Gravity: A Novel of Medical Suspense

by Tess Gerritsen

  “This is very strange,” said Emma. “If we’re dealing with a contagious disease, there ought to be some evidence of infection…”

  “Watson?” a voice called over the module intercom.

  “In the lab, Griggs,” she answered.

  “You’ve got priority E-mail from Payloads.”

  “I’ll get it now.” She sealed off the animal enclosure and said to Kenichi, “Let me check my message. Why don’t you take out the dead mice you put in cold storage. We’ll look at them.”

  He nodded and floated across to the refrigerator.

  At the workstation computer, she called up her priority Email.

  To: Dr. Emma Watson

  From: Helen Koenig, Principal Investigator

  Re: Experiment CCU#23 (Archaeon Cell Culture)

  Message: Immediately abort this experiment. Latest specimens returned by Atlantis show fungal contamination. All Archaeon cultures, along with the containers holding them, should be incinerated in onboard crucible and the ashes jettisoned.

  Emma read and reread the message on the screen. Never before had she received such a strange request. Fungal contamination was not dangerous. To incinerate the cultures seemed a drastic overreaction. She was so preoccupied by this puzzling request she paid no attention to Kenichi, who was taking the dead mice out of the refrigerator. Only when she heard him gasp did she turn to look at him.

  At first all she saw was his shocked face, splattered with a foul slurry of entrails. Then she looked at the plastic bag that had just burst open. In his horror, he had released it, and it floated free, hanging in the air between them.

  “What is that?” she said.

  He said, in disbelief, “The mouse.”

  But it was not a dead mouse she saw in the bag. It was a mass of disintegrated tissue, a putrefied gumbo of flesh and fur that even now was leaking out foul-smelling globules.

  Biohazard!

  She shot the length of the module to the caution-and-warning panel and hit the button to shut off airflow between modules. Kenichi had already opened the emergency rack and pulled out two filter masks. He tossed one to her, and she clapped it over her nose and mouth. They didn’t need to exchange a word; they both knew what had to be done.

  Quickly they closed the hatches on either end of the module, effectively isolating the lab from the rest of the station. Then Emma took out a biocontainment bag and carefully moved toward the drifting bag of liquefied flesh. Surface tension had bound the liquids together in one globule; if she was careful not to stir the air, she could trap it in the bag, without scattering droplets. Gently she lowered the containment bag over the freefloating specimen and quickly sealed it off. She heard Kenichi give a sigh of relief. Hazard contained.

  “Did it leak into the refrigerator?” she asked.

  “No. Only when I took it out.” He wiped his face with an alcohol swab and sealed the swab for safe disposal. “The bag, it was…you know, blown up big. Like a balloon.”

  The contents had been under pressure, the process of decomposition releasing gases. Through the plastic containment bag, she could see the date of death on the label. This is impossible, she thought. In just five days, the corpse had deteriorated to a black puree of rotted flesh. The bag was cold to the touch, so the refrigerator was functioning. Despite cold storage, something had accelerated the body’s decomposition. Flesh-eating streptococcus? she wondered. Or another bacteria, equally destructive?

  She looked at Kenichi and thought, It splashed him in the eye.

  “We need to talk to your principal investigator,” she said. “The one who sent up these mice.”

  It was only five A.M., Pacific Daylight Time, but the voice of Dr. Michael Loomis, principal investigator for the experiment “Conception and gestation in mice during spaceflight,” was fully alert and obviously concerned. He was speaking to Emma from Ames Research Center in California. Though she couldn’t see him, she could picture the man who belonged to this reedy voice: tall, energetic. A man for whom five in the morning is a normal part of the workday.

  “We’ve been monitoring these animals for over a month,” said Loomis. “It’s a relatively low-stress experiment for the animals. We’d planned to mingle the males and females next week, in hopes they’d successfully mate and conceive. This research has important applications for long-term spaceflight. Planetary colonization. As you can imagine, these deaths are pretty upsetting.”

