The Edge of Death: (Sequel to ADRENALINE)

by John Benedict

  “What about his EEG?” Chip asked.

  “Protocol dictated we get pre-procedure and post-procedure EEGs on each successive day, looking for any changes in brainwave activity. I’ve always insisted on proper documentation—I’m a stickler for details. A researcher must be thorough, if nothing else.”

  “What did it show, Dr. Mueller?” Chip said.

  “I’ve never seen an EEG like Chandler’s. Very strange.”

  “In what way?” Chip coaxed.

  “It showed something abnormal in the ultra-high frequency range—the gigahertz range—that I’m completely unfamiliar with.”

  Suddenly Kristin leaned forward in her seat, head slightly cocked. “Can you describe it?” she said, a coolness coming into her voice.

  “Well, yes.” Mueller stroked his chin. “Actually, there was a dead zone—pardon the expression—an absence of signal in one particular band of the high frequency range where normally there is substantial activity. Most peculiar. I have several literature searches pending, but so far as I know, this has never been described before.”

  “And its significance?” she asked.

  “I have no idea.”

  “Did any of the other subjects show this?” Kristin said, her eyes shining with an intensity that Chip had not seen before.

  “No,” Mueller said, and looked away.

  C H A P T E R 2 7

  Saturday, 9:30 a.m.

  “Hey, what was that bit about the electroencephalogram back there?” Chip asked as they headed back down the concrete hallway from Mueller’s office.

  “What do you mean?”

  “You got all weird when Mueller mentioned the EEG part. What do you know about EEGs?”

  Kristin abruptly stopped walking and gave him a strange look, as if she were focused on something distant. “Nothing—it’s just a hunch,” she said. “And it has more to do with photography, not EEGs. I need to get home.”

  “What’s your big hurry? Smokey?”

  “There’s something I gotta do.”

  “Listen, I’ve been thinking and—” Chip paused and tried to read her expression. She still had the distant look in her eyes. “Well, since you’re into photography and I’m an amateur astronomer—I may have mentioned that.”

  She smiled politely at him and fidgeted with her ponytail, but he could tell she wasn’t paying attention.

  “Well,” he continued, “there’s this meteor shower this weekend. We should take pictures or something, and—”

  “Yeah, sure,” she said.

  “The weather’s supposed to be good. Wait, you really want to?”

  “What?” she said.

  “Take pictures.”

  “Huh? Yeah.” Kristin was definitely preoccupied.

  “You know,” he said, struggling to keep the irritation he felt out of his voice, “you just agreed to sleep with me.”

  “What? Are you crazy?” She grimaced. “Listen Chip, I gotta go.”

  “Okay, okay.”

  “Besides, I have plans with Chris this weekend.”

  “Chris?”

  “My roommate.”

  “Oh.”

  She hesitated a moment, then looked away. “We’re going to celebrate our one-year anniversary. He’s taking me out to El Sol, downtown.”

  “Terrific.” He should’ve seen this one coming.

  “Talk to you later,” she said and continued down the hall. “See you Monday.”

  “Yeah, whatever,” he muttered.

  Kristin walked away so fast that she almost decked the gray-haired cleaning lady who was mopping the floor outside of the morgue.

  C H A P T E R 2 8

  Saturday, 9:30 a.m.

  The hospital-wide intercom blared to life. “Code Blue, Main OR complex, Room 16. Code Blue, Main OR, Room 16.”

  Doug had been fitfully dozing in the cramped lounge chair and the page startled him awake. He didn’t know which OR room they had taken Laura to, but he had a bad feeling about the page. He checked the clock on the wall. She’d been gone about an hour and a half—just enough time to get into trouble. He knew he shouldn’t assume the worst—the med center was a busy place with lots of operating rooms; they worked on very sick patients around the clock. Nonetheless, Doug got up and raced toward the main OR.

  It didn’t take Doug long to figure out where the emergency was; Code Blues have a knack for attracting lots of people, especially at a teaching hospital. Doug pushed open the door into a scene of controlled chaos and his worst fears were confirmed in an instant. Laura’s surgeon, Emerick, was there, blood smeared all over his gown and dripping from his gloves, screaming at the ortho resident. The resident was doing chest compressions. Novacinski and his attending, Zimmerman, were at the head of the bed, pushing drugs. The patient on the operating room table was his wife.

