tion of protocol--became projectiles. The stretcher they hadn't had to use for Mr. Galen bounced off one wall. A stethoscope found the pass-through, smacked the windshield, and fell onto the center console.
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For Thomas Harris
Get me a gun
Go back into my room
I'm gonna get me a gun
One with a barrel or two
You know I'm better off dead than
Singing these suicide blues.
--Cross Canadian Ragweed
APRIL 10, 2009
It's always darkest before the dawn.
This elderly chestnut occurred to Rob Martin as the ambulance he drove rolled slowly along Upper Marlborough Street toward home base, which was Firehouse 3. It seemed to him that whoever thought that one up really got hold of something, because it was darker than a woodchuck's asshole this morning, and dawn wasn't far away.
Not that this daybreak would be up to much even when it finally got rolling; call it dawn with a hangover. The fog was heavy and smelled of the nearby not-so-great Great Lake. A fine cold drizzle had begun to fall through it, just to add to the fun. Rob clicked the wiper control from intermittent to slow. Not far up ahead, two unmistakable yellow arches rose from the murk.
"The Golden Tits of America!" Jason Rapsis cried from the shotgun seat. Rob had worked with any number of paramedics over his fifteen years as an EMT, and Jace Rapsis was the best: easygoing when nothing was happening, unflappable and sharply focused when everything was happening at once. "We shall be fed! God bless capitalism! Pull in, pull in!"
"Are you sure?" Rob asked. "After the object lesson we just had in what that shit can do?"
The run from which they were now returning had been to one of the McMansions in Sugar Heights, where a man named Harvey Galen had called 911 complaining of terrible chest pains. They had found him lying on the sofa in what rich folks no doubt called "the great room," a beached whale of a man in blue silk pajamas. His wife was hovering over him, convinced he was going to punch out at any second.
"Mickey D's, Mickey D's!" Jason chanted. He was bouncing up and down in his seat. The gravely competent professional who had taken Mr. Galen's vitals (Rob right beside him, holding the First In Bag with its airway management gear and cardiac meds) had disappeared. With his blond hair flopping in his eyes, Jason looked like an overgrown kid of fourteen. "Pull in, I say!"
Rob pulled in. He could get behind a sausage biscuit himself, and maybe one of those hash brown thingies that looked like a baked buffalo tongue.
There was a short line of cars at the drive-thru. Rob snuggled up at the end of it.
"Besides, it's not like the guy had a for-real heart attack," Jason said. "Just OD'd on Mexican. Refused a lift to the hospital, didn't he?"
He had. After a few hearty belches and one trombone blast from his nether regions that had his social X-ray of a wife booking for the kitchen, Mr. Galen sat up, said he was feeling much better, and told them that no, he didn't think he needed to be transported to Kiner Memorial. Rob and Jason didn't think so, either, after listening to a recitation of what Galen had put away at Tijuana Rose the night before. His pulse was strong, and although his blood pressure was on the iffy side, it probably had been for years, and was currently stable. The automatic external defibrillator never came out of its canvas sack.
"I want two Egg McMuffins and two hash browns," Jason announced. "Black coffee. On second thought, make that three hash browns."
Rob was still thinking about Galen. "It was indigestion this time, but it'll be the real thing soon enough. Thunderclap infarction. What do you think he went? Three hundred? Three fifty?"
"Three twenty-five at least," Jason said, "and stop trying to spoil my breakfast."
Rob waved his arm at the Golden Arches rising through the lake-effect fog. "This place and all the other greasepits like it are half of what's wrong with America. As a medical person, I'm sure you know that. What you just ordered? That's nine hundred calories on the hoof, bro. Add sausage to the Egg McMuffdivers and you're riding right around thirteen hundred."
"What are you having, Doctor Health?"
"Sausage biscuit. Maybe two."
Jason clapped him on the shoulder. "My man!"
