Gately's M.D.-temptation dream (p. 884)

The hinge the whole scene turns on, easy to read past on first pass: everything that follows — the nurse with Joelle's requested notebook and Bic, Ferocious Francis in the visitor chair, the Pakistani trauma M.D. singing through the controlled-substance schedule — is rendered as plain waking narration, and only the reveal on p. 890 exposes it as dream. This line is the membrane's one marker. Carlisle reads the notebook delivery as firmly inside the dream (the waking audit finds it gone); our digest keeps the text's own it-may-have-been-real ambiguity.