by S A Gardner
Then he left my body, turned me on my back, dragged me open over his thighs, then rammed back inside me. His oil-slick hands unraveled me nerve by nerve, massaging to the rhythm of thrusts that impaled me to my heart. His generosity, the enormity of passion on his face had me cresting and crashing again.
This time he joined me, rumbled, “Te amo, Calista!”
I opened for him to take of me as hard, as fully as he needed. I felt his every lurch of release, feeding mine, tears flowing again at the sight, feel, concept.
Barely breathing hard, he reversed our position, the raggedness in his voice all the more moving for being emotionally induced. “Come fill my arms, mi corazón.”
I dove into them, clung, put my lips to his scar and gave thanks. Tomorrow this could end. Or my life. Or the world. Now was all we ever had. I took now, drowned. Replete, complete.
I think I dreamed. Of Damian, turning on me. Of all my friends disappearing. I clung to Damian, trying to stop him from metamorphosing into a monster, and he shook me away as familiar music played a maddeningly comic parody in the background….
“Calista, I’m just going to get your cell phone.”
Consciousness descended like a hammer. I jackknifed up, my head warping under its blow, sagged down again with dread. Matt!
Damian pressed the phone into my limp hand. I punched the answer button. Ayesha’s sob punched back.
“Matt? Did he deteriorate?” I rasped.
Another harsh sob answered me. “It’s worse than that!”
The room reeled.
Worse than that was dead.
Eleven
Matt’s huge body was folded in a tight fetal ball.
The frozen area behind my sternum expanded, my heart pumping ice in my veins. I shuddered.
I had no time for going to pieces. Everything was prepared. The minor surgery room had been turned into a quarantine zone. Everyone was on full safety protocols. We had to assume this was infectious. Whatever “this” was. Just hoped our measures made a difference. That we weren’t already too late.
Megumi finished injecting the infiltration anesthesia, and daubed Matt’s lumbar area with povidine. She raised her eyes. “Done. Want me to do it, Cali?”
As our anesthetist, Megumi was best qualified to perform a lumbar puncture. I should let her do it. I couldn’t. Matt was my responsibility. He wouldn’t let anyone else touch me, either.
I shook my head. “You record the opening pressure when I enter the spinal canal. And be ready for any developments.”
For developments read disastrous complications. At the drop in intracranial pressure when my needle pierced the spinal canal and released cerebrospinal fluid, his brain stem could herniate, jam through his skull outlet, leading to catastrophic or even fatal consequences.
There was no way around this. All ICP lowering measures had failed, and we could no longer wait. A sample of CSF and a diagnosis were our only hope of pulling him out of the vicious cycle he’d entered. It was a choice between waiting or intervening. The first would surely kill him. The second might. Might sounded far better right now.
Ishmael had left one of Matt’s hands outside the surgical drapes. I reached for it. All power gone, limp and dry and hot. Measures to control his fever had failed to bring his temperature to the baseline. We had also had to sedate him again for the procedure. Not that he’d been violent, just disoriented—heartbreaking.
Matt, help us. I need time to find out what’s wrong with you. Please, please hang on.
I covered his hand, came around the table. “Ayesha, spinal guiding needle, twenty-five-gauge, five-inch and Tuohy catheter.” Had to make allowance for Matt’s muscle mass. Most people warranted three-inch only. The catheter was for leaving in after taking my sample, to inject analgesics for his severe back pain, blind antibiotics, and to drain more CSF to lower his ICP. Neither was in our stock lumbar puncture tray. She was ready with them. I picked them up. “Ready fifteen tubes. Ishmael, Megumi, flex him a bit more.”
They held him knee to chest. I palpated for the fourth lumbar vertebra, introduced my needle, perpendicular, just below it, advanced upward, giving myself another chance to try above this spot if I failed. My breath bled out when I felt the pop. I’d pierced his dura mater, the outer covering of his spinal cord. I was in.
I withdrew the stylet of the needle, advanced the catheter, and the cerebrospinal fluid flowed out under pressure. My own pressure shot up, my breath clogging my lungs. Come on, Matt.