The line moved forward. They were two cars from the window when the radio beneath the in-dash computer blared. Dispatchers were usually cool, calm, and collected, but this one sounded like a radio shock jock after too many Red Bulls. "All ambulances and fire apparatus, we have an MCI! I repeat, MCI! This is a high-priority call for all ambulances and fire apparatus!"
MCI, short for mass casualty incident. Rob and Jason stared at each other. Plane crash, train crash, explosion, or act of terrorism. It almost had to be one of the four.
"Location is City Center on Marlborough Street, repeat City Center on Marlborough. Once again, this is an MCI with multiple deaths likely. Use caution."
Rob Martin's stomach tightened. No one told you to use caution when heading to a crash site or gas explosion. That left an act of terrorism, and it might still be in progress.
Dispatch was going into her spiel again. Jason hit the lights and siren while Rob cranked the wheel and pulled the Freightliner ambo into the lane that skirted the restaurant, clipping the bumper of the car ahead of him. They were just nine blocks from City Center, but if Al-Qaeda was shooting the place up with Kalashnikovs, the only thing they had to fire back with was their trusty external defibrillator.
Jason grabbed the mike. "Copy, Dispatch, this is 23 out of Firehouse 3, ETA just about six minutes."
Other sirens were rising from other parts of the city, but judging from the sound, Rob guessed their ambo was closest to the scene. A cast iron light had begun creeping into the air, and as they wheeled out of McDonald's and onto Upper Marlborough, a gray car knitted itself out of the gray fog, a big sedan with a dented hood and badly rusted grille. For a moment the HD headlights, on high beam, were pointed straight at them. Rob hit the dual air-horns and swerved. The car--it looked like a Mercedes, although he couldn't be sure--slewed back into its own lane and was then nothing but taillights dwindling into the fog.
"Jesus Christ, that was close," Jason said. "Don't suppose you got the license plate?"
"No." Rob's heart was beating so hard he could feel it pulsing on both sides of his throat. "I was busy saving our lives. Listen, how can there be multiple casualties at City Center? God isn't even up yet. It's gotta be closed."
"Could've been a bus crash."
"Try again. They don't start running until six."
Sirens. Sirens everywhere, beginning to converge like blips on a radar screen. A police car went bolting past them, but so far as Rob could tell, they were still ahead of the other ambos and fire trucks.
Which gives us a chance to be the first to get shot or blown up by a mad Arab shouting Allahu akbar, he thought. How nice for us.
But the job was the job, so he swung onto the steep drive leading up to the main city administration buildings and the butt-ugly auditorium where he'd voted until moving out to the suburbs.
"Brake!" Jason screamed. "Jesus-fuck, Robbie, BRAKE!"
Scores of people were coming at them from the fog, a few sprinting nearly out of control because of the incline. Some were screaming. One guy fell down, rolled, picked himself up, and ran on with his torn shirttail flapping beneath his jacket. Rob saw a woman with shredded hose, bloody shins, and only one shoe. He came to a panic stop, the nose of the ambo dipping, unsecured shit flying. Meds, IV bottles, and needle packs from a cabinet left unsecured--a viola
"Creep along," Jason said. "Just creep, okay? Let's not make it worse."
Rob feathered the gas and continued up the slope, now at walking pace. Still they came, hundreds, it seemed, some bleeding, most not visibly hurt, all of them terrified. Jason unrolled the passenger window and leaned out.
"What's going on? Somebody tell me what's going on!"
A man pulled up, red-faced and gasping. "It was a car. Tore through the crowd like a mowing machine. Fucking maniac just missed me. I don't know how many he hit. We were penned in like hogs because of the posts they set up to keep people in line. He did it on purpose and they're laying around up there like . . . like . . . oh man, dolls filled with blood. I saw at least four dead. There's gotta be more."
The guy started to move on, plodding now instead of running as the adrenaline faded. Jason unhooked his seatbelt and leaned out to call after him. "Did you see what color it was? The car that did it?"
The man turned back, pale and haggard. "Gray. Great big gray car."
