Praise for The Blood Betrayal
“If you have trouble sleeping, do not read this book. If you don’t have trouble sleeping, you will. THE BLOOD BETRAYAL is a compelling, creepy, complex novel about the all-too-plausible perversion of cutting-edge medical research. Donaldson paints an intriguing portrait of evil and unrestrained human ambition you will not soon forget.”
—Lewis Perdue, New York Times Bestselling Author of PERFECT KILLER and THE DAVINCI LEGACY
“Donaldson’s wizardry keeps the pace of this riveting, bone-chilling thriller fast and furious. The unpredictable hooks and twists and turns will keep you reading well into the night.”
—Gary Birken, MD, author of PLAGUE and EMBOLUS.
“THE BLOOD BETRAYAL is a thriller packing enough high voltage tension to power the Tennessee Valley Authority.”
—Allen Wyler, MD, author of DEADLY ERRORS and DEAD HEAD
“In THE BLOOD BETRAYAL Don Donaldson presents a bucolic, Amish-like community filled with blissful carefree people, then skillfully peels back the layers to reveal the terror and corruption beneath the surface.”
—Mike Lawson, author of THE INTERNAL RING and THE SECOND PERIMETER
Praise for Don’s previous titles
“Donaldson combines an insider’s knowledge of modern technology with a real flair for making the reader’s skin crawl.”
—Booklist
“Donaldson knows the anatomy of a thriller.”
—Michael Palmer
“Donaldson is every bit the nail-biting equal of Robin Cook and Michael Crichton.”
—The Jackson (MS) Clarion-Ledger
“Donaldson is superb at spinning medical fact into gripping suspense.”
—Tess Gerritsen
“[Donaldson is] a skilled practitioner of the medical thriller.”
—The Memphis Commercial Appeal
“Donaldson’s talent and potential as a novelist are considerable.”
—New York Times Book Review
Other Don Donaldson titles from Bell Bridge Books
The Killing Harvest
The Lethal Helix
The Judas Virus
The Memory Thief
The Blood Betrayal
by
Don Donaldson
Bell Bridge Books
Copyright
This is a work of fiction. Names, characters, places and incidents are either the products of the author’s imagination or are used fictitiously. Any resemblance to actual persons (living or dead), events or locations is entirely coincidental.
Bell Bridge Books
PO BOX 300921
Memphis, TN 38130
Ebook ISBN: 978-1-61194-434-1
Print ISBN: 978-1-61194-413-6
Bell Bridge Books is an Imprint of BelleBooks, Inc.
Copyright © 2014 by Don Donaldson
Printed and bound in the United States of America.
All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer, who may quote brief passages in a review.
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Cover design: Debra Dixon
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Chapter 1
DAMN.
I do not want to go in there.
Death seeped under the operating room doors. It slipped through the crack between them and swirled around Carl Martin’s sweat-soaked brow. Dark wet rings were already in full bloom under the armpits of his blue scrubs.
But he’d already agreed to help.
He snatched a quick breath then swallowed hard, his coppery saliva nearly strangling him. He leaned forward and pushed, parting the doors to hell.
Inside, everyone turned to look at him. The scene froze: the bloody-gowned surgeon standing on the far side of the table, both hands in the blue-draped patient’s abdomen, the circulating nurse, the assistant surgeon, the anesthesiologist, all staring at him . . . looking to him for deliverance from the escalating disaster on the table.
Motion had ceased, but he heard the rhythmic wheeze of the respirator playing counterpoint to the cardiac monitor counting each of the patient’s heartbeats. To the right, he was aware of hissing steam escaping from the unlatched autoclave door. It was a moment he didn’t need.
Dick Crandall, the surgeon, spoke and time began flowing again. “That better be you under that mask, Carl.”
“It is,” Carl replied, hurrying to the table.
“Where the hell you been? I was about to swear out a sheriff’s warrant for you.”
“You’re welcome . . . Guess you’ve forgotten I don’t do this kind of thing anymore. I’m only here because you fired George Lee and put your patient at risk.”
“Lee had his chance. He couldn’t help.”
“You’re fortunate I was in my car and was close by.”
“Yeah,” Crandall said. “We’re all just tickled to death at our luck today.”
Crandall had always been a sarcastic asshole, even out of the operating room, so Carl wasn’t surprised by his comment. Looking at the monitor panels, Carl saw that the patient was in much more serious trouble than the nurse on the phone had said. But why was everything going to hell?
He looked back at Crandall. “Why’s he on the table?”
“Liver laceration . . . three knife wounds suffered in a mugging . . . Everything was reasonable for the first few minutes. Got a couple of suture bolts inserted with no problem and was drawing the margins of the first wound together, but then he started leaking like shit . . . even from intact areas of the organ.”
