Jack Ryan 9 - Executive Orders (49 page)

S
HE WOULDN
'
T LIVE
through the night, Moudi decided. Her eyes were open now. What they saw was anyone's guess. Finally, mercifully, she was beyond pain. That happened. He'd seen it before, with cancer patients, mostly, and it was always the harbinger of death. His knowledge of neurology was insufficient to understand the reason for it. Maybe the electro-chemical pathways got overloaded, or maybe there was some editing function in the brain. The body knew what was happening, that the time for battle had ended, and since the nervous system reported pain mainly as a warning system, when the time for warning was past, so was the time for pain. Or maybe it was all his imagination. Possibly her body was simply too damaged to react to anything. Certainly the intra-ocular bleeding had her blind. The last blood line had fallen out, so damaged were her veins now, and she was bleeding from that point in addition to so many others. Only the morphine drip remained, held in place with tape. The heart was being starved of blood, and trying ever harder to pump what diminished supply it had left, it was exhausting itself.

Jean Baptiste still made noises—difficult to hear through the Racal suit—the occasional whimper, and the timing of them made the physician wonder if they might be prayers. They probably were, he decided. Robbed of sanity along with her life, the one thing that remained in her would be the endless hours of prayer, the discipline which had ruled her life, and she'd return to that in her madness because her mind had nowhere else to go. The patient cleared her throat, choking, really, but then murmuring more clearly, and Moudi leaned his head down to listen.

“. . . —ther of God, pray for us sinners . . .”

Oh, that one.
Yes, it would have to be her favorite prayer.

“Fight no more, lady,” Moudi told her. “It is your time. Fight no more.”

The eyes changed. Even though she could not see, the head turned and she stared at him. It was a mechanical reflex, the physician knew. Blind or not, years of practice told the muscles what to do. The face instinctively turned to a source of noise, and the eyes—the muscles still worked—focused in the direction of interest.

“Dr. Moudi? Are you there?” The words came slowly, and not all that clearly, but understandable even so.

“Yes, Sister. I am here.” He touched her hand automatically, then was dumbfounded. She was still lucid?

“Thank you for . . . helping me. I will pray for you.”

She would.
He knew that. He patted her hand again, and with the other increased the morphine drip. Enough was enough. They could put no more blood into her to be polluted with the virus strands. He looked around the room. Both army medics were sitting in the corner, quite content to let the doctor stand with the patient. He walked over to them and pointed to one.

“Tell the director—soon.”

“At once.” The man was very pleased to leave the room. Moudi counted to ten before speaking to the other.

“Fresh gloves, please.” He held up his hands to show that he didn't like touching her either. That medic left, too. Moudi figured he had a minute or so.

The medication tray in the corner had what he needed. He took a 20cc needle from its holder and stuck it into the vial of morphine, pulling in enough to fill the plastic cylinder completely. Then he returned to the bedside, pulled the plastic sheet back and looked for . . . there. The back of her left hand. He took it in his and slid the needle in, immediately pushing down the plunger.

“To help you sleep,” he told her, moving back across the room. He didn't look to see if she responded to his words or not. The needle went into the red-plastic sharps container, and by the time the medic came back with new gloves, everything was as before.

“Here.”

Moudi nodded and stripped the overgloves off into their disposal container, replacing them with a new set. Back at the bedside, he watched the blue eyes close for the last time. The EKG display showed her heart rate at just over one-forty, the spiky lines shorter than they should have been, and irregularly spaced. Just a matter of time now. She was probably praying in her sleep, he thought, dreaming prayers. Well, at least he could be sure now that she was in no pain. The morphine would be well into her diminishing blood supply now, the chemical molecules finding their way to the brain, fitting into the receptors, and there releasing dopamine, which would tell the nervous system . . . yes.

Her chest rose and fell with the labored respiration. There was a pause, almost like a hiccup, and the breathing restarted, but irregularly now, and the flow of oxygen to the bloodstream was now diminishing. The heart rate changed, becoming yet more rapid. Then respiration ceased. The heart still didn't stop at once, so strong it was, so valiant, the doctor thought sadly, admiring this undying part of a person already dead, but that couldn't last long, and with a few final traces on the screen, it, too, ceased to function. The EKG machine began making a steady alarm tone. Moudi reached up and shut it off. He turned to see the medics sharing a look of relief.

