Fatal
Authors: Michael Palmer
B A N T A M B O O K S
Contents
For
Nicholas Aleksandar Palmer
Believe it or not, once upon a time,
your grandpa wrote this book.
And for
Danica Damjanovic Palmer,
Jessica Bladd Palmer,
and
Elizabeth Hanke
For taking such good care of my boys.
ACKNOWLEDGMENTS
ONE OF THE MOST PLEASURABLE THINGS FOR ME
about finishing a novel and knowing that soon it will be in stores and libraries and homes around the world is to take some time to reflect on the help I have received in getting it to this point.
Jane and Don, thanks for being there for me as always, every step of the way.
Bill Massey, thanks for so skillfully editing the manuscript. Nita and Irwyn, Andrea Nicolay, Kelly Chian, and everyone else at Bantam Books, thanks for shepherding it through the arduous path to publication.
Lieutenant Cole Cordray, Dr. Stanton Kessler, Dr. Pierluigi Gambetti, Dr. Erwin Hirsch, Rick Macomber, Barbara Loe Fisher, and Kathi Williams, thank you for your technical assistance. Bill Wilson and Dr. Bob Smith, thanks for what you’ve given to me and so many others.
Daniel, bless you for the website and your ideas; Mimi, Matt, and Beverly, thanks for the readings.
And Luke, wonderful, magical Luke, thanks for understanding that sometimes Dad had to say, “We’ll play later.”
PROLOGUE
IT HAD STARTED WITH A SORE THROAT.
Nattie Serwanga remembered the exact moment. She had been having dinner with her husband, Eli, when some green beans hurt her going down. At the time, the two of them were talking about whether Nadine would be a better choice to name their daughter than Kolette. The discomfort was the beginning of a cold, she thought. Nothing more.
But despite treatment from the doctors in the clinic, the sore throat had gotten progressively worse. Now, nine days after that first scratchy pain, Nattie knew she was sick—really sick. The pounding headache told her so. So did the chills and the sweats and the fiery swelling in her throat that the antibiotics had done nothing to help. And beginning at three this morning, there was the cough.
Across the raised glass counter, the kids from the hospital day-care center were lined up for lunch. Chicken nuggets and spaghetti. Pudding for dessert.
“Hi, Nattie Smattie.” . . . “Me first, Nattie. Me first.” . . . “Ugh, not spanetti again.”
Winking at an adorable four-year-old named Harold, Nattie forced a few drops of saliva past the burning in her throat and filled his plate. A moment later, without enough warning even to raise her hand, she was jolted by a vicious, racking cough—the worst yet. Droplets of her saliva sprayed over the contents of the trays in front of her. She stumbled back but caught herself before she actually fell. Each hack drove a six-inch spike into her brain.
“Damn,” she muttered, regaining her equilibrium. She was tough—tough as nails, one of her sisters liked to say. But this infection was tough, too. Instinctively, she slid her hands beneath her apron and pressed them against her womb. For a few horrible, empty seconds, there was nothing. Then she felt a sharp jab on her right side echoed immediately by one on the left. Despite the headache and the cough and the hot coals in her throat, Nattie Serwanga smiled.
At forty, married seven years, she had begun to believe it was her sad destiny to remain childless. Eli, who came from a family of ten children, desperately wanted kids. He had all but given up, though, and had begun talking about taking in foster children or even adopting. Then the miracle.
“Nattie, are you okay?”
Supervisor Peggy Souza eyed her with concern. Nattie’s smile this time was forced. A piercing ache had materialized between her shoulder blades.
“I’m . . . I’m fine,” she managed. “It’s just a cold that doesn’t want to dry up. I been to my obstetrician—twice.”
“He give you something?”
“First penicillin, then something stronger.”
She decided to leave out the part about sending her to an infections specialist if she wasn’t better soon, or all the questions about the trip she and Eli had just taken to see his family in Sierra Leone.
“You wanna go home?”
Nattie gestured to the crowd on the other side of the counter. A number of nurses and doctors were now lined up behind the kids.
“After the rush, maybe.”
The trip to Africa had used up the last of her vacation. She had been saving up her sick days to use in conjunction with maternity leave. With any luck she would be able to work until the last week and then take almost three months off. There was no way she could leave work just now.
“Well, I tell you what,” Peggy said. “Why don’t you wear one of these surgical masks until you’re ready to leave? That was some nasty coughin’ you were doin’.”
Nattie turned so that Peggy couldn’t see her fumbling with the strings of the mask.
What in God’s name is happening to me?
The next ten minutes were a blur of pain and poorly suppressed coughing. Still, Nattie managed to finish serving the children and even to make a dent in the staff, each of whom, she knew, had almost no time at all for lunch. Now, in addition to the unremitting pain, she was experiencing spasms and fullness in her rectum.
