Code White (33 page)

“No!” she shouted. “They can’t do that! It’ll set off—” Ali had once thought of turning off SIPNI herself. But she knew that during the four hours the device had been on, Jamie’s brain had been rapidly rewiring itself. It was now so entangled with SIPNI that any sudden shutdown could lead to a massive, even fatal, seizure.

“By the way, Odin says the ICU’s been trying to reach you by phone for the past five minutes.”

Ali glared at him. “Oh, God! Why didn’t you tell me, you bastard!”

Kevin waved her off. “Go, my jasmine flower. Go and do your job. But think about my offer—and remember the time is short.”

Ali ran to the door and undid the deadbolt, but then stopped. She didn’t dare leave Kevin. He had to be talked out of this madness. She had been powerless to find the words, but she had to keep trying. She could try to appeal to the love that he obviously still felt for her. She could find a way to use that …

But Jamie was crashing. His doctors were about to kill him. He was
hers,
and it was unthinkable to stand by and let him come to harm. For a moment she stood, paralyzed with indecision, her fingers wrapped around the doorknob. Then she looked at Kevin. “This isn’t over, you son of a bitch!” was all she could say.

“Sure. Bring down the Winslow boy’s chart in the next half hour or so, and I’ll run that simulation you asked about before I leave. I’m not heartless, you know. I’ve washed my hands of SIPNI, ever since Dr. Dildo and all those lawyers from the Medical Center ganged up to steal it from me. But I’d still like to see the kid get his sight back. For Ramsey’s sake.” Kevin turned off the video displays and went back to cryptanalyzing his endless streams of numbers. He was being pointedly blasé, as though nothing that he had revealed to her in the past ten minutes made any difference, because she was powerless to do anything about it.

It’s not over!
she vowed as she shut the door behind her.

3:15
P.M.

When Ali came dashing into the ICU from Kevin’s lab, Dr. Helvelius was studying Jamie’s heart monitor. “There you are,” he said. “We’ve been calling all over looking for you. It’s a damned nuisance working without pagers.”

“I’ve been with Kev … Kevin.”
Oh, God!
she thought.
I can hardly bear to say his name
. “He’s … he, uh, I’ve asked him to run a simulation. To see if Odin can explain any of this.”

“Jamie’s in V-tach.”

“I know. Listen, Richard, don’t turn off the SIPNI device. I’ve been thinking about this. SIPNI’s been working for several hours now, and the axons growing into the CHARM gel are aligned by the pattern of current. If you shut it off abruptly, those axons have nothing to connect with but each other. It could cause a massive short circuit, perhaps even a lethal seizure.”

“Too late,” said Helvelius with visible irritation. “I’ve already shut it off.”

With a sick feeling in her stomach, Ali stepped back as Dr. Brower, the ICU director, pushed past her to the bedside. Using deft, practiced movements, Brower peeled open the paper seals around two adhesive-backed rectangular electrodes, and then stuck these directly to Jamie’s skin—one electrode near his right shoulder, the other over the lower part of his ribcage on the left. He then quickly attached the electrodes to a portable automated external defibrillator, and watched the rhythm analysis on the machine.

“He’s shockable,” said Brower. “Disconnect those EEG leads first, or we’ll damage the unit.” When the nurses had unplugged the wires connected to Jamie’s scalp, Brower shouted out “Clear!” and pressed the red shock button. There was a slight tensing of Jamie’s chest muscles as two hundred joules of current discharged into his body.

Ali watched the small rhythm monitor on the defibrillator. The tracing was briefly scrambled, then returned to a pattern of long, sharp spikes, like the teeth of a comb.

“Still in ventricular tachycardia,” said Brower. “Let’s try again. One, two, three, clear!” Brower hit the button again, and another two hundred joules ran through Jamie’s chest. This time Ali saw his heartbeat return to a normal pattern, resembling a line followed by a stubby wedge, then a line, then a wedge, repeated sixty times per minute. “Want to give him some Amiodarone to keep things from acting up again?” asked Brower.

Helvelius furrowed his brow. “All right, as long as you—”

“No,” said Ali, her voice loud and sharp, like a ruler smacking a desk. “We can’t reverse Amiodarone if there’s a problem with it later. I don’t want to give him anything until we understand what’s going on.”

“Your call,” said Brower.

A tense silence followed. It was broken ultimately by a soft, rattling noise coming from Jamie’s bedrails.

