She glanced down the rest of his body, seeing a number of tattoos-Whoa. That was one hell of an old groin injury. "Let me see the X-ray, and I want an ultrasound of his heart-"
A scream ripped through the OR.
Jane's head snapped to the left. The nurse who'd been stripping the patient was down on the floor in full seizure with her arms and legs flapping against the tile. In her hand she had a black glove the patient had been wearing.
For a split second everyone froze.
"She just touched his hand and went down," someone said.
"Back in the game!" Jane clipped. "Estevez, you see to her. I want to know how she is immediately. Rest of you get tight. Now!"
Her commands snapped the staff into action. Everyone refocused as the nurse was carried over to the bay next door and Estevez, one of the residents, started to treat her.
The chest X-ray came out relatively fine, but for some reason the ultrasound of the heart was of poor quality. Both, however, revealed exactly what Jane expected: pericardial tamponade from a right ventricular gunshot wound: Blood had leaked into the pericardial sack and was compressing the heart, compromising its function and causing it to pump poorly.
"We need an ultrasound of his abdomen while I buy us some time with his heart." With the more pressing injury ascertained, Jane wanted more information on that knife wound. "And as soon as that's done, I want both machines checked. Some of these chest images have an echo."
As a resident went to work on the patient's belly with the ultrasound wand, Jane took a twenty-one-gauge spinal needle and plugged it into a fifty-cc syringe. After a nurse Betadined the man's chest, Jane pierced his skin and navigated the bone anatomy, breaching the pericardial sack and drawing out forty ccs of blood to ease the pericardial tamponade. Meanwhile, she gave out orders to prepare OR two upstairs and get the cardiac bypass team on the ready.
She gave the syringe to a nurse for disposal. "Let's see the abdominal."
The machine was definitely misbehaving, as the images were not as clear as she'd like. They did, however, show some good news, which was confirmed as she palpated the region. No major internal organs appeared to be affected.
"Okay, abdomen appears sound. Let's move him upstairs, stat."
On her way out of the chute, she put her head into the bay where Estevez was working on the nurse. "How's she doing?"
"Coming around." Estevez shook his head. "Her heart stabilized after we hit her with the paddles."
"She was fibrillating? Christ."
"Just like the telephone guy we had in yesterday. Like she'd been hit with a load of electricity."
"Did you call Mike?"
"Yeah, her husband's coming in."
"Good. Take care of our girl."
Estevez nodded and looked down at his colleague. "Always."
Jane caught up with the patient as the staff wheeled him down the chute and into the elevator that went to the surgical suite. One floor up she scrubbed in while the nurses got him onto her table. At her request, a cardio thoracic surgical kit and the heart/lung bypass machine had been set up, and the ultrasounds and X-rays taken downstairs were glowing on a computer screen.
With both hands latexed and held away from herself, she reviewed the chest scans again. Truth be told, both of them were subpar, very grainy and with that echo, but there was enough to orient herself. The bullet was lodged in the muscles of his back, and she was going to leave it there: The risks inherent in removing it were greater than letting it rest in peace, and in fact, most gunshot victims left the chute with their lead trophy wherever it ended up.
She frowned and leaned in closer to the screen. Interesting bullet. Round, not the typical oblong shape she was used to seeing inside her patients. Still, appeared to be made of garden-variety lead.
Jane approached the table where the patient had been hooked up to the anesthesia machines. His chest had been prepped, the regions around it draped in surgical cloth. The orange wash of Betadine made him look like he had a bad fake tan. "No bypass. I don't want to use up the time. Tell me we have blood for him on hand?"
One of the nurses spoke up from the left. "We do, although his blood didn't type."
Jane glanced across the patient. "It didn't?"
"The sample reading came back unidentifiable. But we have eight liters of O."
Jane frowned. "Okay, let's do this."
Using a laser scalpel, she made an incision down the patient's chest, then sawed through the sternum and used a rib spreader to pull open the heart's iron bars, exposing-
Jane lost her breath. "Holy"
"Shit," someone finished.
"Suction." When there was a pause, she looked up at her assisting nurse. "Suction, Jacques. I don't care what it looks like, I can fix it-provided I get a clear shot at the damn thing."
