To the expert eye, these physiological signs pointed toward specific life-threatening complications that would have to be assessed and treated without losing an instant. The severe hemorrhaging alone would have led them to evaluate him for shock, but his lividity left scant doubt of its onset, and the blood pressure cuffs placed on his arm as his stretcher was rolled in had given systolic and diastolic readings of zero over less than zero, indicating a near-cessation of his circulatory processes. His thready breathing also suggested that a tension pneumothorax—in laymen’s terms, an air pocket between the lungs and their surrounding tissues developing as a result of shock—was putting pressure on the lungs and causing them to fully or partially collapse.
The condition would lead to respiratory failure and certain death unless relieved by external means.
Managing a medical crisis requires a constantly unfolding and frequently accelerating series of prioritizations. In this case the priority was to stabilize his vital functions even before the injuries to his internal organs could be determined by Xrays and exploratory abdominal surgery. Only then would it be known with certainty how many times he’d been shot, or what path the bullet, bullets, or bullet fragments had taken.
With the clock ticking, the surgeon in charge at once began giving directions to his assistants in a rapid and assertive manner.
“I want MASTs ...”
This being an acronym for medical shock trousers, which could be slipped onto the patient and inflated with air to force blood up from his lower extremities to his heart and brain.
“... seven units of packed RBCs ...”
Shorthand for red blood cells, the hemoglobin-rich component of blood that provides life-giving oxygen to body tissues. In a typical situation requiring transfusion, the patients’s serum is cross-matched for compatibility with a sample of the blood product to be administered, but because he was an employee of UpLink, this man’s type was already on file on the doctors’ computer database, eliminating that step and conserving precious minutes.
“... a big line ...”
A wide intravenous catheter used to get the RBCs into his system by quick, massive transfusion.
“... and a needle aspirator in him stat!”
The needle aspirator being a large syringe used to drain the air out of the pneumothorax, inflate the lungs, and restore normal breathing; stat, medical jargon for I need it done five seconds ago, a word derived and abbreviated from the original Latin statim, meaning immediately.
While the image of medical professionals working in conditions of ordered, clockwork sterility is a common one, nothing will dispel it faster than a glimpse inside a trauma room, where the battle to save lives is a close, tense, chaotic, messy, sweaty affair. Jabbing a 14-gauge big-bore needle into the chest of a powerfully built two-hundred-pound man, clenching the attached syringe in your fist and unsuccessfully attempting to insert it between hard slabs of pectoral muscle once, twice, and again before finally making a clean entry, then drawing out the plunger and getting a rush of warm, moist air in your face as the pocket that had formed around the lungs decompressed, was nobody’s idea of a picnic—as the young doctor who had been hastily summoned on duty tonight, and who was now toiling away over Rollie Thibodeau here in the ISS facility’s critical-care unit, trying to prevent him from dying before he made it onto an operating table, would have attested if he’d had the time. But he was too busy following the instructions called out by the chief physician, himself standing over the patient, working to get the big line and saline IVs connected to him in a hurry.
With the syringe in place and the air suctioned from the pneumothorax, it was essential to prevent its recurrence and keep the patient breathing. This meant going ahead with a full closed-tube thorascostomy.
The first step was to create an airtight seal around the tube. Barely registering the frantic activity around him, the young doctor lifted a scalpel from an instrument tray and sliced into the flesh between the ribs, making a horizontal incision. Then he took a Kelly clamp off the tray and pushed it into the incision, holding it by the shaft, expanding it to spread the soft tissue and create a tunnel for his finger. Blood splashed up around the clamp as he removed it from the opening and pressed his gloved finger between the lips of the cut, going in as deep as his knuckle, carefully feeling for the lung and diaphragm. After assuring himself that he had penetrated through to the intrapleural area—the space between the lungs and ribs where the air pocket had formed—he asked a scrub nurse for the chest tube and carefully guided it into the opening.
