Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts

Sunday, August 16, 2009

TSI: The Gabon Virus

I'm in the middle of reading TSI: The Gabon Virus by Paul McCusker and Walt Larimore, M.D.. It's an intriguing novel about biological warfare and virus research. It will be interesting to see how the story comes out. You can read the first chapter here!

Time Scene Investigators:

The Eyam Factor




Paul McCusker

And

Walt Larimore, M.D.





[Refer to P4P regarding inclusion of purpose statement.]

Our purpose at Howard Books is to:

Increase faith in the hearts of growing Christians
Inspire holiness in the lives of believers
Instill hope in the hearts of struggling people everywhere
Because He’s coming again!


[Howard Fiction Logo] Published by Howard Books, a division of Simon & Schuster, Inc.

1230 Avenue of the Americas, New York, NY 10020

www.howardpublishing.com


The Eyam Factor © 2009 Paul McCusker and Walt Larimore, M.D.


All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever. For information, address Howard Subsidiary Rights Department, Simon & Schuster, 1230 Avenue of the Americas, New York, NY 10020.


[Add agent line here, if applicable]


Library of Congress Cataloging-in-Publication Data TK


ISBN-13: 9781416569718

ISBN-10: 1416569715



10 9 8 7 6 5 4 3 2 1


HOWARD and colophon are registered trademarks of Simon & Schuster, Inc.


Manufactured in TK


For information regarding special discounts for bulk purchases, please contact: Simon & Schuster Special Sales at 1-800-456-6798 or business@simonandschuster.com.


Edited by TK

Cover design by TK

Interior design by TK


This novel is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously. Any resemblance to actual events, locales, organizations, or persons, living or dead, is entirely coincidental and beyond the intent of either the author or publisher.










DEDICATION


To Elizabeth, Tommy, and Ellie—for their love and patience.

To Barb— for her lifetime of love

.





PART ONE









[July 15, 1666]

REBEKAH SMYTHE LOOKED DOWN AT HER BROTHER’S LIFELESS BODY, his eyes staring vacantly toward the heaven he had hoped and prayed to inhabit. With a pale and trembling hand, she reached down and closed his eyelids.

She had done the same for her father and three of her sisters—all lying so still now in their shallow graves not far from their home; so silent after their days of suffering and anguish. She could not weep for them. Her tears were spent long ago.

She looked at the makeshift cots on which her mother and youngest sister slept fitfully. They had come down with the symptoms just two days earlier. She dared not hold out hope for their survival. In another day or two, if all went as it had for the rest of her family, they’d be gone and she’d be alone. Alone.

By the grace of God, she had resisted the illness. Yet, the outcome of her survival would be loneliness. In her darker moments, she wondered how far God’s grace could carry her.

Agnes Hull, who lived in the next cottage down, had also survived the plague and claimed that the warm bacon fat she drank was the reason. She left bottles of the wretched liquid at the doors of afflicted families, but unfortunately, it didn’t work for Rebekah’s family.

John Dicken, who worked in the local mines, was also a survivor. Believing himself to be immune, he had established himself as the village gravedigger. He would offer his services the instant he’d heard of another victim. After burying the body away from town, he would return to claim the burial fee—reportedly taking whatever he fancied. Most were too sick to stop him. Besides, what use was their money if they were dead? Few of the men were well enough to take the job from Dicken, and it wasn’t as if anyone new would arrive to challenge him. After all, the village was under a strict quarantine.

Rebekah sat on a stool, staring at the fire. The large black kettle bubbled and boiled. Using a pair of large tongs, she moved the kettle to a small table, pouring the steaming water into a pot. The tea leaves were old, but all she had. She didn’t think of pouring a cup for her mother and sister—they wouldn’t taste it anyway.

Pushing a lock of hair away from her face, she was overcome by a feeling of self-pity. How had it come to this? Who could have foreseen last September that something as unassuming as a box of cloth from London would start such an epidemic? Mr. George Viccars, a traveling tailor, certainly couldn’t have. As he opened the box—wet from a rainstorm—and laid the cloth out to dry, he could not have imagined what he was unleashing upon them all. Within a day, he developed the telltale symptoms of rose-colored spots on his skin and quickly died.

The Earl, the village’s patron, sent his personal physician from the castle to examine the tailor’s body. The doctor’s diagnosis was Black Plague. It had arrived in Eyam.

And so began a year of terror.

The village had rallied together. Catherine Mompesson, the vicar’s wife, bravely visited the sick families. Ignoring the risk to herself and her family, she had brought words of comfort and a bouquet of sweet-smelling posies, believing it would ward off the stench of disease.

As she sipped her tea, Rebekah thought about the rhyme sung by local children:

Ring a-ring o' roses,

A pocketful of posies.

a-tishoo! a-tishoo!

We all fall down.

The rhyme went through her mind again and again—

The knock on the door startled her. Few of the villagers would be out and about at this late hour. Perhaps it was the vicar’s wife or the gravedigger.

She stood and crossed the room to the door. Her hand was poised above the latch when it occurred to her who might be calling.

Him.

Despite the still warm air of the summer night, she felt a chill go down her spine.

The Monk.

He came to the families to aid the sick, comfort the dying, and offer peace to the grieving. The women of the village spoke of him as an angel of light. The men called him a demon, unnerved as they were by the mysterious way in which he appeared and disappeared into thin air. Worse was his appearance. Rebekah had not seen it for herself, but the village gossips claimed that beneath his monk’s cowl, he had skin the color of deep water. Blue, they said. The monk’s skin was blue. A curse, the men said.

She could not believe that a man of God, one so merciful and compassionate, could be cursed.

She lifted the latch and opened the door.









[August 10. The Present.]

THE BLACKHAWK HELICOPTER DESCENDED toward a small flat outcropping near the top of the icy cliff. It had no markings on its matte black paint, an exterior designed to absorb radar signals.

