Read an Excerpt
Chapter One
Face white and blistering, eyelids swollen nearly
shut, hair falling from the front of her scalp in thin clusters, the
nurse stumbled blindly through the UCLA Medical Center Emergency
Room doors, both hands waving in front of her. Her cries came from
deep in her chest, rapid animal sounds that twisted into raspy moans
by the time they left her mouth. A half-moon darkened the V of her
scrub-top collar, and the skin along her clavicle had whitened and
softened.
She tried to say something, but it came out a guttural
bark.
A Hispanic gardener leapt up from his seat before the
lobby's check-in windows, cradling the bloody bandage wrapping his
hand and knocking over his chair. He circled wide as the nurse
advanced, as if afraid of attack or contamination. A mother holding
her five-year-old stepped through a set of swinging doors, shrieked,
and beelined to the safety of the waiting room. The guard at the
security desk rose to a half crouch above his chair.
A blister burst near the woman's temple, sending a run
of viscous fluid over the mottled landscape of her cheek. Open sores
spotted her lips, and when she spread her mouth to scream, her
Cupid's bow split, spilling blood down her chin. She groped her way
along the wall, her shoulders racking with sobs, her mouth working
on air.
An expression of horror frozen on her face, Pat Atkins
circled her desk in the small triage room, knocking over her first
cup of morning coffee, and ran into the lobby toward the woman.
The woman retched, sending a thin spray of grayish
vomit across the vivid white wall. She lunged forward, her shin
striking the overturned chair, and tumbled over, breaking her fall
with the heels of her hands.
Pat sprinted over, shouting at the security guard,
"Tell them to get Trauma Twelve ready!"
She reached for a pulse as the nurse rolled onto her
back, sputtering and gurgling, leaving a hank of hair on the clean
tile floor. When Pat saw the nurse's ID badge, she inhaled sharply,
running a hand over her bristling gray hair.
"Jesus God," she said. "Nancy, is that you?"
The swollen head nodded, the whitish raw skin
glistening. "Dr. Spier," she rasped. "Get Dr. Spier."
Nearly knocking over a radiology resident with an
armful of charts, David Spier sprinted into the Central Work Area
bridging the two parallel hallways of exam rooms that composed his
division. He pointed at an intern and snapped his fingers. "Carson's
supposed to stitch up a leg in Seven. Go keep an eye so he doesn't
duck out -- you know how he is with sutures. And I need a urine on
Mitchell in Eight."
He stepped across the CWA, patting his best resident
on the shoulder. "Diane -- let's move."
Diane handed off the phone to a nurse and pivoted, her
shoulder-length straight blond hair whipping around so the nurse had
to lean back out of its way. Grabbing the pen from behind her ear,
Diane slid it into the pocket on her faded blue resident scrubs.
David rested a hand on her shoulder blade, guiding her into Hallway
One. They both shuffle-stepped back as the gurney swept past them
and banked a hard left into the trauma room. They followed behind,
David resting his hands on the back of the gurney. The nurses folded
in on the patient's writhing body, a wave of dark blue scrubs. Pat
leaned over, slid a pair of trauma shears up the moist scrub top,
threw the material to the sides.
"What do we have?" David asked.
A nurse with shiny black hair glanced up. "Caucasian
female, probably midtwenties, some vomiting, erythematous blisters
on face and upper chest, eyes are opaque, moderate respiratory
distress. Appears to be some kind of chemical burn." She reached
down and untwisted the ID badge from the mound of fabric. Her face
blanched. "It's Nancy Jenkins."
The news rippled visibly through the nurses and lab
techs. Though they were accustomed to operating under duress, having
a colleague and friend wheeled into the ER in this state was beyond
even their experience.
David glanced at Nancy's blistering face, her pretty
blond hair lying inloose strands on the gurney, and felt a chill
wash down his chest to his gut. He recalled when they had wheeled
his wife in here two years ago, the night of his forty-first
birthday, but he caught himself quickly, checking his thoughts.
Instinctively, his physician's calm spread through him, protective
and impersonal.
He quick-stepped around the gurney so he could examine
Nancy's face. Her eyelids and lips were badly burnt. If the caustic
agent dripping from her had gotten into her eyes and down her
throat, they were dealing with a whole new host of problems.
"Get me GI and ophtho consults," he said. "And someone
contact the tox center. Let's get the offending agent ID'd."
Pat glanced up from her post behind Nancy's head.
"Some nasal flaring here, and she's stridorous." She chewed her lip.
"Hurry with that monitor."
"Find me some pH strips," Diane called out. "And let's
get saline bottles in here stat."
A clerk ran from the room. Two nurses dashed in,
pulling on latex gloves and snapping them at the wrists.
"Was it an explosion?" someone asked.
"Doubt it," Pat said. "Nancy walked in herself -- it
must've happened right outside. Security's already contacted the
police."
"She's working hard," David said, glancing at the skin
sucking tight against her ribs and around her neck. "Supraclavicular
and substernal retractions. Let's get ready to tube her."
Nancy tried to sit up, but Pat restrained her. Nancy's
breath came in great heaves. "Dr. Spier," she said. Her voice was
thick and rough, tangling in the swell of her throat.
David leaned over Nancy's face. The...
