Chapter
10
For a moment, no one moved, no one spoke: not Blate; not the soldiers who stood poised with their rifles aimed at Kahayn’s heart. Not the nurse who’d brought the crash cart on a dead run; not Arin who’d paled to a shade of light aqua; and not Kahayn. The only person who did move was the dying, blood-soaked man on the gurney. His clothes were in tatters; his knees flexed and extended, and his legs strained against their restraints like he was trying to run in an awkward, slow-motion shuffle. His breathing had dropped off to irregular, deep gasps that scored Kahayn’s heart like jagged glass.
Agonal breaths, brain’s starving for air; we’re running out of time!
“Blate,” Kahayn said, urgently, “Blate, please, you have to let us finish!”
“It could be a trick.”
“Damn you, Blate, I don’t have time for this!” Kahayn shouted so fiercely that even Blate took a step back. “He doesn’t have time! This man is drowning in his own fluids, and he’s going to die if we don’t help him! So either shoot me, or get the hell out!” Then she looked over at Arin, the nurses, the tech. “Let’s go, people, let’s do it!”
She saw the soldiers glance at one another; Blate’s eyes narrowed. Arin hesitated, looked at the soldiers, then at Kahayn, and snapped to. “You heard her! Move!”
That was all her people needed. Personnel swarmed around Blate and the soldiers; the nurse rattled up with the crash cart; Arin slid a tube down the man’s throat, attached a bag, and then the anesthetist pushed his way in and took over as Arin moved to bring up his scanners. Kahayn pulled on fresh gloves as fast as she could, then slapped the man’s skin beneath his right clavicle with antiseptic solution. She bent over him, feeling for the notch of his clavicle with her right index finger and judging the distance before stabbing a large-bore needle threaded through a central venous catheter. There was a flash of blood in her syringe as the needle pierced the subclavian vein.
“I’m in!” She threaded the catheter into the vein and then nodded to a nurse who flicked on the IV while Kahayn threw in two quick sutures to hold the catheter in place. She snapped off her soiled gloves as the nurse moved to bandage the site. The corporal had started a line in the left arm and was taping down the tube. “Careful not to open that up wide; we don’t want to overload him.” She glanced behind her shoulder and saw that Blate and his men had taken up position along the far wall. Best I can hope for. She turned back to the corporal. “Get the rest of his clothes off! Move!”
“I want the clothes,” Blate said, “and that suit!”
“Yeah, yeah, when we’re done,” Kahayn said, not turning around. “Arin, what you got?”
“In a second!” Arin’s fingers flew over his control panels. “Bringing tomography and 3-D on line now!”
“Corporal, check for wounds. Then clean off his face, I want to get a good look at that gash, and get the portable X-ray up here; I want pictures of that skull, make sure—”
“Idit, pressure’s dropping!” Arin sang out. “Heart rate one-thirty-five; we’ve got significant pulmonary hypertension, and I’m getting atrial fibrillations here, sporadic PVCs! No periatrial waves at all!”
“What’s his potassium?” Kahayn shot back.
“Calculating…normal.”
“Dial down the IVs, then hit him with a diuretic, ten of pentalatix! Let’s get some of that fluid out of him. Someone get me a catheter in there, let’s make sure his kidneys are still working.” She spun left toward the anesthetist. “Give me positive pressure ventilation, short bursts, pure oxygen, keep those alveoli open, don’t rupture—”
“Idit,” Arin said, “I’m getting couplets!”
Kahayn swore. “Pull up 3-D of that heart, I want to see what I’m dealing with here.” She snatched up a stethoscope and slapped the drum to the middle of the man’s chest. She frowned. “Where’s…what the…what the hell…I don’t hear…?”
“Idit! V-fib! No pulse!”
Kahayn hopped off the gurney. “Corporal, start compressions! Charge up that defibrillator! Two hundred!” The defibrillator gave a crescendo whine as the machine charged, and she grabbed the gelled defibrillator paddles, rubbed them together. “Everyone off!”
