ought to know what it was, but she couldn't think clearly, and in fact
she didn't care what it was or where she was going or why.
Ahead, a pair of double doors flew open, revealing a space warmed by
yellow light, peopled by several silhouettes of men and women. Then
Lindsey was rushed into the light and among the silhouettes ... a long
hallway ... a room that smelled of alcohol and other disinfectants...
the silhouettes becoming people with faces, then more faces appearing...
soft but urgent voices ... hands gripping her, lifting ... her off the
gurney, onto a bed .. tipped back a little, her head below the level of
her body ...
rhythmic beeps and clicks issuing from electronic equipment of some
kind.
She wished they would just all go away and leave her alone, in peace.
Just go away. Turn off the lights as they went. Leave her in darkness.
She longed for silence, stillness, peace.
A vile odor with an edge of ammonia assaulted her. It burned her nasal
passages, made her eyes pop open and water.
A man in a white coat was holding something under her nose and peering
intently into her eyes. As she began to choke and gag on the stench, he
took the object away and handed it to a brunette in a white uniform.
The pungent odor quickly faded.
Lindsey was aware of movement around her, faces coming and going.
She knew that she was the center of attention, an object of urgent
inquiry, but she did not-could not manage tare. It was all more like a
dream than her actual dreams had been. A soft tide of voices rose and
fell around her, swelling rhythmically like gentle breakers whispering
on a sandy shore: ..... marked paleness of the skin .. cyanosis of
lips, nails, fingertips, lobes of the ears ,...weak pulse, very rapid
... respiration quick and shallow ... blood pressure's so damned low I
can't get a reading "Didn't those assholes "Sure, all the way in."
"Oxygen, CO-2 mix. And make it fast!"
"Epinephrine?"
"Yeah, prepare it."
"Epinephrine? But what if she has internal injuries? You can't see a
hemorrhage if one's there."
"Hell, I gotta take a chance."
Someone put a hand over her face, as if trying to smother her. Lindsey
felt something plugging up her nostrils, and for a moment she could not
breathe. The curious thing was that she didn't care. Then cool dry air
hissed into her nose and seemed to force an expansion of her lungs.
A young blonde, dressed all in white, leaned close, adjusted the
inhalator, and smiled winningly. "There you go, honey. Are you getting
that?"
The woman was beautiful, ethereal, with a singularly musical voice,
backlit by a golden glow.
A heavenly apparition. An angel.
Wheezing, Lindsey said, "My husband is dead."
"It'll be okay, honey. Just relax, breathe as deeply as you can,
everything will be all right."
"No, he's dead," Lindsey said. "Dead and gone, gone forever. Don't you
lie to me, angels aren't allowed to lie."
On the other side of the bed, a man in white was swabbing the inside of
Lindsey's left elbow with an alcohol-soaked pad. It was icy cold.
To the angel, Lindsey said, "Dead and gone."
Sadly, the angel nodded. Her blue eyes were filled with love, as an
angel's eyes should be. "He's gone, honey. But maybe this time that
isn't the end of it."
Death was always the end. How could death not be the end?
A needle stung Lindsey's left arm.
"This time," the angel said softly, "there's still a chance. We've got
a special program here, a real" Another woman burst into the room and
interrupted excitedly: "Nyebern's in the hospital!"
A communal sigh of relief almost a quiet cheer, swept those gathered in
"He was at dinner in Marina Del Rey when they reached him. He must've
driven like a bat out of Hell to get back here this fast."
"You see, dear?" the angel said to Lindsey. "There's a chance.
There's still a chance. We'll be praying."
So what? Lindsey thought bitterly. Praying never works for me.
Expect no miracles. The dead stay dead, and the living only wait to
join them.
Guided by procedures outlined by Dr. Jonas Nyebern and kept on file in
the Resuscitation Medicine project office, the Orange County General
Hospital emergency staff had prepared an operating room to receive the
action the moment the on-site paramedics in the San Bernardino Mountains
had reported, by police-band radio, that the victim had drowned in
near-freezing water but had suffered only minor injuries in the accident
itself, which made him a perfect subject for Nyebern. By the time the
air ambulance was touching down in the hospital parking lot, the usual
array of operating-room instruments and devices had been augmented with
a bypass machine and other equipment required by the resuscitation team.
