Richard again considered his chances of jumping him, but more coolly this time. Better keep him talking, he decided. "What you did, it makes me want to puke."
"What I did . . . was protect a doctor . . . who'd secretly crossed the line into regenerative medicine . . . who could restore damaged hearts . . . and was years ahead of anyone on the planet ... in making stem cells work."
"You used your position of trust to betray Kathleen and me. An innocent policeman and secretary died. Hamlin, Lockman, Edwards, Blain— dead. Maybe Norris, too. All to keep Downs out of jail so she could help you."
Ingram, his chest heaving more laboriously now, studied Richard from under half-closed lids, his eyes burning with contempt. "Sure I wanted to help myself. . . . Otherwise I'd be looking forward ... to an ultimate heart transplant ... a lifetime of antirejection drugs . . . and still ... in all likelihood die young. . . . But I also kept a doctor free . . . who can help millions . . . and intend to keep her that way." As he talked, he laid the gun on the ground within easy reach while he continued to hold the detonator in his left hand, thumb at the ready. With his free hand he grabbed a rubber tourniquet from his kit. Not once did he take his eyes off Richard. Rolling up his sleeve he attempted a one-handed tie using his teeth, the way junkies do to make a vein in the arm bulge. But he repeatedly fumbled it, his holding the detonator at the same time making the task difficult. After several tries he threw the band down and picked up the gun again.
"You don't follow . . . my orders exactly, Richard . . . we all go boom . . . including Kathleen." He caressed the remote with his thumb as he retook his aim at Richard's chest. "Rest assured ... at this range . . . the blast will be . . . mercifully lethal . . . for us. . . . But for Kathleen . . . through the open end of the truck ... it could still rip her inside out . . . yet leave her alive. . . . With all the construction . . . noise in the street ... no one may even hear . . . the explosion. . . . She could suffer for days ... so no notions of sandbagging me ... to save her . . . because I can press faster." Extending his gun arm, he presented his veins while still holding the weapon, but slid his left hand with the remote back away from Richard. "Now inject the first dose of furosemide . . . then the morphine. . . . And stay on my right side."
Richard hesitated.
"Think I'm kidding?" said Ingram, reading his face. "Hey . . . I've nothing to lose. . . . I feel myself going ... I take you with me. . . . As for getting caught and ending my days in jail ... I'd rather die. . . . Pull any stunt that brings in the police . . . same result. . . . Better get busy."
Play for time, Richard kept telling himself. Without another word, he picked up the abandoned tourniquet and kneeling beside Ingram's right arm, wrapped it around the biceps. Ingram jammed the barrel of the gun into his ribs and rummaged it around a bit, making it hurt. In return, Richard, selecting the first syringe of furosemide, plunged the point of the needle into the skin as roughly as he could and poked it about before gently sliding the tip into an engorged vein. When he pulled a slight return of blood into the cylinder, he drove down the plunger, giving him forty milligrams of the potent diuretic. Leaving the needle in place, he detached the empty syringe and replaced it with one full of morphine. Ten milligrams. Plunge it in, he'd probably execute the man, stopping his breathing altogether and putting him in shock. But a little at a time, it gave the heart less to pump, and a chance to recover.
"Tempted?" said Ingram, finding a new pair of ribs to irritate, all the while holding the small remote well out of Richard's reach.
Both men knew a bolus of morphine would still give him time to press the button.
Richard said nothing and slid in two and a half milligrams, an appropriate initial dose, though a bit on the light side.
"Hey, a little more," said Ingram.
"Then do it yourself," he said, leaving the entire syringe dangling in place and walking to the overturned stretcher where he detached the cylinder of oxygen. Club him with it? Wouldn't be fast enough to prevent a flick of the thumb.
Ingram eyed the syringe of morphine hanging out of his arm, but didn't relinquish either the gun or the controller in order to give himself an additional shot. His breathing seemed to be getting worse.