From inside the helicopter, Army Brigadier General Sam Mosley gazed at the frozen valley below—a vast expanse of ice that stretched between two distant mountain peaks. To the untrained eye, it was a wasteland, but the general knew better. What appeared to be a series of ripples in the valley’s floor were actually roofs and camouflage for a large, underground collection of buildings. “The Bunker,” they called it; the only inhabited facility for hundreds of miles.

Icy particles sprang up like a cloud of dust as the chopper nestled onto the snowy pad. This was the emergency landing site, a mile from the regular pad much closer to the facility. The pilot cut the whisper-soft engine.

Mosley swallowed, forcing back the acidic taste in his throat. Was it fear? No, this was the taste of grim determination—the bitter and offensive bile of a tragic duty to perform.

As the ice-cloud dispersed, the general looked across the endless white and remembered the champagne celebration they’d had on the day the scheme to build this laboratory was approved. It seemed like genius—or madness—at the time. Imagine building a lab in the middle of Greenland. Yet all the risk assessments told them the site had the highest probability of safety. Only Mark Carlson, the architect of the entire plan, had expressed doubts. “We’re arrogant,” he said in private, late night meetings. Often the argument took place over day-old Chinese meals. “Eventually we’ll create something that we can’t contain; something that’s too potent. Nature always finds a way of escape. It doesn’t matter how far in the ice we dig.”

Mosley turned to the cockpit. The pilot took off his helmet. “Well?”

“Okay to disembark, General.”

Sam nodded. “Thanks, Tom. Excellent job, as always.”

“We couldn’t have hoped for a better day,” the pilot said. “The weathermen at The Hague said the conditions would be perfect.”

“Glad they got it right for once.”

Nervous chitchat, Mosley thought. He looked out at the snow and ice and frowned and sighed.

“We don’t have much time, General,” the pilot said.

“No, we don’t.”

“Would you like me to come with you?” the pilot asked.

Sam shook his head. “Better that I do this alone.” He climbed out of his seat and moved to the rear of the cabin. He dressed quickly and quietly donning a bright orange suit designed to protect him to fifty degrees below zero.

He glanced at the second suit—the name Mark Carlson was stitched onto the left breast. The thought of Mark gave him pause. Mark should be here. But that would have been too much to ask. Four years of Mark’s life had gone into making this complex a reality. He’d lost a lot in the process: a wife and a child. Some believed he was now damaged goods as a result of those losses. Sam hadn’t wanted to believe it and continually gave Mark the benefit of the doubt. And yet, he hadn’t invited Mark to this occasion. Why risk pushing him over the edge?

The general put his head cover on last, to give added protection to his face and eyes. Certain he was thoroughly protected; Sam threw open door and stepped out.

A sledgehammer of frigid air hit him. He braced himself against the side of the helicopter, then reached up to the door, but the pilot was already there, sliding it closed. The two men exchanged glances and the Mosley noticed he was wearing a compact Glock 36 pistol holstered to his belt. A precaution. Just a precaution. He bowed to the elements and pressed ahead, ankle-deep in a powdery snow that sparkled like kindergarten craft glitter.

The wind made a mournful sound as he walked toward the edge of the cliff. Sam clenched his teeth—not against the cold—but out of a brutal resolve. He stopped and surveyed the scene once more. As a soldier, he hated these moments. As a general, he knew the responsibility was his. As a physician, this action went against everything he believed—against the oath he had sworn when he finished medical school. He searched for comfort in the sad thought that the people below were already dead.

He reached into his pocket and retrieved a small black cell phone. Opening the protective cover, he carefully punched in a sequence of numbers. When he came to the last number, he hesitated and glanced back at the helicopter. He saw the pilot through a slim open crack at the Blackhawk’s door and knew the pilot had orders to shoot him if he showed any hesitation or attempted to deviate from the plan in any way. The Glock only held six rounds, but one .45 caliber bullet was all that an expert shooter needed to kill him instantly.

Sam’s gloved thumb pressed the final digit and he cursed himself. This was their plan of last resort—the one the experts and the computer models had always said couldn’t happen—wouldn’t happen. They had insisted the lab was foolproof, A breach of its safeguards and a failure to contain its virus was unimaginable. Yet the unimaginable had happened—and now Sam had to do the very thing he’d assured Mark they’d never have to do. From the corner of his eye, he saw the Blackhawk’s door open wider. He was taking too long. The pilot was probably taking aim even now.

The general moved his thumb to the Send button and turned toward the complex. Critical life-saving work had gone on in that lab. Years of effort. Its potential had been so great, yet so unfulfilled, and now there’d be nothing but terrible loss.

With a defiant gesture, he pressed the button. At first nothing happened. Then, far below, the ground heaved in the center of the complex, rising as if a fist punched the underside of the ice, growing larger and higher until the white earth burst open with an explosive roar.

Mosley stepped back. The ice—and everything that had been the bunker—blew upward, followed by a massive fireball. The concussive blast hit him; a surprisingly strong wave nearly knocked him off his feet. He fought it, balancing forward.

In less than half a minute everything was calm again. The secret lab had been incinerated—along with its entire staff and an untold amount of data about all things viral.

Sam stood frozen, his gloved hands clenched. “It had to be done,” he said to no one. Turning on his heel, he walked toward the helicopter. He could only hope that the virus had been completely destroyed.

If even one viral particle had survived, it was possible that the world would not.





[August 11]

THE METAL CORRUGATED ROOF CAUGHT THE BLISTERING AFRICAN HEAT and pushed it downward, past the wobbling ceiling fans, to the meeting room below. The air was heavy with humidity. Even the gathering flies moved sluggishly, lazily, as if weighted by the muggy atmosphere.

David sat on a chair in the center of the small makeshift stage at the head of the room. From here, he could see it all: the flies and the horror before him. He scanned the room. No movement. He turned his head to look out of an open window, out to the compound.

For all intents and purposes, it looked like an average African village—a dirt road down the middle and pathways lined with wooden huts, metal shacks, and a few makeshift cottages. A gray cement maintenance shed sat in the center of the compound with donated equipment and supplies to provide them with running water and, at least for a few hours a day, electricity.