  A hush came over the room as Doug entered and everyone stared at him.

  Emerick turned to face Doug and cleared his throat. “Everything was going smoothly—I just about had the IM rod in place,” Emerick said, his speech uncharacteristically halting. “Here, look at the x-ray. Rod’s in perfect position.” He pointed to the monitor of the portable C-arm machine. “We were thinking about closing. And then all hell broke loose.” Emerick shook his head, then nodded to the head of the table. “See if Zimmerman can tell you what happened. I’m still trying to figure it out.”

  Doug made his way through the throng of med students and nurses to the anesthesia end of things. One of the nursing students appeared to be crying; Doug ignored her. He gave Novacinski a quick glare before turning to Zimmerman. “What happened, Chuck?”

  “She arrested several minutes ago,” Zimmerman said. “Not exactly sure why yet. Look, Doug, maybe you should leave.” Zimmerman dropped his eyes. “We’re in the middle of a code here.”

  “Keep running it, Chuck. I’ll stay out of your way.” Doug pushed by Novacinski, to the head of the table. He tried to take in the totality of the situation. He did his best not to look down at Laura’s face; it was critical that he not view the patient as his wife. He focused on the monitors. The EKG was flatline. Pulse ox wasn’t registering and the A-line wave showed weak pulsatile flow with each chest compression. Shit—not good. Doug turned to Novacinski. “What happened first?”

  Novacinski hesitated, scratching his head.

  “Think, damn it,” Doug snapped at him. “What was your first sign of things going bad?”

  “Her C02 level dropped,” Novacinski got out. “Dropped fast.”

  “Probably a fat embolus,” Doug muttered.

  “Yeah, that’s our working diagnosis,” Zimmerman said. “But you know it’s a bear to treat.”

  “Acute right heart failure is the problem,” Doug said.

  “Right,” Zimmerman said. “Novacinski, go get the trans-esophageal echo probe.”

  Novacinski looked relieved to have an excuse to leave the OR; he made a rapid exit.

  The monitor’s alarm sang out. The EKG now showed V-tach. Doug noted that it was a pulseless V-tach—again a very bad sign.

  “Shock her again,” Zimmerman shouted to the ortho resident.

  The resident applied the paddles to Laura’s chest and fired them; her body jumped off the bed like a ragdoll. Doug turned away from the sight and stared at the EKG monitor. Thankfully, the V-tach broke into a rapid sinus rhythm.

  “We need to get the pulmonary artery pressure down,” Doug said, feeling sick to his stomach.

  “Yes, I know,” Zimmerman said. “We’re running Nipride and just started vasopressin. We also sent for prostaglandin from the pharmacy—should be here shortly.”

  Several minutes later, Novacinski came back, wheeling the portable ultrasound machine. “I have the prostaglandin, too,” he said, holding up a small IV bag.

  “Good. Run the drip,” Zimmerman said as he placed the long, snake-like black probe into Laura’s mouth and shoved it deep into her esophagus. He adjusted some controls on the unit and a ghostly image of Laura’s hea
rt appeared on the monitor screen. Her right ventricle was massively dilated, consistent with a pulmonary embolus.

  The ultrasound could not identify the source of the embolus, but Doug believed that fat globules—not the standard blood clot—were the culprit. The fat globules could’ve been released from the marrow of Laura’s femur when Emerick had hammered the IM rod into place. The only good thing was that her left ventricular function appeared to be OK.

  The next ten minutes saw the prostaglandin drip started, several more doses of epinephrine given, and multiple additional countershocks applied. Doug couldn’t shake the feeling of hopelessness settling over him. Laura’s right heart was still failing due to sky-high pulmonary artery pressures caused by a presumptive fat embolus. All the medical maneuvers in the world would be unlikely to overcome this.

  And then a flash of insight blazed across Doug’s mind. He grasped Zimmerman’s shoulder and locked eyes with him. “Chuck, she needs to be on bypass.”