Jason sat back down and looked at Rob. Neither of them had to say it out loud: it was the one they had swerved to avoid as they came out of McDonald's. And that hadn't been rust on its snout, after all.
"Go, Robbie. We'll worry about the mess in back later. Just get us to the prom and don't hit anyone, yeah?"
By the time Rob arrived in the parking lot, the panic was abating. Some people were leaving at a walk; others were trying to help those who had been struck by the gray car; a few, the assholes present in every crowd, were snapping photos or making movies with their phones. Hoping to go viral on YouTube, Rob assumed. Chrome posts with yellow DO NOT CROSS tape trailing from them lay on the pavement.
The police car that had passed them was parked close to the building, near a sleeping bag with a slim white hand protruding. A man lay sprawled crossways on top of the bag, which was in the center of a spreading bloodpuddle. The cop motioned the ambo forward, his beckoning arm seeming to stutter in the swinging blue glare of the lightbar atop his cruiser.
Rob grabbed the mobile data terminal and got out while Jason ran around to the rear of the ambo. He emerged with his First In Bag and the external defibrillator. The day continued to brighten, and Rob could read the sign flapping over the main doors of the auditorium: 1000 JOBS GUARANTEED! We Stand With the People of Our City! MAYOR RALPH KINSLER.
Okay, that explained why there had been such a crowd, and so early in the morning. A job fair. Times were tough everywhere, had been since the economy had its own thunderclap infarction the year before, but they had been especially tough in this little lakefront city, where the jobs had started bleeding away even before the turn of the century.
Rob and Jason started toward the sleeping bag, but the cop shook his head. His face was ashen. "This guy and the two in the bag are dead. His wife and baby, I guess. He must have been trying to protect them." He made a brief sound deep in his throat, something between a burp and a retch, clapped a hand over his mouth, then took it away and pointed. "That lady there might still be with us."
The lady in question was sprawled on her back, her legs twisted away from her upper body at an angle that suggested serious trauma. The crotch of her dressy beige slacks was dark with urine. Her face--what remained of it--was smeared with grease. Part of her nose and most of her upper lip had been torn away. Her beautifully capped teeth were bared in an unconscious snarl. Her coat and half of her roll-neck sweater had also been torn away. Great dark bruises were flowering on her neck and shoulder.
Fucking car ran right over her, Rob thought. Squashed her like a chipmunk. He and Jason knelt beside her, snapping on blue gloves. Her purse lay nearby, marked by a partial tire track. Rob picked it up and heaved it into the back of the ambo, thinking the tire print might turn out to be evidence, or something. And of course the woman would want it.
If she lived, that was.
"She's stopped breathing, but I got a pulse," Jason said. "Weak and thready. Tear down that sweater."
Rob did it, and half the bra, straps shredded, came with it. He pushed the rest down to get it out of the way, then began chest compressions while Jason started an airway.
"She going to make it?" the cop asked.
"I don't know," Rob said. "We got this. You've got other problems. If more rescue vehicles come steaming up the drive like we almost did, someone's gonna get killed."
"Ah, man, there are people lying hurt everywhere. It's like a battlefield."
"Help the ones you can."
"She's breathing again," Jason said. "Get with me, Robbie, let's save a life here. Hop on the MDT and tell Kiner we're bringing in a possible neck fracture, spinal trauma, internal injuries, facial injuries, God knows what else. Condition critical. I'll feed you her vitals."
Rob made the call from the mobile data terminal while Jason continued squeezing the Ambu bag. Kiner ER answered immediately, the voice on the other end crisp and calm. Kiner was a Level I trauma center, what was sometimes called Presidential Class, and ready for something like this. They trained for it five times a year.
With the call-in made, he got an O2 level (predictably lousy) and then grabbed both the rigid cervical collar and the orange backboard from the ambo. Other rescue vehicles were arriving now, and the fog had begun to lift, making the magnitude of the disaster clear.
All with one car, Rob thought. Who would believe it?