Beyond that shed were the schoolhouse and the cafeteria. The workhouse, with the many sewing machines the women used to make the clothing that helped subsidize their community, sat off to the side. A few yards from there, alone and away from the rest of the structures, was David’s single-room main office. Through the trees, he could see its flat roof and the small satellite dish mounted on a corner.

David’s hands hovered above the laptop resting on his lap. A small icon on the screen told him that he had a strong signal and full access to the Internet thanks to that satellite dish—a dish that he’d fought against installing. It was yet another connection to a corrupt and depraved world—a world he had struggled so hard to escape.

Why else would he create a commune in Gabon, of all places? Certainly not to replicate his life in America. This had been a chance for him, his family, and his congregation to break free. But his no-contact rule backfired when Hank Hillier came down with malaria earlier in the year. Malaria was a common malady and easily treated, but Hank’s had gone to his brain and he developed a near-fatal case of meningitis. Only by the grace of God were they able to contact a local missionary pilot and transport him 150 miles to a specialty hospital in Lambaréné. It was a close call that left him and his congregation nervous about their isolation.

With great reluctance David agreed to install the dish and hardware. Just in time, too. Not long afterward, Sarah McFerran was stricken with appendicitis and, with a single e-mail, they got her airlifted to the pediatric hospital in Libreville.

Both Hank and Sarah lay dead in the collection of bodies before him, and now David would use the satellite dish to send out his last words—not as a cry for help, but to ask for forgiveness.

He groaned and rubbed his tired eyes, squeezing them shut. How did it come to this? How did he get from being a very trendy atheist in college, proud of his intellect, relishing his militant cynicism against any and all believers in God, to the counter-cultural pastor of a Christian commune in the middle of a vast African jungle?

No doubt, when their bodies were finally discovered, the press would pore over the details of his life in a vain attempt to answer that question.

They would simplify the complexities of his faith and conviction; gloss over the corruptions and decadence of American culture that drove him to take his family and congregation to Gabon; and caricature them all as mindless cult members, rather than the thriving and rigorous group of disciples they truly were.

He ached to think of it, and he closed his eyes as he thought of his missteps, his misguided idealism and, in the end, his business naiveté that put the community on the edge of financial ruin and sent him into the arms of The Corporation for help.

The Corporation. They had seemed like an answer to his prayers. The representatives expressed genuine interest in David’s hope and vision, and they were persuasive, offering David a ludicrous amount of money in exchange for some help and cooperation. It had appeared so simple and safe. Only his wife Rachel expressed any deep concern. Something in her heart told her it was wrong. “It doesn’t feel right,” she had warned, but couldn’t explain why.

David looked at the bodies closest to the stage. Rachel was there—along with his two young, precious daughters and his teen-age son—the front edge of a sea of corpses.

The altar sat a few feet from David. It had been hand-carved from an ancient oak tree that had fallen outside David’s first church—such a long time ago. A wooden chalice beckoned him. A scrap of bread sat on the wooden plate next to the chalice. There was just enough left for him.

David looked down at the laptop computer. He blinked. His eyes burned. He began to type. This was his final confession. A last e-mail to his father—a man who never accepted or affirmed him, much less ever indicated he loved him. What a surprise it would be. He couldn’t remember the last time he’d spoken to his father. They were never close.

David began to type. He was determined not to write with sentimentality or melodrama. He recounted in the simplest terms his hopes and dreams with Rachel and how he believed, as a matter of faith, that their community was created to help save mankind, both spiritually and physically. Lofty goals, but attainable. Even now, David believed they could have succeeded if only he had been wiser and more discerning—if only he’d listened to Rachel—if only he hadn’t shaken hands with the Devil.

Now it was all undone. A failure of the greatest kind. A tragedy, just as Rachel had predicted. So now David concluded his e-mail by asking his father’s for forgiveness. It was the last thing he needed to do—the most important thing left to do.

A harsh squawk drew David’s attention to the back door. A vulture landed in the courtyard. Then another. They knew. They were gathering. Soon, there would be no stopping them. Soon, his compound would contain a congregation of scavengers.

David’s eyes filled with tears as he shook off the thought of what would happen to the dead bodies strewn across the meeting-room floor. What were they but empty vessels? God had secured their souls. His gaze fell again upon the men and women, boys and girls who’d put their trust in his leadership.

That morning they had each taken communion, knowing it would be their last. After praying together, they lay down, and went to sleep. David was happy they all went peacefully.

And now, it was his turn.

He finished the note to his father:

We were wrong, Dad. Now it’s cost me my dream, my family, my community, and my life.

It may be a very long time before we are found, since none of the local tribe members come to our compound unless we invite them. I am afraid there will be a cover-up if The Corporation finds us first. That is why I am writing to you. If you can do anything to prevent this evil from spreading, in the name of God, do it.

I love you, Dad. I pray that God will touch you—and you’ll accept Him—so we’ll be reunited in heaven. I’ll be waiting there for you.

Your son, David

He reread the e-mail, knowing there was so much more to say. He pressed the send button. A box popped up, confirming its passage. He leaned back and sighed.

With little energy, he turned off the computer, stood, and approached the altar. He was surprised at the sweet aroma. He looked at the flowers on the altar. I don’t remember the orchids smelling so wonderful. He inhaled the fragrance deeply, then dropped to his knees, his hands pressing against the smooth oak.

A prayer from his days as an altar boy welled up in his memory. “Father of mercies and God of all comfort, our help in time of need, we fly unto thee for succor in behalf of this thy servant . . .” He couldn’t remember the rest of this ancient prayer. So, he drank the last of the poison in the cup. God grant that, in this death, there may be true life eternal.

The poison would work quickly, so he rose and went to his family. Rachel’s arm was thrown over her face, as if she had decided not to watch what would unfold. The girls’ dead eyes stared at nothing—their expressions serene. Aaron was on the floor, his face turned away and pressed into the crook of his arm.

