Chapter 9 - THE BLUE MEDICINE
The gas pouring through Blackwood's vents smelled faintly sweet.
Nathan recognized the odor from anesthetic induction rooms.
"Halothane," he said.
"Old, flammable, and fast in an enclosed space."
Cross pulled Sarah across the floor while Caleb searched the wall for a shutoff valve.
Nathan covered Sarah's mouth with his sleeve and forced himself to take shallow breaths.
The hallway tilted.
Red lights stretched into long lines.
Conrad's voice continued over the intercom.
"The facility was designed to calm difficult patients."
"Your sister was always difficult."
Nathan fired the shotgun into the nearest ceiling vent.
The metal grille collapsed, but more gas rushed through the opening.
Caleb found a cabinet marked RESPIRATORY EMERGENCY.
Inside were four rubber masks connected to expired oxygen canisters.
"These could be empty."
"Use them," Nathan said.
He fitted one over Sarah's face and opened the valve.
The pressure needle moved.
Cross took another.
Caleb used the third.
Nathan left the final mask hanging from his neck and continued breathing through fabric.
"Why are you not wearing it?"
Cross asked.
"Sarah needs the strongest flow."
"That answer is heroic and stupid."
"Move."
The hydrotherapy corridor ended at a locked fire door.
Caleb entered the access code from Martin Shaw's badge.
The panel flashed red.
Victor had revoked it.
Cross shot the lock twice.
The door opened into a laundry loading bay where snow blew through a raised metal shutter.
A black ambulance waited outside with its rear doors open.
No driver sat behind the wheel.
"Too convenient," Cross said.
Nathan checked the fuel gauge and the cab.
The keys were in the ignition.
A small camera had been fixed above the dashboard.
A note lay on the driver's seat.
THE HOSPITAL IS THIRTY-TWO MINUTES AWAY.
THE CHILD HAS TWELVE.
Nathan crumpled the paper.
"We take it."
Cross searched beneath the chassis for explosives.
Caleb opened the engine compartment.
"No obvious device."
"That is comforting," Cross said.
They loaded Sarah onto the stretcher.
Nathan connected her to the ambulance oxygen and checked her pupils.
The left reacted slowly.
Her pulse was irregular.
"Possible intracranial bleeding," he said.
Sarah opened her eyes.
"Ethan."
"We are going to him."
"Blue vial."
"What is inside it?"
"Not Cardiovex."
She coughed.
"Conrad uses aconitine."
Nathan knew the poison.
It came from monkshood and disrupted the electrical channels of the heart.
A small dose could cause lethal arrhythmias that resembled catastrophic cardiac disease.
"How do you know?"
"The babies in 2018."
Sarah's eyes filled with a memory more painful than the injuries on her face.
"They were not dying from the trial drug."
"The official report found unexpected toxicity."
"Conrad poisoned them after the trial failed to produce enough adverse events."
Nathan stared at her.
"Why would he need deaths?"
"Victor shorted the manufacturer through offshore funds."
"The foundation lost millions when the trial collapsed."
"Victor made thirty-eight million."
Sarah gripped his wrist.
"I found the transfers."
"Why did my father send you to Blackwood?"
"He did not know the deaths were murder."
Her voice weakened.
"He thought I had stolen files and taken drugs."
"Did he sign the commitment order?"
A tear moved into Sarah's hair.
"The first seventy-two hours."
Nathan looked away.
Even partial innocence would not return the years their father had taken.
"After that?"
"He came for me."
"Why did he leave without you?"
"Victor showed him a video of you."
"What video?"
"You saying I was dangerous."
Nathan remembered no such recording.
"It was edited," Sarah whispered.
"But Dad believed it long enough for Conrad to move me."
Cross started the ambulance.
The tires found the maintenance road.
Blackwood disappeared behind them as flames rose from one of its abandoned wings.
Victor was burning the building before investigators arrived.
Nathan used the ambulance radio to call Pierce Memorial.
Only static answered.
He tried the neonatal unit's direct number.
A nurse picked up and immediately began crying.
"This is Dr. Nathan Pierce."
"Doctor, the unit is locked down."