“Oh, God!” exclaimed Ginnie, looking at Jamie. “He’s seizing again.”

Indeed he was. His body flopped in the air as though goaded by a cattle prod. One leg gyrated, the other kicked. His hands shook in the velcro slings that tied them to the bed rails. His eyes rolled back and forth between half-opened eyelids.

“Watch his head! Watch his head!” someone yelled as Jamie pounded the bandaged crown of his head against the pillow. Nurses on either side rushed to hold him down against the squeaking mattress.

“Valium! STAT!” shouted Helvelius.

“He’s stopped breathing,” cried Ginnie.

Brower pushed the bed away from the wall and quickly dropped the head of the bed down flat. “Give me a laryngoscope!” he shouted as he stood behind Jamie. “I’m going to intubate him.” He threw away Jamie’s pillow and tilted his head back, forcing open his lower jaw with his thumbs.

“Wait!” Ali cried. “Stop it! All of you!” She brusquely pushed Brower aside and took up his position overlooking Jamie’s head. “The induction coil, give it to me! We need to turn SIPNI back on!”

Brower was seething, but at a nod from Helvelius, he stood back and allowed one of the nurses to hand Ali the coil. Ali quickly positioned it as she had in the operating room, with the arms of the coil terminating just behind Jamie’s ears.

“Richard, could you activate it?”

Dr. Helvelius turned to the control panel of the induction coil, set the dial to the correct voltage, and snapped the on switch. Jamie’s body instantly went rigid, with his back arched and his mouth wide open as he sucked in a deep, gasping breath. Then he dropped to the bed, limp and unconscious. For the next minute everyone watched him in dread silence. But relief gradually took hold around the bedside. The seizure had stopped, and he was now breathing freely.

“Dr. O’Day, may I have a word with you?” said Helvelius, replacing the induction coil on top of its control panel. After handing off Jamie to Brower, he put his arm around Ali and ushered her to one side. “There’s a T-T-TV crew in the hallway that’s going to want a progress report from me when I walk out of this room. What in G-God’s name am I supposed to tell them?”

“We have a problem, Richard. SIPNI is malfunctioning.”

“That’s obvious.”

“We can’t turn it off. We’ve already gone too far. If we can’t fix it, we’ll have to … take it out.”

Helvelius frowned. “What happens if we do? W-will there be another seizure? Could it kill him?”

“I don’t know. We really need that simulation. But … I think … I think there’s a problem with Odin.”

“What kind of problem? Odin’s always been a model child.”

“It’s because … I mean … I can’t … I don’t really understand it. But Kevin—”

Helvelius pinched her shoulder. “Look, just go downstairs and tell Kevin to stop j-j-jerking off and get Odin running again. Tell him what’s at stake.”

“Right.” Ali stared at the floor. There was no way she could tell Richard about Kevin and Odin. Always unhesitating in his actions, Helvelius would have had the FBI at Kevin’s door within two minutes. And that was the surest way to get everyone killed. “Right, I need to do that,” she said at last.

“Okay. I’m going out to face the m-music,” Helvelius said. “Keep working on this. At the moment you seem to be the only one who has any idea what’s going on here.”

“Yes. I will.” As Helvelius headed for the door, Ali gazed at Jamie, now lying quietly in his bed.
It won’t last,
she thought.
The next incident will be worse than anything we’ve seen.
Helvelius’s words seemed to mock her, for in truth she had no idea what was happening. Never had she felt so helpless.

Oh, my God! What have we gotten into?
she thought as she twisted Jamie’s lanyard around her fingers.

*   *   *

Stepping into the hall outside the ICU, Helvelius nearly collided with Dutch, the photographer, who had been shooting through the small window in the door. Helvelius realized that the TV crew had gotten film of the whole seizure, and there was no point in trying to cover it up.

Kathleen Brown was at Dutch’s side. “Dr. Helvelius,” she said, “when will we be allowed to film inside the Neurological Intensive Care Unit? You promised us that we could take some footage of Jamie with his nurses as soon as he came to.” There wasn’t any mike in her hand, but Helvelius knew that the camera had its own microphone and it was almost certainly turned on.

“N-n-n-ot now,” said Helvelius. “He’s under heavy s-s-sedation.”

“Is this the expected recovery time line?”

“We don’t know what to expect. This kind of s-s-surgery has no p-precedent.”

“What was it that just happened in there, Dr. Helvelius? Was that an epileptic seizure?”