David kissed his wife, but couldn’t bring himself to do the same to his children. Taking his place next to her, he reached over and pulled her close, his eye-catching sight of the telltale red splotches on her arm. Then, as if he needed one last confirmation, he looked at his own arm.

Yes—they were there.

Perhaps he would be vindicated after all. Perhaps they had stopped the horror from spreading.

The numbing poison-induced sleep came over him like a soft blanket. He closed his eyes. Into Thy hands I commit my . . .

And then he heard a voice.

“Dad.”

It came as a whisper.

He opened his eyes. His son Aaron stood over him. David attempted a smile, remembering the stories of others who’d come this way before—of the long tunnel with the bright light—of family members returning to walk “over” with their loved one, and there to greet him was his boy looking as he had not an hour ago, with his sandy blond, buzz-cut hair, and his lean face which had only just lost its boyish roundness as the passage to manhood had begun. It was a passage that David had stolen from him.

David wanted to speak, but couldn’t frame the words. He blinked, trying to clear his eyes.

“I’m sorry, Dad. I’m so sorry,” his son said.

David’s eyes widened, horrified. His son wasn’t an angel. His son was still alive.

“Dad, I’m sorry. I couldn’t do it. I couldn’t!” Aaron knelt over him, his eyes wide and wet.

David’s body lay helpless. His paralyzed vocal chords could make no sound; his arms could not reach up. Not even a tear could form. Why was his son alive? Didn’t he know what would happen? He’d been inoculated with the evil along with everyone else. The deadly virus was in his system. His death, inevitable and sure, would be awful.

With a final slow exhalation David knew he had failed—once again.

Darkness circled in his open eyes, moving to the center of his vision, obscuring everything to a single pinpoint as he lost consciousness. Dear God, forgive me.





BRIGADIER GENERAL SAM MOSLEY SETTLED INTO the large leather chair behind his cherrywood desk at The Hague. He swiveled away from the mounds of paperwork awaiting his attention and leaned his head back. He scrubbed his hands over his face, and let out a long breath. He was still weary from the flight back to Holland the previous afternoon.

Damage control. When did my job become nothing but damage control?

He had debriefed his superiors at the Pentagon and the CIA by teleconference. “Mission accomplished,” he’d reported. They had commended him on a job well done. He chewed the inside of his lip and thought, Mission accomplished, yes—if the mission was to bury an unmitigated disaster beneath tons of ice. But what about the cause of the disaster? Whose mission was it to discover that? And whom would they make the scapegoat?

Not me, he decided. Sure, there’d be appearances before top-secret subcommittees to discern what had happened at the laboratory and how to keep it from happening again. And a disaster like this always had budgetary ramifications, but he wouldn’t let them lay the blame on his shoulders.

He groaned and wondered when he’d become such a heartless bureaucrat—thinking about debriefings, subcommittees, budgets, and avoiding blame when so many lives had been lost to the failed experiment.

He had known and worked with some of those scientists for over a decade. They had families who, even now, were receiving the terrible news about their loved ones. Not the full truth, of course. Only a handful of people knew that. But each employee had a detailed cover story. Their cause of death would be explained in noble and heroic terms, as if that would soothe the surviving wives, husbands, sons, and daughters. Hopefully the generous checks they would receive would buy them some comfort.

Sam tried to console himself with the knowledge that the team hadn’t died in vain. They had sacrificed their lives to save untold millions—those who might have died in the future to the fatal viruses with names few in the public sector even knew.

He squinted at a large computer screen on the opposite wall. It displayed a map of the world, with multiple colors indicating outbreaks of viruses and diseases anywhere they had been diagnosed in the past year. Some colors remained constant, others blinked to indicate a new report.

He squinted, tapping a key on the keyboard to highlight any outbreaks of Filoviridae, a family of viruses containing the dreaded Ebola and Marburg viruses. Red dots flickered in parts of the Middle East, Asia, and Africa. Each dot represented individuals who, even as he sat in the comfort of his office, were dealing with these aggressive and relentless viruses. There were far too many.

Filoviridae were a formidable and fearsome foe. He had seen its effects for himself, seen how the virus moved quickly, passing rapidly from person to person, even spreading through the air to infect those in the immediate vicinity. Unknown to most of the world, the mutations of these viruses were becoming far more dangerous. The chances of regional epidemics—even a worldwide pandemic—increased almost daily. It was only a matter of time before the big one, the Hiroshima of viral outbreaks, would hit some part of the world and begin its horrific spread. Once it began to metastasize, he doubted it could be stopped—unless his teams could find a treatment.

Sam looked away from the map and his eye caught a slip of paper by the phone. The message stated in his assistant’s immaculate handwriting that Mark Carlson had called from a medical symposium in Cairo to find out if there was a conclusion to the Greenland crisis. The message detailed where he could be found only in an emergency. His cell phone would not be working.

There’s a conclusion all right, and you won’t like it.

He held the slip of paper in his hand and dreaded how he would explain to Mark that the lab in Greenland had been compromised—and then been utterly destroyed. How was he expected to drop that into a conversation?

Standing again, he began to pace. What had gone wrong? How had the virus broken free in the lab? How had it killed so many so quickly?

Sam had considered sabotage—a betrayer in their midst. But who? The staff had been rigorously vetted at the highest levels—with extensive psychological testing. No suicide-saboteurs in that crew. More than likely a careless technician had sent the virus into the air where the other employees then picked it up, triggering the crisis.

By the time the first rosy death-mark had shown up on a technician’s chest or arms, the entire colony could have been infected. Excruciating death came quickly—so quickly, in fact, that headquarters had received only one phone call and two urgent e-mails from separate employees. Then silence.

Camera footage—sent over the security system’s satellite feed—showed the carnage. The scenes were abhorrent and repulsive. There was no choice but to incinerate the base in the hope that every mutant virus within would be destroyed.

He glanced at his watch. It was nearly time to debrief his executive team on all that had happened. His assistant came through the doorway, tapping on the door as he entered.

