The other four members of the team were still staring at Jonas.
Death, he told himself, is just another pathological state.
Most pathological states could be reversed with treatment.
Dead was one thing. But cold and dead was another.
To Gina, he said, “How long's he been dead?”
Part of Gina's job was to serve as liaison, by radio, with the on-site paramedics and make a record of the information most vital to the resuscitation team at this moment of decision. She looked at her watch—a Rolex on an incongruous pink leather band to match her socks—and did not even have to pause to calculate: “Sixty minutes, but they're only guessing how long he was dead in the water before they found him. Could be longer.”
“Or shorter,” Jonas said.
While Jonas made his decision, Helga rounded the table to Gina's side and, together, they began to study the flesh on the cadaver's left arm, searching for the major vein, just in case Jonas decided to resuscitate. Locating blood vessels in the slack flesh of a corpse was not always easy, since applying a rubber tourniquet would not increase systemic pressure. There was no pressure in the system.
“Okay, I'm going to call it,” Jonas said.
He looked around at Ken, Kari, Helga, and Gina, giving them one last chance to challenge him. Then he checked his own Timex wristwatch and said, “It's nine-twelve P.M., Monday night, March fourth. The patient, Hatchford Benjamin Harrison, is dead … but retrievable.”
To their credit, whatever their doubts might have been, no one on the team hesitated once the call had been made. They had the right—and the duty—to advise Jonas as he was making the decision, but once it was made, they put all of their knowledge, skill, and training to work to insure that the “retrievable” part of his call proved correct.
Dear God, Jonas thought, I hope I've done the right thing.
Already Gina had inserted an exsanguination needle into the vein that she and Helga had located. Together they switched on and adjusted the bypass machine, which would draw the blood out of Harrison's body and gradually warm it to one hundred degrees. Once warmed, the blood would be pumped back into the still-blue patient through another tube feeding a needle inserted in a thigh vein.
With the process begun, more urgent work awaited than time to do it. Harrison's vital signs, currently nonexistent, had to be monitored for the first indications of response to therapy. The treatment already provided by the paramedics needed to be reviewed to determine if a previously administered dose of epinephrine—a heart-stimulating hormone—was so large as to rule out giving more of it to Harrison at this time. Meanwhile Jonas pulled up a wheeled cart of medications, prepared by Helga before the body had arrived, and began to calculate the variety and quantity of ingredients for a chemical cocktail of free-radical scavengers designed to retard tissue damage.
“Sixty-one minutes,” Gina said, updating them on the estimated length of time that the patient had been dead. “Wow! That's a long time talking to the angels. Getting this one back isn't going to be a weenie roast, boys and girls.”
“Forty-eight degrees,” Helga reported solemnly, noting the cadaver's body temperature as it slowly rose toward the temperature of the room around it.
Death is just an ordinary pathological state, Jonas reminded himself. Pathological states can usually be reversed.
With her incongruously slender, long-fingered hands, Helga folded a cotton surgical towel over the patient's gen**als, and Jonas recognized that she was not merely making a concession to modesty but was performing an act of kindness that expressed an important new attitude toward Harrison. A dead man had no interest in modesty. A dead man did not require kindness. Helga's consideration was a way of saying that she believed this man would once more be one of the living, welcomed back to the brotherhood and sisterhood of humanity, and that he should be treated henceforth with tenderness and compassion and not just as an interesting and challenging prospect for reanimation.
The weeds and grass were as high as his knees, lush from an unusually rainy winter. A cool breeze whispered through the meadow. Occasionally bats and night birds passed overhead or swooped low off to one side, briefly drawn to him as if they recognized a fellow predator but immediately repelled when they sensed the terrible difference between him and them.
He stood defiantly, gazing up at the stars shining between the steadily thickening clouds that moved eastward across the late-winter sky. He believed that the universe was a kingdom of death, where life was so rare as to be freakish, a place filled with countless barren planets, a testament not to the creative powers of God but to the sterility of His imagination and the triumph of the forces of darkness aligned against Him. Of the two realities that coexisted in this universe—life and death—life was the smaller and less consequential. As a citizen in the land of the living, your existence was limited to years, months, weeks, days, hours. But as a citizen in the kingdom of the dead, you were immortal.
