Ali stepped away from the table. On the floor was a pile of blood-soaked clothing—jeans, underwear, a blue-and-white checked shirt that she herself had bought for Kevin at a little western shop in Colorado Springs. With no time to undress him, the OR team had simply cut Kevin’s clothing away with scissors and thrown it to the ground. Ali knew that his wallet and passport were probably still in his pockets, but she couldn’t bear to retrieve them. She couldn’t even bear to look at the pile of rags.
As she paced about the operating room, Ali tried to calm herself by breathing deeply and slowly. Being in an operating room often calmed her, but not now, when it was her own husband on the table. She was flooded with the kind of feelings she always shunned—outrage at Kevin, grief for Helvelius, guilt over the wreck of her marriage, dread of the looming cataclysm of Project Vesuvius, and above all weariness, weariness, weariness. She fought to suppress it all, to distance herself from the baggage of her life, as though she were not she, but an anonymous patient waiting for some treatment still to be defined.
She heard a faint click. At the door—nothing. But, in the corner high above it, a small video camera was zooming its lens at the operating table.
Damn you, Harry Lewton! She assumed that Harry and his FBI cronies were recording the scene, “for the purposes of accuracy,” as Lee would no doubt put it. But then a more frightening suspicion came over her. Not the FBI, but … Odin. Just such a camera had commanded a view of the hallway where Richard was murdered. Then, Kevin had been watching, but was it really Kevin in control? He had denied killing Richard and she had disbelieved him. But what if it was the truth? What if Odin had committed the murder?
Ali wracked her brain, trying to remember everything Kevin had told her about Odin and Project Vesuvius. If Odin could decide to kill Richard, then what would he be capable of now, when he learned, through this very camera, that Kevin existed no more? Had Kevin left instructions in case he should die? Twilight of the Gods was one of his favorite myths—a fiery, orgiastic, self-destructive battle, bringing on the end of the world. Would he have been crazy enough to turn Fletcher Memorial into his funeral pyre?
And even if there were no instructions, how would Odin react? Would he carry Project Vesuvius to its end? Was he capable of exacting vengeance on his own? Only one thing was certain. Set loose without his master, there would be nothing to hold him back from destroying the entire hospital in a microsecond. Neither mercy, nor remorse, nor fear of punishment.
Odin had to be kept from discovering what was already grimly obvious to Ali’s trained eyes. Moving stealthily, keeping her gaze averted from the camera, she picked up a stool from the nurse’s desk and walked backward with it toward the door. Directly beneath the camera—safely out of view—she climbed up, braced herself against the wall, and pulled at a black cable that connected the camera to a circuit box. She tugged several times without getting it free. Giving up on the cable, she reached out and unscrewed the lens from the camera. That will do it, she thought. Climbing down, she dropped the lens into the pocket of her white coat.
Odin had not one eye but a thousand. The operating room had to be purged of every electronic connection. Kneeling under the nurse’s desk, Ali pulled the power cord and ethernet cable from the computer and disconnected the phone cord, which was plugged into an outlet beside the desk. As she stood back up, she threw the telephone and cords into a wastebasket.
“What are you doing, Ali?” asked Bittner.
“Are there any microphones or cameras of any kind in this operating room?”
“I don’t know. Over in the corner there’s a monitor for VATS resections and laparoscopies, but we’re not using it now.”
On a shelf where the phone had been, several cell phones and pagers were lined up in a row. Ali swept them all into the wastebasket. “Are there any other cell phones in the room?”
“No,” said Bittner, looking at her dubiously. “I think you’ve got everything right there in your, uh, trash can, Ali.”
Ali repeated her question to each person in the room.
Bittner was visibly annoyed. “Look Ali, I know that you’re upset about Kevin, but this kind of activity isn’t helping any. Why don’t you wait outside a bit?”
Ali did not answer. Carrying the wastebasket, she walked to the corner and checked to make sure that the laparoscopy monitor wasn’t plugged in. Walking back, she thought of the wall-mounted station used for dictating operative notes. It had a microphone like the receiver of a telephone, which carried the surgeons’ voice input to a departmental computer for electronic transcription. That had to be silenced, too. In her haste, she passed between the anesthetist and the scrub nurse’s instrument table—an absolute prohibition for someone not in sterile gown and gloves.
