“But—”
“Dr. Bishop, Asher told me this Facility uses some kind of classified pressurization technology. Basically untested in the field. That makes the bends the most likely culprit by far.”
Bishop did not reply; instead, she frowned and looked away.
Crane felt himself growing impatient. “Feel free to talk to Asher if you don’t like it,” he said crisply, “but he brought me down here to make suggestions. Now please get this patient to the chamber.” He paused to let this sink in. “Shall we visit patient number three?”
He had saved the most interesting case for last: a woman who presented with numbness and weakness in both hands and face. She was awake when they entered her room. Latest-generation monitoring equipment surrounded her, bleating quietly. Immediately, Crane sensed a difference. He noted the distress in her yellowish eyes, the wasting body rigid with worry. Even without performing a diagnostic procedure, he knew this case might be serious.
He opened the clipboard, and the LCD screen sprang to life. The patient history came up automatically. Must be tagged to her RFID chip, Crane thought.
He glanced over the summary data:
Name:
Philips, Mary E.
Sex:
F
Age:
36
Brief Presentation:
Bilateral weakness / numbness of hands and face
When he looked up from the clipboard he noticed a naval officer had slipped into the room. The man was tall and lean, and his pale eyes were set unusually—even oddly—close together. The right eye appeared to be exotrophic. Commander’s bars were on his sleeves, and his left collar sported the gold insignia of the Intelligence Service. He leaned against the door frame, hands at his sides, acknowledging neither Crane nor Bishop.
Crane looked back toward the patient, tuning out this new arrival. “Mary Philips?” he asked, falling automatically into the neutral tone he’d long ago learned to use with patients.
The woman nodded.
“I won’t take up much of your time,” he said with a smile. “We’re here to see you back on your feet as quickly as possible.”
She returned the smile: a small jerk of the lips that vanished quickly.
“You’re still feeling significant numbness in your hands and your face?”
She nodded, blinked, dabbed at her eyes with a tissue. Crane noticed that when she blinked her eyes did not seem to close completely.
“When did you first notice this?” he asked.
“About ten days ago. No, maybe two weeks. At first it was so subtle I barely noticed.”
“And were you on or off shift when you first became aware of the sensation?”
“On shift.”
Crane glanced again at the digital clipboard. “It doesn’t say here what your station is.”
It was the man in the doorway who spoke up. “That’s because it isn’t relevant, Doctor.”
Crane turned toward him. “Who are you?”
“Commander Korolis.” The man had a low, soft, almost unctuous voice.
“Well, Commander, I think her station is very relevant.”
“Why is that?” Korolis asked.
Crane looked back at the patient. She returned his gaze anxiously. The last thing he wanted to do, he decided, was increase that anxiety. He motioned Commander Korolis in the direction of the hall.
“We’re performing a diagnostic procedure,” he said, in the corridor and out of the patient’s earshot. “In a differential diagnosis, every fact is relevant. It’s quite possible her work environment is in some way responsible.”
Korolis shook his head. “It’s not.”
“And how do you know that?”
“You’ll just have to take my word for it.”
“I’m sorry, but that’s not good enough.” And Crane turned away.
“Dr. Crane,” Korolis said softly. “Mary Philips works in a classified area of the Facility on a classified aspect of the project. You will not be permitted to ask work-specific questions.”
Crane wheeled back. “You can’t—” he began. Then he stopped, forcing down anger with effort. Whoever this Korolis was, he clearly wielded authority. Or thought he did. Why all this need for secrecy, Crane wondered, at a scientific establishment?
Then he paused, reminding himself he was the newcomer here. He didn’t yet know the rules—overt or covert. It seemed likely this was a battle he couldn’t win. But he’d sure as hell bring it up with Asher later. For the moment, he’d just have to diagnose this patient as best he could.
He stepped back into the hospital room. Dr. Bishop was still beside the bed, her expression studiously neutral.
“I’m sorry for the interruption, Ms. Philips,” Crane said. “Let’s proceed.”
Over the next fifteen minutes, he performed a detailed physical and neurological examination. Gradually, he forgot the watchful presence of Commander Korolis as he grew absorbed in the woman’s condition.
It was an intriguing case. The bilateral weakness to both the upper and lower facial muscles was marked. When tested for pinprick sensation, the woman demonstrated significant impairment in the trigeminal distribution. Neck flexion was intact, as was neck extension. But he noticed that the sensation of temperature was greatly reduced across both the neck and upper trunk. There was also—surprisingly—noticeable, and apparently quite recent, wasting of the hand muscles. As he checked the deep tendon reflexes, then the plantar responses, a suspicion began to take root in his mind.
Every physician dreams of stumbling across a particularly rare or interesting case, the kind one reads about in the medical literature. It rarely happened. And yet, in all observations so far, Mary Philips was presenting with precisely such a condition. And Crane, who often stayed up late catching up on medical journals, thought perhaps—just perhaps—he had just identified such a case. Maybe there is a special reason I’m here, after all.
On a hunch, he examined her tonsils: markedly large, yellowish, and lobulated. Very interesting.