  “We’ve already got cultures incubating,” said Emma. “All the dead mice appear to be decomposing more quickly than they should. Based on the condition of the corpses, I’m concerned about clostridia or streptococcus infections.”

  “Dangerous bugs like that on the station? That would be a serious problem.”

  “Exactly. Especially in a closed environment like ours. We’d all be vulnerable.”

  “What about autopsying the dead mice?”

  Emma hesitated. “We’re only set up to deal with Level Two contamination up here. Nothing more dangerous. If this is a serious pathogen, I can’t afford to risk infecting other animals. Or people.”

  There was a silence. Then Loomis said, “I understand. And I guess I have to agree with you. So you’ll be safely disposing of all the corpses?”

  “Immediately,” said Emma.

  July 31

  For the first time since he’d arrived on ISS, Kenichi could not sleep. He had zipped himself into his restraint bag hours ago, yet he was still awake, still mulling over the puzzle of the dead mice. Though no one had uttered a word of reproach, somehow he felt responsible for the failed experiment. He tried to think of what he might have done wrong. Had he used a contaminated needle, perhaps, when he’d sampled their blood, or a bad setting in the animal rack’s environmental controls? Thoughts of all the possible mistakes he might have made kept sleep at bay.

  Also, his head was throbbing.

  He had first noticed the discomfort this morning, when it had started as a vague tingling around his eye. As the day wore on, the tingling had become an ache, and now the left half of his head hurt. Not an excruciating pain, just a nagging annoyance.

  He unzipped his bag. He was getting no rest in any event; he might as well check on the mice again.

  He floated past Nicolai’s curtained sleep station and headed through the series of connecting modules that led to the U.S. half of the station. Only when he’d entered the lab did he realize someone else was awake.

  Voices murmured in the adjoining NASDA lab. Silently he floated into Node 2 and peered through the open hatch. He saw Diana Estes and Michael Griggs, limbs tangled together, mouths locked in hungry exploration. At once he backed out unnoticed, his face burning with embarrassment at what he’d just witnessed.

  Now what? Should he grant them their privacy and return to his sleep station? This is not right, he thought with sudden resentment. I am here to work, to fulfill my duties.

  He floated to the animal habitat. Deliberately he made a great deal of noise as he opened and closed the rack drawers. A moment later, as he’d expected, Diana and Griggs suddenly appeared, both of them looking flushed. And well they should be, he thought, considering what they’ve been up to.

  “We had a problem with the centrifuge,” lied Diana. “I think it’s fixed now.”

  Kenichi merely nodded, betraying no sign that he knew the truth. Diana was cool as ice about it, and that both appalled and angered him. Griggs, at least, had the decency to look a little guilty.

  Kenichi watched as they floated out of the lab and disappeared through the hatch. Then he turned his attention back to the animal habitat. He peered into the cage.

  Another mouse was dead. A female.

  August 1

  Diana Estes calmly held out her arm for the tourniquet and squeezed her hand open and shut several times to plump up her antecubital vein. She did not flinch or look away as the needle pierced her skin; indeed, Diana was so detached, she might have been watching someone else’s blood being drawn. Every astronaut was poke
d and prodded many times during the course of his or her career. At selection screening, they endured multiple blood draws and physical exams and the most probing of questions. Their serum chemistries and EKGs and cell counts were on permanent record, to be pored over by aerospace physiologists. They panted and sweated on treadmills with electrodes attached to their chests; their body fluids were cultured, their bowels probed; every inch of skin was examined. Astronauts were not just highly trained personnel; they were also experimental subjects. They were the equivalent of lab rats, and while in orbit, they resigned themselves to a sometimes painful battery of tests.

  Today was specimen collection day. As the physician on board, Emma was the one wielding the needles and syringes. No wonder most of her crewmates groaned when they saw her coming.

  Diana, though, had simply held out her arm and submitted to the needle. As Emma waited for the syringe to fill with blood, she sensed the other woman’s gaze appraising her skill and technique. If Princess Diana had been England’s rose, went the joke at JSC, then Diana Estes was England’s ice cube, an astronaut whose poise never cracked, even in the heat of real calamity.