Megumi, ready with the manometer, measured the opening pressure. “Three hundred and eighty mmH2O,” she murmured, her voice almost inaudible, removed it, moved away.
God. Normal opening pressures in recumbent position ranged from a hundred to one-eighty!
Thirty seconds of bated heartbeats passed as we monitored his unassisted breathing, his heart rate, his pupillary reflexes. Nothing changed. He wasn’t herniating.
Oh, God, thank you.
“Tubes.” I forced the word out. Ayesha handed me one after another, opened. I filled each with two cc’s of spinal fluid. Usually we filled five tubes. I was sending a set each to two more labs. Time I yelled for all the help I could get.
Ayesha followed through, dressing the puncture site. We removed the drapes, unfolded Matt, turned him on his back, hooked him back to his monitors, and replenished his supportive measures.
Another neuro and fundoscopic exam showed that CSF withdrawal had relieved the ICP. Not that it had improved his condition. Raised ICP was just the by-product of the underlying disorder.
At first glance, when I’d stormed back into IC, he’d seemed to be having another convulsion. And he had been. It had been his other symptoms that had told me this was something totally new. Neck rigidity, raised ICP, many focal manifestations. One of his eyes had rolled inward, indicating abducent nerve paralysis, the cranial nerve moving extraocular muscles outward. Then the facial nerve followed, with facial paralysis developing.
All our internists and surgeons had been rushed in for a consultation and they’d all had one opinion.
Matt had all signs of acute, fulminating encephalitis.
So we had a diagnosis. At least, they called it that. I called it just a label for his condition. A diagnosis told me causes and their theories sure as hell weren’t providing those. What that label did provide was one thing: the verdict that Matt had changed afflictions again.
His first manifestations clearly had been chemically induced, then they had changed from one class of drugs to another. Now he seemed to be suffering from a brain inflammation caused by a biological agent, a bacteria or a virus.
Somehow, in the space of thirty-six hours he’d gone through two poisonings and one infection.
And it sure as hell didn’t make any kind of sense!
But it had to, if we were to find a way to cure him. We had to be missing something. We just had to be.
Which was what my fellow doctors insisted was the only explanation. That I’d misdiagnosed him from the beginning, and he’d been suffering from encephalitis all along.
My answer? No freaking way. I knew my poisonings and drug-altered statuses like nothing they’d ever imagine. And that was what Matt had suffered from at the outset.
Now to find out what was causing this bizarre sequence of events and progression of symptoms. At all costs.
I turned. “Lucia, Damian’s in our den.” I handed her the multi-tube holder. “Give him five, after you label them. And draw five bloods, too. Tell him I expect him to find out all he can.”
Yeah, what better time for me to make use of his carte blanche? It was also time to get Sir Ashton to make good on his.
Ayesha followed me out of our new quarantine. Her agitation raked along my back. God I had no time for her. I picked up speed.
“I’d only been that scared before when Fatima disappeared.”
Her words almost tripped me. Ignore this!
I couldn’t. My eyes jerked back to hers. No doubt mine were as abuse
d. Almost everyone in my team had lost loved ones in horrific circumstances. I’d lost my sister Clara to a surgeon’s—or was it an anesthetist’s?—mistake. I’d never been able to find out. Matt had lost his wife to a gang rape. But it had to be Ayesha who’d suffered the most mutilating loss. Her daughter had been kidnapped by an organ-harvesting mafia. For her to feel as scared and helpless about Matt as she had been about Fatima said—too much.
I turned, no fitting words or gesture coming to my rescue.
She went on. “He was coming out of it, then he started getting agitated again. I was calling you to ask if re-sedation was in order when he started shouting, ‘My head is bursting—do something.’ I was afraid to give him morphine in case it depressed his central nervous system more. Then he was yelling about his back and his muscles and screaming for us to turn the lights down. God, Cali, I thought he was having a psychotic episode, that that was what was wrong with him all along. And all the time he was in real agony….”