“So soon?” the director asked, coming into the room and seeing the flat, silent line on the EKG readout.

“The heart. Internal bleeding.” Moudi didn't have to say anything else.

“I see. We are ready, then?”

“Correct, Doctor.”

The director motioned to the medics, who had one last job to do. One of them bundled up the plastic sheeting to contain drips. The other disconnected the last IV and the electronic EKG leads. This was done expeditiously, and when the former patient was wrapped like a piece of slaughtered meat, the locks on the wheels were kicked loose, and the two soldiers wheeled her out the door. They would return to clean the room so thoroughly as to make sure that nothing could live on the walls, floor, or ceiling.

Moudi and the director followed them to “Post,” a room in the same confined area behind the double doors. Here was an autopsy table made of smooth, cold stainless steel. They wheeled the treatment bed beside it, uncovering the body and rolling it to a facedown position on the steel, while the doctors observed from the corner, each donning surgical gowns over his protective suit—more from habit than necessity; some habits are just that. Next the plastic sheets were lifted, held by the edges to form a U shape that allowed the accumulated blood to be poured into a container. About half a liter, the doctors estimated. The sheets were carefully carried to a large bin. The medics stuffed them in and left the room, wheeling the bin with them, off to the incinerator. Nervous as they were, it didn't appear that they'd spilled a drop anywhere.

“Very well.” The director pressed a button and the table elevated from the far end. Out of long-standing professionalism, he touched his fingertips to the left carotid artery to make sure there was no pulse, then to the right, where again there was none. When the body was at a twenty-degree angle, he took a large scalpel and cut both arteries, along with the parallel jugular veins. Blood poured out onto the table, pulled by gravity out of the body, channeled into grooves leading in turn to a drain, and over the next several minutes four liters of blood were captured in a plastic container. The body went pale so quickly, Moudi saw. Moments earlier, the skin had been mottled red and purple. It seemed to fade before his eyes, or perhaps it was just imagination. A laboratory technician came to collect the blood container, which he placed on a small wheeled cart. Nobody wanted to carry something like that, even for a short distance.

“I've never posted an Ebola victim,” the director observed. Not that this was a proper postmortem examination. For all the care the director had just shown for the patient's departed humanity, bleeding her out like that, he might have slaughtered a lamb.

They still had to be careful, however. In cases like this, only one pair of hands worked within the surgical field, and Moudi let the director do that, as he made rough, wide incisions. Stainless-steel retractors pulled back the flaps of skin and muscle. Moudi handled those, his eyes locked on the scalpel in the director's gloved hands. In another minute, the left kidney was fully exposed. They waited for the medical corpsmen to return. One of them set a tray on the table next to the cadaver. Moudi was revolted by what he saw next. One effect of the Ebola virus and its disease process was to break down tissue. The exposed kidney was half liquefied, and when the director reached in to remove it, the organ actually broke—pulled itself apart into two pieces like a horrid red-brown pudding. The director clucked at himself with annoyance. He'd known what to expect, but forgotten even so.

“Remarkable what happens to the organs, isn't it?”

“Expect the same from the liver, but the spleen—”

“Yes, I know. The spleen will be like a brick. Watch your hands, Moudi,” the director warned. He lifted a fresh retractor—the instrument was shaped rather like a scoop—to remove the remaining kidney fragment. This went onto the tray. He nodded, and the medic took it off to the lab. The right kidney went more smoothly. At the director's insistence, after all the muscle and blood vessels were disconnected, both doctors used their hands to remove it, and this one stayed reasonably intact—until it landed on the tray. There the organ deformed and split open. The only good thing about it was that the softness of the tissue would not compromise the integrity of their doubled gloves. That fact didn't prevent both doctors from cringing.

“Here!” The director flicked his hand for the orderlies to approach. “Turn it over.”