"Okay," Jason said. "If she ain't stable, it's the best we can do. Let's get her onboard."
Careful to keep the backboard perfectly horizontal, they lifted her into the ambo, placed her on the stretcher, and secured her. With her pallid, disfigured face framed by the cervical collar, she looked like one of the ritual female victims in a horror movie . . . except those were always young and nubile, and this woman looked to be in her forties or early fifties. Too old to be job-hunting, you would have said, and Rob only had to look at her to know she would never go job-hunting again. Or walk, from the look of her. With fantastic luck, she might avoid quadriplegia--assuming she got through this--but Rob guessed that her life from the waist down was over.
Jason knelt, slipped a clear plastic mask over her mouth and nose, and started the oxygen from the tank at the head of the stretcher. The mask fogged up, a good sign.
"Next thing?" Rob asked, meaning What else can I do?
"Find some epi in that junk that flew around, or get it out of my bag. I had a good pulse for awhile there, but it's gone thready again. Then fire this monkey up. With the injuries she's sustained, it's a miracle she's alive at all."
Rob found an ampoule of epinephrine under a tumbled box of bandages and handed it over. Then he slammed the back doors, dropped into the driver's seat, and got cranking. First to the scene at an MCI meant first to the hospital. That would improve this lady's slim chances just a little bit. Still, it was a fifteen-minute run even in light morning traffic, and he expected her to be dead by the time they got to Ralph M. Kiner Memorial Hospital. Given the extent of her injuries, that might be the best outcome.
But she wasn't.
At three o'clock that afternoon, long after their shift was over but too wired to even think about going home, Rob and Jason sat in the ready-room of Firehouse 3, watching ESPN on mute. They had made eight runs in all, but the woman had been the worst.
"Martine Stover, that was her name," Jason said at last. "She's still in surgery. I called while you were in the can."
"Any idea what her chances are?"
"No, but they didn't just let her crater, and that means something. Pretty sure she was there looking for an executive secretary's position. I went in her purse for ID--got a blood type from her driver's license--and found a whole sheaf of references. Looks like she was good at her job. Last position was at the Bank of America. Got d
"And if she lives? What do you think? Just the legs?"
Jason stared at the TV, where basketball players were running fleetly up the court, and said nothing for a long while. Then: "If she lives, she's gonna be a quad."
A beer ad came on. Young people dancing up a storm in a bar. Everyone having fun. For Martine Stover, the fun was over. Rob tried to imagine what she would be facing if she pulled through. Life in a motorized wheelchair that she moved by puffing into a tube. Being fed either pureed gluck or through IV tubes. Respirator-assisted breathing. Shitting into a bag. Life in a medical twilight zone.
"Christopher Reeve didn't do so bad," Jason said, as if reading his thoughts. "Good attitude. Good role model. Kept his chin up. Even directed a movie, I think."
"Sure he kept his chin up," Rob said. "Thanks to a cervical collar that never came off. And he's dead."
"She was wearing her best clothes," Jason said. "Good slacks, expensive sweater, nice coat. Trying to get back on her feet. And some bastard comes along and takes it all."
"Did they get him yet?"
"Not the last I heard. When they do, I hope they string him up by the nutsack."
The following night, while delivering a stroke victim to Kiner Memorial, the partners checked on Martine Stover. She was in the ICU, and showing those signs of increasing brain function that signal the imminent recovery of consciousness. When she did come back, someone would have to give her the bad news: she was paralyzed from the chest down.
Rob Martin was just glad it wouldn't have to be him.
And the man the press was calling the Mercedes Killer still hadn't been caught.
A pane of glass breaks in Bill Hodges's pants pocket. This is followed by a jubilant chorus of boys, shouting "That's a HOME RUN!"
Hodges winces and jumps in his seat. Dr. Stamos is part of a four-doctor cabal, and the waiting room is full this Monday morning. Everyone turns to look at him. Hodges feels his face grow warm. "Sorry," he says to the room at large. "Text message."