Please God, take care of my baby. Don’t let anything happen to her.
“Nattie? . . . Nattie!”
“Huh? Oh, sorry, Peggy. My mind just wandered.”
“You were just standing there starin’ off into space. I think you need to stop for the day an’ . . . Nattie, look over here at me.”
“What?”
“Your eyes. They’re all spotted with blood.”
“What are you talking about?”
“The white part of your eyes. There’s, like, patches of blood all over them. Nattie, you’d better get to a doctor right now.”
A sudden, strangulating tightness in her rectum made it impossible for Nattie to speak. Panicked, she nodded, then hurried as best she could to the rest room. The masked face staring back at her from the mirror looked monstrous. From under her paper hair-covering, clumps of her ebony hair were plastered to the perspiration on her forehead. Below that, the whites of her dull, almost lifeless eyes were nearly obliterated by splashes of bright crimson. She untied the top strings of her mask and let it flop over onto her chest. The inner surface of the mask, spattered with blood, looked like some obscene piece of modern art.
Another spasm from below—a white-hot spear thrusting up inside her.
This is bad. Oh, this is bad.
She hobbled into the stall. Her clothes were drenched with sweat. A viselike cramp in her lower belly was followed immediately by explosive diarrhea. Heavy drops of perspiration fell from her forehead.
Eli . . . oh, honey, I’m so sick. . . .
Nattie struggled to her feet. Behind her, in the bowl, was a hideous mix of stool and curdled blood. More blood. All she could think of was the baby. She tried again to feel the kicking in her womb, but she was shaking so hard, she couldn’t tell. Eli would know what to do, she thought. He was always the calm one. She fumbled in her pocket for some change to call him at work. Nothing. The phone in Peggy’s office. She could call him from there.
Lurching from side to side, unbalanced by her pregnancy, Nattie braced herself against the wall and moved ahead. Sweat was pouring down her now, stinging her eyes and dripping off her nose. Twice she was stopped by rib-snapping salvos of coughing. Her hand and the wall beyond it were speckled with crimson.
“Nattie? . . . Nattie, just lie down! Right there. I’ll call the ER. Jesus, look at her!”
Peggy’s voice seemed to be echoing through a long tunnel.
“My baby . . .”
Nattie sank to one knee as pain exploded in her head. A white light bathed the inside of her eyes. She felt her bowels and bladder give way at the moment her neck jerked back. She knew she was falling, but there was nothing she could do about it.
“She’s having a seizure! Call the ER!”
Peggy’s words were the last thing Nattie heard before a darkness mercifully washed away the pain.
CHAPTER
1
Belinda, West Virginia
“
MATT, THIS IS LAURA IN THE ER. . . . MATT?
”
“Yeah.”
“Matt, you’re still asleep.”
“I’m not.”
“You are. I can tell.”
“Time zit?”
“Two-thirty. Matt, please turn on a light and wake up. There’s been an accident at the mine.”
Matt Rutledge groaned. “Friggin’ mine,” he muttered.
“Dr. Butler has activated the disaster protocol. Team B is it tonight. Matt, are you awake?”
“I’m awake, I’m awake,” he pronounced hoarsely, fumbling with the switch on his bedside lamp. “Nine times seven is fifty-six. The Miami basketball team is the Heat. The fifth president—”
“Okay, okay. I believe you.”
From college, through medical school and residency, and now into his life as an internist, it had always been a chore for Matt to shut his mind down enough to fall asleep—but not nearly the challenge of subsequently waking up. Laura Williams knew this trait of his as well as any nurse, having worked with him in the ER of Montgomery County Regional Hospital for two years before his decision to switch over to private practice. She and all the other nurses had adopted the policy that Dr. Matthew Rutledge wasn’t definitely awake until he could prove it beyond a reasonable doubt.
“Light on? Feet on the floor?”
“I’m up, I’m up. Hold on for a second.” Matt tossed the receiver onto the bed and pulled on a pair of worn jeans, a can aerosols now T-shirt, and a light sweater. “Was it a cave-in?” he asked, tucking the receiver beneath one ear. He sensed a tightening in his gut at even saying the words.
“I think so. Ambulances are out there, but no one’s been brought in here yet. The man from the mine just got here, though. He says he thinks ten or twelve are injured.”
“Man from the mine?” Matt pulled on a pair of gym socks. Two toes—the little one and the fourth—poked through a hole in the left one. He briefly considered a replacement, then pushed the toes back in and went for his boots instead.
“He called himself the safety officer, something like that,” Laura said.
“Tall, black hair with a white streak up the front?”
Sort of like a giant skunk,
Matt wanted to add, but didn’t.
