Chapter 5 - Outlaws in the Operating Theater
Marcus didn't slow his stride. He hit the double doors of Room 412 with his shoulder, blowing them off their magnetic latches with a violent boom.
Inside, the code team froze. Sterling stood over Toby, the defibrillator paddles still smoking in his rubber-gloved hands. The monitor was an unbroken, screaming flatline: zero beats per minute. Toby had been clinically dead for three minutes and forty-two seconds.
"Vance!" Sterling shouted, retreating half a step toward the wall. "You're insane! He's gone! He’s in asystole! You touch this body and you’re an accessory to desecration!"
"Get the hell out of my way, Arthur," Marcus growled.
Silas stepped into the room behind him. The massive biker didn't draw a weapon; he simply grabbed the two male security guards by the collars of their uniforms and hurled them through the door into the corridor like bags of dirty laundry. Bear planted his six-foot-four, three-hundred-pound frame in the doorway, crossing his arms and glaring at the remaining nurses.
"Any of you move toward that panic button," Bear rumbled, "and I’ll feed that plastic badge to you dry."
The code team backed against the far wall, hands raised, terrified.
Marcus didn't waste a millisecond. He unclipped the cryogenic canister from his chest harness, slamming it onto the rolling surgical tray. He spun toward Toby’s bed, his trained eyes scanning the flatlined cardiac monitor, the boy’s blown pupils, and the gray, mottled skin of his chest.
"He's not gone," Marcus hissed between clenched teeth. "He’s in deep tamponade. The pericardial sac is flooded with fluid from the ruptured tumor capsule. Compressions aren't working because the heart doesn't have room to expand!"
Marcus reached into his pocket and pulled out a sterile, sixteen-gauge pericardiocentesis needle—six inches of gleaming stainless steel.
"You can't do a blind subxiphoid tap without an ultrasound!" Sterling shrieked. "You'll pierce the right ventricle! You'll slaughter him!"
"I don't need a machine to find his heart," Marcus snarled. "I know where it is."
Marcus ripped Toby's hospital gown open. Without waiting to swab the skin with iodine, he located the xiphoid process at the bottom of the boy's sternum with his left thumb. He angled the massive needle forty-five degrees toward Toby’s left shoulder.
"Hold his legs, Sarah!" Marcus barked.
Sarah lunged forward, throwing her weight across Toby’s cold, lifeless shins, burying her face against his knees, praying in frantic, broken tongues.
Marcus shoved the needle in.
The steel sank through skin, muscle, and fibrous tissue. Sarah felt a horrific, popping resistance vibrate through the bed frame. Marcus drew back on the plunger of the twenty-cc syringe.
Instantly, the clear plastic barrel filled with dark, pressurized, venous-purple blood mixed with necrotic fluid.
Marcus didn't stop. He disconnected the syringe, letting the blood squirt freely onto the linoleum, reattached it, and drew back another full barrel. Once. Twice. Three times. Nearly sixty milliliters of fluid drained from around Toby’s suffocating heart.
"Now," Marcus roared, dropping the bloody needle and grabbing the defibrillator paddles right out of Sterling’s paralyzed hands. "Charge to seventy! Clear!"
Marcus slammed the hard plastic plates against Toby’s ribs.
*THUMP.*
Toby’s body arched violently.
The monitor gave a pathetic, jagged blip. Then another.
*Beep.*
A pause that felt like an eternity.
*Beep... Beep... Beep.*
The flatline snapped into a fragile, rhythmic sinus rhythm. Thirty beats a minute. Then forty. Fifty. Sixty.
"Sinus bradycardia," the respiratory therapist whispered from the corner, her hand trembling over her mouth. "He's... he's got a pulse. We have return of spontaneous circulation."
Sarah let out a broken, animalistic sob, collapsing against the mattress, kissing Toby’s limp, pale fingers over and over again. "He's back... he's back..."
"He’s back for ten minutes unless we change the battlefield," Marcus said, his forehead dripping with sweat. He spun toward the cryogenic container on the rolling tray.
He cracked the primary seal.
A hiss of pressurized liquid nitrogen vapor erupted from the canister, cascading like an icy white waterfall over the edges of the tray, freezing the blood drops on the floor into frosted pink crystals. With gloved hands, Marcus reached into the sub-zero mist and pulled out a single, thick glass vial encased in a protective titanium lattice.
Inside the vial was fifty milliliters of a luminescent, pale-gold liquid: *Borealis-7.*
"You're really doing it," Sterling whispered, his voice trembling with a mixture of terror and awe. "You brought the living cellular vector into an unmonitored room... without an ethics review... without FDA sign-off..."
"I didn't bring it here to talk about it, Arthur," Marcus said. He pulled a specialized central-line infusion set from his combat pack, spiking the vial with clinical perfection. "I'm infusing the modified T-cells directly into his central venous line. They will target the neuroblastoma surface receptors and begin the cellular lytic cycle within two hours."
"And the cytokine storm?" Sterling challenged, his voice rising. "When his immune system goes nuclear? When his temperature hits a hundred and seven and his lungs flood with inflammatory exudate? Who’s going to manage his pediatric intensive care when the entire board has you arrested?"
"We are," a voice boomed from the doorway.
Sarah and Sterling turned.
Standing beside Bear in the doorway was Dr. Eleanor Hayes. The elderly chief of surgery was wearing sterile blue scrubs, a surgical cap tied around her silver hair, and a pair of sterile trauma shears clutched in her hand.
"Eleanor?" Sterling gasped, dumbfounded. "What are you doing? Have you lost your mind?"
"No, Arthur," Eleanor said calmly, stepping into the room and kicking the door shut behind her. "I remembered why I took the Hippocratic Oath forty years ago. Something you clearly forgot when you started looking at our quarterly dividend returns."
She walked straight to Toby’s bedside, picked up the stethoscope hanging around her neck, and pressed the cold diaphragm to the boy’s chest.
"His breath sounds are diminished bilaterally, but he’s moving air," Eleanor declared with crisp, surgical authority. "Marcus, spike the central line. Let’s get the vector running. Arthur... if you make one more move toward that telephone, I will personally testify before the grand jury that you attempted to administer a lethal dose of morphine to a viable pediatric patient."
Sterling’s mouth opened and closed like a dying fish. He looked at Eleanor, then at the massive, scarred frame of Silas, and finally at Marcus Vance, whose eyes held no mercy whatsoever.
Without a word, Sterling turned on his heel and walked out of the room, leaving the door swinging behind him.
"You've got ninety minutes before the board gets a judge to sign an emergency injunction to seize this floor," Eleanor warned Marcus, her face tight with worry. "We can administer the prime dose. But once the cytokine storm hits... he’s going to need continuous blood purification. Hemoperfusion. And our machines are monitored on the central server."
Marcus connected the line to Toby’s chest port. The golden fluid began to creep down the clear plastic tubing, drop by drop, moving steadily toward the boy's failing heart.
"Then we don't stay here," Marcus said.
"Where could you possibly take a critically ill child in the middle of an experimental cellular storm?" Sarah cried.
Marcus looked up, catching Silas’s eye.
May you like
"To the compound," Silas said. "We got the backup generators. We got the cleanroom we used when Bear’s brother took shrapnel. And we got fifty brothers on the perimeter who won't let a judge, a cop, or the devil himself past the gate."
***