He lived in the borderland.
He hated the world of the living, into which he had been born. He loathed the pretense to meaning and manners and morals and virtue that the living embraced. The hypocrisy of human interaction, wherein selflessness was publicly championed and selfishness privately pursued, both amused and disgusted him. Every act of kindness seemed, to him, to be performed only with an eye to the payback that might one day be extracted from the recipient.
His greatest scorn—and sometimes fury—was reserved for those who spoke of love and made claims to feeling such a thing. Love, he knew, was like all the other high-minded virtues that family, teachers, and priests blathered about. It didn't exist. It was a sham, a way to control others, a con.
He cherished, instead, the darkness and strange anti-life of the world of the dead in which he belonged but to which he could not yet return. His rightful place was with the damned. He felt at home among those who despised love, who knew that the pursuit of pleasure was the sole purpose of existence. Self was primary. There were no such things as “wrong” and “sin.”
The longer he stared at the stars between the clouds, the brighter they appeared, until each pinpoint of light in the void seemed to prick his eyes. Tears of discomfort blurred his vision, and he lowered his gaze to the earth at his feet. Even at night, the land of the living was too bright for the likes of him. He didn't need light to see. His vision had adapted to the perfect blackness of death, to the catacombs of Hell. Light was not merely superfluous to eyes like his; it was a nuisance and, at times, an abomination.
Ignoring the heavens, he walked out of the field, returning to the cracked pavement. His footsteps echoed hollowly through this place that had once been filled with the voices and laughter of multitudes. If he had wanted, he could have moved with the silence of a stalking cat.
The clouds parted and the lunar lamp beamed down, making him wince. On all sides, the decaying structures of his hideaway cast stark and jagged shadows in moonlight that would have seemed wan to anyone else but that, to him, shimmered on the pavement as if it were luminous paint.
He took a pair of sunglasses from an inside pocket of his leather jacket and put them on. That was better.
For a moment he hesitated, not sure what he wanted to do with the rest of the night. He had two basic choices, really: spend the remaining pre-dawn hours with the living or with the dead. This time it was even an easier choice than usual, for in his current mood, he much preferred the dead.
He stepped out of a moon-shadow that resembled a giant, canted, broken wheel, and he headed toward the moldering structure where he kept the dead. His collection.
“Sixty-four minutes,” Gina said, consulting her Rolex with the pink leather band. “This one could get messy.”
Jonas couldn't believe how fast time was passing, just speeding by, surely faster than usual, as if there had been some freak acceleration of the continuum. But it was always the same in situations like this, when the difference between life and death was measured in minutes and seconds.
He glanced at the blood, more blue than red, moving through the clear-plastic exsanguination tube into the purring bypass machine. The average human body contained five liters of blood. Before the resuscitation team was done with Harrison, his five liters would have been repeatedly recycled, heated, and filtered.
Ken Nakamura was at a light board, studying head and chest X rays and body-sonograms that had been taken in the air ambulance during its hundred-eighty-mile-per-hour journey from the base of the San Bernardinos to the hospital in Newport Beach. Kari was bent close to the patient's face, examining his eyes through an ophthalmoscope, checking for indications of dangerous cranial pressure from a buildup of fluid on the brain.
With Helga's assistance, Jonas had filled a series of syringes with large doses of various free-radical neutralizers. Vitamins E and C were effective scavengers and had the advantage of being natural substances, but he also intended to administer a lazeroid—tirilazad mesylate—and phenyl tertiary butyl nitrone.
Free radicals were fast-moving, unstable molecules that ricocheted through the body, causing chemical reactions that damaged most cells with which they came into contact. Current theory held that they were the primary cause of human aging, which explained why natural scavengers like vitamins E and C boosted the immune system and, in long-term users, promoted a more youthful appearance and higher energy levels. Free radicals were a by-product of ordinary metabolic processes and were always present in the system. But when the body was deprived of oxygenated blood for an extended period, even with the protection of hypothermia, huge pools of free radicals were created in excess of anything the body had to deal with normally. When the heart was started again, renewed circulation swept those destructive molecules through the brain, where their impact was devastating.
