Gravity: A Novel of Medical Suspense

by Tess Gerritsen

  Listening in on the loop chatter, Jack quickly pieced together the nature of the crisis Carpenter was now dealing with. Jack had faced just such a problem in his own integrated sim two years ago, when he was still in the astronaut corps, preparing for STS 145. The shuttle crew had reported a precipitous drop in cabin pressure, indicating a rapid air leak. There was no time to track down the source; they had to go to emergency deorbit.

  The flight dynamics officer, sitting at the front row of consoles known as the Trench, was rapidly plotting out the flight trajectories to determine the best landing site. No one considered this a game; they were too aware that if this crisis were real, the lives of seven people would be in jeopardy.

  “Cabin pressure down to thirteen point nine psi,” reported Environmental Control.

  “Edwards Air Force Base,” announced Flight Dynamics. “Touchdown at approximately thirteen hundred.”

  “Cabin pressure will be down to seven psi at this rate,” said Environmental. “Recommend they don helmets now. Before initiating reentry sequence.”

  Capcom relayed the advice to Atlantis.

  “Roger that,” responded Commander Vance. “Helmets are on. We are initiating deorbit burn.”

  Against his will, Jack was caught up in the urgency of the game. As the moments ticked by, he kept his gaze fixed on the central screen at the front of the room, where the orbiter’s path was plotted on a global map. Even though he knew that every crisis was artificially introduced by a mischievous sim team, the grim seriousness of this exercise had rubbed off on him. He was scarcely aware that his muscles had tensed as he focused on the changing data flickering on the screen.

  The cabin pressure dropped to seven psi.

  Atlantis hit the upper atmosphere. They were in radio blackout, twelve long minutes of silence when the friction of reentry ionizes the air around the orbiter, cutting off all communications.

  “Atlantis, do you copy?” said Capcom.

  Suddenly Commander Vance’s voice broke through: “We hear you loud and clear, Houston.”

  Touchdown, moments later, was perfect. Game over.

  Applause broke out in the FCR.

  “Okay, folks! Good job,” said Flight Director Carpenter. “Debriefing at fifteen hundred. Let’s all take a break for lunch.” Grinning, he pulled off his headset and for the first time looked at Jack. “Hey, haven’t seen you around here in ages.”

  “Been playing doctor with civilians.”

  “Going for the big bucks, huh?”

  Jack laughed. “Yeah, tell me what to do with all my money.” He glanced around at the flight controllers, now relaxing at their consoles with sodas and bag lunches. “Did the sim go okay?”

  “I’m happy. We made it through every glitch.”

  “And the shuttle crew?”

  “They’re ready.” Carpenter gave him a knowing look. “Including Emma. She’s in her element, Jack, so don’t rattle her. Right now she needs to focus.” This was more than just friendly advice. It was a warning: Keep your personal issues to yourself. Don’t screw around with my flight crew’s morale.

  Jack was subdued, even a little contrite, as he waited outside in the sweltering heat for Emma to emerge from Building 5, where the flight simulators were housed. She walked out with the rest of her crew. Obviously they had just shared a joke, because they were all laughing. Then she saw Jack, and her smile faded.

  “I didn’t know you were coming,” she said.

  He shrugged and said sheepishly, “Neither did I.”

  “Debriefing’s in ten minutes,” said Vance.

  “I’ll be there,” she said. “You all go on ahead.” She waited for her team to walk away; then she turned to face Jack again. “I’ve really got to join them. Look, I know this launch complicates everything. If you’re here about the divorce papers, I promise I’ll sign them as soon as I get back.”

  “I didn’t come about that.”

  “Is there something else, then?”

  He paused. “Yeah. Humphrey. What’s the name of his vet? In case he swallows a hair ball or something.”

  She fixed him with a perplexed look. “The same vet he’s always had. Dr. Goldsmith.”

  “Oh. Yeah.”