“Excuse me, General,” Colonel Kevin Maklin said in an apologetic tone.

“What is it, Kevin?”

“I’m sorry, but there’s an inspector from Interpol here to see you. Martin Duerr.”

“Am I scheduled to see him?”

“No. He said it’s urgent.”

“Urgent? How?”

“He wouldn’t tell me. He said he must speak with you personally.”

Mosley looked at his watch again. “All right. I’ll give him a few minutes.”

His assistant stepped out and a short man with a round face, round wire-framed glasses, and wild white hair came in. He wore a tan suit that on anyone else would have looked crisp and sharp. On him, it hung like bad curtains.

“General Mosley?” he inquired in a low voice that came as a rumble from somewhere deep inside of him. He had a French accent.

“If it’s about those parking fines . . .”

The man chuckled politely. “No, sir. That’s the police. Parking fines are not within our jurisdiction.” He handed Mosley his credentials: a picture I.D. and gold badge with the blue insignia of a sword and globe overlaid with the letters OIPC/ICPO—the French and English acronyms for the International Criminal Police Organization, the world’s largest international police organization. “I’m an Inspector for Interpol. I’ve been sent from our headquarters in Lyon.”

“Beautiful city. What can I do for you, Inspector Duerr?”

Duerr looked as if he wanted to sit down, but Sam didn’t offer him a seat. “Have you ever heard of the Return to Earth movement?”

Mosley thought about it. “No. Should I have?”

Duerr shrugged, then produced a notepad from his pocket. Without looking at it, he said, “The Return to Earth is an extremist group—a combination of fanatical environmentalists and animal rights activists who’ve joined forces.”

Mosley gazed at the inspector but didn’t react.

Duerr cleared his throat. “They believe that humankind has lost his right to govern the earth because of his abuse of the world and of animals. In essence, they believe that humans should be returned to the earth, as in dead and decomposing, so that the earth can return to its natural state, in harmony with the animals.”

“I see.”

Duerr closed the notepad. “To be blunt, General, they’re terrorists—suicide bombers for Mother Earth. They will do anything to take mankind out of the equation. Anything. They’ll target individuals, families, industrial plants, factories, polluters, pharmaceutical companies, biochemical research sites, cosmetic companies, and any other entity they deem worthy to put on their hit-list for testing on animals or hurting the earth.”

“Am I on their hit-list?” Mosley asked. “Is that why you’re here?”

“Not in the way you think. But your name did come up in one of their meetings.”

Mosley scowled. “What meeting?”

“A cell meeting in Switzerland. They have cells worldwide, a loose network that supports and encourages one another. But they maintain enough distance to keep us from effectively tracking them. The individuals often don’t know who the other members are. There might be two or more working on the same project and they won’t know it. So, when we grab one, the others disappear back into the woodwork.”

“If you can’t track them, then how do you know I was mentioned?”

“One of our agents has infiltrated a cell in Basel. This is a significant breakthrough for us, as you can imagine. We have access to some of their activities as never before. Our agent flagged your name—in connection with some top secret facility in Greenland.”

Sam felt a cold hand squeeze his heart. He pressed his lips together to keep from speaking.

The Interpol agent nodded. “Yes, I know. I do not have the clearance for you to confirm or deny the existence of any top-secret facilities, but I want you to know that they know about it—and my agent was led to believe that they were going to take some sort of action against it.”

“What sort of action?”

“We don’t know,” the inspector replied. “Their modus operandi is usually centered around destruction, sabotage, intimidation.”

“Hypothetically speaking, if we were to have any sort of facility or facilities, and of course, I’m not saying or even insinuating we do or would, why would they target us?”

“Any facility that experiments on animals is suitable for attack. Or perhaps you were doing something that posed a risk to the environment. Or you may have been working on something that would accelerate their efforts to erase mankind from the earth. Pick one.”

Pick one, or all three. Was it possible these fanatics knew what they were testing and believed they could unleash a pandemic by infiltrating and sabotaging the facility? He swallowed an unnerving feeling of fear.

“How strong are they?”

The inspector pursed his lips. “They’re, shall we say, resourceful. Not only do they seem to have endless funding, but their ability to find out what a government or company is doing and where they are doing it is astounding. They seem to have followers buried deep within the most guarded enterprises. They insulate themselves anywhere and everywhere. Some of their members are experts in various fields, working at the highest levels. Or they plant an employee with, say, an outside contractor for a security firm, the military, or a government on one or more highly secure sites. Or, perhaps an employee of a janitorial service works at a secret site. You get the idea.”

“What do you need from me?” asked Mosley.

“I want you to be aware, to warn your people in a discreet way, so as not to jeopardize our operation.” Duerr thought, then added, “I need access to you in case we need your help. And, of course, I will keep you informed as best as I can.”

Sam thought about Greenland. How different would things have turned out had he spoken to Duerr earlier? “All right, Inspector. I’ll help in any way I can.”

Duerr waited as if something else should be said, then bowed slightly. “Merci, General.”

Once the Inspector had left, Mosley called Macklin into the office.

“Sir?”

“Get the team in here. We’ve got a problem.”

“Yes, sir.”

Mosley sat down in his chair, his mind working on how he could alert their research facilities about Return to Earth without alerting the terrorists.

A gentle chime sounded behind him and he swiveled the chair around to face his computer screen. An e-mail alert. He clicked on the message box.

His body stiffened when he saw the sender’s name. The message loaded and the text appeared. As he read, his hands became sweaty and his mouth dry.

It began, “Dear Dad . . .

Wednesday, July 1, 2009

Critical Care


Here's an excerpt from the exciting first novel in the new Mercy Hospital series. If you enjoy medical drama, this is for you!

Chapter One:


Don’t die, little girl.

Dr. Logan Caldwell pressed the heel of his hand against Amy Hester’s chest, taking over heart compressions in a last attempt to save the child’s life. Her small sternum hollowed and recoiled under his palm at a rate of one hundred times per minute, the best he could do to mimic her natural heartbeat. A respiratory therapist forced air into her lungs.