"Where is Dr. Cole?"
"Operating Room Six."
"Where is Ethan Carter?"
"With her."
"Has anyone administered medication from a blue vial?"
The nurse hesitated.
"Dr. Vale ordered it."
"Conrad Vale has no hospital privileges."
"He had a credentialing badge."
"Listen to me carefully."
Nathan leaned toward the radio.
"The vial may contain aconitine."
"Oh God."
"Did it enter the infant's line?"
"I do not know."
"Get to Miriam and tell her."
A man's voice spoke in the background.
The connection ended.
Nathan tried again.
No one answered.
At Pierce Memorial, Miriam pushed Lily's wheelchair into Operating Room Six and locked the manual bolts.
Owen lay inside a mobile incubator beside them.
Rosa had regained consciousness but could barely speak after Conrad's hand closed around her throat.
A respiratory therapist manually ventilated Ethan because the network shutdown had reset the machine.
Miriam held the blue vial beneath the surgical light.
The label looked authentic.
The lot number did not.
Cardiovex-B had used eight-digit lot codes.
This vial had nine.
"Do not connect it," she said.
The nurse beside Ethan looked terrified.
"Dr. Vale said it was the only medication that could stabilize him."
"Dr. Vale is not a physician in this hospital."
A heavy impact struck the operating room door.
Conrad spoke from the corridor.
"Miriam, you are delaying treatment."
"Go to hell."
"You signed the original Cardiovex protocol."
"So did Nathan."
"And three infants died."
"We stopped the trial because they died."
"You stopped it because Sarah began asking questions."
Miriam looked at the vial again.
A tiny puncture marked the rubber seal.
Someone had already drawn medication from it.
She turned toward Ethan's intravenous line.
The nurse followed her gaze.
"I flushed the line after Dr. Vale connected the syringe."
"How much did he give?"
"Maybe half a milliliter."
Ethan's monitor alarmed.
His heart rate jumped from one hundred twenty to two hundred eight.
Then it fell to forty.
The rhythm became wide and chaotic.
Miriam's blood went cold.
"Start compressions."
The respiratory therapist began chest compressions with two fingers.
Miriam ordered amiodarone, magnesium, and activated charcoal through the gastric tube.
The door shook again.
The top hinge bent.
Lily covered her ears.
"He always gets in."
Rosa crawled toward the instrument table and took a scalpel.
"Not this time."
Miriam looked at her.
"You can barely stand."
"Then I will fight sitting down."
The monitor showed ventricular tachycardia.
Miriam charged the smallest defibrillator paddles.
"Clear."
Ethan's body jerked.
The rhythm continued.
She shocked him again.
The door opened two inches.
Conrad's silver ring appeared through the gap.
Rosa drove the scalpel into the back of his hand.
He shouted and pulled away.
Lily stared at Rosa with enormous eyes.
"He can bleed."
Rosa gripped the scalpel.
"All monsters can."
The ambulance reached the lower highway with twenty minutes remaining to the hospital.
A county patrol car appeared behind them.
Cross checked the mirror.
"No lights."
The patrol car accelerated.
Its front bumper struck the ambulance once.
Sarah rolled against the restraints.
Nathan protected her head with both hands.
"Can you lose them?"
"This is an ambulance on ice."
"That was not my question."
Cross glanced at him.
"You are becoming annoying."
The patrol car struck again.
Caleb opened the rear equipment cabinet and found road flares.
He lit one and threw it through the partially opened rear door.
The burning flare landed beneath the pursuing car.
The driver swerved.
Cross turned onto an unplowed forestry road.
The ambulance fishtailed between trees.
The patrol car followed.
Nathan found a portable suction canister and a length of tubing.
"What are you doing?"
Caleb asked.
"Improvising."
Nathan filled the tube with saline, opened the rear door, and released it across the road.
The line caught around the patrol car's grille and dragged the metal canister beneath its front wheel.
The car bounced, struck a snowbank, and rolled onto its side.
Cross looked in the mirror.
"Remind me never to underestimate medical supplies."
They reached Pierce Memorial at 8:17 a.m.