He paused, studied the patient, and exhaled a sigh of relief. The patient’s breathing was stronger and more regular, his skin color vastly improved. A water collection system at the opposite end of the chest tube would keep the air draining from the patient’s chest while insuring that no air was drawn back into it. To complete the procedure, the young doctor would suture the skin around the tube to preserve the seal.
A very long night still lay ahead, but Thibodeau would have something like a fighting chance as the doctors hustled him into the OR, opened him up, and got a look at the extent of the damage that had been done inside him.
SIX
CHAPARE REGION WESTERN BOLIVIA APRIL 18, 2001
A LOOK OF QUIET GRATIFICATION ON HIS FACE, HARLAN DeVane watched the line of three flatbed trucks roll along the hardpack at the eastern border of his ranch as they approached the airstrip and the waiting Beech Bonanza in a cloud of dust. Now, before midday, the sun was a firebrand hanging above the battered old camiones and the wide, flat pasture closer by, where he could see his cattle, prime heifers imported from Argentina, grazing indolently in the heat. There was no wind, and the ash and smoke from the forest fires seemed an inert smear above the horizon. Once the afternoon breezes stirred, however, it would rise and spread into a blanketing gray haze, dimming the sun so that one could look directly up into it with the unprotected eye. It was a price of development that DeVane found regrettable, but he was a man who dealt with realities as they presented themselves. The loggers bulldozed new roads, and the opportunistic peasant farmers and ranchers who came here to settle followed along those roads, and because the soil was quickly depleted in the Amazon basin—good for no more than three years’ growing of crops—they would clear previously untouched tracts of forest as their fields dried up and grew fallow. The cycle was implacable yet unavoidable. Nothing in life came free of charge, and most often you paid as you went.
“It appears the plane soon will be on its way, Harlan,” Rojas said, taking a sip of his chilled guapuru.
DeVane looked at him from under the brim of his white Panama hat. His skin was tightly stretched over his cheeks and almost colorless. His eyes were a frozen shade of blue set deep in their sockets. He wore a white double-breasted suit that had been custom-tailored from some lightweight fabric, probably in Europe. The collar points of his blue silk shirt were neatly buttoned down under blue-and-yellow pinstriped suspenders. Unbothered by the torrid weather, he seemed to occupy his own still pocket of space, putting Rojas in mind of the lion-fish that floated in the waters of the Carribean—so illusively delicate in appearance, so serenely poisonous.
“And you, Francisco?” he said, speaking Portuguese although Rojas was proficient in English. “Will you be leaving with it? Or can I assume you’ve made other arrangements?”
“You know it is my habit let the perico fly on separately,” Rojas said. “As a precaution.”
DeVane was inwardly amused by his choice of words. The cocaine made you manic and talkative. Like a parrot, perico in Spanish. It was a term of low slang he might have expected from some street-level dealer in San Borja, not a Brazilian police official of considerable rank. But Rojas was of a type. A gutless, corrupt, lazy little south-of-the-equator bureaucrat trying to affect the manner of an outlaw. Light a firecracker outside his office window and he would hide quailing under his desk.
“I’ll have my driver take you back to the airport in Rurrenabaque when we
’re finished,” he said. “You’re entitled to feel safe.”
Rojas heard the note of derision in DeVane’s voice and held his hands apart.
“Things happen,” he said. “I expect no problems, but as always will be relieved when the shipment reaches its destination.”
In fact, Rojas thought, his relief would begin the moment he was out from under the hard eyes of DeVane’s bodyguards. And away from Kuhl. Kuhl seemed less a human being than a cold precision weapon... and how dangerous it was for such a murderous instrument to be controlled by someone with a boundless appetite for wealth and power. Kuhl had acquired a forbidding reputation on his own, but there was no doubt that his association with DeVane had enhanced his innate capacity for violence and given it a chance for its fullest, bloodiest expression.