  They stood in silence for a moment, the sun beating on their heads. Sweat trickled down his back. She suddenly seemed so small to him and insubstantial. Yet this was a woman who’d jumped out of an airplane. She could outrace him on horseback, spin circles around him on the dance floor. His beautiful, fearless wife.

  She turned to look at Building 30, where her team was waiting for her. “I have to go, Jack.”

  “What time are you leaving for the Cape?”

  “Six in the morning.”

  “All your cousins flying out for the launch?”

  “Of course.” She paused. “You won’t be there. Will you?”

  The Challenger nightmare was still fresh in his mind, the angry trails of smoke etching across a blue sky. I can’t be there to watch it, he thought. I can’t deal with the possibilities. He shook his head.

  She accepted his answer with a chilly nod and a look that said: I can be every bit as detached as you are. Already she was withdrawing from him, turning to leave.

  “Emma.” He reached for her arm and gently tugged her around to face him. “I’ll miss you.”

  She sighed. “Sure, Jack.”

  “I really will.”

  “Weeks go by without a single call from you. And now you say you’re going to miss me.” She laughed.

  He was stung by the bitterness in her voice. And by the truth of her words. For the past few months he had avoided her. It had been painful to be anywhere near her because her success only magnified his own sense of failure.

  There was no hope of reconciliation; he could see that now, in the coolness of her gaze. Nothing left to do but be civilized about it.

  He glanced away, suddenly unable to look at her. “I just came by to wish you a safe trip. And a great ride. Give me a wave every so often, when you pass over Houston. I’ll watch for you.” A moving star was what ISS would look like, brighter than Venus, hurtling through the sky.

  “You wave too, okay?”

  They both managed a smile. So it would be a civilized parting after all. He held open his arms, and she leaned toward him for a hug. It was a brief and awkward one, as though they were strangers coming together for the first time. He felt her body, so warm and alive, press against him. Then she pulled away and started toward the Mission Control building.

  She paused only once, to wave good-bye. The sunlight was sharp in his eyes, and squinting against its brightness, he saw her only as a dark silhouette, her hair flying in the hot wind. And he knew that he had never loved her as much as he did at that very moment, watching her walk away.

  July 19

  Cape Canaveral

  Even from a distance, the sight took Emma’s breath away. Poised on launchpad 39B, awash in brilliant floodlights, the shuttle Atlantis, mated to its giant orange fuel tank and the paired solid rocket boosters, was a towering beacon in the blackness of night. No matter how many times she experienced it, that first glimpse of a shuttle lit up on the pad never failed to awe her.

  The rest of the crew, standing beside her on the blacktop, were equally silent. To shift their sleep cycle, they’d awakened at two that morning and had emerged from their quarters on the third floor of the Operations and Checkout building to catch a nighttime glimpse of the behemoth that would carry them into space. Emma heard the cry of a night bird and felt a cool wind blow in from the Atlantic, freshening the air, sweeping away the stagnant scent of the wetlands surrounding them.

  “Kind of makes you feel humble, doesn’t it?” said Commander Vance in his soft Texas drawl.

  The others murmured in agreement.

  “Small as an ant,” said Chenoweth, the lone rookie on the crew. This would be his first trip aboard the shuttle, and he was so excited he seemed to generate his own field of electricity. “I always fo
rget how big she is, and then I take another look at her and I think, Jesus, all that power. And I’m the lucky son of a bitch who gets to ride her.”

  They all laughed, but it was the hushed, uneasy laughter of parishioners in a church.

  “I never thought a week could go by so slowly,” said Chenoweth.

  “This man’s tired of being a virgin,” said Vance.

  “Damn right I am. I want up there.” Chenoweth’s gaze lifted hungrily to the sky. To the stars. “You guys all know the secret, and I can’t wait to share it.”

  The secret. It belonged only to the privileged few who had made the ascent. It wasn’t a secret that could be imparted to another; you yourself had to live it, to see, with your own eyes, the blackness of space and the blue of earth far below. To be pressed backward into your seat by the thrust of the rockets. Astronauts returning from space often wear a knowing smile, a look that says, I am privy to something that few human beings will ever know.