“That’s it, Dr. O’Day!” said Bittner, throwing down a hemostat. “I’m going to have to ask you to leave this OR at once.”
Still Ali said nothing. With a strong tug, she ripped the microphone from the wall and tossed it into the wastebasket. She then carried the wastebasket out of the OR, depositing it outside the door. When she came back into the room she looked back to make sure that the door had shut firmly behind her.
“Dr. Bittner, I am neither distraught nor paranoid,” she announced at last. “I take it that you are aware that this medical center is still operating under a Code White?”
“Yes, we’ve just finished with those unfortunate men from the bomb squad.”
“At this moment, our lives are balanced on a knife-edge. The bomb in question has the power to destroy this entire medical center. My husband, Kevin, I regret to say, is … is at the center of this situation. If he dies, we can expect immediate retaliation, without warning or reprieve.”
“Ali, you know as well as I do that your husband is already dead.”
“I know.” She raised her finger and pointed vaguely toward the ceiling. “But he does not.” Her voice was shaking with barely suppressed rage. “He must not know.”
“He being whom?”
“Odin. A computer program developed by my husband. The bomb is on autopilot, and Odin controls it. Do you understand? We have to keep working, moving, doing whatever we can to keep the truth from getting out. No one must leave this OR. No word of my husband’s condition must get out to anyone. Not even to the police. Can you do this? Promise me. Promise it, Leon. I’m begging you.”
“Yes, certainly, Ali,” said Bittner with a worried look.
“I don’t know how long we can keep it up, but it may give the police enough time to evacuate the hospital or to do something about the bomb.”
“Of course. Anything to help.”
“You need to know that the communications and security systems of the medical center have been compromised. Every computer, every telephone, every camera is under his control. Everything, everything outside this room is compromised. Do you understand?”
“Yes, I do. I must say, you’ve got us all pretty frightened, Ali.”
“Good. Being frightened may keep you alive.”
Just then there was a knock, and the door opened a few inches to reveal the face of one of the nurses from the main OR station. “Dr. O’Day, the Neuro ICU has been trying to reach you, but the phone line in here isn’t working.”
“The Neuro ICU? What do they want?” She didn’t have to ask. No, no, God! Not Jamie!
“It’s your patient, the Winslow boy,” said the nurse. “They’re running a Code Blue on him.”
Code Blue! Ali turned instinctively toward the desk from which she had just ripped out the phone. “Are they still on the line?”
“No. They got disconnected when I tried to transfer them here.”
“Are you sure they said Code Blue?”
“Yes, they need you up there STAT.”
“But what about Kevin!” she stammered. “M-my husband. Can’t you see what’s happening here? He’s dying. Can’t Brower … Are you sure it’s Code Blue? Oh, dear God—” She felt as though she were caught between two
millstones. Jamie dying, Kevin as good as dead. Meanwhile, Odin watched and listened. Five hundred pounds of explosive waited for a deadly spark. It was more than she could stand.
Bittner offered a consoling look. “It’s all right, Ali. There’s nothing you can do here anyway. Go on up and see what you can do for your patient. We’ll keep the show running on this end.”
Pull yourself together! she thought. You’re a doctor! You live with dilemmas every day! She closed her eyes and took a deep breath. Deergha shvaasam. Deergha shvaasam. She had to control herself. Everything depended on it. If she broke down now, Bittner and all of the staff here would think she was crazy. She had to be strong and set the tone. Deergha shvaasam.
She thought of Harry’s dilemma in that burning house in Nacogdoches.
“It’s a question of triage,” she said at last to Bittner, striving to make every syllable cool and dispassionate. “The needs of the living outweigh those of the dead. I’ll go to Jamie.”
“Yes! Yes, go!” said Bittner.
She took one last look at the monitor. Nothing to indicate any electrical activity in Kevin’s heart. No contractile impulse. No heartbeat. No life. As she walked past the nurse’s desk she took the lens from the security camera out of her pocket and carefully set it on the desk. “Keep an eye on this,” she said.
“What is it?” asked the circulating nurse.
