Mercy 6 (8 page)

“I was right,” she said. “Wasn't I? Trauma through the bronchus in Fleming. In Verdasco,” she nodded toward the body, “through the brain stem and thorax.”

“More or less,” said Claiborne.

She sensed Silva's approach.

“Trauma,” said Mendenhall. “So, trauma.”

Claiborne shook his head. “Viral. Everything points to viral.

Maybe fungal. I never rule that out too soon. But viral is the way to go. Hemorrhagic and sudden. Thorpe's fear.”

“Thorpe's hope, you mean.”

Claiborne closed his eyes and took a breath. There was a draw on the violin. “I want you to be right, Dr. Mendenhall. Like I want to be eating Thai with my wife. But he is right. You know it, too.”

She thought, searched past the fatigue. She looked at Silva's face, relieved to find the tech's mask down, furtive lips and nose, eyes lifted. “No. I don't know it.”

“Look, Doctor.” Claiborne opened his hands, his arms. “You are very good at what you do. You made the call right away. You saw it.”

She looked at the clean bodies, their skin reflecting the aimed light. “There should've been more bleeding, less isolation. Even in something fast. Dengue fever, even. Any VHF.”

“That's what I thought. After you sent your predictions. So I searched. . . . I found this.” Claiborne changed Verdasco's overhead to show a scan of his brain. Mendenhall saw a faint cloud along the edge of Verdasco's frontal lobe.

“And this.” Claiborne changed the scan to Verdasco's left kidney.

Another cloud.

“Those are pretty vague.”

Claiborne shook his head. “They just got started. Then he died.”

Silva stepped closer, almost getting between them. Mullich would have found that interesting, would have drawn the triangle, noted its slightness.

“We found similar hemorrhaging in the others,” Silva said. “In other major organs. Dozier's liver and brain, Fleming's kidneys and brain. Thorpe confirmed something similar in Peterson's brain and lungs.”

“You mean
incipient
hemorrhaging.” Mendenhall eyed Verdasco's display as she spoke, trying not to lessen her tone.

“Don't fight this,” said Claiborne. His gaze was that same look again, the one he gave her on the trail before he increased his pace.

“You are the one giving us—including Thorpe—some of the best anticipations. Use them right.”

He motioned to Verdasco's brain scan, then continued, “We most likely have a virus that produces trauma. We know viruses that do that—induce trauma, shock. This is new, yes. But it's in the continuum. New means nothing more to me than indication.

Indication to find and identify. It doesn't mean panic. It doesn't mean containment. It means work for me. For us.”

Mendenhall could not help inverting his first premise. It was what she did. It was what she had been taught. It was why she had gone to that abandoned file room. She closed her eyes and went there in her thoughts, just for the moment it took her to think out the inversion. Trauma that produces virulent hemorrhaging.

“I know what you're thinking,” said Claiborne, “and it makes no sense. Not with what we have. Not with time and placement. It all happened here. Inside.”

Mendenhall looked across the lab at Mullich's displays.

Claiborne followed her gaze.

“He's doing it right, too,” said Claiborne. “Using you right.

Finding patterns. Hopefully a center.”

Mendenhall looked at Silva.

“No,” said Claiborne. “She's doing it right, too. Don't go there.”

“You'll get me fired.” Silva returned their looks.

“I want you to keep coming down here, Doctor.” Again

Claiborne opened his hands to her. “Because it will help you up there.” He motioned toward the ceiling. “And it's helping us down here. But not if you're going to fight every finding. For fight's sake.”

Mendenhall rubbed her own shoulders, kneaded them, resisting the urge to press her eyes and face. “When does containment end, then? Assuming no more outbreak. Assuming Thorpe disregards those last hystericals.”

“All early cultures and tests are negative. But he staggered the patients. We'll go home in the morning.”

She nodded as she looked down, felt Silva watching her.

Mendenhall liked how Claiborne called them patients. His patients were neither dead nor alive. Even the dead ones, for him, kept giving.

“Thorpe's good,” said Claiborne. “Maybe even a good person.

He's just intense. How he should be—for what he does.”