Crandall seemed annoyed at having to explain things, as though he expected Carl to just wave a magic wand and bail them out of this mess.
Carl glanced at the Foley tube emerging from under the drape. Not good. The urine was tinged with blood.
Moving closer, he pulled the drape aside and looked at the IV entrance wound in the back of the patient’s hand.
Blood was oozing from the margins.
He moved to the foot of the table, lifted the drape, and examined the patient’s legs. On both shins, he saw scattered sores with fresh blood glistening in their centers.
Bleeding sores . . . but they had crusted edges . . . strange.
Staying on his side, Carl went to the other end of the table, past the blue tent that isolated the patient’s head from the rest of his draped body. He gently rolled the upper lip back from the patient’s gums. They too, were bloody. He lifted the right eyelid. What should have been pure white was punctuated with tiny hemorrhages. Thanks . . . thank you very much.
“You planning to actually do anything about this problem?” Crandall said. “I can’t stand here and compress these bleeders forever.”
“Where’s the blood work?”
“Over here,” the circulating nurse said.
Carl followed her to a stainless steel countertop. She picked up a piece of paper and handed it to him. Quickly perusing the report, he saw that the patient’s ability to form a clot was five times slower than normal. And the amount of the main clotting protein in h
is blood was dangerously low. A new freshet of sweat pearled out of Carl’s pores onto his forehead. This was exactly why he shouldn’t have come. He wiped at the sweat with his arm.
“I guess we’ve also got peripheral smears . . .”
“On the computer,” the nurse said, leading him to the work station tied to the blood lab.
The nurse typed in the patient’s name . . . Benjamin Rasco.
Suddenly, behind them, the cardiac monitor began to stutter. Carl’s own heart, already at a trot, kicked up to a canter. He glanced over at the monitor.
Wrong angle . . . he couldn’t read it.
“Heart slipping into ventricular tachycardia,” the anesthesiologist said, in a gas passer’s usual monotone.
Oh great . . . Not only was he bleeding to death, the lack of blood was now starving his heart.
“Damnation, what are you waiting for?” Crandall yelled. “Get your ass moving.”
“Doctor, the images are ready.”
Carl looked back at the work station computer screen and saw a menu to choose from. He clicked on the first image from the preoperative smear, and the most bizarre red blood cells he’d ever seen flicked up on the screen. Instead of smooth contours, each of these reds had a large blister on them. He clicked on the second pre-op image and saw the same thing. What the hell?
Then something in the room changed.
The cardiac monitor . . . it was back to a normal sinus rhythm. They’d just gained some time, but probably damned little.
Focus . . . focus . . .
He clicked on the first image taken from a smear made after the uncontrolled bleeding began. Now, the picture was totally different. Instead of intact red cells, there were only fragments.
That confirmed it. Shit.
The guy on the table had DIC . . . Disseminated Intravascular Coagulation . . . coined Death Is Coming by those who had to deal with it.
The trouble started when the patient’s blood suddenly began clotting all over his body. The clots blocked the tiny vessels in all his organs. Thousands of little pieces of him were now dying. With all the clotting factors in his blood consumed by the clotting process, blood was also leaking from the damaged vessels. His reds had fragmented as they were forced through the clots.
Carl had encountered five cases of DIC in his career. He had prevailed in all of them, becoming widely known as the best blood doc in town. Crandall knew it. That’s why he’d asked for him and not someone else.
But stay in the ring long enough and even the best will catch a haymaker in the face. Carl’s keen awareness of that was why he didn’t want to be there. After losing two patients to leukemia and another to a bacterially contaminated blood transfusion in the same week, he had closed his practice, needing to be finished with battles where other lives were at stake.
Yet here he was again, up against a clotting problem that shouldn’t even be happening. So why was it? And what’s with those sores . . . and the weird red cells?
Can’t dwell on any of that now.
He returned to the operating table.
Rasco’s heart was still banging out a normal sinus rhythm. Despite being given plasma expanders, the beat was even faster now than a moment ago, as his heart tried harder to compensate for the loss of blood leaking into his body cavities.
Carl looked at Crandall. “You said—”
The cardiac monitor spit out four quick beeps then fell silent.
The muscles in Carl’s groin went into spasm. No. I need more time.
He stared at the monitor readout.
No EKG . . .
Another second of silence . . .
Still no sound and nothing on the screen . . .
A beep sounded . . .
Then again . . . And another, in rhythm. The EKG tracing resumed its normal pattern.
“Gentlemen,” the anesthesiologist said, “We were lucky that time. Just so you know . . .”
Carl turned to Crandall. “You said Lee had his chance. What did he do?”
From behind him, the circulating nurse said, “He gave him thirty thousand units of heparin IV, followed twenty minutes later by twelve buttons of platelets and a unit of fresh frozen plasma.”
