A droplet splattered her face. She swiped at the of moisture and was startled to see her finger was smeared with blood.
"Capcom, he"s pa.s.sed through Node One. Bleeding from his IV puncture site."
"Recommend you shut off airflow between modules."
"Roger that." She glided through the hatchway of the hab module.
The lights had been dimmed, and in the gloom, she saw Griggs and Luther, both sound asleep and zipped into their restraint bags.
No Kenichi.
Don"t panic, she thought as she shut off the intermodule airflow.
Think. Where would he go?
Back to his own sleep station, at the Russian end of ISS. Without waking Griggs or Luther, she left the hab and moved quickly into the tunnel of connecting nodes and modules, her gaze darting left and right in search of her fugitive patient. "Capcom, still haven"t located him. I"m through Zarya and heading for the RSM." She slipped into the Russian service module, where Kenichi normally slept. In the gloom she saw Diana and Nicolai both asleep, floating as though drowned, their arms drifting free of restraint bags. Kenichi"s station was empty.
Her anxiety turned to real fear.
She gave Nicolai a shake. He was slow to awaken, and even after he opened his eyes, it took him a moment to understand what she was telling him.
"I can"t find Kenichi," she repeated. "We need to search every module."
"Watson," said Capcom over her headset. "Engineering reports intermittent anomaly in Node One air lock. Please check status."
"What anomaly?"
"Off and on readings indicate the hatch between the equipment and crew locks may not be fully secure." Kenichi. He"s in the air lock.
With Nicolai right behind her, she shot like a flying bird through the station and dove into Node 1. At her first frantic glance the open hatch, into the equipment lock, Emma caught a startling glimpse of what looked like three bodies. Two were only the pair of EVA suits, the hard-sh.e.l.led torsos mounted on the air lock walls easy donning.
Hanging in midair, his body arched backward in a convulsive spasm, was Kenichi.
"Help me get him out of here!" said Emma. She maneuvered behind him and, bracing her feet against the outer hatch, shoved toward Nicolai, who pulled him out of the air lock. Together, propelled him toward the lab module, where the medical equipment had been set up.
"Capcom, we"ve located the patient," said Emma. "He appears to be seizinga"grand mal. I need Surgeon on the loop!"
"Stand by, Watson. Go ahead, Surgeon." Emma heard a startlingly familiar voice over her headset. "Hey, Em. Hear you"ve got yourself a problem up there."
"Jack? What are you doinga""
"How"s your patient?" Still in a state of shock, she focused her attention on Kenichi.
Even as she restarted the IV, attached EKG wires, she was wondering what Jack was doing in Mission Control. He had not sat at a flight surgeon"s console in a year, now here he was on the comm loop, his voice calm, even casual, as he asked about Kenichi"s status.
"Is he still seizing?"
"No. No, he"s making purposeful movements nowa"fightinga"
"Vital signs?"
"Pulse is rapida"one twenty, one thirty. He"s moving air."
"Good. So he"s breathing."
"We"re just getting the EKG hooked up now." She glanced at the monitor, at the cardiac rhythm racing across the screen.
"Sinus tach, rate of one twenty-four. Occasional PVCS."
"I see it on biotelemetry."
"Taking BP nowa" She whiffed up the cuff, listened to the brachial pulse as the pressure was slowly released. "Ninety-five over sixty. Not significantlya"" The blow caught her by surprise. She gave a sharp cry of pain as Kenichi"s hand flailed out, striking her across the mouth. The impact spun her away, and she flew across the module, colliding with the opposite wall.
"Emma?" said Jack. "Emma?" Dazed, she reached up to touch her throbbing lip.
"You"re bleeding!" said Nicolai.
Over her headset, Jack"s frantic voice demanded, "What the h.e.l.l is going on up there?"
"I"m okay," she murmured. And repeated, irritably, "I"m okay, Jack. Don"t have a cow." But her head was still buzzing from the blow. As Nicolai strapped Kenichi to the patient restraint board, she hung back, waiting for her dizziness to pa.s.s. At first she did not register Nicolai was saying.