Play for time, Richard told himself once more, gritting his teeth and hooking Ingram up to the tank. Though how a few more minutes would do any good, he'd no idea. What about Kathleen? So far she'd said nothing. But she must have overheard them and caught on. Maybe she still could make the cellular work. Yet Ingram didn't seem too worried about that. Had he forgotten about the phone? Or did he know that with all the concrete and virtually no windows, it couldn't work? Even if it did, Kathleen had no more idea where they were than he did.
Ingram moaned. "Christ, Richard . . . I'm getting worse. ... I swear I'll blow it."
Richard gave more morphine. And if he pulled Ingram through, soon as he felt better, he would kill them— but maybe if Ingram knew he had a chance to live, he wouldn't be so ready to blow himself up. That would at least take the bomb out of play. With just the gun to worry about, Richard calculated, he might be able to jump him.
He continued to race through the possibilities, assessing options, selecting or discarding what he could and couldn't do just as he did with life-and-death choices in ER, yet he knew anything he tried here would be a "Hail Mary," long on odds, short on success.
She heard them talking and caught sight of Richard whenever he stood up. But Ingram, lying somewhere near the end of the truck, remained below her line of sight. Despite her daily resignation to a death by stroke these last sixteen days, she was not ready to just lie here and be skinned in a hail of nails. She'd be damned if she'd let him decide when to push that button, she thought, having abandoned trying to make the cell phone work.
Surely there was something she could do.
First she had to free herself of IVs and tubes. Though weak, she managed to rip off the tape securing them, then pull out the needles. Blood ran onto her skin from the puncture sites, but she paid it no mind.
Next she reached down and undid the plastic bladder she'd detested since her admission. More fluids ran free. She couldn't care less.
Unable to roll herself from her back to her side, she used her elbows and heels to heave her trunk an inch sideways. A few more tries, and she added a slight turn to the maneuver, slowly rotating the line of her body so that instead of being lengthways in the truck, she edged toward lying across its floor. Each movement was an effort, and she breathed heavily after less than a dozen attempts, but the continuous sound of the jackhammer outside masked her huffing and scraping. Once she turned completely sideways, she moved directly toward the open delivery doors, though only an inch at a time. Richard occasionally looked in her direction, at least where she had been, and gave a wan smile of encouragement.He couldn't see her in the dark, she realized.
As she inched closer, the bottom of Ingrams's legs came into view, splayed out where he lay. Every few seconds she caught sight of his hand rising up in the air as he held it away from Richard. In it was the tiny detonator he'd threatened to push.
If she had her muscles back, she could grab it.
No way now.
Then she noticed the key chain dangling below it.
He finished adjusting the flow of 02. Returning to the syringe, he gently pressed the plunger, slowly giving Ingram another dose of morphine. "Was Francesca in on your cover-up?" he asked, wanting to distract him so he wouldn't notice the amount was less than the first. He'd settled on drawing out the resuscitation, keeping him in limbo, neither letting him slip too far nor improve too quickly.
"Francesca? No way. . . . You know she's the original . . . Girl Scout."
"Then why did she tie in with Hamlin?"
"She tied in with Norris. . . . He's the one who included Hamlin."
"You figured all this out by looking at their records."
"And hacking into their research files. . . . People think their cute passwords and numbers . . . keep them
secure. . . . Not from me."
"What made her idea work and not Hamlin's?"
"Because Hamlin's an idiot. . . . Where Francesca restricted herself. . . doing to humans . . . even in secret . . . only the technique she'd perfected with mice . . . Hamlin never accepted such restraints. . . . He'd rushed ahead . . . prematurely trying what he hadn't proved . . . using untested, improvised procedures. . . . And with his DOAs starting to arrive in ER ... it was only a matter of time . . . before the whole scheme would be discovered. ... To protect Francesca . . . especially after his bone-headed play of using Kathleen to try and recruit you ... I turned to Robert here . . ."