The vitamin and chemical scavengers would deal with the free radicals before they could cause any irreversible damage. At least that was the hope.
Jonas inserted the three syringes in different ports that fed the main intravenous line in the patient's thigh, but he did not yet inject the contents.
“Sixty-five minutes,” Gina said.
A long time dead, Jonas thought.
It was very near the record for a successful reanimation.
In spite of the cool air, Jonas felt sweat breaking out on his scalp, under his thinning hair. He always got too involved, emotional. Some of his colleagues disapproved of his excessive empathy; they believed a judicious perspective was insured by the maintenance of a professional distance between the doctor and those he treated. But no patient was just a patient. Every one of them was loved and needed by someone. Jonas was acutely aware that if he failed a patient, he was failing more than one person, bringing pain and suffering to a wide network of relatives and friends. Even when he was treating someone like Harrison, of whom Jonas knew virtually nothing, he began to imagine the lives interlinking with that of the patient, and he felt responsible to them as much as he would have if he had known them intimately.
“The guy looks clean,” Ken said, turning away from the X rays and sonograms. “No broken bones. No internal injuries.”
“But those sonograms were taken after he was dead,” Jonas noted, “so they don't show functioning organs.”
“Right. We'll snap some pictures again when he's reanimated, make sure nothing's ruptured, but it looks good so far.”
Straightening up from her examination of the dead man's eyes, Kari Dovell said, “There might be concussion to deal with. Hard to say from what I can see.”
“Seconds count here. Be ready, people,” Jonas said, although he knew they were ready.
The cool air couldn't reach his head because of his surgical cap, but the sweat on his scalp felt icy. Shivers cascaded through him.
Blood, heated to one hundred degrees, began to move through the clear plastic IV line and into the body through a thigh vein, surging rhythmically to the artificial pulse of the bypass machine.
Jonas depressed the plungers halfway on each of the three syringes, introducing heavy doses of the free-radical scavengers into the first blood passing through the line. He waited less than a minute, then swiftly depressed the plungers all the way.
Helga had already prepared three more syringes according to his instructions. He removed the depleted ones from the IV ports and introduced the full syringes without injecting any of their contents.
Ken had moved the portable defibrillation machine next to the patient. Subsequent to reanimation, if Harrison's heart began to beat erratically or chaotically—fibrillation—it might be coerced into a normal rhythm by the application of an electric shock. That was a last-hope strategy, however, for violent defibrillation could also have a serious adverse effect on a patient who, having been recently brought back from the dead, was in an exceptionally fragile state.
Consulting the digital thermometer, Kari said, “His body temperature's up to only fifty-six degrees.”
“Sixty-seven minutes,” Gina said.
“Too slow,” Jonas said.
“Let's go for it,” Ken advised.
“Fifty-seven degrees,” Kari said.
“At this rate,” Helga said worriedly, “we're going to be past eighty minutes before he's anywhere near warm enough for the heart to kick in.”
Heating pads had been placed under the operating-table sheet before the patient had been brought into the room. They extended the length of his spine.
“Okay,” Jonas said.
Kari clicked the switch on the heating pads.
“But easy,” Jonas advised.
Kari adjusted the temperature controls.
They needed to warm the body, but potential problems could arise from a too-rapid reheating. Every resuscitation was a tightrope walk.
Jonas tended to the syringes in the IV ports, administering additional doses of vitamins E and C, tirilazad mesylate, and phenyl tertiary butyl nitrone.
The patient was motionless, pale. He reminded Jonas of a figure in a life-size tableau in some old cathedral: the supine body of Christ sculpted from white marble, rendered by the artist in the position of entombment as He would have rested just prior to the most successful resurrection of all time.
Because Kari Dovell had peeled back Harrison's eyelids for the ophthalmoscopic examination, his eyes were open, staring sightlessly at the ceiling, and Gina was putting artificial tears in them with a dropper to insure that the lenses did not dry out. She hummed “Little Surfer Girl” as she worked. She was a Beach Boys fan.
No shock or fear was visible in the cadaver's eyes, as one might have expected. Instead, they held an expression that was almost peaceful, almost touched by wonder. Harrison looked as if he had seen something, in the moment of death, to lift his heart.