The corporal jumped back, and Kahayn slapped the paddles onto the man’s chest, one at the apex of his right chest and the other at the tip of the sternum. But then what she’d heard flashed through her brain. Nothing in the center or to the right; heart’s shifted left; what’s it doing there, maybe pushed over because the right lung’s boggy, but that doesn’t make sense and the sound’s all wrong; what am I missing? She closed her eyes, imagined how that heart must look beneath the chest, how the electrical impulse must flow, and then she repositioned the paddles, the sternal paddle directly over the sternum just beneath the notch and the apical paddle on the left chest just below and left of the nipple.
“What are you doing?” cried the anesthetist. “Doctor, no, that’s wrong.”
“No, leave her!” Arin shouted. “Idit, go!”
“Clear!” Kahayn thumbed the push button of the apical paddle. There was a faint puh as the paddles discharged, but not the melodramatic flopping around that holodramas were so fond of. “Arin?”
He shook his head. “Still in V-fib. No pulse.”
“Charging again, two hundred…” Listening to that crescendo whine, thinking about that weird heart: Arin said no periatrial waves at all. Her eyes raked over the man’s body, over smooth skin and taut muscle. I’m missing something, what’s missing; what if he doesn’t have a periatrium to jump-start…? The defibrillator trilled. “Clear!” She discharged the paddles, heard the puh, waited. “Arin, anything?”
“Nothing.”
“Okay; charging up; nurse, get me an amp of xentracaine ready after this next—” She broke off as the charger whined. “Arin, you said no periatrial waves, right?”
Arin gave her a look. “That’s what I said.”
“That can’t be right,” said the anesthetist. To Arin: “It’s not reading right.”
“It’s right,” said Arin, giving her that look again. “I’m reading it right.”
No periatrium, no way to jump-start— Kahayn gasped, then jerked around to the nurse. “Charge it to three hundred.”
The nurse went as goggle-eyed as Blate. “Doctor?”
“Just do it!”
“Wait a second,” said the anesthetist. “That’s not—”
“Three hundred,” Kahayn said to the nurse.
“But, Doctor—”
“Are you deaf? Three hundred!”
The nurse swallowed hard, looked at the anesthetist, who shrugged, and then to Arin, who did nothing. Then she toggled up the charge. “Three hundred.”
“Clear,” Kahayn said, hoping like hell that she was right. She thumbed the discharge. There was that dull puh. “Arin?”
“That did something.” Arin looked at her over his glasses. “I got about five, six beats before the rhythm degenerated.”
“I got a little flutter up here,” said the anesthetist, almost grudgingly. “Though heaven knows why.”
Kahayn let out a breath. “Okay; Corporal, resume compressions; nurse, push in that amp of xentracaine, see if that’ll tamp down that cardiac irritability. Charge up the defibrillator again.” She and Arin exchanged a wordless stare; then he gave a minute nod, easily missed if she hadn’t been looking for it, and Kahayn said, “Three…fifty.”
She saw the nurses glance at one another before the nurse dialed up the voltage. Without a word, she took up the paddles. “Tell me when the minute’s up.”
That minute crawled by in an eternity of seconds, and it was long enough for Kahayn to wonder what she would do if this man—whoever and whatever he was—pulled through. The corporal had managed to clear away most of the blood and she stared now at his face: black, close-cropped curls slicked with blood capping a high forehead; delicate cheekbones; a chin that was more oval than square. That forehead wound was ugly and oozing, and he looked as if his nose was broken. They would probably have to give him some blood, and that forehead would need stitches. She would make him a nice scar…
And then, with a jolt, she realized what was missing.
No scars. Her eyes traveled over the man’s chest, his abdomen, his hips and legs. There are no scars anywhere, nothing, as if he’s never had a wound or prosthetic in his life.
“One minute, Doctor.”
“Right.” But she didn’t move. She stared into that face, and for a brief, disorienting instant, that wasn’t a stranger lying there—and whatever else you are because you are not like us, not like us at all—but her Janel, because they did look a bit alike and she missed the man he’d been.
And then he was not Janel but a stranger who needed her: a man without scars inflicted by time and an unkind planet. And the difference between the two, between the man who had been Janel and the one here now, was the wound in her heart that had never properly healed.
Oh, my beloved, how I wish I could have saved you, really saved you.
“Clear,” she said, and then as the corporal jumped down, she placed the paddles on the man’s chest, took a deep breath and pushed the button.