Okay. Enough. I took her by the shoulders. “Don’t blame yourself. There was no way you could have guessed what was wrong with him. Hell, we have tons of investigations on our hands, and ten doctors around and we still don’t know a thing.”
She closed her eyes. Her agony splashed on the backs of my hands. “What do you make of the investigations?” she whispered.
I withdrew my hands, tempted to wipe the scalding emotion off. “What’s to make? Perfect CTs and the most extensive toxicology tests came up with only traces of his anti-allergic medication, and not even the most distant metabolites of any drug causing his first or second toxidromes. No elevated enzymes indicating poisoning or white blood cells or immunoglobulins or antibodies indicating any inflammation or infection.
“The positive findings are only to be expected. The elevated myoglobin in his urine and potassium and phosphate in his blood are only normal after his violent exertion. The elevated lactate is agitation-induced alone. Clotting factors are also abnormal but they are consistent with his violence, convulsions and hyperthermia. So nothing specific. No answers, no pointers, no leads. For all these results show, this is a bursting-with-health, clean-living man after a grueling squash match who should be on his feet and out there smashing bad guys.”
“Maybe this round of CSFs will be more revealing?”
“We can only hope. But I’m not holding my breath and waiting. We could be dealing with a new drug that marries many existing ones successfully, manifesting all their effects.”
“But wouldn’t we still find traces of something, even if we didn’t know what it was?
“I don’t know, Ayesha. Maybe it’s a new formula that leaves behind no metabolites for detection with current testing kits. Maybe a hundred different things. Only way to find out is to retrace Matt’s steps during the past week or so. Find out who could have gotten to him, poisoned him. We have to find out if there is such a new agent on the streets, and get our hands on an antidote. Or at least a sample, to make our own.”
She chewed her lip. “But what if the tests come back with results that make all this unnecessary?”
I exhaled. “The only tests left out are ultra-specific serologic tests that can take days to weeks to come out. I don’t think we have that long, Ayesha. I have a gut feeling this is a message, and I intend to find out who sent it.”
A giggle escaped Ayesha, a weird sound, her warped smile an even weirder sight in her current agitation. “And we all know how reliable your gut feelings are.”
“Oh, shut up. Take care of Matt. Don’t hesitate to call all of us back if anything happens.”
This time, I walked away. Right into Damian.
In my mind’s eye, I completed the collision, surged into him and sought refuge. In this realm, I pulled back, hands on hips. “You’re still here? Don’t you have something to do?”
His eyes swept over me, gauging my state. His compressed lips detailed the ugly truth. “Yeah, Lucia gave me my assignment.”
I started walking, headed for the room in which I took rest breaks at Sanctuary. “So?”
“It’s been taken care of.”
“Meaning you saddled one of your people with the job.”
“One of the perks of being the leader.”
I turned on him, a barrage on my lips, about how important those samples were, that I expected him to do it himself.
He dispersed it. “Suz was going out of her mind worrying over Matt, and dying to be of use. Anyway, she’s better than me in handling fragile stuff. Not that it’s fragile. With Lucia’s packaging it would take a bomb to mess those samples up. Suz is already halfway across the city to our best PACT-affiliated labs. There’ll be no questions and twenty-four-hour, full-facilities dedication to Matt’s samples. I had to stay here. For you.”
Had to have the last word, huh? I had nothing to say to any of that. I wanted him here. I needed him.
There, I’d admitted it.
He followed me into my room. Well, I didn’t need help changing. “And where do you think you’re going?”
His reply was nonchalant. “I don’t know. I’m just following you.”
“You’re taking that to new heights, huh? I want to change.”
He nodded, reached for my jeans’ buttons.
I jumped back, my nerves jangling. “I do remember how to take off my own clothes.”
One eyebrow arched his opinion of my prudishness. “Go ahead then. I wanted to help. But watching is as much fun.”
I shook my head, turned to my zipped plastic closet. Striking while the iron was still molten, huh? Entrenching his “lover” status into status quo.
