Fatal

CHAPTER 33

The burning in Matt's chest — the first sensation of air hunger — began after just fifteen or twenty seconds of swimming beneath the surface of the chilly, pitch-black water. His awkward swimming became even more uncoordinated. Fearing that if he tried to break the surface he would encounter only the ceiling of his tomb, he pulled himself ahead for another twenty seconds. The fire in his lungs was becoming unbearable. Terrified, he reached overhead. His hands broke water, but then, almost immediately, with his elbows still bent and his feet scraping along the bottom, his fingers touched rock. There was some air space above him, though it was difficult to be certain how much.

Battling a horrible, smothering sensation, he pinched his nose closed, tilted his head back as far as he could, planted his feet on the bottom, and pushed himself up. His face was level with his forearm when it broke water. There was not enough room for him to stand straight up, but there was a four- or five-inch space. With his forehead pressed upward against the rock, he took half a dozen grateful breaths of stale, heavy air. Next he lowered himself

until his eyes were just above the water's surface and slowly turned 180 degrees. The darkness behind him was intense and absolute. It was doubtful Nikki and Ellen had already left the bridge, so he concluded that he had either swum farther than he reckoned or that the river had turned sharply. The cold water flowed steadily past his face. He worked his way around again so that the current was behind him, then tilted back so he could breathe once more.

Even pinching his nose shut, with his forehead pressed tightly against the ceiling, water still sloshed into his mouth, making it hard to get air in consistently. Fingers of panic, infinitely colder than the water, squeezed at his throat. He was alive, but nearly immobilized by fear. The oppressive, claustrophobic sensation was worse than he'd expected — much worse. There was absolutely no way he could go on. He had to get back — back to where he could straighten up, back to where there was more space to breathe, back to Nikki. He struggled unsuccessfully to swing around again, but his strength seemed gone.

The current, though not that forceful, kept pushing him downstream, lifting his feet off the stony bottom, and dragging him underwater. With effort, he could wedge himself between the floor and roof of the tunnel, but only for ten seconds at a time before the current won out. Aware of little beyond the hideous impotence of being confined, he floated on. An outcropping of rock struck his hand and forehead with surprising force, dazing him momentarily. The walls of the tube scraped at his arms. The energy it took just to hold himself in place quickly had him gasping.

He simply couldn't take it anymore.

He had to stand up straight.

Damn you, Grimes.

Matt braced himself once more and shut his eyes tightly. Vision was useless here anyhow. He calmed himself down some by imagining that there was a cave just ahead… a vast cavern… unlimited air… space to move… space to turn around and stand… space to think.

Slowly, with his head dragging against the ceiling, he lowered his mouth and nose below the surface and took a controlled step downriver… then another, and still another. He sensed his pulse begin to slow and his thoughts to focus. The icy fingers loosened their grip. Every six or seven steps, he paused long enough to tilt his head back and suck in a few more gulps of air. Emboldened, he actually dropped down beneath the surface and propelled himself forward with several breaststrokes. However, this time when he broke water, he could straighten up even less than before, and the air space had become reduced by half — two inches, maybe three. There was the chance for only a couple of incomplete breaths before the current pushed him ahead. Another few feet and the space disappeared completely. With less than full lungs, he dropped down, leveled off, and began to swim forward again, this time desperately and with all his strength. Twice he tried to break through the surface. Twice he was met by rock.

This was it. This was the end.

The current was increasing now as well, and turbulence was becoming an additional problem. Frantically, he clawed through the churning water, trying to stabilize his body. His lungs were afire once more, and each heartbeat was a shell-burst inside his skull. The walls of the tunnel seemed to be closing together, tearing at him as he tumbled past.

Don't breathe!, Hang on!..

At the instant he had to inhale, his face broke the surface of the water. Coughing and gagging, he struggled to adjust to the now powerful current, trying to keep himself upright as he sucked in some of the dense air from what he sensed might be a small cave or even a cavern. But his weakness and merciless coughing made regaining control impossible.

The river had widened and become shallower. No more than three feet deep, it churned ahead at intense speed through the pitch-black space. Matt tried to scramble to the right-hand bank, but water roiled about him, forcing him under, then flipping him over like a rag doll. Twice he was slammed into rocks protruding from the bottom. Over the years, he had rafted a number of West Virginia's rivers, traversing dozens of rapids either by oar or swimming. The goal either way was to avoid boulders, and the technique when in the water was to navigate feet first, in a near-sitting position, using one's arms as rudders. Constantly being hammered by rocks, he attempted to establish that position. But in the dark, with no visual cues and no warning of an approaching boulder, he had little chance.