Don’t die. Logan glanced up at the ER resuscitation clock, ticking on without mercy. Twenty-seven minutes since they’d begun the code. No heartbeat. Not once. Time to quit but . . .

He turned to his charge nurse, Erin Quinn, very aware of the insistent wail of sirens in the distance. “Last dose of epi?”

“Three minutes ago.”

“Give another.” Logan halted compressions, his motionless hand easily spanning the width of the two-year-old’s chest. He watched until satisfied with the proficiency of the therapist’s ventilations, then turned back to the cardiac monitor and frowned. Asystole—flatline. Flogging this young heart with atropine and repeated doses of epinephrine wasn’t going to do it. A pacemaker, pointless. She’d been deprived of oxygen far too long before rescue.

Logan pushed his palm into Amy’s sternum again and gritted his teeth against images of a terrified little girl hiding in a toy cupboard as her day care burned in a suffocating cloud of smoke, amid the chaos of two dozen other burned and panicking children.

“Epi’s on board,” Erin reported, sweeping an errant strand of coppery hair away from her face. She pressed two fingers against the child’s arm to locate the brachial pulse and raised her gaze to the doctor’s. “You’re generating a good pulse with compressions, but . . .”

But she’s dead. With reluctance, Logan lifted his hand from the child’s chest. He studied the monitor display and then nodded at the blonde nurse standing beside the crash cart. “Run me rhythm strips in three leads, Sarah.” After he drew in a slow breath of air still acrid with the residue of smoke, he glanced down at Amy Hester, her cheeks unnaturally rosy from the effects of carbon monoxide, glossy brown curls splayed against the starched hospital linen. Dainty purple flower earrings. Blue eyes, glazed and half-lidded. Tiny chin. And lips—pink as a Valentine cupid—pursed around the rigid breathing tube, as if it were a straw in a snack-time juice box. Picture-perfect . . . and gone.

He signaled for the ventilations to stop and checked the code clock again. “Time of death—9:47.”

There was a long stretch of silence, and Logan used it to make his exit, turning his back to avoid another glance at the child on the gurney . . . and the expressions on the faces of his team. No good came from dwelling on tragedy. He knew that too well. Best to move on with what he had to do. He’d almost reached the doorway when Erin caught his arm.

“We’ve put Amy’s parents and grandmother in the quiet room the way you asked,” she confirmed, her green eyes conveying empathy for him as well. “I can send Sarah with you, if—”

“No. I’ll handle it myself,” Logan said, cutting her off. His tone was brusquer than he’d intended, but he just wanted this over with. “We need Sarah here.” He tensed at a child’s shrill cry in the trauma room beyond, followed by the squawk of the base station radio announcing an ambulance. “There are at least five more kids coming in from the propane explosion. We’ll need extra staff to do more than pass out boxes of Kleenex. I want nurses who know what they’re doing. Get them for me.”

***

Why am I here?

Claire Avery winced as a child’s painful cry echoed up the Sierra Mercy emergency department corridor and blended with the wail of sirens. Almost an hour after the Little Nugget Day Care explosion, ambulances still raced in. Fire. Burns. Like my brother. No, please, I can’t be part of this again.

She leaned against the cool corridor wall, her mouth dry and thoughts stuttering. Being called to the ER was a mistake. Had to be. The message to meet the director of nursing didn’t make sense. Claire hadn’t done critical care nursing since Kevin’s death. Couldn’t. She wiped a clammy palm on her freshly pressed lab coat and stepped away from the wall to peer down the corridor into the ER. Then jumped, heart pounding, at the thud of heavy footfalls directly behind her.

She whirled to catch a glimpse of a man barreling toward her with his gaze on the ambulance entrance some dozen yards away. He looked a few years older than she was, maybe thirty-five, tall and wide shouldered, with curly dark hair and faded blue scrubs. He leveled a forbidding scowl at Claire like a weapon and slowed to a jog before stopping a few paces from her.

“What are you doing?” he asked, grabbing his stethoscope before it could slide from his neck.

“I’m . . . waiting,” Claire explained, awkwardly defensive. “I was paged to the ER.”

“Good. Then don’t just stand there holding up the wall. Let’s go. The charge nurse will show you where to start.”

“But I—,” she choked, her confusion complete.

“But what?” He glanced toward sounds at the ambulance bay and then back at her.

Claire cleared her throat. “I don’t know why I’m here.”

He shook his head, his low groan sounding far too much like a smothered curse. “If that question’s existential, I don’t have time for it. But if you’re here to work, follow me. Erin Quinn will tell you everything you need to know.” He pointed toward a crew of paramedics racing through the ambulance doors with a stretcher. A toddler, his tiny, terrified face raw and blistered behind an oxygen mask, sat bolt upright partially covered by a layer of sterile sheets. “See that boy? That’s why I’m here. So either help me or get out of the way.” He turned and began jogging.

Speechless, Claire stared at the man’s retreating back and the nightmarish scene beyond: burned child, hustling medics, a flurry of scrubs, and a hysterically screaming parent. Help or get out of the way? What was she supposed to do with that ultimatum? And what gave this rude man the right to issue it?

Then, with a rush of relief, Claire spotted the Jamaican nursing director striding toward her. This awful mistake was about to be cleared up.

“I’m sorry for the delay,” Merlene Hibbert said, her molasses-rich voice breathless. “As you can imagine, there have been many things to attend to.” She slid her tortoiseshell glasses low on her nose, squinting down the corridor. “I see you already met our Dr. Caldwell.”

Claire’s eyes widened. Logan Caldwell? Sierra Mercy Hospital’s ER director?

Merlene sighed. “I’d planned to introduce you myself. I hope he wasn’t . . . difficult.”

“No, not exactly,” she hedged, refusing to imagine a reason she’d need an introduction. “But I think there’s been a mistake. He thought I’d been sent down here to work in the ER.” Tell me he’s mistaken.