Mendenhall disagreed, felt it as the beginning of a shudder but let it go. She stayed there and looked at their scans, all of the clouds and lines and patterns. She found solace in the quiet movements of Claiborne and Silva, in the violin and chill and distilled air. But she went into her own world.

Cause of trauma affects treatment. A stab, a bullet, a toxin, blunt force call for distinct treatments. But only in the in-between, the sometimes long-between. First you treat the trauma itself. You hold a hand, say something, apply pressure, anodyne. Last you make sure to treat the trauma again, try to end it. If you don't, the patient is damaged forever, dies.

And the inverse of Claiborne's premise—his sound premise, the one they were all working under—stayed with her. Trauma produces virulent reaction.

But circumstance canceled trauma as the first cause. Circumstance allowed for virus as first cause, trauma as result, trauma as cause of demise. Mendenhall needed to do some research, five minutes on her screen. She stood aside in Pathology, still watching Silva and Claiborne. Claiborne, she could see, was getting ready to send the bodies into drawers. He was measuring Verdasco with a laser pen, the numbers scrolling onto the overhead. The thought of returning to her floor depressed Mendenhall.

Silva was starting to close out Mullich's laptop.

“Wait,” Mendenhall told her, then stepped close.

Silva raised her brow.

“Can I use that?” Mendenhall asked. “Mullich won't mind. In fact he'd prefer it. So he can see what I'm doing.”

Silva deferred to Claiborne. Claiborne fired his laser pen at Mendenhall's heart. She touched the red dot.

“I'm not fighting. Look, this way you can see right away what I'm thinking. Please, Dr. Claiborne. It's nice down here.”

Claiborne returned to his task.

Mendenhall sat before Mullich's laptop, and Silva went to assist Claiborne. They listened to the single violin. Mendenhall felt her movements slow along with the rest of the room. She breathed, tasted the air as it dried her lips and tongue. The paper scroll beside the laptop was a blueprint of the hospital, a vertical. The ER was the longest rectangle. The roof was two brackets, opened to the sky, the empty blue.

On screen she brought up a recent study of hydrostatic shock.

The accompanying video showed a rectangular block of gel being penetrated by a bullet in super slow-motion. The visual study showed a series of shots, each successive one lowering the caliber of the projectile while increasing velocity. The experiment aimed to demonstrate the value of velocity over the size of the caliber.

The final demonstration showed a missile the size of a shotgun pellet passing through the gel at extreme velocity. On initial impact, a large cone of air instantly expanded the gel block, distorting it into an oval, almost exploding the entire block. Swirls of distorted gel spiraled outward, barely contained by the membrane, forming translucent waves. The pellet exited through a pinpoint at the tip of the cone, and the gel block returned to its original shape, but with coils of air caught along the perimeter and in the corners.

These were trauma lines, vague and distant parentheses around the primary line left by the ballistic path.

It was pretty. It seemed to dance to the long draw of the violin bow sounding above the lab. The gel block was backlit with amber light to accentuate the trauma lines.

“Come see,” said Mendenhall, softly, in case they were listening.

Silva came; Claiborne remained with Verdasco. Mendenhall ran the last video again, the highest velocity.

“It's hydrostatic shock,” Mendenhall told Silva. She felt the lab tech near her shoulder. “It shows how high-velocity projectiles, even when very small, cause peripheral damage. Extreme damage.”

Mendenhall repeated the demo.

“The body returns to form.” Silva's voice was plaintive.

“I know that study.” Claiborne spoke without leaving his position, the direction of his voice downward. Mendenhall imagined him behind them, talking to Verdasco. “You're fighting, Dr. Mendenhall.”

“I'm not.” She ran the video again, pausing at impact, the birth of the spiral. “I'm doing what I should do at this point. My expertise.

What I know that causes peripheral hemorrhaging. Why people die from what should be nonfatal invasion. Why bodies die from impacts to nonvital tissue. Why I have patients die from getting shot in the shoulder, the thigh, the foot. Why I had one die from a piece of glass through her bicep.”

“Those are extreme velocities,” said Claiborne.

“We live in a world of extreme velocities.”

“We have no ballistic,” replied Claiborne. His voice was even lower, crouching closer to Verdasco. “We have no entry or exit.”