Sputtering on aspirated water, he careened helplessly down a steep slope. The swirling, foaming river seemed to be moving closer and closer to vertical, and now he could hear a roar echoing off the rock — the roar of falling water. He tumbled on, slamming against the stony bottom and one boulder after another. His arms, which he was using to protect his head and face, were absorbing a fearsome pounding. His wind was gone, his consciousness was waning, and his lungs were filling with water. Suddenly, what had been a slope became a drop. Weightless and airborne, he hurdled over the precipice. He hit the shallow pool below awkwardly and with great force. Pitching forward, his forehead smacked against a jagged rock. Pain exploded through his brain from the impact. An instant later, there was nothing.

For fifteen minutes, Nikki and Ellen stood silently by the bridge, a lantern fixed on the opening where the river left the cavern.

"I'm frightened for him," Nikki said finally.

"I understand why. That was a very brave thing he did."

"He has claustrophobia. He told me so himself."

"The river has to come out someplace. He can do it."

"You don't know!"

Ellen put her arm around Nikki's shoulders.

"Sorry. I was just trying to sound positive. I know how awful this must be for you. It's terrible for me, too."

"Sorry to have popped off," Nikki said.

"Nikki, what Matt chose to do was right. You and I both know that as things stand, we don't have much of a chance here. I'm going to wait a couple of hours, and if nothing's happened and we can't think of anything else, I'm going to try and make it out of here, maybe going upstream. Are you ready to go back and check on the others?"

Nikki peered toward the narrow slit between the river's surface and the ceiling of the tunnel. The lantern beam sparked off the water, then vanished into the darkness. Reluctantly, she picked up the light and lay her arm around Ellen's shoulders. Her ankle was throbbing with even slight movements, but it really didn't matter. She had always done pretty well with pain.

"You're a very good person," she said as she hobbled and hopped back toward where Colin Morrissey lay.

"As are you," Ellen replied, her arm around Nikki's waist. "As are you."

The girl, her flaxen hair matted and filthy, was sitting beside Morrissey stroking his hand. Nikki cringed at the fibromas that distorted what might have once been a pretty face. Morrissey, whose face was even more disfigured than the girl's, was still unconscious and not moving air at all well. The stridor, a sign that at least there was some airflow, was reduced to barely audible wheezing.

"He's dead," the girl said in a distant, singsong voice that was devoid of emotion.

"No. No, he's not," Nikki replied, kneeling next to her. "My name's Nikki. I'm a doctor. This is Ellen. She teaches school. What's your name?"

"Sara Jane Tinsley. Are ya gonna help him?"

No fear, no anxiety, no questions about what had happened to her or where they were now. Nikki decided not to press the issue unless the girl asked pointedly. Clearly, shock and denial were at work, along with the residual effect of whatever drug she had been given, and maybe even the spongiform disease that was probably eating away at her brain.

Just as well, Nikki thought. The less aware the girl was of their circumstances, the better.

"I'm going to try, Sara Jane," she said.

"Ah think he's dead, dead, dead."

"No, see, he's br — "

Nikki stopped in midsentence. Morrissey's wheezing was gone. His contused, swollen throat had finally closed entirely. She checked his pulse, which was weaker than it had been but still present. From this instant until irreparable brain damage, she had three to four minutes to bypass the obstruction and deliver some oxygen to his bloodstream. Almost in spite of herself, she hesitated, her mind unable to get past the likelihood that Morrissey already had an irreparable, progressive brain disease.

Rapidly, though, that notion gave way to thoughts of Kathy Wilson and Hal Sawyer, of Joe Keller and the dead miners, and of the other cases of the Belinda syndrome that Grimes and his crew had probably already dealt with. And suddenly all of her anger, all of her frustration and fear became focused on this young man, innocent of anything more malevolent than doing what his doctor and his mother recommended a decade ago.

Colin Morrissey was not going to die — not if she could help it!