Not if I had anything to say about it.
But I wasn’t saying anything now. Matt’s crisis was the thing on my plate. Resolving my ambiguous state of affairs, pun intended, with my Machiavellian lover didn’t feature right now.
Yeah, lover. He could keep the title if he so wanted it. I sure wasn’t endowing anyone else with it. Not in this lifetime. If he didn’t use it, it would just rust and fade into nonexistence.
I undressed in less then my usual minute, not once looking back to see Damian’s reaction. He wanted to watch? He was welcome. He’d seen—and done—it all by now. I shouldn’t even think of being uncomfortable having him around.
Weird thing was, I was. Blotched-red-down-to-my-toes uncomfortable. If I didn’t know better I’d even say—shy.
I rummaged for my disguise for today. I kept two dozen identities to keep my true one a secret from the dangerous world we worked in. Staying anonymous meant staying alive. I pulled out a black Lycra micro-dress and coat, thick flesh-tinted hose, six-inch platform shoes. Completing the picture were jade contact lenses, purple lipstick and a black shoulder-length wig.
I sat down in the only chair in the tiny room, started putting the hose on. Damian’s eyes scorched a path to my core. Good thing I was too messed up over Matt to respond in full power. He moved his gaze away. Suddenly I felt bereft.
He swooped down on the dress. One good look, then he stated, “You’re not wearing this. Not if you want to leave this room.”
I snatched it from his grip, hiked it on in two motions. “I thought you were only watching. Commentary isn’t in the bargain.” I shoved my feet into the shoes, stood up.
He took a step away, appraised the result. “If it’s for my benefit, I prefer you in fatigues. Or naked. Take it off.”
For answer, I turned my back on him, started the complicated ritual of wrapping masses of hair flat around my head. Once done, I flopped the wig on, popped the lenses in. Then it was on to applying another face. I needed mortuary-strength makeup to cover up my bruises.
He came behind me, capturing my eyes in the mirror, his simmering even in the cold reflection. “So where do you think you’re going dressed like that?”
Absurd-answer-to-stupid-question time. “To pick up men, of course. I worked up an appetite last night.”
For a split second, a spurt of danger leapt off him. Couldn’t even
be teased about it, huh? Possessiveness red alert! Then he switched it off, just like that, turned oh-my-goodness-I’ll-die-if-I-don’t-get-me-some-of-that seductive. “Then you should wait until you get a taste of the second course I had planned for you. I’d still be serving it if I hadn’t been interrupted.”
And of that I was certain. If not for Matt, I would have been back in my bed, over and under him, trying my futile darnedest to get him out of my system through overload therapy.
“Damian, we’ll resume this set of our verbal match sometime in the distant future. I have work to do.”
All seduction left his face, another ultra-convincing mood and mask slipping on seamlessly. “What’s your plan?”
Nice save. Nicer performance. Superlative actually. If they held Academy Awards at PACT, he’d rack in every one. I shrugged. “I’m going to retrace Matt’s steps, pay a visit to a couple of stoolies, check out a new designer drug racket. I found a memo about it in Matt’s stuff. It’s my best lead in all this.”
He frowned. “But you said his new symptoms look like brain inflammation and not poisoning or overdose.”
“Yeah, but he started off hallucinating. Maybe his condition now is a coincidence. Aseptic encephalitis with no infective agent is rare, but not unheard of. Or maybe it’ll turn out to be a known side effect of the unknown drug I’ll investigate. Matt’s notes say the designer drug allegedly about to hit the streets is being hailed as the biggest thing since Ecstasy. Maybe someone recognized Matt, managed to slip him an advance sample of it—revenge, or a warning. Maybe when I get a sample, study its composition, it will explain all the discrepancies in timing and symptoms.”
He looked as convinced as I felt. He didn’t voice his opinion, though. Weird. I would have thought he’d be the first to tell me to wake up and smell the formalin. What was that confounding man up to?
“You have names? Pseudonyms? Possible locations? Connections?” he asked.