Treatment would not take place in the regular emergency room. Those
facilities offered insufficient space to deal with Harrison in addition
to the usual influx of patients. Though Jonas Nyebern was a
cardiovascular surgeon and the project team was rich with surgical
skills, resuscitation procedures seldom involved surgery. Only the
discovery of a severe internal injury would require them to cut
Harrison, and their use of an operating room was more a matter of
convenience than necessity.
When Jonas entered from the surgical hallway after preparing himself at
the scrub sinks, his project team was waiting for him. Because fate had
deprived him of his wife, daughter, and son, leaving him without family,
and because an innate shyness had always inhibited him from making
friends beyond the boundaries of his profession, these were not merely
his colleagues but the only people in the world with whom he felt
entirely comfortable and about whom he cared deeply.
Helga Dorner stood by the instrument cabinets to Jonas's left, in the
penumbra of the light that fell from the array of halogen bulbs over the
operating table. She was a superb circulating nurse with a broad face
and sturdy body reminiscent of any of countless steroid-saturated female
Soviet track stars, but her eyes and hands were those of the gentlest
Raphael Madonna. Patients initially feared her, soon respected her,
eventually adored her.
With solemnity that was characteristic in moments like this, Helga did
not smile but gave Jonas a thumbs-up sign.
Near the bypass machine stood Gina Delilo, a thirty-year-old RN and
surgical technician who chose, for whatever reasons, to conceal her
extraordinary competence and sense of responsibility behind a pert,
cute, ponytailed exterior that made her seem to be an escapee from one
of those old Gidget or beach-party movies that had been popular decades
ago.
Like the others, Gina was dressed in hospital greens and a string-tied
cotton cap that concealed her blond hair, but bright-pink ankle socks
sprouted above the elastic-edged cloth boots that covered her shoes.
Flanking the operating table were Dr. Ken Nakamu
ra and Dr. Kari
Dovell, two hospital-staff physicians with successful local private
practices. Ken was a rare double threat, holding advanced degrees in
intern medicine and neurology. Daily experience with the fragility of
human physiology drove some doctors to drink and caused others to harden
their hearts until they were emotionally isolated from their patients;
Ken's healthier defense was a sense of humor that was sometimes twisted
but always psychologically healing. Kari, a first-rate specialist in
pediatric medicine, was four inches taller than Ken's five-feet-seven,
reed-thin where he was slightly pudgy, but she was as quick to laugh as
the internist.
Sometimes, though, a profound sadness in her eyes troubled Jonas and led
him to believe that a cyst of loneliness lay so deep within her that
friendship could never provide a scalpel long or sharp enough to excise
it Jonas looked at each of his four colleagues in turn, but none of them
spoke. The windowless room was eerily quiet.
For the most part the team had a curiously passive air, as if
disinterested in what was about to happen. But their eyes gave them
away, for they were the eyes of astronauts who were standing in the exit
bay of an orbiting shuttle on the brink of a space walk: aglow with
excitement, wonder, a sense of adventure and a little fear.
Other hospitals had emergency-room staffs skilled enough at
resuscitation medicine to give a patient a fighting chance at recovery,
but Orange County General was one of only three centers in all of
southern California that could boast a separately funded, cutting-edge
project aimed at maximizing the success of reanimation procedures.
Harrison was the project forty-fifth patient in the fourteen months
since it had been established, but the manner of his death made him the
most interesting. Drowning. Followed by rapidly induced hypothermia.
Drowning meant relatively little physical damage, and the chill factor
dramatically slowed the rate at which postmortem cell deterioration took
place.
More often than not, Jonas and his team had treated victims of
catastrophic stroke, cardiac arrest, asphyxiation due to tracheal
obstruction, or drug overdose. Those patients usually had suffered at
least some irreversible brain damage prior to or at the moment of death,
before coming under the care of the Resuscitation Project, compromising
their chances of being brought back in perfect condition.
And of those who had died from violent trauma of one kind or another,
some had been too severely injured to be saved even after being
resuscitated. Others had been resuscitated and stabilized, only to
succumb to secondary infections that soon developed into toxic shock.
Three had been dead so long that, once resuscitated, brain damage was
either too severe to allow them to regain consciousness or, if they were
conscious, too extensive to allow them to lead anything like a normal
life.
With sudden anguish and a twinge of guilt, Jonas thought of his
failures, of life incompletely restored, of patients in whose eyes he
had seen the tortured awareness of their own pathetic condition.