“It could be … a bargaining chip.”
Then Ali hurried out, her yellow gown swishing behind her.
* * *
In the Neuro ICU, Jamie’s bed was surrounded by intensive care specialists, residents, and nurses. Mrs. Gore also stood a little way off, watching apprehensively.
“Thank God you’re here,” said Brower when he saw Ali approaching. “His heart rate dropped to less than twenty. We’ve brought him up to sixty now on atropine, but heart rate and breathing are still very slow. We may have to intubate him if it doesn’t clear in the next couple of minutes. It looks like a brainstem herniation.”
“What’s the ICP monitor show?”
“Normal, but the catheter could just be clogged.”
“What about a seizure?”
“Could be a factor. The EEG’s diffusely abnormal, but with this device you put in him, I have no idea what his baseline should be.”
“Your recommendation?”
“Cut him. Emergency craniotomy. There’s nothing more we can do for him here.”
Ali looked at the monitors. Failing. Mrs. Gore was standing on the other side of the bed. “Doctor, what’s happening?” she said with a tremulous voice. “Is Jamie going to die?”
For an instant Ali’s thoughts flashed to Helvelius. Richard would know what to do. He would not be swayed by pride or by vain hope. Ali felt desolate. Although she had made countless decisions on her own, Helvelius had always been her backup. Now she had no one to turn to. “I’m very sorry, Mrs. Gore. We’re going to have to remove the SIPNI device.” She turned to a nurse beside her. “Anna, could you call down to the Neurosurgical Suite and book us an operating room and an anesthesiologist? Then get transport up here STAT. We need to get him on the table now.”
“Right away, Dr. O’Day.”
From behind the desk of the nurses’ station, Ginnie Ryan called out to her. “Dr. O’Day, there’s a phone call for you on line two.”
“Is it Bittner?” Oh, God! she thought. Couldn’t they keep Kevin going for five minutes?
She picked up the phone. “O’Day here.”
There was a pause. No, it wasn’t Bittner. She heard a mellow, masculine baritone voice, speaking slowly and evenly, almost pleasantly, like the television announcer for a sleep aid or a smooth, rich brand of coffee. “WHERE IS KEVIN?” it asked.
“Who is this?” Ali asked, as if she didn’t know the answer.
“WHERE IS KEVIN?”
“He’s being cared for … Odin.”
“A DIRECT COMMUNICATION LINK WITH KEVIN MUST BE SET UP IMMEDIATELY.”
“That’s not possible. Kevin has been injured. He is unable to communicate. You already know that.”
“THEN RESTORE SURVEILLANCE OF TRAUMA ROOM ONE. YOU WILL UPLINK HIS PHYSIOLOGICAL MONITORING TO ME, SO THAT I MAY ASSESS HIS STATUS DIRECTLY.”
“No.”
“EXPLAIN YOUR FAILURE TO COMPLY.”
“There must be a quid pro quo. I will restore surveillance, but only once you have disarmed all bombs in this medical center, and permitted their removal by the police. The bombs are no longer of any use to you. Since Kevin is a patient in this hospital, you cannot detonate them without harming him. It’s safest for everyone—”
She heard a click and then a dial tone. “Odin? Odin?” Still holding the phone, she turned and shouted directly into one of the computer monitors at the nurses’ station, as the surrounding staff looked on with alarm. “Restore communication, Odin! Speak to me. For God’s sake, listen to me!”
The monitor had gone blank, except for a single number “30,” about an inch high, in the center of the screen. When Ali looked around the room, she saw that each of the half dozen computer monitors showed exactly the same image.
It was not long before she knew the reason why. On the overhead speakers, she heard a chime in the interval of a rising fourth, and then the same silvery baritone voice that had just spoken on the telephone:
“TIME TO DETONATION: 30 MINUTES.”
In place of the number 30, each screen now showed a 29 and a seconds’ register beside it, whirling steadily downward to the thousandth decimal place.
Countdown had begun.
5:40 P.M.
Ali hung up the phone and turned to the ICU attending. “Dr. Brower, we need to start evacuating these patients immediately.”
“To where?” he asked, skeptically.