Then she saw the look of disbelief in his eyes. "Look at his stomach," Nicolai whispered. "Look!" Emma moved closer. "What the h.e.l.l is that?" she whispered.
"Talk to me, Emma," said Jack. "Tell me what"s going on." She stared at Kenichi"s abdomen, where the skin seemed to ripple and boil. "There"s something movinga"under his skina""
"What do you mean, moving?"
"It looks like muscle fasciculations. But it"s migrating across the bellya"
"Not peristalsis?"
"No. No, it"s moving upwards. It"s not following the intestinal tract." She paused. The squirming had suddenly stopped, and she was staring at the smooth, unworried surface of Kenichi"s abdomen.
Fasciculations, she thought. The uncoordinated twitching of muscle fibers. It was the most likely explanation, except for one detail, Fasciculations do not migrate in waves.
Suddenly Kenichi"s eyes shot open, and he stared at Emma.
The cardiac alarm squealed. Emma turned to see the EKG whipsawing up and down on the screen.
"V tach!" said Jack.
"I see it, I see it!" She flipped on the defibrillator charge b.u.t.ton, then felt for a carotid pulse.
There it was. Faint, barely palpable.
His eyes had rolled up, and only the bloodred sclerae were visible. He was still breathing.
She slapped on defibrillator pads, positioned the paddles on the chest, and pressed the discharge b.u.t.tons. An electric charge of hundred joules shot through Kenichi"s body.
His muscles contracted in a violent and simultaneous spasm.
His legs thrashed against the board. Only the restraints kept him from flying across the module.
"Still in V tach!" said Emma.
Diana came flying into the module. "What can I do?" she asked.
"Get the lidocaine ready!" snapped Emma. "CDK drawer, right "Found it."
"He"s not breathing!" said Nicolai.
Emma grabbed the ambu-bag and said, "Nicolai, brace me!" He maneuvered into position, planting his feet on the opposite wall, his back pressed against Emma"s to hold her in place as she applied the oxygen mask. On earth, performing cardiopulmonary resuscitation is demanding enough, in microgravity, it is a nightmare of complex acrobatics, with drifting equipment, tubes and tangling in midair, syringes filled with precious drugs away. The simple act of pressing your hands against a patient"s can send you tumbling across the room. Although the crew had practiced this scenario, no rehearsal could reproduce the genuine chaos of bodies frantically maneuvering in a closed s.p.a.ce, racing against the clock of a dying heart.
With the mask over Kenichi"s mouth and nose, she squeezed the ambu-bag, forcing oxygen into his lungs. The EKG line continued to thrash across the screen.
"One amp lidocaine IV push now," said Diana.
"Nicolai, shock him again!" said Emma.
After the briefest hesitation, he reached for the paddles, placed them on the chest, and pressed the discharge b.u.t.tons. This time two hundred joules arced through Kenichi"s heart.
Emma glanced at the monitor. "He"s gone into V fib! Nicolai, start cardiac compressions. I"m going to intubate!" Nicolai released the defib paddles, and they floated off, dangling at the ends of the wires.
Bracing his feet against the wall of the module, he was about to place his palms on Kenichi"s sternum when he suddenly jerked his hands away.
Emma looked at him. "What is it?"
"His chest. Look at his chest!" They stared.
The skin on Kenichi"s chest was boiling, squirming. At the contact points where the defib paddles had delivered their electric jolts, two raised circles had formed and were now spreading, like ripples cast by a stone in water.
"Asystole!" came Jack"s voice over her headset.
Nicolai was still frozen, staring at Kenichi"s chest.
It was Emma who swung into position, bracing her back against Nicolai"s.
Asystole. The heart has stopped. He will die without cardiac compressions.