  “Doug, I already thought of that. You know we can’t get her to a heart room, crack her chest, and insert all the cannulae in time.”

  “How about percutaneous cardiopulmonary support?” Doug said.

  “I’ve read about it,” Zimmerman said, looking doubtful. “But I’ve never actually tried it.”

  “Me either. But do you have the necessary equipment?”

  Zimmerman paused, his brow furrowing deeper. “Yeah, I’m pretty sure we do. We can access the femoral artery and vein quickly and place her on peripheral cardiopulmonary support to decrease the strain on the right heart. It just might work.”

  “We need to do it fast, though,” Doug said.

  “Novacinski,” Zimmerman shouted. “Go to the workroom and tell the techs to bring us all the peripheral bypass equipment—femoral cannulae, membrane oxygenator, and mini-pump. Move your ass! And go find Dr. Moyer, too.”

  An hour later, Laura’s pressure was still 50/30, despite being on full PCPS and receiving massive dose pulmonary artery vasodilators. Even with the assistance of Dr. Moyer, the facility’s expert on extracorporeal membrane oxygenators, they were running out of tricks. Doug began to face the inevitable. He blinked back tears.

  Someone tapped Doug on the shoulder. He turned to look into an older man’s hazel eyes. The man looked familiar, but with his surgical mask up, Doug couldn’t place him. However, he soon recognized his voice.

  “We need to talk, Dr. Landry. My name is Gunter Mueller.”

  C H A P T E R 2 9

  Saturday, 10:45 a.m.

  “There’s only one way I’ll sign your form,” Doug said as they pushed the litter with his wife on it down the long hallway through the basement corridors, past the morgue.

  “You’re hardly in a position to bargain, Dr. Landry,” Mueller said.

  Doug met the pathologist’s gaze. “I can help you. She’s extremely critical and I am familiar with her physiology.”

  “This is highly unorthodox.” Mueller returned his stare. “Family members generally are a great hindrance and usually do nothing but get in the way.”

  “I need to be with her,” Doug insisted.

  “You may cause us to lose her. Do you understand that?”

  “Yes,” Doug said. “I’ll take that chance.”

  Mueller hesitated. “All right, Dr. Landry,” he said with a sigh. “But I give the orders here. Understood? I’m in charge.”

  “Of course,” Doug replied.

  “There will be no committee or group discussion here.”

  “I understand completely,” Doug said.

  They came to a stop in front of the glass doors with the frosted lettering. The Postmortem Laboratory. “Here we are,” Mueller said and reached out to unlock the door.

  “One more thing,” Doug said.

  Mueller gave him an exasperated look. “What now, pray tell?”

  “Call me Doug.”

  Mueller cracked a thin smile at this as he swung the door open. “Okay, Doug it is.”

  They wheeled Laura Landry into the PML.

  C H A P T E R 3 0

  Saturday, 11:30 a.m.

  Kristin tossed her purse on the kitchen table and went directly to the crate. “Sorry that took so long,” she said as she unlatched the door.

  Smokey emerged from his crate, stretched briefly, and made his way to the French doors leading to the backyard. “Now, go pee,” she instructed him as she opened one and Smokey walked out onto the small flagstone patio.

  Smokey hesitated and looked back at her.

  “Hurry up.” She waved a hand at him.

  Smokey stood his ground and sniffed the air.

  “No—don’t even go there. I know it’s beautiful out and you’ve been cooped up all morning, but there’s something I have to do.”

  Reluctantly, tossing his head in indignation, Smokey padded down the cement steps into the yard to do his business.

  Kristin marched over to the closet to get her camera bag. Her Nikon camera felt particularly weighty in her hands.

  Smokey was soon scratching at the back door to be let in. She opened the door and Smokey sauntered by, brushing up against her thigh. “Don’t you give me that look,” she said, but Smokey did anyway. “Oh, you’re impossible.” She set her camera down on the kitchen table, sighing. “All right, you win. Go get your leash. I’ll get my sneakers.” Smokey scampered away to the laundry room.

