Michael Palmer - The fifth vial

"You are working the day shift?" Anson managed as she set his mask in place and started the oxygen flow at maximum.

"Just breathe," she said. "I…um…one of the other nurses got sick. I am working for her."

Anson missed her deeply troubled expression. He withdrew a cortisone inhaler from the top drawer and took two deep breaths from it, followed by two puffs from a bronchodilator.

"It is good to see you," he said.

"You are feeling better?"

"The humidity makes it hard."

"The humidity is only going to get worse until the rains start."

"Then it will be worse still. A hundred percent humidity. I do not know how I will ever deal with that."

Again, a shadow crossed the nurse's face.

"You are going to be all right," she said with more than casual determination.

"Of course I am, Claudine."

"You are scheduled for your Wednesday lunch with Dr. St. Pierre. Should I cancel that?"

"No, no. I do not cancel things. You know that."

Anson, once no more reliable than the wind, had become a creature of absolute discipline and unwavering habit. On Wednesdays at noon — every Wednesday — he met with St. Pierre in the small hospital dining area, where he ate conch chowder and a green salad, drank a bottle of Guinness Cameroun, brewed in Yaounde, and finished his meal off with a scoop of chocolate ice cream. It was there they informally discussed the business affairs of the hospital, clinic, and laboratory, as well as his Sarah-9 research and, over recent years, his health.

"Excuse me for saying so, Doctor," Claudine said, "but your breathing is as labored as it has been for some time."

"It is…unpredictable."

"And there is no other treatment I can get for you?"

"I…am…on so much…medication I…am jittery…most of the…time."

"Please, just relax and breathe. Perhaps I should get Dr. St. Pierre, or a respirator."

Anson motioned her to stay calm and wait. The nurse backed off to one side of the room, but her dark eyes, moist with caring and concern, never left him. Unseen by Anson, she reached into the pocket of her uniform and nervously fingered the vial of clear liquid that was there.

Exactly one-point-four cc's — no more, no less.

That was the instruction.

Exactly one-point-four…

Lunch was scheduled for noon, but it was a quarter after before Anson had enough breath to set the oxygen aside and make his way to the dining area. The room was empty save for St. Pierre, who was seated at one of the

three small tables, eating a tuna sandwich, drinking a tall iced tea, and going over some ledgers. She wore khaki shorts and a white tee that accented her alluring breasts. For a few moments, Anson was actually diverted from his respiratory difficulty. Over the years, he had often felt their relationship was about to move beyond a close friendship, but that had yet to happen. He settled in at the table, and moments later the cook reverently set his meal in front of him, a reminder that there was no one in the hospital or lab at the center whose life had not in some way been touched by the man.

"I'll never know," he said to St. Pierre in English, pausing once for air, "how you manage to look so fresh in the face of this humidity."

"I suspect you would look fresher if you were breathing at something better than an oxygen saturation of eighty percent."

"I have managed to put in a full day's work."

"I fear that won't last much longer."

"Who can say: Lungs adjust."

"Not with pulmonary fibrosis they don't, Joseph, and you know that as well as I do."

Anson picked at his salad and, as was his habit, took a lengthy pull straight from the bottle of his Guinness Cameroun. Elizabeth was right, he was thinking. She was always right when it came to his health. Still -

"It just isn't the time for me to submit to a transplant. The monsoons are almost upon us. Our work in the lab is going so well. I simply have too much to do."

"You are risking death every day from sudden heart failure or even a stroke." She reached over and placed her hand on top of his. Her expression left no doubt that her concern for him was personal as well as professional. "You have done so much for so many, Joseph. I don't want anything more to happen to you. Your breathing is getting worse, and it is destined to get even worse still. If matters deteriorate much more, any operation will become far more risky."

"Perhaps."

"The recovery from surgery won't be nearly as lengthy as you think. The doctors with whom I have been working are some of the greatest transplant surgeons in the world. They are standing by to ensure that you get the best care possible."

Anson drained his bottle, hoping for at least a little fortitude in the battle to convince Elizabeth that the medical indications for a transplant were not overwhelming, and the timing was poor.

"I've had several good days in a row," he tried.

"I beg you to get honest with yourself. Just because you haven't stopped in the middle of the day for therapy on a respirator doesn't mean you've had a good day. Look at you now. You are an intellectual, a scholar, yet you don't say half the things that are on your mind because you don't have enough breath to get the words out." Again she took his hand in hers. "Joseph, listen to me, please. The doctors at Whitestone have learned of a donor — a twelve out of twelve donor, Joseph — a perfect tissue match for you. It's what we've been searching the world for. You will be on virtually no anti-rejection medication. That means no debility or side effects. You will be back here at work before you even know it."

Anson stared across at her. This was the first time a donor had actually been located, let alone one who was a virtually perfect tissue match. Elizabeth and the others with whom she had been consulting had just increased the ante in this high-stakes game.

"How long have you had people looking for someone?" "Ever since we tissue-typed you and realized that your profile was unusual and rare."

Anson slumped back, shaking his head. "Where is this match?" he asked.

"India. Amritsar, India. It's in Punjab State, north and west of Delhi. A man lies on machines in the hospital there. He is brain-dead from a massive cerebral hemorrhage. His hospital wants to move forward with the harvesting of his organs, but we have begged them to wait."

Anson stood and walked across the room. The short distance strained his breathing, but, he rationalized to himself, the humidity was intense.

"I can't do it," he said finally. "I just can't. There's work to do here and Sarah to notify and…and…"

"Please, Joseph," St. Pierre said firmly. "Please stop! If this is something you're not ready to do then that's the way it's going to be. Why don't you go on back to your apartment and rest for an hour until afternoon clinic. I'll cover for you here."

"O'okay," Anson said, his tone almost a baby's. "I'm glad you're not angry with me."

"I'm worried for you, Joseph, and I'm worried for our Sarah-nine project, but I am hardly angry. Let me get the security guard to accompany you to your room. Would you like a wheelchair?"

"No!" Anson snapped. As he turned away, a sudden wave of weakness and profound fatigue swept over him. "On second thought, maybe a wheelchair would be best," he capitulated.

By the time the guard entered the dining area and helped Anson into a wheelchair, his fatigue had intensified, and he was barely able to take in any air at all. He strained to breathe, but it was as if his mind had decided it could no longer be involved in such an effort. He tried to speak, to call for help, but no words emerged.

The room was whirling as the guard wheeled the chair out the doorway and onto the path to the living quarters. Just a few feet into the journey, Anson realized his breathing had stopped altogether. The scene around him dimmed, then grew black. Helpless and rapidly losing consciousness, he toppled forward out of the chair, landing face-first on the gravel.