She felt nothing moving, nothing unusual. Just skin stretched over the bony landmarks of his breastbone. Muscle fasciculations, she thought. It had to be. There"s no other explanation. With body braced in position, she began chest compressions, her hands performing the work for Kenichi"s heart, pumping blood to his organs.
"Diana, one amp IV epinephrine!" she ordered.
Diana injected the drug into the IV line.
They all looked at the monitor, hoping for, praying for, a blip the screen.
"There has to be an autopsy," said Todd Cutler.
Gordon Obie, director of Flight Crew Operations, flashed him an irritated look. Some of the others in the conference room gave Cutler dismissive nods as well, because he had merely stated the obvious. Of course there would be an autopsy.
Over a dozen people had gathered together for this crisis meeting.
An autopsy was the least of their concerns. Right now, Obie was dealing with more urgent issues. Normally a man of few words, he"d suddenly found himself in the uncomfortable position of having reporters" microphones thrust at his face whenever he appeared in public. The excruciating process of a.s.signing blame had begun.
Obie had to accept a portion of responsibility for this tragedy, because he had approved the choice of every member of the flight crew. If the crew screwed up, in essence, he had screwed up. his choice of Emma Watson was starting to look like a major error.
That, at least, was the message he was hearing in this room. As the only physician aboard ISS, Emma Watson should have realized Hirai was dying.
An immediate CRV evac might have saved him.
Now a shuttle had been launched, and a multimillion-dollar rescue mission had turned into nothing more than a morgue run. Washington was hungry for scapegoats, and the foreign press was asking a politically incendiary question, Would an American astronaut have been allowed to die?
The PR fallout was, in fact, this meeting"s major topic of discussion.
Gretchen Liu said, "Senator Parish has gone on the record with a statement." JSC director Ken Blankenship groaned. "I"m afraid to ask."
"CNN-Atlanta faxed it over. And I quote, Millions of tax dollars went into the development of the emergency Crew Return Vehicle. Yet NASA chose not to use it. They had a critically ill up there whose life might have been saved. Now that courageous astronaut is dead, and it"s apparent to everyone that a terrible mistake was made. One death in s.p.a.ce is one death too many. A congressional inquiry is in order." Gretchen looked up with a expression. "Our favorite senator speaks."
"I wonder how many people remember that he tried to kill our Crew Return Vehicle program?" said Blankenship. "I"d love to rub that in his face right now."
"You can"t," said Leroy Cornell. As NASA administrator, it was second nature for Cornell to weigh all the political ramifications.
He was their link to Congress and the White House, and he never lost sight of how things would play out in Washington. "You launch a direct attack on the senator, and things will really hit the fan."
"He"s attacking us."
"That"s nothing new, and everyone knows it."
"The public doesn"t," said Gretchen. "He"s making headlines with these attacks."
"That"s the whole pointa"the senator wants headlines," said Cornell. "We fire back, it"ll feed the media beast. Look, he"s never been our friend. He"s fought every budget increase we"ve ever asked for. He wants to buy gunships, not s.p.a.ceships, and we"ll never change his mind." Cornell took a deep breath and looked around the room.
"So we might as well take a good hard look at his criticism. And ask ourselves if it isn"t justified." The room went momentarily silent.
"Obviously, mistakes were made," said Blankenship. "Errors in medical judgment. Why didn"t we know how sick the man was?" Obie saw an uneasy glance fly between the two flight surgeons.
Every one was now focused on the performance of the medical team. And on Emma Watson.
She wasn"t here to defend herself, Obie would have to speak up for her.
Todd Cutler beat him to it. "Watson"s at a disadvantage up there. Any doctor would be," he said. "No X ray, no OR. The point is, none of us know why Hirai died. That"s why we need the autopsy. We have to know what went wrong. And whether microgravity was a contributing factor."
"There"s no question about an autopsy," said Blankenship.
"Every one"s agreed on that point."
"No, the reason I mention it is because of thea" Cutler dropped his voice, "preservation problem." There was a pause. Obie saw gazes drop in uneasy contemplation of what that meant.