  Four years ago, Diana had been aboard Atlantis when a main engine failed. On tapes of the crew transmissions, the voices of the shuttle commander and pilot had risen in alarm as they scrambled to guide the shuttle in a transatlantic-abort. But not Diana’s voice. She could be heard coolly reading the checklist as Atlantis hurtled to an uncertain landing in North Africa. What had sealed her icy reputation were the biotelemetry readings. On that particular launch, the entire crew had been wired to record their blood pressure and pulse. While the heart rates of everyone else had skyrocketed, Diana’s had barely accelerated to a leisurely ninety-six beats per minute. “That’s because she’s not human,” Jack had joked. “She’s really an android. The first in NASA’s newest line of astronauts.”

  Emma had to admit there was something not quite human about the woman.

  Diana glanced at the puncture site on her arm, saw that the bleeding had stopped, and matter-of-factly turned back to her protein crystal growth experiments. She was indeed almost android perfect, long-limbed and slender, her flawless skin paled to milky white from a month in space. All that plus a genius IQ, according to Jack, who had trained with Diana for the shuttle mission he had never completed.

  Diana had a doctorate in materials science and had published over a dozen research papers on zeolites—crystalline materials used in petroleum refinement—prior to being accepted into the astronaut program. Now she was the scientist in charge of both organic and inorganic crystals research. On earth, crystal formation was distorted by gravity. In space, crystals grew larger and more elaborate, allowing thorough analysis of their structure. Hundreds of human proteins, from angiotensin to chorionic gonadotropin, were being grown as crystals aboard ISS—vital pharmaceutical research that could lead to the development of new drugs.

  Finished with Diana, Emma left the ESA lab and floated into the hab, to find Mike Griggs. “You’re next,” she said.

  He groaned and reluctantly held out his arm. “All in the name of science.”

  “It’s just one tube this time,” said Emma, tying on the tourniquet.

  “We’ve gotten so many needle sticks we look like junkies.”

  She gave his skin a few gentle slaps to bring out the antecubital vein. It plumped up, blue and cordlike on his muscular arm. Griggs had been compulsive about staying in condition—not a simple thing while in orbit. Life in space took its toll on the human body. Astronauts’ faces were bloated, swollen by shifts in fluids. Their thigh and calf muscles shrank until they had “chicken legs,” poking out pale and scrawny from their bloomerlike shorts. Duties were exhausting, the irritations too numerous to count. And then there was the emotional toll of being confined for months with crewmates who were under stress, scarcely bathed, and wearing dirty clothes.

  Emma swabbed the skin with alcohol and pierced the vein. Blood shot back into the syringe. She glanced at him and saw his gaze was averted. “Okay?”

  “Yeah. I do appreciate a skillful vampire.”

  She released the tourniquet and heard his sigh of relief when she withdrew the needle. “You can eat breakfast now. I’ve drawn everyone’s blood but Kenichi’s.” She glanced around the hab. “Where is he?”

  “I haven’t seen him this morning.”

  “I hope he hasn’t eaten. That’ll screw up his glucose level.”

  Nicolai, who’d been floating off in a corner, quietly finishing his breakfast, said, “He is still asleep.”

  “Strange,” said Griggs. “He’s always up before everyone else.”

  “His sleep is not so good,” said Nicolai. “Last night, I hear him vomit. I ask if he needs help, and he tells me no.”

  “I’ll check on him,” said Emma.

  She left the hab and headed up the long tunnel to the RSM, where Kenichi’s sleep station was. She found his privacy curtain was closed.

  “Kenichi?” she called out. There was no response. “Kenichi?” She hesitated a moment, then opened the curtain and saw his face.

  His eyes were a brilliant bloodred.

  “Oh, my God,” she said.

  THE SICKNESS

  NINE

  The flight surgeon manning the console for ISS Mission Control was Dr. Todd Cutler, a physician who was so fresh-faced and youthful the astronauts had dubbed him “Doogie Howser” after the TV show about a teenage doctor. Cutler was, in reality, a ripe old thirty-two and known for his cool competence. He acted as Emma’s personal physician while she was in orbit, and once a week, during their private medical conference, she spoke to him on a closed communications loop, reporting the most intimate details about her health. She trusted Todd’s medical skills and was relieved that he was the surgeon on duty at that hour in the ISS control room at Johnson.

