Just as well, Nikki thought. The less aware the girl was of their circumstances, the better.
"I'm going to try, Sara Jane," she said.
"Ah think he's dead, dead, dead."
"No, see, he's br — "
Nikki stopped in midsentence. Morrissey's wheezing was gone. His contused, swollen throat had finally closed entirely. She checked his pulse, which was weaker than it had been but still present. From this instant until irreparable brain damage, she had three to four minutes to bypass the obstruction and deliver some oxygen to his bloodstream. Almost in spite of herself, she hesitated, her mind unable to get past the likelihood that Morrissey already had an irreparable, progressive brain disease.
Rapidly, though, that notion gave way to thoughts of Kathy Wilson and Hal Sawyer, of Joe Keller and the dead miners, and of the other cases of the Belinda syndrome that Grimes and his crew had probably already dealt with. And suddenly all of her anger, all of her frustration and fear became focused on this young man, innocent of anything more malevolent than doing what his doctor and his mother recommended a decade ago.
Colin Morrissey was not going to die — not if she could help it!
Silently, Nikki cursed herself for not making preparations in advance for an emergency tracheotomy. She had been too wrapped up in their predicament and her pain to think clearly, and possibly she had also been influenced by the hopelessness of the untreatable disease that she believed was ravaging the man's brain. She reminded herself that hindsight was always 20/20. What had happened had happened. What she needed to deal with now was this moment.
"Ellen, I'm going to have to get some sort of airway into him. I'll need your help."
"Just tell me what to do."
Nikki tipped the young man's head back, straightening his windpipe. Morrissey responded with a single, surprisingly effective breath, regaining the precious seconds that had been lost since his last one. In Nikki's mind, the four-minute clock was reset.
"Please keep his head in this position," she said. "Do you by any chance have a pen or anything else that's hollow?"
"I'm afraid not."
"Sara Jane, I'm going to do some things to help this man if I can. There may be some bleeding from his neck."
"Ah seen blood," the girl said, looking about at the cave as if for the first time.
There was no more time to explain. The skin above Colin Morrissey's collarbones was retracting inward as his lungs struggled unsuccessfully to suck in air. Nikki grabbed the first-aid kit and searched through it frantically. The disposable scalpel she had used on Carabetta was there, along with a pair of bandage scissors that she could use as spreaders. Now she needed something round, hollow, and sturdy — something wide enough to allow enough air through, but not so big that it tore the trachea apart. A large-bore needle would buy her a little more time, and a long pen cap would be perfect. Acutely aware of the passing seconds, she dumped the entire kit onto the stone floor. A 2cc syringe, still in its sterile wrapper, had been buried beneath some bandages.
Perfect!
"We're in business," she said.
Nikki discarded the plunger and used the bandage scissors to cut off the end of the barrel where the needle would have attached. The inch-and-a-half-long hollow tube was as good as she could have hoped for.
Pain shot from her ankle as she shifted so that she was hunched over Morrissey's swollen, discolored throat. Ellen clumsily tried to adjust the light while maintaining the neck extension Nikki required.
"Sara Jane," she said finally, "can you shine this lantern right here on this spot?"
"Ah kin do thet."
"Good girl. We need you, Sara Jane. Be steady."
Nikki had no idea how much of the four minutes had elapsed, but there would be no stopping for any reason.
"Not on my watch," she whispered as she focused in. Not on my watch.
She located the spot just above Morrissey's larynx that she felt represented his cricothyroid membrane — the best place to make her incision. If she was wrong, she would make do. But she wasn't going to hesitate, and she was damn well not going to screw up. A dozen or more had already died to make Grimes and his people rich. Hundreds, maybe thousands more were in danger if they succeeded in getting their vaccine onto the market.
But not this man — at least, not now.
Using the precious scalpel, keeping it parallel with the cartilaginous rings of the trachea, she made a stab wound through the skin and straight down through the windpipe. Instantly, a bloody froth bubbled out. Reflexively, Morrissey coughed, spattering Nikki's shirt and chin. The drug he had been given was wearing off. His consciousness was returning. Deftly, mindless of the blood, Nikki inserted the scissors into the incision and spread them to open up the hole. Then she slid the plastic tube down into the trachea. There was a whistling, gurgling sound as the first rush of air entered the man's lungs. Quickly, his breathing calmed.
Minutes later, Colin Morrissey lifted one arm, and soon after that, his eyes fluttered open.
Two more hours passed as Ellen and Sara Jane tended to their four patients. Fred Carabetta remained comatose, although he seemed to respond a bit when cold river water was sponged over his face and lips. Sid, the guard, lay nearby, alternately sobbing and cursing. He was clearly paraplegic, and now was woefully aware of that fact. The woman who had attacked Nikki remained trussed up with tape. She slept much of the time and rattled on incoherently when she was awake. Seemingly mindless of their predicament, Sara Jane crawled from the woman to Morrissey and back, comforting them, sponging their foreheads, holding their hands, and even singing to them.
"They're lak me," she said in one of the rare instances when she spoke to Ellen and Nikki. "They're jes lak me."
Nikki had insisted that Morrissey's hands be taped securely to his belt to prevent him from pulling the tube from his makeshift tracheotomy. Now, exhausted and more apprehensive each minute, she lay on the dusty floor, propped against a large boulder, her injured, throbbing leg elevated on a pile of stones. There was nothing more she could do now than wait. Horrible visions kept impinging on her mind — visions of Matt, his body wedged forever between two rocks, his limbs wafting lifelessly in the black water. In addition, the sickly sweet air seemed to be getting thicker and harder to breathe. Was it vanishing already?
Not with a bang, but a whimper… Not with a bang…
As she lay there, Nikki marveled at Ellen, who remained in almost constant motion, tending to the others, speaking cheerfully and hopefully with them and with Sara Jane. Periodically she would return to where Nikki lay to assure her that her patients were okay, and that Matt was going to make it, and so were they. On this trip, however, she had no such message. For the first time, tension etched her face.
"I'm going to try the river," she said.
"What?"
"I won't go downstream, but I have to try something. It's been almost three hours and I think we might be running low on air. Do you think you can manage without me?"
What difference does it make? Nikki stopped herself from saying.
"I'll do what I can do," she said instead. "You don't think he made it out, do you?"
Ellen sat beside her and took her hands.
"I don't know what I think right now, except that we can't just sit back and let them win. For one thing, we both have new men in our lives. I want to see how that turns out for me. And for another, in just a few hours that vaccine is going to be the standard of care.
Pediatricians all over the country have been primed by the public-relations people from the pharmaceutical houses and the dear President and his wife. I wouldn't be surprised if a couple of thousand doses of the stuff get administered by sunset today."