Thanking the woman for her patience, he stepped away, picked up the clipboard, and glanced at the blood work:
White-cell count (per mm)
3,100
Hematocrit (%)
34.6
Platelet count (per mm)
104,000
Glucose (mg/dl)
79
Triglycerides (mg/dl)
119
Erythrocyte sedimentation rate (mm/hr)
48.21
He withdrew to speak with Dr. Bishop. “What do you think?” he asked.
“I was hoping you could tell me,” she replied. “You’re the expert.”
“I’m no expert. Just a fellow doctor looking for a little cooperation.”
Bishop simply looked back at him. Crane felt the anger returning, stronger now: anger at all the inexplicable secrecy, anger at the meddling Commander Korolis, and particularly anger at the unhelpful, resentful Dr. Bishop. He’d take her down a peg, show her how much he did know.
He closed the clipboard sharply. “Did you think to do any antibody tests, Doctor?”
She nodded. “Viral hepatitis A and C, sulfatide IgM. All negative.”
“Motor-conduction studies?”
“Normal bilaterally.”
“Rheumatoid factor?”
“Positive. Eighty-eight units per milliliter.”
Crane paused. These were, in fact, the tests he would have performed next.
“There was no history of arthralgia, anorexia, or Raynaud’s phenomenon, for that matter,” she offered.
Crane looked at her in surprise. It wasn’t possible the same exotic conclusion had occurred to her as well. Was it?
He decided to call her bluff. “The incipient wasting of the hand muscles would seem to suggest syringomyelia. So would the loss of sensation in the upper trunk.”
“But there’s an absence of leg stiffiness,” she replied immediately, “and little to no medullary dysfunction. It i
sn’t syringomyelia.”
Crane was now even more surprised by the depth of her diagnostic technique. But it couldn’t hold.
Time to lay my cards on the table, he thought. “What about the sensory defects? The neuropathy? And did you notice the tonsils?”
Bishop was still staring at him, her face expressionless. “Yes, I did notice the tonsils. Enlarged and yellowish.”
There was a silence.
Gradually, a smile crept over her features. “Why, Doctor,” she said. “Surely you’re not suggesting Tangier disease?”
Crane froze. Then slowly—very slowly—he relaxed. He found that he couldn’t help smiling back. “As a matter of fact, I was,” he said a little ruefully.
“Tangier disease. So, what: now we’ve got a hundred rare genetic diseases floating about this station?” But her voice was mild, and there was no hint of reproof that Crane could detect. Even the smile, he decided, might be genuine.
At that moment a series of alarms sounded, loud and fast, cutting through the wash of classical music. An amber light snapped on in the hallway outside.
The smile left Bishop’s face. “Code orange,” she said.
“What?”
“Med-psych emergency. Let’s go.” She was already running toward the door.
10
Bishop stopped at the front desk just long enough to grab a radio. “Get Corbett!” she called to a nurse behind the desk. Then she ran out of the medical suite and down the corridor, Crane at her heels, heading toward Times Square.
As she ran, she punched a code into the radio, dialed through the bands. “This is Dr. Bishop, requesting location of code orange.”
There was a brief pause before the return squawk. “Code orange location: deck five, rover repair hangar.”
“Deck five, roger,” Bishop replied.
An elevator stood waiting beside the sidewalk café; they ducked inside and Bishop pressed the lowest button on the panel, 7.
She turned once again to the radio. “Request nature of emergency.”
Another squawk. “Incident code five-twenty-two.”
“What’s that stand for?” Crane asked.
She glanced at him. “Floridly psychotic.”
The doors opened again, and Crane followed her out into a brightly lit intersection. Corridors led away in three directions, and Bishop ran down the one directly before them.
“What about medical supplies?” Crane asked.
“There’s a temporary infirmary on deck four. We’ll get an MICU kit from it if necessary.”
Crane noticed this deck felt a lot more confining than the ones he’d previously seen. The corridors were narrower, the compartments more cramped. The people they passed wore either lab coats or jumpsuits. He recalled this was the science level and computer center. Despite the audible rush of ventilation, the air was heavy with the smell of lab bleach, ozone, and hot electronics.
They reached another intersection and Bishop jogged right. Glancing ahead, Crane saw something unexpected: the corridor widened dramatically and ended in a black wall. This wall was smooth and broken only by a single airlock set in its center. The airlock hatch was guarded by four MPs with rifles, and a fifth sat in a high-tech pillbox to one side. A large LED above the airlock glowed red.
“What’s that?” he asked, slowing instinctively.
“The Barrier,” Bishop replied.
“I’m sorry?”
“Portal to the classified levels.”
As they approached, two of the MPs took up positions directly before the airlock, rifles across their chests. “Clearance, ma’am?” one of them asked.
Bishop trotted over to the pillbox. The fifth MP stepped out and passed a bulky scanner over her forearm. There was a loud beep.
The MP glanced at a small LED screen set into the top of the scanner. “You’re not cleared.”
“I’m Michele Bishop, chief medical officer of the Facility. I have qualified emergency access to decks four, five, and six. Check again.”