“Exactly.”
“That would be Blaine LeBlanc. He’s a very important person in Mineville. Just ask him. Laura, thanks. I’m up and dressed and on my way.”
“Great. The first rescue unit won’t be here for a little while, so drive slowly.”
“I know. I know. Motorcycle equals donorcycle.” He pulled on his boots. “I won’t go over five, I promise. The rest of the team on their way in?”
“All except Dr. Crook. So far he hasn’t answered his phone or his pager.”
Please let it stay that way,
Matt thought. Robert (“Don’t ever call me Bob”) Crook was a carriage trade cardiologist. One of the senior medical citizens in the multispecialty Belinda Medical Group, he had been the most vocal in opposition to Matt’s move from the ER into their practice. Ultimately, though, those who thought a well-liked, Belinda-born-and-raised, Harvard-trained internist and ER specialist might just help fill the desperate need for a primary care doc won out over Crook, whose main objection (spoken) was that Matt was an arrogant weirdo who didn’t dress or look like a doctor, and (unspoken) that he had once turned down his daughter’s invitation to the prom.
“Well, I should be there in ten minutes.”
“Make it fifteen.”
“Okay, okay.”
“And Matt?”
“Yes?”
“Nine times seven is sixty-three, not fifty-six.”
“I knew that.”
Matt set the phone down, pulled his dark brown hair back into a ponytail, and secured it with a rubber band. For as long as he and Ginny had known each other, he had worn his hair short—not exactly a crew cut, but almost. And by her decree, she was the only one allowed to barber him. Since her death, he hadn’t done more than trim his sideburns. The stud in his right earlobe had followed a year or so later, and the tattoo on his right deltoid a few months after that. It was a masterful rendering done from a photograph of the white-blossomed hawthorn tree in their yard—Ginny’s favorite.
The five-room log cabin the two of them had designed together was perched on a bluff looking out across the Sutherland Valley at the Allegheny Mountains. Pulling on a denim windbreaker, Matt stepped out onto the broad porch where, toward the end, Ginny had spent most of her time. In fact, only the tattoo artist in Morgantown had kept him from having the porch etched permanently into his arm instead of the hawthorn tree. (“I can dig the sentiment, man, but believe me, the aesthetic is just bogus.”)
Anytime Matt began doubting his decision to come back to West Virginia—and of late those times were increasingly frequent—he needed only to walk out the front door of the cabin. This was Ginny’s kind of night. There wasn’t a single cloud in the new-moon sky. Directly overhead, the eternal river of the Milky Way shimmered across the blackness. The chilly late-summer air was, as always, tinged with a hint of smoke from the huge coal processing plant adjacent to the mine. Nevertheless, it was still sweet and fragrant with the scents of lavender, linden, wild orchids, wild roses, St. John’s Wort, and hundreds of other kinds of blossoms.
Country roads, take me home, to the place I belong. . . .
Matt looped around the cabin to his one-car garage and fired up his maroon Harley Electraglide. In addition to the hog, he had a 900cc Kawasaki roadster and a 250cc Honda dirt bike, all of which he could pretty much maintain himself. The Harley was his choice for cruising, and the jackrabbit-quick roadster for those days when he wanted to live a bit more on the edge. The Honda, in addition to being a thrill a second in the woods, was invaluable in making house calls to a large portion of his practice, inaccessible by any but the most primitive road.
As he rolled down the gravel drive to State Highway 6, Matt started feeling the first rush of adrenaline at what the next few hours might hold. This accident was hardly the first he had dealt with courtesy of the Belinda mine, although at ten to twelve injured it would be the biggest. Over the years, there had been bruises, gashes, strains, sprains, and fractures too numerous to mention. There had also been a few deaths. But the only other time disaster team B had actually been called in proved to be a farce. An underground train known as a maintrip had derailed deep in the mine. Twenty members of team B had milled around the ER from two until three in the morning before word was received that instead of the thirty to forty casualties originally reported, there were none.
However, this new disaster, Matt sensed, was the real deal.
The six-mile ride to the hospital was along a serpentine road for which the motorcycle seemed expressly created. Matt leaned into the familiar turns with a rhythm that had become second nature. He wondered if this latest disaster was yet another monument to the Belinda Coal and Coke Company’s cutting safety corners wherever possible. Despite the constant pressure for modernization and improved safety that he and a few other brave souls tried to keep on the mine owners, little had changed. BC&C was persistently unwilling to do anything but the barest minimum to ensure the well-being of the miners. It was that way with the massive conglomerate today just as it had been that April night twenty-two years ago when the ceiling of Tunnel C-9—the tunnel cutely nicknamed Peggy Sue—caved in, crushing to death three miners, including shift foreman Matthew Rutledge, Sr.
