Buffalo, New York, functions less as a single crime scene than as a point where separate strands of the investigation and Leimert Fusco’s family history converge. A report datelined from the city concerns an alleged poisoning in Rochester; Buffalo police are later faulted for failing to pursue Roger Sharveneau’s account of Michael Ferris Burke; and Fusco’s move there to raise Victoria ends in her final hospitalization at a local hospital, where Sharveneau was on duty.

Setting and Relocation

Five years after his wife died of breast cancer, Leimert Fusco requested a transfer from his position directing behavioral sciences in the Midtown Manhattan office. He said he wanted a quieter place to raise his daughter, Victoria, and an administrative post was arranged for him in the Buffalo office. He bought a home near Lake Erie. The transfer is presented as a family decision rather than a career advance: Fusco was a sole parent, and Victoria had already survived a bone tumor diagnosed when she was a toddler.

Victoria’s earlier treatment at Sloan-Kettering had apparently cured the tumor. Years later, when she was sixteen, she developed leukemia, which doctors believed had been caused by the radiation used to treat the earlier cancer. The family’s move to Buffalo had offered a quieter home, but it did not remove the need for treatment elsewhere or protect Victoria from a second, grave illness.

Buffalo in the Burke Investigation

A reprinted news item dated fifteen months earlier carries a Buffalo dateline and reports that Michael Ferris Burke, a thirty-eight-year-old emergency-room physician, was being sought in connection with an attempted poisoning. The alleged target was Selwyn Rabinowitz, chair of emergency medicine at Unitas Critical Care Center in Rochester, who had recently suspended Burke over questionable medical practices. The item says Burke had made veiled threats, and that Rabinowitz became ill almost immediately after taking one sip of doctored coffee. He remained hospitalized in stable condition.

The report distinguishes suspicion from proof. Police suspected Burke because of the threats and his departure from town; syringes and vials found in a physicians’ lounge locker were recovered, but the police would not say whether they belonged to him. Buffalo is the report’s dateline, not the location of the alleged poisoning: the account places Rabinowitz and Unitas in Rochester. Its presence in the investigation gives the city a documentary role, carrying a published version of the Burke case without resolving the evidence against him.

Police Leads and Unpursued Testimony

Buffalo police also figure in the later review of Sharveneau’s connection to Burke. Leimert Fusco tells Milo Sturgis that Buffalo investigators never checked Sharveneau’s story about Burke. Sharveneau had worked at Unitas for three months, during the same period as Burke; according to Fusco, he mentioned Burke and died a week later. The account makes the missed inquiry consequential, while leaving the substance and reliability of Sharveneau’s claim unsettled.

Fusco explains why the police may have discounted Sharveneau: he had appeared deeply disturbed and had repeatedly changed his story, alternately confessing, recanting, and suggesting he might have killed some patients but not others. He also called press conferences, changed lawyers, went on a hunger strike while jailed, and refused to speak to court-appointed psychiatrists. Fusco nevertheless believes Sharveneau knew Burke and that Burke had some influence over him. In this strand, Buffalo is associated not with a solved case but with an investigative omission that leaves a possible connection open.

Victoria’s Final Hospitalization

After Victoria’s leukemia returned, Fusco took her to Sloan-Kettering in New York for renewed treatment. She experienced a remission, relapsed, underwent more chemotherapy, and achieved only a partial remission. Experimental drugs helped her improve, but she grew weaker. Fusco then chose to continue treatment nearer home, at a hospital in Buffalo, with the aim of building her strength enough for a bone-marrow transplant back in New York.

Victoria improved for a time, but chemotherapy had weakened her immune system, and she developed pneumonia. Her doctors hospitalized her in Buffalo, where she died. The account characterizes her death as neither unexpected nor inevitable, preserving the uncertainty surrounding how her illness would end rather than presenting it as a foregone conclusion.

Sharveneau was on duty during Victoria’s final hospitalization. Whether he had ever been her therapist is unclear, and the discussion raises the possibility of missing records without settling the matter. This detail connects Fusco’s private loss to the novel’s unresolved Burke investigation: Buffalo is both the place where he tried to build a life with his daughter and a setting for the uncertain overlap between Sharveneau, Victoria’s care, and the claims about Burke.