He was speeding up his talking, trying to get more words in between ever shorter breaths, Richard thought. And he was straying off topic. Sure signs that Ingram was growing worse. Whenever he saw it, this compulsion to talk as death approached, the physician in him always had put it down to delirium from a lack of oxygen. But sometimes it seemed as if the dying had to get their story out.". . . As chief of ethics I had Nape ... or Nappin Junior if you like . . . and his previous indiscretions . . . when he was an orderly in the reproduction center ... on file. . . . It's dead simple, if you know how ... to track down his type ... on the Internet these days. . . . Even back then ... I'd found his links . . . with the Legion of the Lord ... so I knew he was hard-core . . . and where to find him now. . . . Well, you know the rest. . . . The first two kills went well. . . . He insisted on leaving a 'message.' ... I suggested a pile of 'stems' because I figured . . . it'll make sense to him . . . but nobody else will get it. . . . Everybody will just put it down to some psycho's twisted thinking . . ."
Much shorter gasps now. Ever more pressured speech. And the wheezing was louder, accompanied by bubbly sounds deep in his chest. Definitely worse. Got to get him back before he felt he was hopeless.
". . . but then he stopped following orders. . . . Figured I had to get rid of the creep as well . . . Agreed to meet him . . . Promised I'd help him get Kathleen to himself. . . . Figured to shoot him, then blow the bunch of you up. . . . Let the police figure out a story from the body parts. . . . Whatever they made of it . . . no proof against Francesca ... I already got a consult on Norris's case . . . will make sure he doesn't talk . . ."
"What do you mean?"
"ICU asked me ... to help treat him . . . should be easy . . . making sure ... he doesn't survive."
"I better tourniquet your other limbs," said Richard, resorting to an old-fashioned way to further reduce the return of blood to the heart. He grabbed the strip of rubber he'd used before, this time cinching it tight around the other arm. He then whipped off Ingram's shoes and requisitioned the man's socks to tie around his thighs.
"I'm going, Steele. . . . Damn you." He raised the controller.
Richard tensed, ready to make a lunge at it, but knew he'd never have time. "No, you're not," he lied and injected as much morphine as he dared. In ER he'd have had a slew of instruments and readings to tell him the response, guiding him, helping him determine which drugs to give and how much. This was like trying to land a plane in fog without radar. He couldn't even get a blood pressure, except Ingram's weak and rapid pulse told him it was low.
"This feels bad," said his patient, the key chain making a tiny clinking noise as he changed his grip on the remote and grew more agitated from lack of air. His hand with the gun started to move restlessly around the front of his chest, his index finger still on the trigger, but his thumb plucking at the buttons on his monogrammed blue shirt as if he thought loosening them would let him breathe better. Soon the hand clutching the black box got into the act.
Christ, he was going to blow them up by accident. "Any urge to pee, yet?" said Richard, making him focus on something so the hands might go still.
"Yeah." He kept fingering his shirt buttons and collar.
"Then go. Just let it flow," said Richard, watching that left thumb. It was still squarely on the LOCK button.
"No. Get me a pot."
"I don't have one."
"Oh, Jesus. I can't breathe." He started to whimper.
"Piss your pants, damn you. This isn't a fucking hospital."
Despite his dark pants, an even darker stain began to spread in the crotch, and the unmistakable odor of urine rose around them. "I'm going to die," he cried.
"Gordon, you're liable to press that button by accident. Then for sure I can't help you. Better give it here."
"No!" he screeched, trying to hide it behind his back.
Defiant again. But a lot more scared than minutes before. And possibly easier to frighten. "Then why the fuck should I help you? You're going to kill me and Kathleen anyway."
"No, I won't."
"Bullshit!"
"I swear."
His defiance vanished again. His eyes pulsed wide with terror, frantically darting right and left as if looking for a way out, the way patients always do when they can't breathe. With the darkness all around them, Ingram seemed to be watching for something in the shadows that nobody else could see. "Oh, God, save me," he cried.
"God save you? I don't think so. But I can."
"Please!"
Time for the "Hail Mary." Richard grabbed the remaining syringes and stepped away from him. As he did, he saw Kathleen slide sideways to the back of the truck and lay along the rear edge of its floor. She turned her head toward him, her eyes flashing, and nodded, her lips silently mouthing / love you. With two moves, she positioned herself directly above Ingram.
