Lincoln Child - The Third Gate

“What’s the problem?” Logan asked.

“If he remembers his basic training, nothing. But if he panics, holds his breath as he surfaces…” Rush fell silent a moment. “For every thirty-three feet you descend, the air in your lungs loses half its volume to pressure. They were at thirty-five feet at last report. If he surfaces with all that air in him-”

“It will expand to twice its size,” Logan said.

“And rupture his lungs.” Grim faced, Rush hurried to the medical station, where the nurse was talking rapidly into a phone.

They gathered around the dark, yawning circle of the Maw: tense, tight-lipped. At Valentino’s clipped order, additional lights were snapped on overhead, throwing the shivering, quaking surface below into sharp relief. As Logan stared down at it, it seemed to him that the Sudd was a living thing, its brownish surface the skin of some vast beast, and that their perching on it like this was an act of monumental folly…

And then one of the cables leading down into the mire jerked spasmodically, and a strange gargling noise sounded over the radio.

Valentino ran back to the transmitting station. “Echo Bravo? Echo Bravo! ”

“Romeo Foxtrot here,” came the disembodied voice. “Still no sign of him. It’s black as hell down here, can’t see a thing-”

With a clatter, two white-clad medics appeared at the entrance to Yellow, each pushing large carts full of medical equipment.

There was another jerk on the cable as the radio sounded again. “Romeo Foxtrot to base, I see him. I’ve got hold of him. Surfacing now.”

Suddenly, the mottled surface of water and decayed vegetation began to churn and heave. A moment later, a black-gloved hand abruptly broke the surface, grasping a rung of one of the ladders. This was followed by a neoprene hood and mask. Despite the air of crisis, Logan was momentarily arrested by the strangeness of the image: the emerging diver seemed like an insect, struggling to break free from some primordial ooze.

Beside him, Dr. Rush had been waiting, tense and silent, like a coiled spring. Now he dashed forward and-with the help of one of the medical technicians-began to free the man from the Sudd’s grip. The diver had his arm around a second neoprene-clad man, who was struggling weakly. The two were pulled up out of the Maw and onto the floor of the Staging Area. Both were covered head to foot with matter the consistency of oatmeal. The room suddenly reeked of decay and dead fish.

“Hose them down,” Valentino ordered.

But even as a team rushed to blast the muck from the divers, Dr. Rush was shifting the injured man to a waiting stretcher. He plucked the mask and hood from his face, then-with a scalpel-slashed the neoprene suit open from neck to navel. The man moaned and thrashed on the stretcher, bloody foam flecking his lips.

Quickly, Rush placed a stethoscope on the man’s bare chest.

“He panicked,” the other diver said as he came over, wiping his face and hair with a towel. “A rookie mistake. But diving in that shit, you forget-”

Rush raised a hand for silence. He moved the stethoscope around the chest, listening. His movements were jerky, almost violent. Then he straightened. “Extravasation of air,” he said. “Resulting in pneumothorax.”

“Doctor,” said the nurse, “we can take him to Medical, where the-”

“There’s no time!” Rush snapped as he pulled on a pair of latex gloves. The man on the stretcher twitched, clawing at his throat, gargling inarticulately.

Rush turned toward the medics. “A needle aspiration would be insufficient. Our only option is a thoracoscopy. Give me the chest tube, stat!”

Logan looked on with mingled surprise and apprehension. Up to this point, Ethan Rush had been the epitome of calm assurance. But this-the sudden, almost frantic movements, the impatience and barked orders-was a Rush he had not seen before.

While one of the medics turned to his crash cart, Rush swabbed an area beneath the diver’s left arm with iodine and a topical anesthetic, and then-with another swipe of the scalpel-made a two-inch incision between the ribs. “Hurry up with that chest tube!” he said over his shoulder.

The medic brought it over, unwrapping it from the sterile covering. Rush knelt before the struggling man and carefully threaded it into the incision he had made. He checked the placement, grunted, then rose.

“Chest drain,” he rapped.

Another medic trotted over, pushing a floor stand that held a white-and-blue plastic device that, to Logan, looked like a blood-pressure monitor on steroids. It had several vertical gauges, and two clear plastic tubes led away from its upper housing.

“Suction-control stopcock?” Rush barked.

“On.”

“Fill water seal to two millimeters.”

“Yes, Doctor.”

As the medic added water to the device, Logan saw the reservoir chamber turn blue. Meanwhile, Rush attached one of the plastic tubes to the line inserted into the injured diver’s chest. Logan glanced over at the diver: his struggles were weaker now, his movements erratic.

“Catheter in place,” Rush said. “Initiating suction. Setting pressure at minus twenty cm H 2 O.” He snapped a switch on the device, then began turning a stopcock on the unit’s housing. Instantly, the liquid in the suction control chamber began to bubble. Rush turned the stopcock farther; the bubbling increased. The tube leading from the incision in the diver’s side began to fill with mingled water and blood.

“If we can get the fluid out of the thoracic cavity quickly enough, the lungs might reinflate,” Rush told the medical tech. “There’s no time to operate.”

The large room fell silent except for the hum of the machine and the bubbling of water draining from the tube.

Rush looked from the man on the stretcher to the water seal and back again in growing agitation. “He’s becoming cyanotic,” he said. “Increase vacuum pressure to negative fifty mmHg.”

“But such a high level-”

Rush rounded on the tech. “Damn it, just do it.” Then, walking briskly around the stretcher, Rush opened the now-motionless diver’s mouth and began administering artificial respiration. Fifteen seconds passed, then thirty. And then, quite suddenly, the diver’s limbs jerked; he coughed up blood and water and then took a deep, ragged breath.

Slowly, Rush straightened. He looked at the diver, then at the water seal. “Dial it back to negative twenty,” he murmured.

He glanced around at the assembled faces, then pulled off the gloves. “Keep an eye on the collection chamber,” he told the nurse. “I’ll go prep medical for a thorough evaluation.” And without another word, he turned on his heel and strode out of the Staging Area.

A s lunchtime approached, Logan found that his feet-he’d been wandering around the facility, trying to get his bearings-had brought him unbidden to what appeared to be the medical center. If there were really only a hundred and fifty people on the project, Medical seemed to him larger than necessary-until he recalled how far they were from any kind of help.

The center seemed quiet, almost somnolent. Logan walked down the central corridor, looking through the open doorways, at the empty beds and unused equipment. A woman at the nurse’s station was making notations on a clipboard. He passed a large open area labeled OBSERVATION. The injured diver was here, surrounded by various diagnostic machines.

Logan continued, stopping at the next room. This was apparently Rush’s office; the doctor was inside, his back to the door, speaking into a digital voice recorder.

“A catheter was inserted into the thoracic cavity and tension pneumothorax alleviated before the condition could degrade to a mediastinal shift or air embolism,” he recited, “either of which might have caused the case to terminate fatally, due to the fact that under the circumstances it would have been unfeasible to…”