rear of the building. I pulled on the door to the barbershop: locked. There was a five-foot-wide gap in the building, like a missing tooth, and I looked into the dark alcove where a steel door was propped open, revealing the bottom of a set of stairs.

  I stepped into the alcove and saw another piece of paper taped on a door. This was on the inside of the door before the stairs, I assumed so it could be seen when the door was held open. There was a coat of arms on the paper with boxing gloves and interlocking capital letters P and C. Below that it read Pugilists’ Club.

  Having confirmed I was getting warm, I took the stairs up. As I ascended I picked up the sound of soft chatter and the drone of a television. At the top there was a locked door to my right and an open door to my left, which I stepped through.

  The Pugilists’ Club, looking like a relic from another age, took up the entire floor above the barbershop and the dollar store. The stained, paneled walls were filled with photographs of boxers in the ring and in various set poses. Stackable metal seats surrounded chipped wooden tables, and worn leather chairs clustered by the windows. At the end was a tiled bar not unlike an Italian café, with a large espresso machine and rows of liquor bottles at the back. Beer taps behind the bar offered two kinds: Bud and Bud Light.

  Only the flat-screen televisions mounted around the room appeared to be from this century, all tuned in to boxing matches but muted. There were roughly a dozen people in the whole place.

  I weaved in between tables toward the bar, where three people were chatting with the bartender. She looked like the original article. Her hair was bottle blond and the lines at the corners of her mouth suggested she had smoked for a long time. She put a beer in front of one patron and followed it with a wink.

  I took a leather stool at the end and waited for the bartender to come my way. As she did, I noted her eyes were welcoming but her mouth was not.

  “Help you, darlin’?”

  “Can I get a beer?”

  “Sorry, this is a private club.”

  “So I heard. Harv suggested I come by.”

  “Did he now? You don’t look like a boxer, darlin’.”

  “No, ma’am, I’m not. My name is Miami Jones. I’m helping Johnny Cabrini get some money to cover his medical costs.”

  “That right? How is Johnny?”

  “Good days and bad days.”

  “And his wife?”

  “Tina’s doing it hard, to be honest.”

  “It must be tough on those boys of his.”

  “Not really, given he doesn’t have any boys. But Tina’s trying to shield their daughters as best as she can.”

  The woman smiled out of one side of her mouth. “What’ll you have?”

  “Whatever’s cold.”

  She stepped away to the taps and poured two beers, placed one in front of an old-timer, and brought the other back to me.

  “Cheers,” I said before taking a sip.

  “Back at ya,” she said, sucking what looked like ginger ale through a candy-striped straw.