The medics did so, one grasping the shoulders, and the other the knees, flipping the body over as briskly as they could. That caused blood and some tissue to spatter on their cloth gowns. The orderlies pulled back, keeping as far away as possible.

“I want the liver and spleen, that's all,” the director told Moudi, looking up. He turned to the orderlies. “Then you will wrap the body and remove it to the incinerator. This room will then be disinfected thoroughly.”

Sister Jean Baptiste's eyes were open, as sightless now as they had been thirty minutes earlier. The doctor took a cloth and covered the face, murmuring a prayer for her soul which the director heard.

“Yes, Moudi, she is doubtless in
Paradise
. Now, shall we continue?” he asked brusquely. He made the usual Y-shaped incision to open the thorax, deep and crude as before, peeling back the layers quickly, more like a meat-cutter than a physician. What they saw there even shocked the director. “How did she live so long like this . . . ?” the man breathed.

Moudi thought back to his medical-school days, remembering a life-sized plastic model of the human body in his first anatomy class. It was as though someone had taken the model and poured in .a bucket of powerful solvent. Every exposed organ was misshapen. The surface tissue layer on most of them was. . . dissolved. The abdomen was a sea of black blood. All they'd put in, Moudi thought . . . not even half of it had leaked out. Amazing.

“Suction!” the director commanded. An orderly appeared at his side with a plastic tube leading to a vacuum bottle, and the sound of it was obscene. The process lasted fully ten minutes, with the doctors standing back while the orderly moved the suction tube around, like a maid cleaning a house. Another three liters of contaminated, virus-rich blood for the lab.

The body was supposed to be a
Temple
of
Life
, the Holy Koran taught. Moudi looked down to see one transformed into—what? A factory of death, more surely than the building in which he stood. The director moved back in, and Moudi watched his hands uncover the liver, more carefully than before. Perhaps he'd been spooked by the blood in the abdominal cavity. Again the blood vessels were cut, the connective tissue cut away. The director set his instruments down, and without being so bidden, Moudi reached in to lift out the organ and set it on the tray which, again, an orderly removed.

“I wonder why the spleen behaves so differently?”

D
OWNSTAIRS, OTHER MEDICAL
orderlies were at work. One by one, the monkey cages were lifted from the orderly piles in the storage room. The African greens had been fed, and they were still recovering from the shock of their travel. That somewhat reduced their ability to scratch and bite and fight the gloved hands moving the cages. But the panic of the animals returned soon enough when they arrived in another room. This part of the operation was being handled ten at a time. Once in the killing room, when the doors were all tightly closed, the monkeys knew. The unlucky ,ones got to watch as one cage at a time was set on a table. The door to each was opened, and into the cage went a stick with a metal-band loop on the end. The loop went over the head of each monkey and was yanked tight, usually to the faint crackling sound of the broken neck. In every case the animal went taut, then fell limp, usually with the eyes open and outraged at the murder. The same instrument pulled the dead animal out. And when the loop was loosened, the body was tossed to a soldier, who carried it to the next room. The others saw and screeched their rage at the soldiers, but the cages were too small to give them room to dodge. At best one might interpose an arm in the loop, only to have that broken as well. Intelligent enough to see and know and understand what was happening to them, the African greens found it not unlike sitting in a lone tree on the savanna, watching a leopard climb up, and up, and up. . . and there was nothing they could do but screech. The noise was troublesome to the soldiers, but not that troublesome.

In the next room, five teams of medical corpsmen worked at five separate tables. Clamps affixed at the neck and at the base of the tail helped keep the bodies in place. One soldier, using a curved knife, would slice open the back, tracing up the backbone, and then the other would make a perpendicular cut, pulling the hide apart to expose the inner back. The first would then remove the kidneys and hand them to the second, and while the small organs went into a special container, he would remove the body, tossing it into a plastic trash barrel for later incineration. By the time he returned to pick up his knife, the other team member would have the next monkey corpse fixed in place. It took about four minutes per iteration of the procedure. In ninety minutes, all the African green monkeys were dead. There was some urgency to this. All the raw material for their task was biological, and all subject to biological processes. The slaughtering crew handed off their product through double-doored openings cut into the walls, leading to the Hot Lab.