Neal Stephenson - Interface

She took the opportunity to rest her head on his chest for just a moment. She didn't exactly cry, though tears were in her eyes.

"It's a hard thing for a parent to look at, isn't it?" Ray said. "It's our worst nightmare come to life. Like an image from the Holocaust."

Eleanor took a half step away from Ray and drew a few deep breaths. "Are the parents inside?" she said.

"Yes. Anna has been sedated. Carlos is drinking a lot and vowing to kill himself. Anna's family is trying to keep him on an even keel. It's very difficult."

"I heard that there is a problem with the surviving child's medical care and I am here to inform the Ramirez family that Senator Marshall is at their service in whatever capacity is needed. Do you think that you could go in and relay that message to them?"

Ray snorted with just the tiniest hint of amusement and glanced down at his wristwatch. "The Senator runs a tight ship. As always."

Ray went into the house and came out a couple of minutes later with Anna's sister Pilar. From a distance Pilar seemed utterly stonefaced, but from arm's length her eyes were swollen and red and she looked stunned, rather than impassive.

"I told her what you said," Ray said. "She has authorized me to explain the child's medical situation."

"Okay."

"When they arrived this morning and found their four children unresponsive, they called the ambulance. Three children were pronounced dead at the scene. The fourth, the eight-year-old girl Bianca, still had a pulse. The ambulance took her straight to Arapahoe Highlands Medical Center."

"Why there?" Highlands was a private hospital, well endowed, certainly not the closest to this bungalow. Not the kind of place where migrant workers ended up.

"Carbon monoxide poisoning was obviously the culprit here. And Highlands has a hyperbaric oxygen chamber. It is the best treatment. So that's where they went. The emergency room staff at Highlands treated Bianca but they refused to admit her for hyperbaric oxygen treatment. Instead they dumped her back to Denver County, where she is now."

"How can they justify that?"

Ray just shrugged. "As we say in the Third World, Quién sabe?"

Something clicked in the back of Eleanor's head. Maybe it was her temper breaking. She squared her shoulders and flared her nostrils. "Would you please come with me, Ray?" she said.

"Okay. Where we going?"

Eleanor realized that she didn't even know. "We're just going to take care of a few things, that's all."

The two of them got into Eleanor's car and headed in the direction of Denver County Hospital, were Ray knew some doctors.

"This happens hundreds of times every year," Ray said. "All over North America."

"What happens?"

"Exactly this situation. Remember what a migrant worker is: someone who migrates. These people cover a lot of territory and the vehicle of choice is a pickup truck. It's always the same: the parents sit up front in the cab and the kids lie down in the back and try to sleep. The exhaust comes up through holes in the floor, or else it leaks through the crack under the tailgate. In warm weather they open the windows and survive. But if it's chilly, like it was last night, they close the cab up and suffocate."

"You'd think that they would have gotten some indication before. That their kids would have gotten headaches or felt woozy."

Ray snorted. "If you drove for eight or ten hours in the back of a truck, you'd feel that way even without carbon monoxide."

At the county hospital, Ray tracked down Dr. Escobedo, a young internist who was looking after Bianca. They all sat around a table in the corner of the cafeteria.

"Should Bianca be here, or at Arapahoe Highlands?" Eleanor said.

"At Highlands," Dr. Escobedo said without hesitation, and without rancour.

"Why?"

"They have a hyperbaric oxygen chamber."

"And that is the standard treatment for this kind of thing?"

"Not exactly," he said. "That's the problem."

"What do you mean, not exactly?"

"Well, for example, there are a lot of migrant workers up in Washington State, and this kind of thing has happened up there on a fairly regular basis. Now, there is a hospital in Seattle that has a hyperbaric oxygen chamber, which is basically used to decompress divers with the bends. When you put a patient with carbon monoxide poisoning into such a chamber, it helps get oxygen into their tissues, which is what such a patient needs. So people up there have learned that when an unconscious kid is pulled out of the back of a pickup truck, you send them straight to the one hospital with the hyperbaric chamber. But this is kind of a new practice, and in the eyes of some, it's experimental."

"And that's what the people at Highlands think."

"Exactly. If this treatment were standard medical practice, they'd have no excuse not to admit Bianca. But because they can label it experimental, there's no way they'll admit her. Because they know they'll lose money."

"Why does Denver have a chamber like this?" Ray said. "We don't have many scuba divers around here."

"It's used for diabetics and other people with poor circulation," Escobedo said. "So it's popular in areas with a large middle-aged and elderly population that's well insured. It's an expensive treatment with a high profit margin for the hospital. Which is why they don't want to tie up the chamber with a charity case."

"Okay, I get the picture," Eleanor said. "Now, who is in charge of Arapahoe Highlands Medical Center?"

"The chief administrator is Dr. Morgan," Escobedo said.

Eleanor stood up and yanked her jacket off the back of the chair. "Let's go kick his white ass," she said.

Ray and Escobedo looked astonished and glanced at each other, a bit nervously. "You might want to call ahead and find out where he is first," Ray suggested.

"I'm sure that an important man like Dr. Morgan has a secretary who is very good at putting people like me off - over the phone," Eleanor said. "The more I get in that secretary's face, the more helpful she'll be."

"This may not be an appropriate time for me to get political," Ray said, after they had been driving in silence for a few minutes, humming down Broadway toward the rolling, prosperous southern suburbs. "But this is going to be a long drive and I can't help myself."

"Shoot," Eleanor said. " It would be unlike you not to get political."

"Okay. Well, there is one question you have forgotten to ask me about this whole affair."

"What question is that?"

"Why did the Ramirezes suddenly jump into their truck and take a six-hour drive across the prairie in the middle of the night?"

Eleanor thought that one over, feeling slightly embarrassed. "I thought you said this was what migrant workers do. They migrate."

"They're human beings," Ray said.

"I know that," Eleanor said, somewhat testily. Ray had a tendency to be a little too obnoxious in his political correctness.

"So they have to sleep. They generally do it at night. And they drive during the daytime, like everyone else."

"Okay. So tell me, Ray, why did the Ramirezes suddenly get it into their heads to jump into their truck and go on a long night drive?"

"Because a couple of months ago, after the State of Union address, there was a stock market crash."

Eleanor looked over at Ray. He was smiling back at her mysteriously.

"I'll bite," she said.

"The capital markets crashed. People sold their stocks and needed somewhere else to put their money. In times of economic uncertainty, people tend to invest in commodities. So, on the Chicago Board of Trade, the price of beef went up. Raising cattle became a money-making proposition. But it takes time to raise cattle, you don't make a full-grown steer overnight. So cattlemen in this state began to raise a larger number of calves than usual.