  “He’s got scleral hemorrhages in both eyes,” she said. “It scared the hell out of me when I first saw it. I think he got them from vomiting so hard last night—the sudden changes in pressure popped a few vessels in his eyes.”

  “That’s a relatively minor concern right now. The hemorrhages will clear up,” said Todd. “What about the rest of the exam?”

  “He’s got a fever of thirty-eight point six. Pulse one twenty, blood pressure one hundred over sixty. The heart and lungs sound fine. He does complain of a headache, but I can’t find any neurologic changes. What really worries me is the fact he has no bowel sounds, and his abdomen is diffusely tender. He’s vomited several times in just the last hour—so far, it’s negative for blood.” She paused. “Todd, he looks sick. And here’s the bad news. I just ran his amylase level. It’s six hundred.”

  “Oh, shit. You think he’s got pancreatitis?”

  “With a rising amylase, it’s certainly possible.” Amylase was an enzyme produced by the pancreas, and its levels usually skyrocketed when the organ became inflamed. But a high amylase level could also indicate other acute abdominal processes. A bowel perforation or a duodenal ulcer.

  “His white blood cell count is also high,” said Emma. “I’ve drawn blood cultures, just in case.”

  “What’s the history? Anything worth noting?”

  “Two things. First, he’s been under some emotional stress. One of his experiments is crashing on him, and he feels responsible.”

  “And the second thing?”

  “He was splashed in the eye two days ago, with body fluids from a dead lab mouse.”

  “Tell me more.” Todd’s voice had gone very quiet.

  “The mice in his experiment have been dying, for reasons unknown. The corpses have decomposed at an amazing rate. I was concerned about pathogenic bacteria, so I took samples of the body fluids for culture. Unfortunately, all those cultures are ruined.”

  “How?”

  “I think it’s fungal contamination. The plates have all turned green. No known pathogens can be identified. I had to discard the plates. The same thing happened to another experiment, a
cell culture of marine organisms. We had to abort that project because fungi got into the culture tube.”

  Fungal overgrowth, unfortunately, was not an uncommon problem in closed environments like ISS, despite the continually recirculating air. Aboard the old Mir station, the windows were sometimes coated with a fuzzy layer of fungi. Once the air of a spacecraft has been contaminated by these organisms, it is next to impossible to eliminate them. Luckily, they were by and large harmless to people and lab animals.

  “So we don’t know if he’s been exposed to any pathogens,” said Todd.

  “No. Right now, it looks more like a case of pancreatitis, not a bacterial infection. I’ve got an IV started, and I think it’s time for a nasogastric tube.” She paused, then added reluctantly, “We need to think about emergency evacuation.”

  There was a long silence. This was the scenario everyone dreaded, the decision no one wanted to make. The Crew Return Vehicle, which remained docked to ISS whenever personnel were aboard, was large enough to evacuate all six astronauts. Since the Soyuz capsules were no longer functioning, the CRV was the only escape vehicle on the station. If it left, they would all have to be aboard it. For the sake of one sick crew member, they would be forced to abandon ISS, ending hundreds of in-flight experiments. It would be a crippling setback to the station.

  But there was an alternative. They could wait for the next shuttle flight to evacuate Kenichi. Now it came down to a medical decision. Could he wait? Emma knew NASA was relying on her clinical judgment, and the responsibility weighed heavily on her shoulders.

  “What about a shuttle evac?” she asked.

  Todd Cutler understood the dilemma. “We have Discovery on the pad for STS 161, launch minus fifteen days. But her mission is classified military. Satellite retrieval and repair. One sixty-one’s crew hasn’t been prepping for ISS docking and rendezvous.”

  “What about replacing them with Kittredge’s team? My old crew from 162? They’re scheduled to dock here in seven weeks. They’re fully prepared.”