  Emma had worn such a smile when she’d emerged from Atlantis’s hatch over two years ago. On weak legs she had walked into the sunshine, had stared up at a sky that was startlingly blue. In the span of eight days aboard the orbiter, she had lived through one hundred thirty sunrises, had seen forest fires burning in Brazil and the eye of a typhoon whirling over Samoa, had viewed an earth that seemed heartbreakingly fragile. She had returned forever changed.

  In five days, barring a catastrophe, Chenoweth would share the secret.

  “Time to shine some light on these retinas,” said Chenoweth. “My brain still thinks it’s the middle of the night.”

  “It is the middle of the night,” said Emma.

  “For us it’s the crack of dawn, folks,” Vance said. Of all of them, he had been the quickest to readjust his circadian rhythm to the new sleep-wake schedule. Now he strode back into the O and C building to begin a full day’s work at three in the morning.

  The others followed him. Only Emma lingered outside for a moment, gazing at the shuttle. The day before, they had driven over to the launchpad for a last review of crew escape procedures. Viewed up close, in the sunlight, the shuttle had seemed glaringly bright and too massive to fully comprehend. One could focus on only a single part of her at a time. The nose. The wings. The black tiles, like reptilian scales on the belly. In the light of day, the shuttle had been real and solid. Now she seemed unearthly, lit up against the black sky.

  With all the frantic preparation, Emma had not allowed herself to feel any apprehension, had firmly banished all misgivings. She was ready to go up. She wanted to go up. But now she felt a sliver of fear.

  She looked up at the sky, saw the stars disappear behind an advancing veil of clouds. The weather was about to change. Shivering, she turned and went into the building. Into the light.

  July 23

  Houston

  Half a dozen tubes snaked into Debbie Haning’s body. In her throat was a tracheotomy tube, through which oxygen was forced into her lungs. A nasogastric tube had been threaded up her left nostril and down her esophagus into the stomach. A catheter drained urine, and two intravenous catheters fed fluids into her veins. In her wrist was an arterial line, and a continuous blood pressure tracing danced across the oscilloscope. Jack glanced at the IV bags hanging over the bed and saw they contained powerful antibiotics. A bad sign; it meant she’d acquired an infection—not unusual when a patient has spent two weeks in a coma. Every breach in the skin, every plastic tube, is a portal for bacteria, and in Debbie’s bloodstream, a battle was now being waged.

  With one glance, Jack understood all of this, but he said nothing to Debbie’s mother, who sat beside the bed, clasping her daughter’s hand. Debbie’s face was flaccid, the jaw limp, the eyelids only partially closed. She remained deeply comatose, unaware of anything, even pain.

  Margaret looked up as Jack came into the cubicle, and gave a nod of greeting. “She had a bad night,” said Margaret. “A fever. They don’t know where it’s coming from.”

  “The antibiotics will help.”

  “And then what? We treat the infection, but what happens next?” Margaret took a deep breath. “She wouldn’t want it this way. All these tubes. All these needles. She’d want us to let her go.”

  “This isn’t the time to give up. Her EEG is still active. She’s not brain dead.”

  “Then why doesn’t she wake up?”

  “She’s young. She has everything to live for.”

  “This isn’t living.” Margaret stared down at her daughter’s hand. It was bruised and puffy from IVs and needle sticks. “When her father was dying, Debbie told me she never wanted to end up like that. Tied down and force-fed. I keep thinking about that. About what she said . . .” Margaret looked up again. “What would you do? If this was your wife?”

  “I wouldn’t think about giving up.”

  “Even if she’d told you she didn’t want to end up this way?”

  He thought about it for a moment. Then said with conviction, “It would be my decision, in the end. No matter what she or anyone else told me. I wouldn’t give up on someone I loved. Ever. Not if there was the smallest chance I could save her.”

  His words offered no comfort to Margaret. He didn’t have the right to question her beliefs, her instincts, but she had asked his opinion, and his answer had come from his heart, not his head.