“Of course. A natural mistake. He’s expecting two more agency nurses.”

Claire’s knees nearly buckled with relief. “Thank goodness. They need help. I can see that from here.” She glanced at the ER, where patients on gurneys overflowed into the hallway. A nurse’s aide held a sobbing woman in her arms, her face etched with fatigue. Styrofoam coffee cups, discarded cardboard splints, and scraps of cut-away clothing littered the floor. All the while, the distant cries of that poor child continued relentlessly.

“Yes, they do,” Merlene agreed. “And that’s exactly why I called you.”

“But I’ve been at Sierra Mercy only a few months, and my hours are promised to the education department—to train the students, write policies, and demonstrate new equipment.” Claire floundered ahead as if grasping for a life preserver. “I’ve interviewed to replace Renee Baxter as clinical educator. And I haven’t done any critical care nursing in two years, so working in the ER would be out of the—”

“That’s not why you’re here,” Merlene said. Her dark eyes pinned Claire like a butterfly specimen on corkboard. “I need you to assess my staff to see how they’re coping emotionally. I don’t have to tell you this has been one miserable morning.” She studied Claire’s face and then raised her brows. “You listed that in your résumé. That you’ve been recently trained in Critical Incident Stress Management?”

CISM? Oh no. She’d forgotten. Why on earth had she included that? “Yes, I’m certified, but . . .” How could she explain? Merlene had no clue that Claire’s entire future—maybe even her sanity—depended on never setting foot in an ER again. It was the only answer to the single prayer she’d clung to since her firefighter brother’s death in a Sacramento trauma room two years ago. Being helpless to save him left her with crippling doubts, sleep-stealing nightmares, and . . . She’d mapped her future out meticulously. The move to Placerville, a new hospital, a new career path, no going back. Everything depended on her plan.

Claire brushed away a long strand of her dark hair and forced herself to stand tall, squaring her shoulders. “I understand what you’re asking. But you should know that I haven’t done any disaster counseling beyond classroom practice. I’m familiar with the principles, but . . .” What could she possibly offer these people? “Wouldn’t the chaplain be a better choice?”

“He’s going to be delayed for several hours. Erin Quinn’s my strongest charge nurse, so if she tells me her ER team is at risk, I believe it. They received six children from that explosion at the day care. Four are in serious condition, and a two-year-old died.” Merlene touched the amber and silver cross resting at the neckline of her uniform. She continued, frowning. “Dr. Caldwell’s working them ragged. An agency nurse threatened to walk out. Security’s got their hands full with the media. . . . You’re all I can offer them right now.”

Claire’s heart pounded in her throat. With every fiber of her being, she wanted to sprint into the northern California sunshine; fill her lungs with mountain air; cleanse away the suffocating scents of fear, pain, and death; keep on running and not look back. It would be so easy. Except that these were fellow nurses in that ER; she’d walked in their shoes. More than most people, Claire understood the awful toll this work could take. The staff needed help. How could she refuse? She took a breath and let it out slowly. “Okay. I’ll do it.”

“Good.” Relief flooded into Merlene’s eyes. She handed Claire a dog-eared sheaf of papers. “Here’s our hospital policy for staff support interventions. Probably nothing new there.” She gestured toward her office a few yards away. “Why don’t you sit down and review it for a few minutes before you go in? You can report to me later after I make my rounds.”

Before Claire could respond, the ambulance bay doors slammed open at the far end of the corridor. There was an answering thunder of footsteps, rubber-soled shoes squeaking across the faded vinyl flooring.

Logan Caldwell reappeared, shoving past a clutch of reporters to direct incoming paramedics. He raked his fingers through his hair and bellowed orders. “Faster! Get that stretcher moving. Give me something to work with, guys. And you—yeah, you, buddy—get the camera out of my face! Who let you in here?” The ER director whirled, stethoscope swinging across his broad chest, to shout at a tall nurse who’d appeared at the entrance to the ER. “Where are those extra nurses, Erin? Call the evening crew in early; a double shift won’t kill anyone. We’re working a disaster case here. Get me some decent staff!”

Claire gritted her teeth. Though she still hadn’t officially met him, there was no doubt in her mind that Logan Caldwell deserved his notorious reputation. Dr. McSnarly. The nickname fit like a surgical glove. Thank heaven she didn’t have to actually work with him—the man looked like he ate chaos for breakfast.

Claire turned to Merlene. “I’ll do the best I can,” she said, then drew a self-protective line. “But only for today. Just until the chaplain comes.”

“Of course. Very short-term.” Merlene began walking away, then stopped to glance over her shoulder. “Oh, a word of caution: Dr. Caldwell hates the idea of counseling. I’d watch my back if I were you.”

Claire hesitated outside the doors to the emergency department. She’d reviewed the summary of steps for an initial critical stress intervention and was as ready as she’d ever be. Considering she’d never done any peer counseling before. I’m a fraud. Why am I here?

She shut her eyes for a moment, hearing the din of the department beyond. It had been stupid to put the CISM training on her résumé. She’d taken the course last fall and participated reluctantly in the mock crisis situations, mostly because it would look impressive on her application for the clinical educator position. But afterward Claire knew that she could never volunteer as a peer counselor. Never. It felt too personal, too painful.

Healing the healers, they called it, the basis for the work of volunteer teams that waded into horror zones after events like 9/11, the killer tsunami in Indonesia, and the devastating aftermath of Hurricane Katrina. And a Sacramento, California, trauma room after a warehouse fire that killed seven firefighters.

Claire fought the memories. Yes, the counseling teams made sure that caregivers took care of themselves too, assessing them for burnout and signs of post-traumatic stress. Like difficulty making decisions, sleeplessness, nightmares, and relationship failures. Claire knew the symptoms only too well. She’d struggled with most of them herself these past two years, exactly the reason she’d run away from that Sacramento hospital—after refusing its offer of stress counseling—and never looked back.