“A seizure, yes.”

“Was it caused by Jamie’s surgery?”

“Seizures are not uncommon c-complications following any interv-v-ention in the brain. It may have been caused by the surgery. It m-may be r-r-related to his AVM. We’re treating it with appropriate medications. Hopefully there will be no r-r-r-recurrences.”

“Could the SIPNI device itself be at fault?”

“We are c-c-considering that.” Helvelius’s stutter was becoming unmanageable. He knew that to fight against it would only make it worse, so he tried the only remedy that ever worked—to ignore it and to focus on what he needed to say. “Let me … let me speak to you frankly. We are all explorers here. In our g-generation, we are barely venturing out from the shoreline into that vast uncharted s-s-sea that is the human brain. Our ways of deciphering the brain’s reactions to stress and injury depend on a small stock of c-concepts and ideas. It’s like attempting to transcribe
Hamlet
using only the letters
u, i, o,
and
p
. Most of the story is lost to us. M-much of what we conjecture to be true is hogwash. I wish I could tell you more. I wish to God I knew more. But it is still our duty to undertake the exploration as best we can. Future generations of scientists will judge more clearly of our triumphs and our m-m-mistakes. But there will be no future at all if we do not push the frontier now, accepting the risks that go along with that.

“As for Jamie, I can tell you that he has been awake and spoken to us at times, and that he is aware of the efforts we are making on his behalf. I have never had a more c-courageous patient than this young boy. When the Vostok and Mercury space capsules were launched into space, some m-m-man had to be the first to brave the great unknown, little knowing whether he would ever return. Well, Jamie is our Yuri Gagarin, our Alan Shephard. He undertook this role willingly and unflinchingly, not just to win back his eyesight, but out of a b-belief that he was opening up new possibilities for countless patients to come. Someday, his name will be known better than mine—just as we remember Yuri Gagarin and not the designers of his rocket or his spacesuit. Jamie Winslow—not just a pioneer, but a benefactor of mankind.”

“Those are moving words, Dr. Helvelius. But they sound like a eulogy. Are you implying that you’ve given up hope for your patient?”

Helvelius looked directly into Dutch’s camera, and suddenly his stutter was completely gone. “No! Decidedly not! We’re doing all that science and art can attempt. We will continue to do so. We will not give up!” With that, he turned and walked toward the elevator. As he waited for it, he turned back briefly. “If you’ll excuse me now, I need to have a private word with Jamie’s guardian.”

*   *   *

The elevator door opened, and Helvelius stepped inside, turned about, and pushed the down button. As the doors closed, Dutch’s camera caught his craggy face, looking firmly and resolutely at Kathleen Brown and her camera crew.

And then—a boom, like the sound of a giant sledgehammer smashing into a colossal steel drum. The air went white with dust. Kathleen Brown and several of her crew were knocked to the floor by a shock wave. They lay, choking from the dust and from an overpowering, acrid smell like the smell that lingers after a lightning strike, but mixed with a strange metallic component, plus something that burned the nostrils like ammonia.

*   *   *

Ali had been standing with Jamie’s open chart in her hand, preparing to write an order for Valium, when the floor lurched beneath her, and all the monitor stands and IV poles clanged and jostled like reeds in a gust of wind. She threw the chart onto the counter and ran to the sound of the explosion, followed by Brower and several nurses.

Nearly blinded by the cloud of dust in the hallway, she collided with Kathleen Brown, who was crawling on the floor on her hands and knees.

“My God, what happened?” cried Ali.

“Don’t know,” gasped Kathleen Brown.

“The elevator,” said Dutch. With the balance of a mountain goat, he alone had never lost his footing.

Through the dust cloud, Ali could see how the doors of the elevator had buckled outward and peeled apart from each other, leaving a six-inch gap between them. More dust could still be seen streaming through the gap.

Kathleen Brown climbed to her feet. “We were talking. Dr. Helvelius said he was—” She broke off into a coughing fit. “He got into … into the elevator. Then it just b-blew up.”

“Dr. Helvelius?” asked Ali, not believing what she had just heard. “
Richard
?”

Kathleen Brown nodded.

Ali ran to the elevator and began pounding on the doors. “Richard! Richard! Are you in there?” As Brower and the TV soundman caught up with her, Ali got onto her knees and peered through the gap between the doors. “Look!” she cried. “It’s only gone down a couple of feet. He’s still in there!” And she began pounding more frantically than before.