She opened the ledger to a page dated November 1982.

Every entry was written in neat, black ink, except for a scattering of names written in bright, crimson ink.

“What does the red ink mean?” I asked, leaning closer to read the names.

“It means they had no insurance,” Martha said.

She pointed a crooked finger at a name near the bottom of the page.

“And it meant we were ordered to turn them away.”

I stared at the red ink, feeling a cold dread settle in my stomach.

“But Westside was a charity hospital back then,” I said. “They received millions in state funding to treat the poor.”

Martha let out a dry, bitter laugh.

“That was the scam,” she said. “The state paid the Carters based on their success rates.”

She turned the page, showing me more rows of crimson ink.

“If we admitted patients who were too sick, or who couldn’t pay for follow-up care, our success rate dropped,” she explained.

“So Daniel’s father ordered us to falsify the intake logs.”

My chest tightened as I looked at the names of people who had been rejected.