There was a hissing sound as the blood was removed, and then she got a good gander at a physical anomaly she'd never seen before: a six-chambered heart in a human chest. That "echo" she'd seen on the ultrasounds was, in fact, an extra pair of chambers.
"Pictures!" she called out. "But make it quick, please."
As photographs were taken, she thought, Boy, the Cardiology Department is going to go nuts over this. She'd never seen anything like it before-although the hole torn in the right ventricle was totally familiar. She'd known a lot of them.
"Suture," she said.
Jacques slapped a pair of grips into her palm, the stainless-steel instrument carrying a curved needle with a black thread clipped onto the end. With her left hand, Jane reached in behind the heart, plugged the back end of the hole with her finger, and stitched the front impact site closed. Next move was to lift the heart out of its pericardial sac and do the same underneath.
Total elapsed time was under six minutes. Then she released the spreader, put the rib cage back where it was supposed to be and used stainless-steel wire to close the two halves of the sternum back together. Just as she was about to staple him from his diaphragm to his collarbone, the anesthesiologist spoke up and machines started to beep.
"BP is sixty over forty and falling."
Jane called out the heart-failure protocol and leaned down to the patient. "Don't even think about it," she snapped. "You die on me and I'm going to be really ticked off."
From out of nowhere, and against all medical rationale, the man's eyes blinked open and focused on her.
Jane jerked back. Good God his irises held the colorless splendor of diamonds, shining so bright they reminded her of the winter moon on a cloudless night. And for the first time in her life, she was stunned into immobility. With their locked stares, it was as if they were linked body-to-body, twisted and intertwined, indivisible-
"He's V-fibbing again," the anesthesiologist barked.
Jane snapped back to attention.
"You stay with me," she ordered the patient. "You hear me? You stay with me."
She could have sworn the guy nodded at her before his lids shut. And she got back to work saving his life.
"You so need to lighten up about that potato-launcher incident," Butch said.
Phury rolled his eyes and eased back in the banquette. "You broke my window."
"Of course we did. V and I were aiming for it."
"Twice."
"Thus proving that he and I are outstanding marksmen."
"Next time can you please pick someone else's" Phury frowned and lowered the martini from his lips. For no apparent reason, his instincts were suddenly alive, all lit up and ringing like a slot machine. He glanced around the VIP section, looking for some flavor of trouble. "Hey, cop, do you-"
"Something's not right," Butch said as he rubbed the center of his chest, then took his thick gold cross out from under his shirt. "What the hell is doing?"
"I don't know." Phury ran his stare through the crowd in the VIP section again. Man, it was as if a foul odor had sneaked into the room, coloring the air with something that made your nose want a new job description. And yet there was nothing wrong.
Phury took out his phone and dialed his twin. When Zsadist got on the line, the first thing the brother asked was whether Phury was okay.
"I'm fine, Z, but you're feeling it, too, huh?"
Across the table, Butch put his cell up to his ear. "Baby? You all right? You okay? Yeah, I don't know Wrath wants to talk to me? Yeah, sure, put him on Hey, big man. Yeah. Phury and me. Yeah. No. Rhage is with you? Good. Yeah, I'm calling Vishous next."
After the cop hung up, he punched a couple of keys and the phone went back to his ear. The cop's brows came down. "V? Call me. As soon as you get this."
He ended the call just as Phury got off with Z.
The two of them sat back. Phury fiddled with his drink. Butch played with his cross.
"Maybe he went to his penthouse to work on a female," Butch said.
"He told me he was going to do that first thing tonight."
"Okay. So maybe he's in the middle of a fight."
"Yeah. He'll call us right back."
Although all of the Brotherhood's phones had GPS chips in them, V's didn't work if the phone was on him, so calling back to the compound and putting a trace on his RAZR wasn't going to help much. V blamed that hand of his for throwing off the functionality, maintaining that whatever made his palm glow caused an electrical or magnetic disturbance. Sure as hell affected call quality. Whenever you called V there was fuzz on the line, even if he was on a landline.
Phury and Butch lasted about a minute and a half before they looked at each other and spoke at the same time.