Yes, it would be good to be elsewhere.
Rojas reached for his glass again and took a long drink. This was not the first time he had met with these men, and by now he ought to be able to curb his uneasiness. The trick was to steer his attention away from Kuhl and the armed guards. Concentrate on his physical surroundings. He would try, and be satisfied if he were halfway successful. Certainly the scenery was pleasant. They were at a table shaded by a flowering mimosa in the foreyard of DeVane’s impressive ranch house, a place of rambling sunbaked walls and a tiled roof that might have been built for a Spanish Don—some descendent of the Conquistadores perhaps—with only the swimming pools and tennis court on its desultory grounds betraying its far more recent vintage. Quite grand indeed, and just one of many lavish homes DeVane kept around the world, traveling continuously between them as he oversaw his far-reaching business empire.
Out across the grassland, the camiones had reached the tarmac and lumbered to a halt in the shadow of the waiting plane. Rojas watched as their ragtag Quechua drivers began to unload the backs of the trucks and carry their bundles toward the Beech’s cargo bay.
“Your ability to keep the Indians loyal is extraordinary, Harlan,” he said. “I’d never ever have expected it.”
DeVane studied his face.
“How so?” he said. “They’ve traded with Americans before.”
Rojas tried to make his shrug look casual. “Yes, but not on the terms you have set. It is a singularly unusual arrangement. Buying from the Peruvians, employing the local cocaderos only for refining and distribution ...”
He let the sentence fade.
DeVane kept his eyes on him.
“Go on,” he said. “Please.”
Rojas hesitated, then said, “The laborers are poor and the Chapare crop is their main resource. A hundred kilos might bring three million dollars in greenbacks if they handled production from beginning to end. Instead, they must either find other buyers for their plants or have them rot in the field.”
Devane smiled, his small, even white teeth showing suddenly and briefly. “Give your people too little and they resent you. Too much and they no longer need you. The secret of holding onto their loyalty is to let them have just enough, Francisco.”
“I would still think that your dealing with outside growers would cause resentment,” Rojas said, his curiosity momentarily overbalancing his caution. “And that the Sendero Luminoso would have its own reasons to balk. They have long had their own processing system in place, and are adamant about protecting their interests.”
“No more so than I am, and they know it,” DeVane said. “I have my reasons for keeping the leftist rebels part of the operation. And they have their unprecedented earnings to make them happy.”
Rojas decided to back off, feeling vaguely as if he’d been maneuvered.
“As I say, you have my admiration,” he said. “It is a dance of devils that I could never manage.”
DeVane didn’t seem inclined to end the conversation. “The devil can be the best of partners once you know his steps,” he said. “You are aware, I’m sure, that the nickname he has been given by the tin miners in the southern mountains is El Tio. The Uncle. On Sunday mornings they attend church with their families, make their genuflections, and sing the praises of Jesus and his saints. But before going down into the mine shafts, they pause at their entrances to leave offerings before statues of El Tio—alcohol, cigarettes, and coca leaves.”
Rojas’s discomfort was escalating again.
“Appropriate gifts for the Lord of Hell,” he commented.
“Precisely.” DeVane flashed his quick, icy grin again. “Their reasoning is wonderfully pragmatic. If you’re going to work where it’s dark and hot, you must learn how to get by. And appease the gods whose bounty you seek.”
There was a long period of silence. The sun had climbed into the center of the sky and hammered the livestock across the field into immobility. Rojas glanced around at the young guards standing near the table with their Kalashnikovs in plain view, then turned his attention back toward the airstrip and the workmen moving heavily between their trucks and the plane. He felt tired and depleted, and once more wished he were somewhere else.
DeVane took a small sip from his glass, then placed it carefully down on the table.
“I’d like your assistance with something, Francisco,” he said. “A matter of considerable importance.”