Silently, Nikki cursed herself for not making preparations in advance for an emergency tracheotomy. She had been too wrapped up in their predicament and her pain to think clearly, and possibly she had also been influenced by the hopelessness of the untreatable disease that she believed was ravaging the man's brain. She reminded herself that hindsight was always 20/20. What had happened had happened. What she needed to deal with now was this moment.

"Ellen, I'm going to have to get some sort of airway into him. I'll need your help."

"Just tell me what to do."

Nikki tipped the young man's head back, straightening his windpipe. Morrissey responded with a single, surprisingly effective breath, regaining the precious seconds that had been lost since his last one. In Nikki's mind, the four-minute clock was reset.

"Please keep his head in this position," she said. "Do you by any chance have a pen or anything else that's hollow?"

"I'm afraid not."

"Sara Jane, I'm going to do some things to help this man if I can. There may be some bleeding from his neck."

"Ah seen blood," the girl said, looking about at the cave as if for the first time.

There was no more time to explain. The skin above Colin Morrissey's collarbones was retracting inward as his lungs struggled unsuccessfully to suck in air. Nikki grabbed the first-aid kit and searched through it frantically. The disposable scalpel she had used on Carabetta was there, along with a pair of bandage scissors that she could use as spreaders. Now she needed something round, hollow, and sturdy — something wide enough to allow enough air through, but not so big that it tore the trachea apart. A large-bore needle would buy her a little more time, and a long pen cap would be perfect. Acutely aware of the passing seconds, she dumped the entire kit onto the stone floor. A 2cc syringe, still in its sterile wrapper, had been buried beneath some bandages.

Perfect!

"We're in business," she said.

Nikki discarded the plunger and used the bandage scissors to cut off the end of the barrel where the needle would have attached. The inch-and-a-half-long hollow tube was as good as she could have hoped for.

Pain shot from her ankle as she shifted so that she was hunched over Morrissey's swollen, discolored throat. Ellen clumsily tried to adjust the light while maintaining the neck extension Nikki required.

"Sara Jane," she said finally, "can you shine this lantern right here on this spot?"

"Ah kin do thet."

"Good girl. We need you, Sara Jane. Be steady."

Nikki had no idea how much of the four minutes had elapsed, but there would be no stopping for any reason.

"Not on my watch," she whispered as she focused in. Not on my watch.

She located the spot just above Morrissey's larynx that she felt represented his cricothyroid membrane — the best place to make her incision. If she was wrong, she would make do. But she wasn't going to hesitate, and she was damn well not going to screw up. A dozen or more had already died to make Grimes and his people rich. Hundreds, maybe thousands more were in danger if they succeeded in getting their vaccine onto the market.

But not this man — at least, not now.

Using the precious scalpel, keeping it parallel with the cartilaginous rings of the trachea, she made a stab wound through the skin and straight down through the windpipe. Instantly, a bloody froth bubbled out. Reflexively, Morrissey coughed, spattering Nikki's shirt and chin. The drug he had been given was wearing off. His consciousness was returning. Deftly, mindless of the blood, Nikki inserted the scissors into the incision and spread them to open up the hole. Then she slid the plastic tube down into the trachea. There was a whistling, gurgling sound as the first rush of air entered the man's lungs. Quickly, his breathing calmed.

Minutes later, Colin Morrissey lifted one arm, and soon after that, his eyes fluttered open.

Two more hours passed as Ellen and Sara Jane tended to their four patients. Fred Carabetta remained comatose, although he seemed to respond a bit when cold river water was sponged over his face and lips. Sid, the guard, lay nearby, alternately sobbing and cursing. He was clearly paraplegic, and now was woefully aware of that fact. The woman who had attacked Nikki remained trussed up with tape. She slept much of the time and rattled on incoherently when she was awake. Seemingly mindless of their predicament, Sara Jane crawled from the woman to Morrissey and back, comforting them, sponging their foreheads, holding their hands, and even singing to them.

"They're lak me," she said in one of the rare instances when she spoke to Ellen and Nikki. "They're jes lak me."

Nikki had insisted that Morrissey's hands be taped securely to his belt to prevent him from pulling the tube from his makeshift tracheotomy. Now, exhausted and more apprehensive each minute, she lay on the dusty floor, propped against a large boulder, her injured, throbbing leg elevated on a pile of stones. There was nothing more she could do now than wait. Horrible visions kept impinging on her mind — visions of Matt, his body wedged forever between two rocks, his limbs wafting lifelessly in the black water. In addition, the sickly sweet air seemed to be getting thicker and harder to breathe. Was it vanishing already?