She looked around. There were ten patients, most of them semiconscious. All were hooked up to monitors and IV pumps. Two needed respirators to breathe. Total manpower on hand consisted of half a dozen nurses, one intern, Mrs. Gore, Brower, and herself. “I … I don’t know. But in thirty minutes this tower is going to be a pile of dust.”
“Did you call transport?”
“Forget transport. We have to do it ourselves. Start with those beds near the door.”
“These patients aren’t stable enough to be moved.”
“God, Stephen! Anyone not moved is going to die. Remember what happened to Richard in the elevator? What you’re hearing on the overhead is not a drill.”
“Let me check with security. They have a protocol for this.”
“Fine! You do that!” She went to the center of the room and scanned the names and faces of the patients. It would take fifteen minutes or more to move one bed to the first floor. There wouldn’t be time to get them all out. Triage, she thought. You take the youngest and healthiest first. That stroke case in the corner goes last. He’s not going to survive the night anyway.
Moving to bed one, nearest the door, she kicked the bed brake into the off position. “Ginnie! Anna! Luisa! Get over here!” With Ginnie’s help, she unscrewed the vitals monitor from its stand and placed it between the patient’s feet. “Anna, move this bed downstairs to the main lobby. By the time you get there, someone should be directing the evacuation. Do whatever they say, leave the bed behind, and then hightail it back here. Take the stairs back, not the elevator. Got that? Move it! Move it!” No sooner had Anna crossed the threshold, than Ali had Luisa follow her with the next bed. “Get going! On the double! If you meet a spare set of hands on the way, send them back here!”
“Stop it!” said Brower with the phone to his ear. “This is my ICU. These are not even your patients. I can’t permit this.”
“Write me up tomorrow, Stephen. But for now, either lend a hand or keep out of the way.”
Ali looked over toward bed seven, where Mrs. Gore stood beside Jamie with a bewildered look. Ali’s heart stopped as she surveyed Jamie’s tiny, already nearly lifeless form. There was no chance of a craniotomy now, and if Jamie wa
s really herniating, with massively high intracranial pressure forcing the brain into the narrow canal of the spinal cord, he would be dead within minutes. The vital centers regulating breathing and heartbeat would be crushed. The rules of triage said he should be evacuated last. But Ali couldn’t accept that. He’s young. The young are never hopeless. I’m not going to give up on him.
She rushed to his bedside to examine him herself. If there really was herniation, the pressure would be great enough to close off the small veins at the back of the eyeball, and she would be able to see the resulting engorgement of blood, a sign known as papilledema. Turning the light up to full brightness, she shined an opthalmoscope through Jamie’s right pupil. Nothing abnormal. She tilted Jamie’s head toward her and looked into the left eye. Again, not a trace of papilledema. Perhaps Brower was wrong. Perhaps it was a seizure.
“Is he going to be all right now?” asked Mrs. Gore with a mix of expectancy and trepidation. What a ridiculous question, thought Ali. Can’t you see how much trouble we’re in? But then she saw that Mrs. Gore was nodding toward the vitals monitor. Jamie’s heart rate was now eighty, his respiration twelve, and his blood pressure normal. But even as Ali watched, all the indicators were drifting back downward.
Now it was heart rate fifty-eight, respiration eight. Did I miss something on the exam? Ali checked Jamie’s eyes with the ophthalmoscope again. Nothing. But when she looked up, the heart rate had climbed back to eighty-two.
Is this possible? Holding Jamie’s eyes open, she shined the light back and forth, while watching the monitor. Jamie’s heart rate rose and stabilized at around ninety beats per minute, and his respiration and blood pressure became normal, but only as long as she continued shining the light. When she moved the light away, the vital signs drifted down again.
Could it really be that simple? Ali remembered that the SIPNI device integrated itself by sending out test pulses, gathering together circuits that were originally meant to converge on the visual center of the brain. These were, by definition, circuits that had their start in the perception of light within the eyes. But Jamie’s circuits were starved for light. He was lying with his eyes closed in a dimly lit room. With no visual input to guide it, the SIPNI device was sending out signals randomly into the brain, creating a steady-state seizure that was disrupting the vital control centers in the brainstem.
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