"This time will be different." Kari Dovell's voice was soft, only a
whisper, but it shattered Jonas's reverie.
Jonas nodded. He felt considerable affection for these people. For
their sake more than his own, he wanted the team to have a major,
unqualified success.
"Let's do it," he said.
Even as he spoke, the double doors to the operating room crashed open,
and two surgical orderlies rushed in with the dead man on a gurney.
Swiftly and skillfully, they transferred the body onto the slightly
tilted operating table, treating it with more care and respect than they
might have shown a corpse in other circumstances, and then exited.
The team went to work even as the orderlies were heading out of the
room. With speed and economy of movement, they scissored the remaining
clothes off the dead man, leaving him naked on his back, and attached to
him the leads of an electrocardiograph, an electroencephalograph, and a
skin-patch digital-readout thermometer.
Seconds were golden. Minutes were beyond price. The longer the man
remained dead, the less chance they had of bringing him back with any
degree of success whatsoever.
Kari DoveIl adjusted the controls of the EKG, sharpening the contrast.
For the benefit of the tape recording that was being made of the entire
procedure, she repeated what all of them could see: "Flat line. No
heartbeat."
"No alpha, no beta," Ken Nakamura added, confirming the absence of all
electrical activity in the patient's brain.
Having wrapped the pressure cuff of a sphygmomanometer around the
patient's right arm, Helga reported the reading they expected: "No
measurable blood pressure."
Gina stood beside Jonas, monitoring the digital-readout thermometer.
"Body temperature's forty-six degrees."
"So low!" Kari said, her green eyes widening with surprise as she stared
down at the cadaver. "And he must've warmed up at least ten degrees
since they pulled him out of that stream. We keep it cool in here, but
not that cool."
The thermostat was set at sixty-four degrees to balance the comfort of
the resuscitation team against the need to prevent the victim from
warming too fast.
Looking up from the dead man to Jonas, Kari said, "Cold is good, okay,
we want him cold, but not too damned cold. What if his tissues froze
and he sustained massive cerebral damage?"
Examining the dead man's toes and then his fingers, Jonas was almost
embarrassed to hear himself say, "There's no indication of vesicles-"
"That doesn't prove anything," Kari said.
Jonas knew that what she said was true. They all knew it. There would
not have been time for vesicles to form in the dead flesh of
frost-bitten fingertips and toes before the man, himself, had died.
But, damn it, Jonas did not want to give up before they had even
started.
He said, "Still, there's no sign of necrotic tissue-"
"Because the entire patient is necrotic," Kari said, unwilling to let go
of it.
Sometimes she seemed as ungainly as a spindly-legged bird that, although
a master of the air, was out of its element on the land. But at of
times, like now, she used her height to advantage, casting an
intimidating
shadow, looking down at an adversary with a hard gaze that seemed to say
better-listen-to me or-I-might-peck-your-eyes-out-mister. Jonas was two
inches taller than Kari, so she couldn't actually look down at him, but
few women were that close to being able to give him even a level-eyed
stare, and the effect was the same as if he had been five-feet-two.
Jonas looked at Ken, seeking support.
The neurologist was having none of it. "In fact the body temperature
could have fallen below freezing after death, then warmed up on the trip
here, and there'd be no way for us to tell. You know that, Jonas.
The only thing we can say for su
re about this guy is that he's deader
than Elvis has ever been."
"If he's only forty-six degrees now Kari said.
Every cell in the human body is composed primarily of water. The
percentage of water differs from blood cells to bone cells, from skin
cells to liver cells, but there is always more water than anything else.
And when water freezes, it expands. Put a bottle of soda in the freezer
to quick-chill it, leave it too long, and you're left with just the
exploded contents bristling with shattered glass. Frozen water bursts
the walls of brain cells-all body cell-in a similar fashion.
No one on the team wanted to revive Harrison from death if they were
assured of bringing back something dramatically less than a whole
person.
No good physician, regardless of his passion to heal, wanted to battle
and defeat death only to wind up with a conscious patient suffering from
massive brain damage or one who could be sustained "alive" only in a
deep coma with the aid of machines.
Jonas knew that his own greatest weakness as a physician was the
extremity of his hatred for death. It was an anger he carried at all
times.
At moments like this the anger could swell into a quiet fury that
affected his judgment. Every patient's death was a personal affront to