Brian O'Grady - Hybrid

“What do you think?” Dr. Neval asked him.

“I think he’s fucked,” he answered glibly. “You can’t control his ICP without meds, and the meds make him hypotensive. I think its game over.”

Neval was about to respond, but his pager suddenly beeped. “Guess who?” he said, exasperated, after checking the message.

“Rucker.”

“Right the first time. You’re almost smart enough to be a neurosurgeon,” Neval said while leaving the reading room, ignoring the sarcastic response of his friend.

“We can’t keep his pressure up with all this sedation, Doctor,” said Sandy Fuller, confronting Neval at the doors of the emergency unit. All the ICU patients had been moved to the emergency room, doubling its burden. “I’ve had three nurses with him for six hours now, and we’re only losing ground. I hate myself for saying this, but we’re going to lose other patients who can be saved.”

Neval knew this was more than just nursing exhaustion. Even before the destruction of the ICU this morning, it had been working at twice its capacity with only two-thirds the nursing staff.

“If we extubate him, can we keep him where he’s at?” asked Neval. Removing Phil’s breathing tube was tantamount to a death sentence. Without the respirator hyperventilating him, the pressure in Phil’s brain would build to the point where blood could no longer circulate through it.

“It’s not a question of space. I just can’t have three nurses in with him every moment, and right now, that’s what it takes.”

“Extubate him,” Neval said reluctantly. Phil Rucker was going to die, but his death would allow the nurses to save two, maybe three more lives. “Turn off the Propofol drip, and let his blood pressure find its own level.”

“I’m sorry, Doctor,” she said, and she was. Both of them knew that with proper resources, Phil could have been saved. “Goddamn them,” she said, walking away.

Neval was a Muslim; it wasn’t a secret, but it also wasn’t something he advertised. He watched the head nurse as she communicated his orders to her staff and wondered who Sandy Fuller was damning. If someone like Sandy had started condemning all Muslims to hell, then he too wanted the terrorists to burn for all eternity. The president had vowed that the United States would survive this cowardly attack and bring to justice all those involved, no matter who they were. It was the last line that had echoed in his mind. Jeser had replaced Al-Qaeda, and Jaime Avanti had replaced Osama bin Laden; but they were all Muslims, and twice in ten years, Muslims had attacked the United States.

Neval began to walk towards the ER’s single isolation room, but noticed several nurses huddled at the operations desk. He swung a little closer and saw that they were watching a television. “What’s going on?” he said, suddenly conscious of his slight accent.

Several people shushed him, and a large black man glared at him for a long second before turning back to the screen. One of the nurses suddenly realized who they had just shushed and motioned to her colleagues. The knot parted a little, allowing him to see the screen. “The Iranians just shot thirty-six cruise missiles at the Eisenhower battle group,” one of the supervisors said.

Neval noticed that a woman he didn’t know was sitting in a chair, a handkerchief over her mouth and tears streaming down her face.

“Beverly’s son is on the Eisenhower ,” the nurse whispered.

The large black man turned up the volume as aggressively as he could. Neval saw a smoking aircraft carrier for a moment, and then the news bulletin switched back to the studio announcer. “Seven have been confirmed dead, and fourteen are missing,” the news anchor reported as Beverly sobbed loudly.

A security guard patted her shoulder gently. He bent down to whisper encouragement into her ear as the scene changed again, back to the wounded carrier.

“Flight operations continue and all fires have been controlled, but the USS Ronald Reagan has now assumed control of the battle group.”

An aerial view of a second aircraft carrier filled the screen.

“I’m sorry for interrupting you, John, but the president is just about to address the nation.”

The president’s tired and sagging face suddenly replaced that of the news anchor. “My fellow Americans, for the second time today, I have the sad duty of informing you of an attack upon the United States. Eight hours ago, the Islamic Republic of Iran, without provocation, fired more than three dozen cruise missiles at the USS Eisenhower . Sadly, one of them penetrated her defensive screen and struck her.” He paused, not so much for effect, but out of genuine grief.

“She has suffered casualties, and so have we.”

Neval had never seen the Californian so sincere.

The president’s face hardened. “The Eisenhower and her battle group had been in the Persian Gulf for three months and were in international waters when she was attacked. It has long been an assertion of the Islamic Republic of Iran, in contradistinction to international law, that they maintain sovereignty out to fifty miles from her coast. The Eisenhower and her battle group were seventy-two miles out to sea, steaming away from Iran. She posed no threat to the Iranians or their interests. These are irrefutable facts that can be, and have been, confirmed by British, Japanese, and Russian satellites.

“Two hours ago, combined naval and air forces of the United States of America responded.” He paused again only long enough to lean slightly towards the camera. “It has not been a proportionate response.”

The words hung in the air across the globe.

“The naval and airbase on Kefer Island has been destroyed. The Revolutionary Guard training facilities in Teget, Al Kum, and Teheran have also been destroyed. The six fast attack submarines that the Iranians purchased in secret over the past two years have been destroyed.”

The president continued for two more minutes and then finally took a sip of water. “I have instructed my commanders to destroy every piece of Iranian military hardware over the next two weeks. Further, I have ordered that the nuclear processing facility outside of Quom be destroyed. Finally, all air and sea traffic within the territory of Iran will cease immediately. If you choose to violate this order, we will see you, and we will destroy you.” There was no bluster in his voice, which made the message all the more penetrating.

“I would like to address Iranian military personnel. The United States has no quarrel with you. The responsibility for this attack lies with your leaders. Therefore, I encourage you to abandon your posts. Otherwise, you will die needlessly. I extend this advice also to the personnel of the nuclear plant outside of Quom. You have twenty-four hours from this moment.

“To the president of Iran and the Grand Ayatollah. I hold you both personally responsible for this attack and will pursue this matter through the United Nations and the World Court. In addition, if you or one of your citizens retaliates by harming any American citizen in Iran or anywhere else, we will begin to destroy your civilian infrastructure.

“And now to the rest of the world. To our allies and those who stand with us against terrorism and rogue states, I thank you, and assure you that the United States of America has always and will always abide by the rule of law. We have a sovereign right to defend ourselves. To those who stand against us, let me assure you that we will exercise that right. Good night.”

The television switched back to a wide-eyed anchorman. “Strong words and actions from President Wilson following the attack. .”

Neval melted away back towards Phil’s room. The world is coming apart , he thought. He couldn’t really blame the president; a weak response would have only encouraged the radicals.