Exactly right, Carl thought. Problem was . . . it failed. “Anything else?”
“After that . . .” She shrugged. “He just stood there, sweating.”
“I want another thirty thousand units of heparin all at once. Two minutes later, two buttons of platelets also through the IV injection port. Then, immediately hang ten more buttons of platelets, a unit of plasma, and a unit of packed red cells.”
Carl watched to make sure she followed his orders. Once the heparin was in and all the component bags were hung and delivering their contents, he began a vigil in which his eyes traveled over the monitor readings one by one.
The heart rate was still way too fast. Oxygen levels in the blood were slipping even lower. At least the sinus rhythm was holding.
He checked the Foley tube. No change . . . urine still tinged with blood.
Despite the anesthesiologist’s warning, Carl believed there was still time to win this one. But he was so tense, he could hardly get a decent breath. He looked again at the monitor readings. Damn it, pressure down another two units. Blood oxygen level still falling.
Another three minutes passed. All monitor readings stabilized. Carl’s hopes began to rise.
Suddenly, the monitor emitted a staccato series of beeps. Abnormal EKG spikes clustered on the readout, then a flat line appeared.
Carl felt a giant straw sucking at his intestines. He became a muttering cheerleader for return of a normal beat. “Come on . . . come on . . . you can do it . . . You did it before . . . do it now.”
Two of the longest seconds in history passed. Then, miraculously, another beep and a normal tracing. Another silent second passed, More silence. More silence.
As the anesthesiologist abruptly stood up, another beat occurred.
Three and a half seconds later, the cardiac monitor began to scream.
Chapter 2
CARL DROVE through the heavily forested valley deep in the mountains fifty miles from Little Rock hardly noticing the brilliant fall foliage, his mind ruminating obsessively over the death of Benjamin Rasco the previous day.
Goddammit. He’d given up his practice so he’d never have to watch another patient die. And what good had it done?
That bleeding just wouldn’t stop.
It should have. He knew how to handle DIC. Sure . . . he’d been called in only after Rasco was in major trouble. But there’d still been time to save him.
Why didn’t the treatment work?
And what the hell were those blistered red cells all about? Never seen anything like that before. Were they involved?
It wasn’t his nature to accept failure without knowing why it happened. He had to have answers. Then at least something worthwhile would come out of the situation. Of course, this whole trip could turn out to be a waste of time. But he had to try.
Suddenly he came to a big white sign with bold red letters beside the road:
ATTENTION: This means you. Visitors are required to pick up a guest pass for their vehicle at the information kiosk. Pass must be displayed at all times. NO EXCEPTIONS. God loves you.
Carl’s eyes shifted from the big sign on the shoulder to the razor wire-topped chain-link fence ahead that ran off into the woods on each side of the two-lane road.
Now what?
He nudged the gas and proceeded to the little, gray cedar shake, white-trimmed building dividing the lanes.
Through the big window in the side of the kiosk, a strapping young guy in khaki fatigues waved, then came outside carrying a clipboard. On his hip he wore a nasty-looking sidearm. Carl rolled down his wind
ow.
“Good Morning, sir. May I inquire about the nature of your business?”
This deep in the mountains, Carl had expected to hear an Ozark twang. But this guy sounded like big-city Midwest. And he was one healthy-looking specimen.
“I’m not sure I’m in the right place. I’m looking for Artisan, the town.”
“It’s just down the road.”
“Inside that fence?”
“We’re a company town . . . like the old coal mining villages, except we make furniture. Who did you want to see?”
“I’m Dr. Martin, from Arkansas Pharmaceuticals. I’d like to speak with the director of the hospital.”
“Sir, I’ll need to see some identification.”
“Of course.”
Carl shifted in his seat, got his wallet, and held out his Arkansas Pharm ID.
“Are you expected?”
“No. I didn’t call ahead because I couldn’t find a number.”
The guy perused the ID, then looked at Carl with cold gray eyes. “And what will you be discussing with the director?”
“A man named Benjamin Rasco.”
“Wait here, please.”
Carl was there because he’d learned that Rasco’s body had been claimed by two locals, the director of the town hospital and the pastor of the town’s only church, who had been looking for Rasco since he’d disappeared from Artisan nearly a week ago. Since this was where Rasco lived, it seemed likely the hospital would possess at least some information on his medical history.
The guard went back to the kiosk and Carl saw him pick up a phone.
IN THE ARTISAN hospital, the director spun his head around and stared at the ringing phone. He walked slowly to his desk, a premonition warning him this was the fallout he’d feared might come from Benjamin Rasco’s death. He gingerly picked up the phone and slowly put it to his ear. “Meggs speaking.”
He listened to the guard on the other end, and the temperature in the room began to soar. It was about Rasco. And of all people, Carl Martin was at the gate. Carl Martin . . . Damn it.
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