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‘Dr Walker, this is Sergeant Jim Gardiner from the Elmendorf-Richardson base in Anchorage. Are you OK?’

‘Yes, I’m OK.’

‘Is the aircraft armed?’

‘Tell him exactly as it is,’ said Yumatov.

Two searchlights came on from each of the skids showing a landscape of snow and rocks.

‘There is a machine gun on either side of me,’ said Carrie.

‘International regulations require arming of aircraft for protection against polar bears,’ said Yumatov.

Irritation crept into Gardiner’s tone. ‘OK, Colonel. No one’s cracking jokes around here. Get your aircraft back down on the Little Diomede helipad and no one’s going to get hurt.’

The top of the island was a white plateau speckled with dark rocks. The pilot bought the aircraft to a hover. He turned westwards and tilted the beam of his spotlight. Snow blew across the surface from the rotor blades, and when it cleared Carrie saw a scene that took her straight back to the worst human carnage of Iraq. An overhead light shone on her face.

‘These images and our conversation are now being broadcast live on Russian television,’ said Yumatov. ‘The internal camera is showing Dr Carrie Walker. Are you hearing me, Sergeant Gardiner?’

‘Copy that.’

‘We need Dr Walker to confirm that these men are dead and to treat the wounded if any have survived.’

‘Copy that.’ Gardiner’s voice stayed flat and carried no reaction.

‘We came here on a humanitarian mission to save a young woman’s life. Your government must answer to the international community as to why nine of our comrades have been murdered in cold blood.’

‘Copy that.’

‘Do more than that, damn you. Guarantee us safe passage.’

‘I am awaiting orders, Colonel.’

Jagged granite rocks, caked in ice, stuck out from the snow. The helicopter was inches from the ground, swaying so erratically that Carrie couldn’t see any way to get down to examine the bodies. In any case, none could have survived. She had seen plenty of gunshot deaths. But these were different. This was Rake’s work. One by one, bullet by bullet, he had killed each one of them. A couple had died cleanly, but three of them had been torn up and mutilated by lead.

The four soldiers facing her unclipped their belts and jumped out. They loaded the dead into the back of the aircraft and signaled to the pilot. Rake had killed five. Four men were taking their place. Her headphones echoed with the emptiness of radio static.

The pilot took the helicopter up and turned towards Big Diomede. An eerie band of cloud ringed the island. She saw the shapes of observation posts dotted along its looming ridges. At the bottom, ice glowed against dark rocks. She found herself leaning out, looking down, following tracks in the ice, seeing water flows, huge serrated blocks taller than a person and flat white like a skating rink. She hoped she would see Rake. She scanned the landscape for her killing machine of a fiancé while waiting for an American missile to shoot them down.

As they came around the northern edge, she saw the military base, rows of helicopters, their blades drooping, people moving around, and long white concrete buildings with gun emplacements on the roofs. She counted ten helicopters, six white and four green, of varying sizes. The three biggest, with two sets of rotor blades, were for transport. There were more inside the large open hangars. There were no fixed-wing aircraft, and the short airfield didn’t look big enough to take one. Men wheeled trolleys towards them. She smelt aviation fuel. The base formed part of the curve of the mountainside, and with the snow it was difficult to tell what was natural, what was concrete, and what had been hewn out of the granite. The wind was weaker around this side of the island.

Two men in dark green overalls helped her down from the helicopter and led her across the tarmac towards the long single-story building. A wooden plaque of the Russian flag was displayed above the entrance. As the door slid open, she was faced with plastic transparent strips hanging down as extra protection against the weather. She walked through them into a small hallway with bright overhead lights. Warmth hit her face, and the sudden change of temperature set her blood tingling. In Russian, she asked to see the patients. The men led her into a room on the right that looked like a reception area with a set of black leather sofas and chairs and a meeting table. There was a line of stainless-steel food containers on warmers. The soldiers left the room, closed the door, and locked it.

Years of emergency medicine had taught Carrie to eat and sleep whenever she had a chance. The meal was a beef stew with cabbage and rice. She ate fast, not realizing how hungry she was. She washed it down with bottled water and felt strength return. She poured a cup of coffee, black, no sugar.

The door opened with a flourish. She had expected a military person to be in charge, but the short stocky man who strode in was dressed in a dark pinstripe suit with a tiny Russian flag pinned to his right lapel. ‘How is your meal?’ he asked in English.

Carrie stood up, coffee cup in hand. ‘I need to see the mother and baby. Then I will determine if they can safely be taken back to the island.’

‘I’m Admiral Alexander Vitruk, commander of the Far East Military District.’ He spoke fluently, his English, like Yumatov’s, laced with an American accent. He poured himself a small cup of coffee and downed it quickly. ‘Come, then, if you’ve finished; I’ll take you to them.’

He held the door open. Several men fell in behind as they led her into a control room with rows of computers and television feeds on the wall. On one screen, there was a split image of Carrie in the helicopter and a map of the Diomede islands. Vitruk took her through a tented walkway warmed by large overhead electric heaters into a mobile field hospital. She had worked in many. This had six beds, three on each side. Akna was the only patient, on a drip, propped up in bed holding her baby daughter.

Carrie wasn’t a pediatrician but she didn’t like what she saw. The head looked enlarged and the baby wore a gray woolen hat often used for premature births. A monitor recorded Akna’s heart and breathing, which were within an acceptable range. The incubator was on the left side of the bed. Rake’s uncle and aunt, Henry and Joan Ahkvaluk, sat together on two upright wooden chairs to the right. They stood up when they saw Carrie.

‘Are you guys OK?’ she asked.

‘The baby is very sick,’ said Joan. ‘She has water on the brain, and they don’t know what to do.’

Carrie looked for a bedside clipboard. There was none. ‘What medication is she on?’

‘They won’t tell us.’

She took a tube of antiseptic gel from her pocket, sanitized her hands, and put on a pair of blue polymer medical gloves from her medical bag. She sat on the bed. ‘Akna, I’m Carrie. Remember? I was with you before you came here.’

Akna stared at her, eyes dulled by drugs. American military painkillers weren’t subtle. Russian ones would be even worse.

‘You’ve given her a name, Iyaroak. It’s beautiful.’ Carrie checked her pulse, which was slow. She pulled down the covers to see the Caesarean wound. It was clean, without infection. But the stitching was rough, and Akna would be scarred there for life. She put the covers back and turned her attention to the baby. Gently, she slid back the woolen hat. Iyaroak didn’t react. Her eyes were tilted down, which was a symptom matching what Joan had described, corroborated by the head size. The soft bones of Iyaroak’s skull were being pushed out by cranial fluid that was not draining away as it should, instead putting pressure on the tiny unformed brain. If it were not treated immediately, Iyaroak could be left seriously disabled with brain damage. Or she would die.