"You mind if we just swing by-"
"Let's just go-"
They both stood up and headed for the club's emergency side door.
Outside in the alley, Phury looked up to the night sky. "You want me to dematerialize over to his place real quick?"
"Yeah. Do that."
"I need the address. Never been there before."
"Commodore. Top floor, southwest corner. I'll wait here."
For Phury it was the work of a moment to put himself on the windy terrace of a flashy penthouse some ten blocks closer to the river. He didn't even bother approaching the wall of glass. He could sense that his brother wasn't inside, and was back at Butch's side in a heartbeat.
"Nope."
"So he's hunting-" The cop froze, an odd, fixated expression hitting his face. His head whipped around to the right. "Lessers."
"How many?" Phury asked, opening his jacket. Ever since Butch had had his run-in with the Omega, he'd been able to sense slayers like you read about, the bastards coins to his metal detector.
"A pair. Let's make this quick."
"Damn right."
The lessers came around the corner, took one look at Phury and Butch, and fell into the ready position. The alley right outside ZeroSum was not the best place for a fight, but luckily because the night was so cold, there weren't any humans around.
"I'm on cleanup," Butch said.
"Roger that."
The two of them lunged at their enemy.
Chapter Eight
Two hours later Jane pushed the door to the Surgical Intensive Care Unit wide. She was packed up and ready to go home, her leather bag on her shoulder, car keys in her hand, her windbreaker on. But she wasn't leaving without seeing her gunshot patient first.
As she walked over to the nursing station, the woman on the other side of the counter looked up. "Hey, Dr. Whitcomb. Come to check on your admit?"
"Yeah, Shalonda. You know me-can't leave ' em alone. What room did you give him?"
"Number six. Faye's in with him, now making sure he's comfortable."
"See why I love you guys? Best SICU staff in town. By the way, has anyone come to see him? We find a next of kin?"
"I called the number on his medical record. Guy who answered said he'd lived in the apartment for the last ten years and had never heard of a Michael Klosnick. So the addy was a false one."
As Shalonda rolled her eyes, the two of them said at the same time, "Drug-related."
Jane shook her head. "I'm not surprised."
"Neither am I. Those tats on his face don't exactly play him as an insurance adjuster."
"Not unless he's pushing paper for a bunch of pro wrestlers."
Shalonda was laughing as Jane waved and headed down the corridor. Number six was all the way down on the right, and as she went she looked in on two other patients she'd operated on, one who'd had a perforated bowel from liposuction gone wrong and another who'd been impaled on a fence rail in a motorcycle accident.
SICU rooms were twenty by twenty square feet of all business. Each one was glass-fronted, with a curtain that could be pulled for privacy, and they were not the kind of digs that had a window or a Monet poster or a TV with Regis and Kelly on it. If you were well enough to worry about what you were watching on the tube, you didn't belong here. The only screens and pictures were from the monitoring equipment orbiting the bed.
When Jane got to six, Faye Montgomery, a real veteran, looked up from checking the patient's IV. "Evenin', Dr. Whitcomb."
"Faye, how are you?" Jane put her bag down and reached for the medical record that was in a pocket holder by the door.
"I'm good, and before you ask, he's stable. Which is amazing."
Jane nipped through the most recent stats. "No kidding."
She was about to close up the medical record when she frowned at the number on the left-hand corner. The ten-digit patient ID was thousands and thousands of numbers away from the ones given to new admits, and she checked the date the file had first been opened: 1974. Flipping through, she found two admits to the ED: one for a knife wound, the other for a drug overdose; '71 and '73 were the dates.
Ah, hell, she'd seen this before. Zeros and sevens could look alike when you wrote them fast. The hospital hadn't made the move to computerized records until late in 2003, and before that everything had been handwritten. This record had clearly been transcribed by data processors who misread what was there: instead of '01 and '03, the person had transcribed the date back into the seventies.
Except the DOB didn't make sense. With the one listed, the patient would have been thirty-seven three decades ago.
She closed the folder and rested her palm on it. "We have to get better precision from that transcription service."
"I know. I noticed the same thing. Listen, you want some time alone with him?"
"Yeah, that'd be great."