Rojas had been waiting for this moment. In most instances he would have sent a courier along with payment for a shipment of product, but when DeVane had insisted on his presence today he’d obliged without asking for an explanation—aware the American wouldn’t offer one until he was good and ready.
“If it concerns the Guzman fiasco, then you may be pleased to know I’ve gone ahead and intervened,” he said. “Give me another day and I’ll have him out of his prison cell and back across the border.”
“I appreciate that and will provide whatever funds are necessary to secure his release,” DeVane said. “But this has nothing to do with him.”
Rojas lifted his eyebrows. Eduardo Guzman was a bottom runner in DeVane’s organization, an errand boy whose arrest on suspicion of narcotics and weapons trafficking had resulted from his involvement with a prostitute who was cooperating with the anti-drug police. In ordinary circumstances he would have been beneath DeVane’s notice, a scrap to be thrown to the wolves, but because it was widely known that his uncle was one of DeVane’s major executives in Sao Paulo, Rojas had assumed the American would want him pulled out of his own shit, and made discreet overtures to the prosecutors getting ready to arraign him on formal charges. Little to his surprise, nearly all of them had hinted they might be influenced into changing their minds for a price.
However, DeVane had just made it very clear that he did not want to talk about Guzman. Leaving what he did want to talk about a mystery.
“Forgive my confusion,” Rojas said. “I’d thought—”
“There was an incident last night in the Mato Grasso, a break-in of sorts at an American industrial site,” Kuhl interrupted. It was the first time he’d spoken since Rojas’s arrival. “Did you hear anything about it before starting out this morning?”
“I don’t think so,” Rojas said. In fact, he knew that he hadn’t. But as a rule, it paid to stay out of the water until you knew which way it was flowing.
“Rest assured, you will before too long,” Kuhl said. “What you should know is that a number of the intruders were captured or killed by this facility’s private security force. I can’t tell you how many survived, or even if they’ve been turned over to the gendarmerie. But that is certain to occur. When it does, you must see that these men are never interrogated. I don’t care whether they are freed or executed or simply disappear. My sole interest is making sure that they do not talk to their captors.”
Rojas looked at him, trying to think of a response. Eight months ago his relationship with DeVane had begun with a straightforward purchase of cocaine, but almost before he knew what was happening, it had grown into a complicated tangle of affairs. He had helped DeVane to cloak transactions that might otherwise have attracted the unwanted interest of the Brazilian govern
ment. He had been a conduit to political and law-enforcement circles. He had been a small link in a very long chain, a tiny drop of oil in an immense machine, and he’d been handsomely rewarded for it. There had been money and women, stays in extravagant hotel suites, and trips to foreign countries.
Only in recent weeks had Rojas awakened to how deeply he was enmeshed in DeVane’s affairs. The things he was being asked to do were becoming riskier, and the pressure to carry them out increasingly direct. But there were limits. There had to be limits. And it sounded as if the problem he was being asked to fix went beyond any he could have imagined.
“I don’t know,” he said. “The Mato Grasso is outside my jurisdiction. I could ask some questions. Find out the status of the prisoners without too much difficulty. But if the regional authorities want to conduct an interrogation, I can’t think of how to stop them.”
Kuhl was staring at him.
“You’ll cope with it,” he said. “There is no other choice.”
Rojas looked into his eyes and was quiet for close to a full minute. The sun seemed suddenly hotter. His palms and underarms were moist with sweat. It had been mad to believe he could link himself to DeVane without losing his independence. Completely mad. He had been bought and paid for in regular installments, and was now expected to obediently jump to his master’s wishes.
At last he turned to DeVane and said, “You understand that I don’t want to make promises I can’t keep.”
“Nor would we want that, obviously,” DeVane said. “All we expect is that you give it your best.”
Rojas raised his drink to his lips and drained it. The mimosa’s shade had dwindled, making the heat almost intolerable. For an irrational moment he pictured himself spontaneously erupting into flames while DeVane and Kuhl looked on without expression.
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