  Feeling guilty now, he gave Margaret one last pat on the shoulder and left the cubicle. Nature would most likely take the decision out of their hands. A comatose patient with a systemic infection is already on death’s threshold.

  He left the ICU and glumly stepped into the elevator. This was a depressing way to kick off his vacation. First stop, he decided as he stepped off on the lobby level, would be the corner grocery store for a six-pack. An ice-cold beer and an afternoon loading up the sailboat was what he needed right now. It would get his mind off Debbie Haning.

  “Code Blue, SICU. Code Blue, SICU.”

  His head snapped up at the announcement over the hospital address system. Debbie, he thought, and dashed for the stairwell.

  Her SICU cubicle was already crowded with personnel. He pushed his way in and shot a glance at the monitor. Ventricular fibrillation! Her heart was a quivering bundle of muscles, unable to pump, unable to keep her brain alive.

  “One amp epinephrine going in now!” one of the nurses called out.

  “Everyone stand back!” a doctor ordered, placing the defibrillator paddles on the chest.

  Jack saw the body give a jolt as the paddles discharged, and saw the line shoot up on the monitor, then sink back to baseline. Still in V fib.

  A nurse was performing CPR, her short blond hair flipping up with each pump on the chest. Debbie’s neurologist, Dr. Salomon, glanced up as Jack joined him at the bedside.

  “Is the amiodarone in?” asked Jack.

  “Going in now, but it’s not working.”

  Jack glanced at the tracing again. The V fib had gone from coarse to fine. Deteriorating toward a flat line.

  “We’ve shocked her four times,” said Salomon. “Can’t get a rhythm.”

  “Intracardiac epi?”

  “We’re down to Hail Marys. Go ahead!”

  The code nurse prepared the syringe of epinephrine and attached a long cardiac needle. Even as Jack took it, he knew that the battle was already over. This procedure would change nothing. But he thought about Bill Haning, waiting to come home to his wife. And he thought about what he had said to Margaret only moments ago.

  I wouldn’t give up on someone I loved. Ever. Not if there was the smallest chance I could save her.

  He looked down at Debbie, and for one disconcerting moment the image of Emma’s face flashed through his mind. He swallowed hard and said, “Hold compressions.”

  The nurse lifted her hands from the sternum.

  Jack gave the skin a quick swab of Betadine and positioned the tip of the needle beneath the xiphoid process. His own pulse was bounding as he pierced the skin. He advanced the needle into the c
hest, exerting gentle negative pressure.

  A flash of blood told him he was in the heart.

  With one squeeze of the plunger, he injected the entire dose of epinephrine and pulled out the needle. “Resume compressions,” he said, and looked up at the monitor. Come on, Debbie. Fight, damn it. Don’t give up on us. Don’t give up on Bill.

  The room was silent, everyone’s gaze fixed on the monitor. The tracing flattened, the myocardium dying, cell by cell. No one needed to say a word; the look of defeat was on their faces.

  She is so young, thought Jack. Thirty-six years old.

  The same age as Emma.

  It was Dr. Salomon who made the decision. “Let’s end it,” he said quietly. “Time of death is eleven-fifteen.”

  The nurse administering compressions solemnly stepped away from the body. Under the bright cubicle lights, Debbie’s torso looked like pale plastic. A mannequin. Not the bright and lively woman Jack had met five years ago at a NASA party held under the stars.

  Margaret stepped into the cubicle. For a moment she stood in silence, as though not recognizing her own daughter. Dr. Salomon placed his hand on her shoulder and said gently, “It happened so quickly. There was nothing we could do.”

  “He should have been here,” said Margaret, her voice breaking.

  “We tried to keep her alive,” said Dr. Salomon. “I’m sorry.”

  “It’s Bill I feel sorry for,” said Margaret, and she took her daughter’s hand and kissed it. “He wanted to be here. And now he’ll never forgive himself.”

  • • •

  Jack walked out of the cubicle and sank into a chair in the nurses’ station. Margaret’s words were still ringing in his head. He should have been here. He’ll never forgive himself.