  As she knelt on the tile floor to tie her sneakers, Smokey returned with his leash in his mouth. “You should’ve heard what I heard today. About the crazy man. If I told you, you wouldn’t believe it. And guess what. Chip asked me out again—to stargaze, I think. Interesting, huh? I said no, of course. I still don’t think I’m ready for any of that.”

  She stood up and looked at Smokey, who was now staring at her. “What? You think I’m being stubborn? What would you know? You’ve never had your heart broken, have you?” She paused to regard him. “I didn’t think so.”

  Kristin and Smokey set off down the driveway, Smokey tugging on the leash with extra exuberance. “Hold your horses there, bucko. Listen, just a short loop today. And promise me, no more sad eyes, okay?”

  Several hours later, tingling with excitement, Kristin stood in the small room in her basement that functioned as her darkroom, her gloved hands bathed in the soft red glow from the safelight in the corner. Three large plastic trays partially filled with her developing chemicals were lined up on the countertop before her, next to her enlarger. The time had come.

  Her hand trembled as she grasped the photographic print paper with sponge-tipped plastic tongs and dipped it into the first tray—the developer. She agitated the paper gently in the solution and bent over to take a closer look. As if by magic, a ghostly image appeared on the paper, intensifying and darkening with each passing second. Kristin never grew tired of this part. Soon, she could make out Chip’s face as he blew out the makeshift birthday candle.

  She dunked the paper into the next tray—the stop bath—that would stop the darkening process. Finally, the print went into the fixer to arrest the developing process. After thirty seconds, she retrieved the glossy print and clipped it on a wire strung across the sink. Again she leaned in to take a closer look at the wet print. Even in the dim light, she could clearly make out Chip’s handsome face. Her eyes fixed on his hair. Soon she saw a distinctive aura radiating from his head.

  Smokey growled upstairs, cutting her inspection short. She cocked her head to listen. The black Lab growled again. Then he was silent. Probably just annoyed at squirrels scampering about in his backyard. Kristin turned her attention back to the new print.

  Bingo! Her intuition had been right. Her heart pounded. She could make out Heather through the window for Room 237 in the background of the photo. She studied Heather’s image. There, rising from Heather’s blonde hair, was her aura—faint, but clearly visible.

  Chandler was visible as well, sitting up, eyes open. At first glance, she didn’t think she could see any aura around him. But here in
the dim, weak light thrown off by the safelight, she couldn’t be sure. Maybe his aura was hiding in the shadows or obscured by the white bedsheets? She yanked the print from the wire and held it up close to the safelight. She tilted it back and forth, hoping for a better angle, then put her nose right up to it. Searching. Searching for any hint of an aura coming from Chandler. Her blood ran cold as it finally hit home. There was no aura.

  She would have to examine the print under a bright white light and probably use her magnifying glass to be sure, but she felt sick with foreboding. What did it mean?

  She recalled hearing about this phenomenon many years ago in a lecture she had attended on Kirlian photography. She had pretty much forgotten about it, relegated it to the weird science folder in her mind, until Mueller had stirred up her imagination. What was it he had said this morning? “An absence of EEG signal in the gigahertz range.” She had never imagined in her wildest dreams that she would ever be holding a photograph like this in her hands, let alone one she’d taken and developed herself. Let alone knowing the subject in the photo and what they suspected he was capable of. Chills raged up and down her spine.

  Kristin reached down to her hip and fumbled with her phone case. Damn—it was empty. She must’ve left her phone upstairs. Her mind raced. Should she run up and call Chip? Or should she dry the print and examine it with a magnifying glass in the daylight first?

  And then she heard the cellar staircase creak.

  C H A P T E R 3 1

  Saturday, 1:00 p.m.

  Three flights of stairs to his apartment—seemed like four or five today, Chip thought as he trudged up them. After much coaxing and cursing, he finally got his key to turn the persnickety lock and release the deadbolt. One of these days, he was sure, the key would simply snap as he twisted it. This image nearly brought a smile to his face. Then there’d be a real fuck-storm, he thought. You wouldn’t want to be around to hear that.