Faye paused by the door. "Heard you were pretty awesome in the OR tonight."
Jane smiled a little. "The team was awesome. I just did my part. Hey, I forgot to tell Shalonda I'm taking UK in Spring Madness. Would you-"
"Yup. And before you ask, yes, she's Duke again this year."
"Good, we can abuse each other for another six weeks."
"That's why she picked 'em. Public service so the rest of us can watch you guys go at it. You two are such givers."
After Faye left, Jane pulled the privacy curtain into place and went over to the bedside. The patient's respiration was machine-driven through his intubation, and his oxygen levels were acceptable. Blood pressure was steady, although low. Heart rate was sluggish, and it read funny on the monitor, but then again, he had six chambers beating.
Christ, that heart of his.
She leaned over him and studied his facial features. Caucasian in derivation, most likely middle European. A looker, not that that was relevant, although the handsome thing was thrown off a little by those tattoos on his temple. She moved in closer to study the ink in his skin. She had to admit it was beautifully done, the intricate designs like Chinese characters and hieroglyphics combined. She figured the symbols must be gang-related, although he didn't seem like a boy to play at warfare; he was more fierce, like a soldier. Maybe the tats were a martial-arts thing?
When she glanced at the tube inserted in his mouth, she noticed something odd. With her thumb she pushed his upper lip back. His canines were very pronounced. Shockingly sharp.
Cosmetic, no doubt. People were doing all kinds of freaky stuff to their appearances these days, and he'd already marked up his face.
She lifted up the thin blanket that covered him. The wound dressing on the chest was fine, so she worked her way down his body, pushing the covers out of her way while she went. She inspected the stab wound's dressing, then palpated his abdominal area. As she gently pushed to feel his internal organs, she looked at the tattoos above his pubic area, then focused on the scars around his groin.
He'd been partially castrated.
Given the messy scarring, it hadn't been a surgical removal, more likely the result of an accident. Or at least, she hoped it had been accidental, because the only other explanation would be torture.
She stared at his face as she covered him up. On impulse, she put her hand on his forearm and squeezed. "You've led a hard-core life, haven't you."
"Yeah, but it's done me good."
Jane wheeled around. "Jesus, Manello. You scared me."
"Sorry. Just wanted to check in." The chief went around to the other side of the bed, his eyes going over the patient. "You know, I don't think he wouldn't have lived under someone else's knife."
"Have you seen the pictures?"
"Of his heart? Yeah. I want to send them to the boys at Columbia for a little look-see. You can ask them what they think when you're there."
She gave that one a pass. "His blood wouldn't type."
"Really?"
"If we can get his consent, I think we should do a total workup on him down to the chromosomes."
"Ah, yes, your second love. Genes."
Funny that he remembered. She'd probably mentioned only once how she'd almost ended up in genetics research.
With a junkie's rush, Jane pictured the inside of the patient, saw his heart in her hand, felt the organ in her grip as she saved his life. "He could present a fascinating clinical opportunity. God, I would love to study him. Or at least participate in studying him."
The soft beeping of the monitoring equipment seemed to swell in the silence between them until moments later some kind of awareness tickled the back of her neck. She glanced up. Manello was staring at her, his face grave, his thick jaw set, his brows down low.
"Manello?" She frowned. "Are you okay?"
"Don't go."
To avoid his eyes she looked down at the bedsheet that was folded once and tucked under her patient's arm. Idly she smoothed the white expanse-until it reminded her of something her mother had always done.
She stilled her hand. "You can get another surg-"
"Fuck the department. I don't want you to go because" Manello pushed a hand through his thick dark hair. "Christ, Jane. I don't want you to go because I'd miss you like hell, and because I shit, I need you, okay? I need you here. With me."
Jane blinked like an idiot. In the last four years there'd never been any suggestion that the man was attracted to her. Sure, they were tight and all. And she was the only one who could calm him down when he lost his temper. And okay, yeah, they talked about the inner workings of the hospital all the time, even after hours. And they ate together every night when they were on duty and he'd told her about his family and she'd told him about hers
Crap.
Yeah, but the man was the hottest property on hospital grounds. And she was about as feminine as well, an operating table.