Police vehicles surrounded the emergency entrance.
Half belonged to the county.
The others carried private security markings from Hale Strategic Services.
Cross stopped beneath the ambulance bay.
"Stay inside until I identify who is legitimate."
Nathan opened the rear door anyway.
A hospital guard recognized him.
"Dr. Pierce, they are looking for you."
"Where is Ethan?"
"Operating Room Six."
"And Miriam?"
"Inside."
"Who has control of security?"
The guard looked toward the private officers.
"Victor Hale arrived with a court order."
Nathan pushed the stretcher toward the entrance.
Two Hale officers moved to stop him.
Cross displayed his badge and ordered them back.
One officer reached for Sarah.
Caleb broke the man's wrist before Cross could intervene.
The second officer drew his weapon.
Cross aimed first.
"Do not turn a hospital entrance into a shooting range."
The officer lowered his gun.
They moved Sarah through emergency triage.
Nathan ran toward surgery while Cross stayed with her.
He reached Operating Room Six as the door finally tore free from its upper hinge.
Conrad entered with blood running from his hand.
Rosa sat on the floor between him and Lily.
Miriam was performing compressions on Ethan.
Nathan hit Conrad from the side.
They crashed into the instrument cart.
Conrad swung the broken door hinge like a blade.
Nathan caught his wrist.
For a moment, they were face to face.
Conrad smelled of antiseptic and expensive cologne.
"Your sister screamed your name for eleven months," he said.
Nathan drove his forehead into Conrad's nose.
Bone cracked.
Conrad staggered backward.
Caleb entered and tackled him through the damaged doorway.
Cross's arriving deputies secured both men before Nathan could follow.
Nathan turned to Ethan.
The monitor showed another unstable rhythm.
Miriam looked up.
"Aconitine."
"How much?"
"Unknown."
"Temperature?"
"Thirty-three point one."
"We need bypass support."
"The perfusion team is trapped below the lockdown doors."
Nathan looked at the operating room equipment.
"We have a pediatric circuit in OR Three."
"You are not credentialed for neonatal bypass anymore."
"Then fire me after he lives."
They moved Ethan onto the surgical table.
Nathan opened the tiny chest through a controlled incision while Miriam managed the rhythm and ventilation.
Each heartbeat looked fragile enough to stop beneath the weight of light.
He placed the cannulas with hands that had performed thousands of larger operations.
The machine began supporting Ethan's circulation.
The rhythm slowly organized.
Forty became sixty.
Sixty became ninety.
Miriam watched the monitor.
"He is responding."
Nathan did not allow relief yet.
"We warm him slowly."
"Nathan."
"Not yet."
"Nathan, look at me."
He did.
Miriam's eyes were wet.
"You saved him."
A camera in the corner of the operating room rotated toward Nathan.
Its red recording light came on.
The doors opened.
Victor Hale stood outside with Judge Malcolm Voss, two state investigators, and a line of officers.
Victor's expression was solemn.
"Dr. Pierce," one investigator said.
"Step away from the patient."
Nathan did not move.
"The child is on bypass."
"Dr. Cole will continue."
The investigator held up an arrest warrant.
"Nathan Pierce, you are under arrest for falsifying the 2018 Cardiovex-B trial, causing the deaths of three infants, and attempting to murder a surviving witness this morning."
Nathan looked at Conrad in the corridor.
He was no longer in handcuffs.
Caleb was.
Victor had reversed the room in less than five minutes.
The investigator approached.
"Put your hands where I can see them."
Sarah appeared at the far end of the corridor on a stretcher.
She lifted her head and saw the warrant.
"No."
Victor leaned over her with the tenderness of an old family friend.
"Sarah, this is what Nathan has always done."
"He saves people in public."
Victor's voice dropped low enough for only her to hear.
"Then he signs their deaths in private."
Sarah stared past him at Nathan.
For one terrible second, doubt crossed her face.
The clock above the operating room changed to 8:29 a.m.
Thirty-one minutes remained before the trust transfer.
Victor smiled.
May you like
"At nine o'clock, none of you will belong to this family anymore."
THE BRACELET IN THE BLIZZARD