But here she was at another ER door, peeking inside through a narrow panel of bulletproof glass. And now she was responsible for helping these people deal with everything she was trying so hard to forget and expected to offer the kind of counseling she’d never accepted herself. Beyond ironic—impossible and completely at odds with her plan.

Claire raised her palm and pushed the door inward.

Heal my heart and move me forward. She’d prayed it every single day.

So why was her life slamming into reverse?

The essence of Sierra Mercy ER hit Claire’s senses like an assault. Sounds: anxious chatter, a burst from the overhead PA speakers, beeping of electronic monitors, inconsolable crying, and painful screams. Smells: nervous perspiration, stale coffee, surgical soap, bandaging adhesive, the scorched scent of sterile surgical packs . . . and of burned hair and flesh.

No, no. Claire’s stomach lurched as she clutched her briefcase like a shield and scanned the crowded room for the charge nurse. Find Erin Quinn. Concentrate on that.

She took a slow breath and walked farther into the room, searching among the eddy of staff in multicolored scrubs—technicians, nurses, and registration clerks. She forced herself to note the glassed-in code room, a small central nurses’ station and its large dry-erase assignment board, the semicircular arrangement of curtained exam cubicles with wall-mounted equipment at the head of each gurney, and the huge surgical exam lights overhead.

Claire tried to avoid the anxious faces of the family members huddled close to the tiny victims. Because she knew intimately how much they were suffering. No, much worse than that. I feel it. I still feel it.

When she’d agreed to do this for Merlene, she’d hoped this smaller ER—miles from the Sacramento trauma center and two years later—would be somehow different, but nothing had changed. Especially how it made Claire feel, the same way it had in those weeks after Kevin’s death. Unsure of herself for the first time in her nursing career, she’d been antsy, queasy, and clammy with doubt. Dreading the wail of approaching sirens and jumping at each squawk of the emergency radio. No matter how hard she tried, she couldn’t shake the irrational certainty that the very next ambulance stretcher would be carrying someone she loved, someone she’d be unable to save, and . . .

A cry in the distance made Claire turn. Her breath caught as the young charge nurse opened a curtain shielding a gurney.

A child, maybe three years old, rested upright in a nest of blue sterile sheets, tufts of his wispy blond hair blackened at the tips—some missing in spots—reddened scalp glistening with blisters. One eye had swollen closed, and his nose was skewed a little to one side by the clear plastic tape securing a bandage to his cheek. The other blue eye blinked slowly as if mesmerized by the drip chamber of the IV setup taped to his arm. An oxygen cannula stretched across his puffy, tear-streaked face.

Beside him, a stainless steel basin, bottles of sterile saline, and stacks of gauze squares sat assembled on a draped table. Burn care: control pain, cool the burn to stop it from going deeper, monitor for dehydration, and prevent tetanus and infection. All the bases covered. Unless the burns are horrific and complicated, like Kevin’s. Unless there is profound shock, heart failure, and . . . No, don’t think of it.

Claire exhaled, watching as Erin Quinn pressed the button on a blood pressure monitor and efficiently readjusted the finger probe measuring the child’s lung status. She made a note on a chart and moved back to the bedside as the child stirred and cried out.

“Mommy?”

“Mom’s getting a bandage on her leg, Jamie, remember?” she explained gently, then caught sight of Claire and acknowledged her with a wave. She called to another nurse across the room. “Sarah, can you finish the ointment on Jamie’s scalp? watch him for few minutes?” After giving a brief report to the petite blonde nurse, she crossed to where Claire stood.

“Good, you found me,” Erin said, noting Claire’s name badge and offering a firm handshake. Strands of coppery hair had escaped from her ponytail, and her blue scrubs were splotched with snowy white burn ointment. She nodded as Claire glanced once more at the injured boy. “Second-degree burns. No explosion trauma, otherwise he’d be on a chopper ride to Sacramento. But Jamie’s got asthma, and the smoke stirred things up. So . . .”

“He needs close observation,” Claire finished. “I understand.”

Erin smiled. “Hey, I really appreciate your coming here. We’ve had a horrible shift, and my staff are workhorses, but the Hester child was a real heartbreaker. We worked a long time to save her, but it didn’t happen. And only last weekend we had the first drowning of the season. Junior high boy fishing on the river. Overall my crew seems to be coping fairly well, but today might be that last straw, you know? So I have a couple of issues I’d like to discuss with you. I can spare about ten minutes to fill you in. Will that be enough to get you started?”

“Yes . . . okay.” Claire tried to recall the details of her review. How much could she offer here? One person couldn’t do more than a brief assessment and let the staff know more assistance was available. At least she’d found the self-help pamphlets. “But first I should tell you that I left a message for the hospital social worker because if an actual debriefing is needed, then a mental health professional is required. That’s policy.” She swallowed, hoping she sounded more confident than she felt. “The debriefing should be done tomorrow or the next day.”

“What?” Erin shot her a look that clearly implied Claire was the one who needed mental help. “Tomorrow? I called you here because we need help now. Didn’t Merlene tell you that?” She pressed her fist to her lips. “Look, I’ve had a lab tech faint, the media’s harassing family members in the waiting room, and an agency nurse threatened to walk out. Walk out, when I’m short-staffed already! I’m sorry if I seem testy, but I’m responsible for the quality of nursing care here. My team needs help, and I’ll do everything it takes to make that happen. Merlene told me you were a trained peer counselor. Aren’t you?”

She hated herself. Erin Quinn was right. Claire needed to do whatever she could for these people. Somehow. She reached into her briefcase and grabbed a sheaf of glossy pamphlets. “Yes, I’ve been trained. And I can start an initial assessment, get things going in the process. I promise I’ll do as much as I can to help, and . . .” Her voice faltered as heavy footsteps came to a stop behind her. She fought an unnerving sense of déjà vu and impending doom.

“Help?” A man’s voice, thick with sarcasm, prodded her back like the devil’s pitchfork.

Claire turned, several pamphlets slipping from her fingers.

It was time to officially meet the newest threat to her plan, Dr. Logan Caldwell.