Not sure what she had in mind, Richard continued to play his hand. "Then give me the gun and the remote, or I bash these on the cement."
"No, please!"
"It's not so easy to say you're ready to die once death is on your doorstep, is it Gordon?"
"Stop!" He started to cough. Red-streaked sputum flecked with bubbles came out his mouth. His useless gasps couldn't move enough oxygen to keep a canary alive.
"You know what comes next, don't you Gordon? You've seen it often enough. Blood and foam coming out your nose and mouth, no air, yet conscious for the longest thirty, forty seconds at the end of life as your heart slows to zero before you finally and mercifully die."
"No! No! No . . . I'll blow the switch first."
"You need nerve to do that, Gordon. You haven't the guts. You're desperate to live. So give me the remote and the gun while there's still a chance to get an ambulance here."
His whole chest heaved, the way an animal's does when it's trying to throw up. Red bubbles ballooned out of his nostrils and mouth like crimson soapsuds. His face grew dark purple around eyes bulging out big as golf balls.
But straining backward, keeping the key chain up in the air and away from Richard, Ingram still kept his thumb on the button and the gun pointed straight ahead.
Kathleen swung at the loop of the chain with fingers curled.
She hooked it and the whole thing flew out of his hand.
He reflexively pointed the gun up and behind him, firing three shots, all above Kathleen's head.
Richard flung himself at Ingram, easily wrenching the weapon from his grip. The remote continued to arch its way across the room. He held his breath as it struck the concrete, only to slide harmlessly a few feet across the floor.
At Richard's feet, Ingram's face, mauve as an eggplant, seemed to twist in on itself while his body jackknifed forward into a seizure. The frantic jerking lasted for half a minute, more foam seeping out between his locked lips and flying into the air around his head. Then the movements tapered off, slowing and becoming less violent, ultimately diminishing into little more than an occasional twitch. Despite all the wet spittle remaining in his throat, he gave up a sound dry as bones rattling in a gourd, and the muscles around his eyes pulled up his brow into a look of surprise.
Chapter 21
Three Weeks Later,
Friday Morning, July 20
Norris was still heavily bandaged over his ear, his throat, and the stump of his right forearm. A patch covered where his right e
ye had been. He also was unable to speak well. The scalpel thrust into his neck had severed some of the motor nerves to his soft palate and tongue. The speech pathologist had been trying to do some rudimentary therapy with him in order that he could compensate for the deficit, but it seemed unlikely he'd ever talk normally.
"So where did Downs go to?" McKnight demanded.
I've no idea, Norris scrawled with his left hand.
"And she's made no attempt to contact you?"
No.
"So what's your best guess where she is?"
Norris simply shrugged. The grilling had been going on for half an hour. Norris wasn't admitting or confirming anything. "Jesus Christ," McKnight muttered, then flipped shut his notebook. "This is fuckin' useless."
Norris snorted.
As McKnight pivoted and walked out of the room, Norris gestured to Richard and began to scribble something furiously on his pad. He ripped off what he'd written and held it out. Don't worry about Kathleen. I didn't let Hamlin give her the same immature cells he used on his other patients.
"What?"
More scribbling. He initially used very immature ceil lines. That was the problem. They replicated everything, including the abnormal vasculature. With Dr. Sullivan, I used cells that were already well on their way to forming precursors for neural tissue.
"What do you mean?"
Harvested them from the neuronal crest in embryos at the eight-week stage. Those cells can only form neurons. She shouldn't have any trouble. Richard thought a few seconds. "So why didn't he use the more mature tissue in the first place?"
He didn't know, hadn't done the proper long-term trials, was in too big a rush. But the remaining patients can be helped.
"How?"
Remove any recurrent malformation before it bleeds, then reinfuse more stem ceils, but of the neuronal type, to assure whatever benefit they might have on long-term recovery will continue. That's what he planned to offer Dr. Sullivan, as an incentive to make you cooperate.
Critical Condition Page 33