The MP stepped into the pillbox and consulted a computer monitor. After a moment, he came out. “Very well. Go on through. A security escort will be waiting on the other side.”
Bishop stepped toward the airlock. Crane swung into place behind her, but the guards closed rank in front of him. The MP with the scanner came forward and ran it over Crane’s arm.
“This man isn’t cleared, either,” he said.
Bishop glanced back. “He’s a doctor, here on temporary assignment.”
The MP turned to face Crane. “You cannot proceed, sir.”
“I’m with Dr. Bishop,” Crane said.
“I’m sorry, sir,” the man said, his voice hardening. “You cannot proceed.”
“Look,” Crane said. “There’s a medical emergency, and—”
“Sir, please step back from the Barrier.” The pillbox MP exchanged quick glances with the others.
“I can’t do that. I’m a doctor, and I’m going to assist with the emergency, whether you like it or not.” And he stepped forward again.
Immediately, the men guarding the Barrier raised their rifles, while the MP with the scanner dropped a hand to his belt and drew out his sidearm.
“Stand down, Ferrara!” came a deep voice from within the darkness of the pillbox. “Wegman, Price, you others, at ease.”
As quickly as they had raised their weapons, the MPs lowered them again and stepped back. Glancing toward the pillbox, Crane saw that it was in fact a portal to a far larger chamber, apparently a control room for the Barrier. A dozen screens were set into its walls, and countless small lights blinked and glowed in the dimness. A shape within drew closer then emerged into the light: a heavyset, broad-shouldered man in a white admiral’s uniform. He had iron-gray hair and brown eyes. He glanced from Crane, to Bishop, then back to Crane.
“I am Admiral Spartan,” the man said.
“Admiral Spartan,” Crane said. “I’m—”
“I know who you are. You’re Howard Asher’s asset.”
Crane did not know quite how to respond to this, so he merely nodded.
Spartan looked at Bishop again. “The emergency’s on five, correct?”
“Yes, sir. The rover repair hangar.”
“Very well.” Spartan turned to the MP named Ferrara. “Clear him for this incident only. Make sure they’re accompanied by an armed escort at all times, and take a nonsensitive route to the site. See to it personally, Ferrara.”
The MP stiffened, gave a smart salute. “Aye, aye, sir.”
Spartan let his gaze rest another moment on Crane. Then he nodded to Ferrara, turned, and disappeared back into the control room.
Ferrara stepped into the pillbox and typed a series of commands on a console. There was a low buzz, then a series of tiny lights winked on around the perimeter of the airlock. The LED above the Barrier turned green. There was a clank of heavy locks disengaging, a hiss of pressurized air, and the airlock opened. Ferrara spoke into a mike built into his console, then motioned Bishop and Crane to step through, following behind.
Beyond the airlock was a chamber about twelve feet square. Two more MPs waited here, standing stiffly at attention. The beige walls were bare, and there was no instrumentation save for a small panel beside one of the guards. Crane noted that it consisted of simply a palm-geometry reader and a rubberized handle.
The airlock door closed. The MP placed one hand on the reader and the other on the handle. There was a red glow as his palm was scanned. Then he twisted the handle clockwise. Crane’s stomach gave a brief lurch as they started to descend. The chamber was, in fact, an elevator.
His thoughts went to Admiral Spartan. He had known several flag officers during his tours of duty, and they were all comfortable with command, used to being obeyed immediately and without question. But even on such short acquaintance Crane sensed something a little different in Spartan. He had a depth of self-possession unusual even in an admiral. Crane thought about that last look the man had given him. The
re was something unreadable in his dark eyes, as if you could never be sure just what his next move might be.
They glided smoothly to a stop. There was another low hum, another clank of locks springing free. The airlock was opened from outside by another group of armed MPs. “Dr. Bishop?” one asked. “Dr. Crane?”
“That’s us.”
“We’re here to escort you to the repair hangar. Follow me, please.”
They moved out quickly, two guards leading and two bringing up the rear. Ferrara, Admiral Spartan’s man, followed. Normally, Crane would be irritated by such an entourage, but now he almost welcomed it. Floridly psychotic, Bishop had said. That meant the person was grossly disorganized, delusional, perhaps even violent. In such instances you tried to be calm and reassuring, establish a rapport. But when a patient was truly out of control, the first priority—the very first—was to outnumber him.
Labs and research facilities passed in a blur: the so-called classified section of the Facility seemed, outwardly at least, little different from the upper decks. Several people ran past them in the opposite direction. And now, up ahead, Crane could hear something that made his blood run cold: the sound of a man screaming.
They ducked through a hatchway and Crane found himself in a large, almost cavernous room. He blinked a moment, unaccustomed already to so much space. It appeared to be a machine shop and repair facility for robot submersibles—the rovers Bishop had mentioned.
The screaming was louder here: ragged, ululating. Small groups of workers stood nearby, held back by military police. Farther ahead, a cordon of naval personnel and more MPs blocked the way. Several were talking on mobile radios; others were staring ahead at an equipment bay set into the far wall. It was from there the screaming came.