Certainly had as many curves as one.
"Come on, Jane, how clueless can you be? If you gave me a thin inch, I'd be inside your scrubs in the next heartbeat."
"Are you insane?" she breathed.
"No." His eyes grew heavy-lidded. "I'm very, very lucid."
In the face of that summer-night sultry expression, Jane's brain took a vacation. Just flew right out of her skull. "It wouldn't look right," she blurted.
"We'd be discreet."
"We fight." What the hell was coming out of her mouth?
"I know." He smiled, his full lips curving. "I like that. No one stands up to me but you."
She stared across the patient at him, still so dumbfounded she didn't know what to say. God, it had been so long since she'd had a man in her life. In her bed. In her head. So damned long. It had been years of coming home to her condo and showering alone and falling into bed alone and waking up alone and going to work alone. With both her parents gone she had no family, and with the hours she pulled at the hospital, she had no outside circle of friends. The only person she really talked to was well, Manello.
As she looked at him now, it occurred to her that he truly was the reason she was leaving, though not just because he was standing in her way in the department. On some level she'd known this heart-to-heart was coming, and she'd wanted to run before it hit.
"Silence," Manello murmured, "is not a good thing right now. Unless you're trying to frame something like, 'Manny, I've loved you for years, let's go back to your place and spend the next four days horizontal.' "
"You're on tomorrow," she said automatically.
"I'd call in sick. Say I've got that flu. And as your chairman, I would order you to do the same." He leaned forward over the patient. "Don't go to Columbia tomorrow. Don't leave. Let's see how far we can take this."
Jane looked down and realized she was staring at Manny's hands his strong, broad hands that had fixed so many hips and shoulders and knees, saving the careers and the happiness of so many athletes, professional and amateur alike. And he didn't just operate on the young and in shape. He had preserved the mobility of the elderly and the injured and the cancer-stricken as well, helping so many to continue to function with arms and legs.
She tried to imagine those hands on her skin.
"Manny" she whispered. "This is crazy."
Across town, in the alley outside of ZeroSum, Phury rose from the motionless body of a ghost-white lesser. With his black dagger he'd opened up a yawning slice in the thing's neck, and glossy black blood was pumping out onto the slush-covered asphalt. His instinct was to stab the thing in the heart and poof it back to the Omega, but that was the old way. The new way was better.
Although it cost Butch. Dearly.
"This one's ready for you," Phury said, and stepped back.
Butch came forward, his boots crunching through icy puddles. His face was grim, his fangs elongated, his scent now carrying the baby-powder sweetness of their enemies. He had finished with the slayer he had fought with, done his special business, and now he would do it again.
The cop looked both motivated and in pain as he sank to his knees, planted his hands on either side of the lesser's pasty face, and leaned down. Opening his mouth, he positioned himself above the slayer's lips and began a long, slow inhale.
The lesser's eyes flared as a black mist rose out of its body and was sucked into Butch's lungs. There was no break in the inhale, no pause in the draw, just a steady stream of evil passing out of one vessel and into another. In the end, their enemy became nothing but gray ash, its body collapsing, then fragmenting into a fine dust that was carried away by the cold wind.
Butch sagged, then gave out altogether, falling to his side onto the alley's slushy road. Phury went over and reached his hand-
"Don't touch me." Butch's voice was a mere wheeze. "I'll make you sick."
"Let me-"
"No!" Butch shoved at the ground, pushing himself up. "Just gimme a minute."
Phury stood over the cop, guarding him and keeping an eye on the alley in case more came. "You want to go home? I'll go look for V."
"Fuck, no." The cop's hazel eyes lifted. "He's mine. I'm going to find him."
"Are you sure?"
Butch got up onto his feet, and though his body waved like a flag, he was nothing but green light. "Let's go."
As Phury fell into step with the guy and the two of them went down Trade Street, he didn't like the look on Butch's face. The cop had the loose-goose expression of someone whose blender was on frappé, but it didn't seem like he was going to quit unless he fell over.
And as the two of them scoured the urban armpit of Caldwell and came up with jack shit, the no-V situation clearly made Butch even sicker.