Not with a bang, but a whimper… Not with a bang…

As she lay there, Nikki marveled at Ellen, who remained in almost constant motion, tending to the others, speaking cheerfully and hopefully with them and with Sara Jane. Periodically she would return to where Nikki lay to assure her that her patients were okay, and that Matt was going to make it, and so were they. On this trip, however, she had no such message. For the first time, tension etched her face.

"I'm going to try the river," she said.

"What?"

"I won't go downstream, but I have to try something. It's been almost three hours and I think we might be running low on air. Do you think you can manage without me?"

What difference does it make? Nikki stopped herself from saying.

"I'll do what I can do," she said instead. "You don't think he made it out, do you?"

Ellen sat beside her and took her hands.

"I don't know what I think right now, except that we can't just sit back and let them win. For one thing, we both have new men in our lives. I want to see how that turns out for me. And for another, in just a few hours that vaccine is going to be the standard of care.

Pediatricians all over the country have been primed by the public-relations people from the pharmaceutical houses and the dear President and his wife. I wouldn't be surprised if a couple of thousand doses of the stuff get administered by sunset today."

"You're right," Nikki said, pushing herself up. "We've got to keep trying. You said you're a good swimmer?"

"A fish."

"Let me hop you over. Sara Jane and I'll do fine here."

"I know you will."

Both women were breathing harder from the trip across the cavern than they might have expected. No comment was necessary. The supply of oxygen was definitely dwindling.

Nikki watched as Ellen made her way around the pile of wood and rubble that had once been the second bridge and lowered herself into the water. This was one hell of a woman, she was thinking — courageous, intelligent, resilient, and kind, precisely the sort of person she would like to be in her sixties. The notion of even reaching sixty brought a rueful smile. Several hours had passed since Matt headed off. It was doubtful that he had made it out of the mountain, and now what little remained of their hope for survival rested with a wisp of a woman who was nearly twice his age. Ellen would not only have to find a way out of the mountain swimming upstream, but she would have to avoid Grimes and his gunmen, find people who could and would help, and make it back to the cavern before it became an airless tomb. The chances of her pulling all that off were slim indeed.

But slim wasn't none.

Lantern in hand, Nikki settled down on the bank and waited. Her wait was not a lengthy one. Not five minutes after Ellen had paddled into the pitch-black tunnel, she came floating slowly back, feet first, facedown in the water. Nikki scrambled onto her hands and knees and reached for Ellen's blouse. The fabric slipped from her hand. Ignoring the stunning pain from her ankle, she pushed off the rocky bank in a clumsy dive and wrapped her arms around the older woman's waist just before they reached the second bridge. Holding tightly, Nikki grabbed a fistful of Ellen's hair and pulled her face clear of the water. Then she braced herself against the bridge and managed to set her one good foot on the bottom. The river lapped by just beneath her chin.

Inch by painful inch, drawing on a reserve of strength that surprised her, Nikki pushed Ellen upward until she was sprawled out prone on the bridge, her legs dangling down into the water. Then, crying out in pain, she hauled herself onto the bank and crawled over to where Ellen lay. A single downward thrust on both sides of her back cleared much of the water from Ellen's lungs. A second thrust, and she began breathing on her own, sputtering and coughing reflexively. In less than a minute, she began to come around. For some time she lay that way, her chest heaving.

"Rocks," she said finally. "Tunnel was blocked by rocks." Another minute passed before she spoke again. "I… tried to move them… Foot got caught… Couldn't get free… Water got down my — "

"Easy," Nikki said, cradling her head in her lap. "Easy. You gave it a great try. Just relax and catch your breath. I'm just grateful you made it back here."

It was many minutes before Ellen could push herself up, still violently coughing out river water.

"God, but that was awful," she said. "The rocks collapsed on me. I couldn't get my leg out."

Nikki hauled herself up using the bridge railing. The two women, soaked and shivering, held each other tightly. Then Ellen pulled away.

"Where are you going?" Nikki asked.

"Up on that pile of rock," Ellen replied, gesturing toward what remained of the entrance Nikki and the others had used. "Send Sara Jane up to help me move some of that stuff."

Nikki started to protest, then merely shrugged and nodded.

Dead waiting around helplessly was no different than dead trying.