Michael Palmer - The fifth vial

After getting their masks and surgical hair covers in place, he led Natalie into the narrow scrub room, set between the two ORs, and nodded her toward the second of two stainless steel sinks. As they washed with antiseptic impregnated sponges, her mind was consumed with finding a way to kill him. Antonio Vargas and probably Luis as well killed by their nature, but this beast and his fanatic Guardians killed by choice. Put a gun in her hand, and she would have no trouble pointing it at her former mentor and role model, and pulling the trigger.

"And so," he was saying, "at the very core of the Guardians is Plato's concept of the Forms — his determination that perfection is inborn in the Guardians. He used this concept to conclude that the soul of such as us must be immortal, because how else could the notion of what perfection is be present at birth?"

"It's been a while since I took philosophy at Harvard," Natalie replied, "but from what I recall, I don't think you've got it quite right. The only perfect thing you Guardians are doing is being perfectly immoral."

In the mirror, Natalie could see the tightness and tension in Berenger's eyes.

Keep jabbing, she told herself. Whatever you do, keep jabbing.

"The Forms tell me otherwise," he replied. "Our organization has prospered and has benefited millions and millions of the citizens of the world at very little cost. People will never know whose music is being brought to their ears because of us, or whose buildings they are marveling at that would never even have been conceived of. They will never know that the lifesaving drug they are taking was developed because we were able to supply its creator with the perfect organ at the perfect time. You see de Natalie, the Guardians are all about perfection and the Forms. Now 1 t harvest our heart and place it where it belongs and where it can do the most good."

"How about we harvest yours instead?"

At that moment the door to the scrub room burst open and Randall the heart-lung bypass pump technician, rushed in.

"The pump is ready, Doctor," he said.

"Any sign of Dr. Khanduri or the nurses?"

"None. Dr. al-Rabia says to tell you the prince is slipping."

"Damn it. Go have a chopper sent up to find out where the others are, and then get ready. If necessary, we'll put the prince on the bypass pump right now and just keep him there. Meanwhile, I'm going to get started next door. Come on, assistant, let's get cracking."

Berenger followed Natalie into the OR, where the anesthesiologist, having put their patient to sleep and intubated her, helped them gown and glove. Seeing Sandy Macfarlane looking so serene, Natalie felt a trickle of relief make its way into her profound sadness.

Just before her Achilles tendon repair, she remembered asking the anesthesiologist, only partly in jest, "How am I going to know if I didn't wake up?"

The man merely smiled down, patted her on the arm, and injected the preop meds. It was totally disheartening to possess that information about Sandy, and to be helpless to do anything about it.

Hey, Doc, tell me. How am I going to know if I didn't wake up from my surgery?

"Dorothy, are you all set?" Berenger asked. "We've got to move on this

one.

"All set."

"Do you have ice ready? There's going to be a delay between the harvest and the transplant."

"Always."

Natalie again looked across at Berenger's eyes. He was clearly frazzled, but for twenty years or more he had been the Man outside of and within the OR, and had successfully handled countless medical crises.

With no nurse to assist them, the anesthesiologist had pulled two large instrument stands across the operating table so that both surgeon and assistant could get at them. Doug Berenger was not only one of the most elegant, brilliant surgeons Natalie had ever seen, he was one of the fastest. Without asking for her help, he began rapidly swabbing russet-colored Betadine antiseptic over Sandy's chest.

"Let me tell you one last time, Natalie, if you make any odd or unusual moves, any at all, I will tell Dorothy over there to turn off the anesthesia before we proceed. Have I made myself clear?"

"Clear."

"Then just shut up and do as I say. Have sponges and hemostats ready just in case. Dorothy, we're opening."

As Natalie picked up what Berenger asked for, she noticed three scalpels lying side by side on the far edge of the instrument tray. There was no way she could get at them without being seen, but there was also nothing else available that even looked like a weapon. A desperate situation called for desperate measures, and one way or another, she also knew that like the poor woman on the table, she wasn't going to wake up from her operation.

Without another word, Berenger snatched one of the scalpels from the tray and made a foot-long incision from top to bottom along Sandy's sternum. Blood instantly began oozing from a dozen or more small vessels, but unless one of them began hemorrhaging rapidly, Berenger would not bother to gain control.

There was no need.

"The bone saw is right there, Natalie. So are the spreaders."

Natalie felt sick as she reached for them.

The operating room door opened. Berenger turned to see the Arab physician, al-Rabia.

"Dr. Berenger," the man said urgently, "the prince's blood pressure is zero. I cannot bring it back up."

The few seconds Berenger was distracted were enough. Natalie swept her gloved hand across the two remaining scalpels and came away with one of them tucked in the sleeve of her surgical gown. Then she glanced over at the anesthesiologist to ensure that she, too, was focused on al-Rabia.

Now, her mission was clear — somehow to get close to Berenger, and then, for Rosa and Luis and Ben, and herself and all the other victims of the Guardians, to be fearless.

Berenger was clearly on edge — the juggler of balls, who had just reached a personal best when one more was thrown into the mix.

But he was still the Man.

"All right, Doctor," he said, "let's wheel him quickly into the OR, and I'll get him on the pump. Dorothy, just leave the gas on here and come with us. Natalie, let's go, we have work to do."

Berenger took a step toward the door, then another. Natalie, moving from the other side of the table, was now a pace behind him.

There is often only one chance.

With Luis's words resonating in her mind, she slipped the scalpel into her hand.

"Doug!"

Startled, Berenger turned toward her, exposing his jaw and the side of his neck.

Fearless!

With all the force she could manage, Natalie swung the blade up from her hip and swiped it viciously across Berenger's throat. Instantly, the opening of his severed trachea appeared where his larynx had been. A moment later, bright crimson arterial blood began spewing from a laceration through his carotid artery, splattering Natalie, and coating the floor.

Unable to speak, pawing futilely at his neck, the man called Socrates, one of the founders of the Guardians of the Republic, lurched backward and fell heavily, awash in the rapidly ebbing essence of his being. His last moments were spent staring up at Natalie in silent, absolute, wide-eyed disbelief.

"Come, Dr. Berenger!" al-Rabia cried from the OR next door. "The prince's heart has stopped! Come quickly!"

Natalie stripped off her gown and raced in to help, but she knew that unless the dysfunctional muscle that had caused the prince's heart failure could be replaced, there was nothing that drugs or cardiac compressions could do.

"Oh, dear Allah!" al-Rabia kept muttering. "Dear Allah, help us!"

Natalie continued performing CPR, but the cardiac monitor remained absolutely discouraging. She considered trying, with the help of the pump technician, to hook him up to the bypass machine, but her knowledge and surgical skill stopped well short of that. Al-Rabia, clearly a gifted physician, tried several shocks from the defibrillator, even though he knew that his master's problem was not fibrillation — a potentially reversible lethal rhythm — but rather, complete cardiac standstill — a virtually untreatable flat line. There really was no hope.