They were on the very fringes of downtown, all the way out by Redd Avenue, when Phury stopped. "We should turn back. I doubt he'd come out this far."
Butch stopped. Looked around. In a dull voice he said, "Hey, check it. This is Beth's old apartment building."
"We need to double back."
The cop shook his head and rubbed his chest. "We've got to keep going."
"Not saying we stop looking. But why would he be this far out? We're on the edge of residential land. Too many eyes for a fight, so he wouldn't come here looking for one."
"Phury, man, what if he got jacked? We haven't seen another lesser out tonight. What if something big went down, like they bagged him?"
"If he was conscious, that would be highly unlikely, given that hand of his. Helluva weapon, even if he got stripped of his daggers."
"What if he was knocked out?"
Before Phury could respond, the Channel Six News-Leader van tore by at a dead run. Two streets down its brakelights flared and the thing hung a louie.
All Phury could think was, Shit. News vans didn't show up in a rush like that because some old lady's cat was in a tree. Still, maybe it was just human shit, like a gang-related lead shower.
Trouble was, some horrible, crushing prescience told Phury that wasn't the case, so when Butch started walking in that direction, he went along. No words were spoken, which meant the cop was probably thinking exactly what he was: Please, God, let it be someone else's tragedy, not ours.
When they came up to where the TV van was parked, there was your typical crime convention, with two Caldwell Police Department cruisers parked at the entrance to Twentieth Avenue's dead-end alley. As a reporter stood spotlit and addressing a camera, men in uniform walked around within a circle of yellow tape, and kibitzers huddled together, drama-feeding and yakking.
The gust of wind barreling down the alley carried the smell of V's blood as well as the sweet baby-powder stench of lessers.
"Oh, God" Butch's anguish rolled out into the cold night air, adding a sharp, shellaclike tang to the mix.
The cop lurched forward toward the tape, but Phury grabbed the guy's arm to stop him-only to blanch. The evil in Butch was so palpable, it shot up Phury's arm and landed in his gut, making his stomach roll.
He held on to his friend anyway.
"You stay the fuck back. You probably worked with some of those badges." When the cop opened his mouth, Phury talked right over him. "Pop your collar, pull your brim, and hold tight."
Butch tugged on his Red Sox hat and tucked his jaw in. "If he's dead-"
"Shut up and worry about keeping yourself on your feet." Which was going to be a challenge, because Butch was a ragged mess. Jesus if V was dead, not only would that kill each and every one of the Brothers, but the cop had special problems. After he pulled that Dyson routine with the slayers, V was the only thing that could get the evil out of him.
"Go on, Butch. It's too much exposure for you. Go on now."
The cop walked off a couple yards and propped himself up against a parked car in the shadows. When it looked like the guy was going to stay there, Phury went over and joined the hangers-on at the edge of the yellow tape. Surveying the scene, the first thing he noticed were the residuals from where a lesser had been offed. Fortunately, the police weren't paying attention to them. They probably thought the glossy puddle was just oil spilled from a car and the scorched place leftover from a homeless person's makeshift fire. No, the badges were concentrating on the center of the scene, where Vishous had clearly lain in a pool of red blood.
Oh God.
Phury glanced at the random human next to him. "What happened?"
The guy shrugged. "Gunshot. Some kind of fight."
A young kid dressed in rave clothes spoke up, all hyped out, like this was the coolest thing ever. "It was in the chest. I saw it happen, and I was the one who called nine-one-one." He waved his cell phone like it was a prize. "The police want me to stick around so they can interview me."
Phury looked over at him. "What went down?"
"God, you wouldn't have believed it. It was right outta The World's Most Shocking Moments Caught on Tape show. You know that show?"
"Yeah." Phury checked out the buildings on either side of the alley. No windows. This was probably the only witness. "So what happened?"
"Well, all's I was doing was walking down Trade. My friends ditched me at Screamer's and I got no ride, you know? Anyway, I'm walking and I see this bright flash of light up ahead. It was like a massive strobe thingy coming out of this alley. I walked a little faster, 'cause I wanted to see what was going down, and that's when I heard the gunshot. It was like a pop sound. Actually, I didn't even know it was a gunshot until I got here. You'd think it'd be louder-"