“Okay. Okay. I'm just showing peripheral trauma. Peripheral hemorrhaging as indicator for extreme trauma. Hemorrhaging distant from the point of initiation. Bleeding in the most liquid organs.” Mendenhall pointed to the amber swirls in the corners of the gel block, drawing Silva closer. “Far perimeter clouds in the brain and liver.”

Mendenhall winced at her own words. Metaphor indicated lack of precision, a skip in the equation.

“Far perimeter clouds?” Claiborne knew what she was thinking.

“Okay. Perimeter bruising.” Mendenhall turned away from the screen and looked at Claiborne, waited for him to quit Verdasco.

After a moment he straightened and looked at her.

“That's what you have,” she told him. “Something—a viral impact, if you want—that causes perimeter hemorrhaging in uninvolved organs. That's a valid assumption until you find something in those peripheral tissues. Those far tissues. I think you should focus on those samples first. While Thorpe's people go after the primary hemorrhages.”

“I am Thorpe's people.” Claiborne looked at Silva. “We are Thorpe's people.”

“You know what I mean.”

Claiborne joined her and Silva by the laptop. They stood together beneath Mullich's charts.

“Run it again,” he said, nodding toward the laptop screen. “It's pretty. My eyes need a break.”

Silva was the one who tapped it into motion. They watched the pellet pass straight through the gel block, the spiral of amber distorting the whole into a sideways tornado.

“I'm helping,” said Mendenhall. “Increasing efficiency.”

“Providing entertainment.” Claiborne took control of the video, his hand dark and slender, freshly peeled from its glove. He made the demonstration run backward and forward, repeating. He darkened the screen, deepening the amber backlight. The impact seemed to bring the gel block to life, morphed it into a cell, quickening, seeking another.

When Mullich returned to the lab they had to explain

themselves. Claiborne had already moved back to Verdasco's body, drawing Silva with a nod. He must have sensed the architect's approach, the breach in his underworld. Mendenhall sat alone by the laptop, the video still looping, caught.

Mullich let the door ease shut behind him. He sterilized his hands with lotion, pulled on fresh gloves, all while scanning the others in the room, the screen displays. Everything was there for him. Mendenhall started to explain, then caught herself. This was Mullich. She returned his gaze and drew back from the desk, letting him see. Claiborne and Silva continued their work, innocent.

Mullich stood above Mendenhall and watched the loop.

Intermittently he glanced back to the bodies. Then he moved to Claiborne's desk, studied the scans showing the primary trauma patterns.

When Mendenhall joined him, she said nothing.

“In these two,” Mullich pointed to the scans of Dozier and Verdasco, “the cone is reversed.”

“It's not the cone we're—I'm—focused on.” Mendenhall found a laser pen on Claiborne's desk. She drew the bead of light across both diagonals, slashing the brainstems. Then she aimed it at the scans of the frontal lobes, Verdasco's lung, Dozier's liver, the vague clouds in each.

“These show incipient hemorrhaging in peripheral organs.

Major organs.” She let Mullich see, just see.

“You think that,” Mullich pointed toward the video, “happened to them?” He held his hand toward the bodies.

“Not exactly.” Mendenhall led him to Verdasco. Claiborne stepped aside, one eyebrow raised as he looked at her. Silva pressed Verdasco's chin, extending the throat.

“The body reacts in known ways, according to preset nerve patterns. We develop these as we go through life. Kisses, caresses, slaps, pinpricks, falls, dives into water that violently strain our necks. Innocent, little things we never really register. Things that begin in utero.

“These bodies didn't roil like that gel block. The nerve patterns just reacted as if they did, as if they would. As if they were shot through. The most vital and liquid organs anticipated hydrostatic shock, began to hemorrhage along the far nerve endings. The end of a whip. But without the whip.”

She lunged toward Mullich, her fingers flashing straight to his eyes. He drew back. Silva gasped.

“Like that,” said Mendenhall, keeping her hand raised, her fingers spiked before his eyes. “Actually, exactly that.”

She lowered her hand. “Your body registered that all over the place. You closed your eyes, obviously. But feel. Look.” She motioned toward Mullich's hands which had balled into fists.