Everything Shelby knew about science, medicine and police work told him there was a logical explanation for everything. He recalled that in the police academy, they taught two main principles. Number one, follow procedure. Number two, there is a reason for everything and it’s usually simple. Somehow, as he sat waiting for Salinas to answer him, things didn’t seem simple.
Salinas looked tired as he pushed himself up and said, “Captain, please, just follow me to ICU, okay?”
Shelby paused, then followed. The light was dim, and an eerie sensation of death hung in the air of the ICU ward. He felt chilled by the surrealistic gloom of the room’s low level illumination and its hushed stillness, broken only by the rhythmical beeps of cardiac monitors and the steady push-pull mechanical hiss of the respirators. Salinas moved with familiarity to an alcove where one of the HBV victims lay in a waist-high bed, surrounded by intravenous bottles and state-of-the-art medical equipment. The cubicle had the appearance of a jumbo jet cockpit. Shelby immediately noticed that none of the electrical leads or chemical tubes were connected to a body in the bed that looked more like a mummy than a person.
Salinas stood close to the patient, a pensive look on his face. Shelby said nothing and waited. The seconds ticked by, and Shelby found himself breathing in rhythm with the respirators in the background. He glanced around the room and saw that some of the patients were awake, but most appeared to be asleep. An unsettling feeling had lingered in his mind ever since Esquivel had phoned him. Now that feeling of uncertainty spread to every atom of his being.
A nurse appeared from nowhere. “There’s been no change, Doctor.” Her nametag read Tessy Wilson, ICU. She was tall with keen eyes that sparkled, even in the subdued light. She was very attractive with her dark hair pulled back into a tight knot.
Salinas nodded and turned to Shelby. “Normally one of the critical aspects of patient care in ICU is maintaining fluid balance. But in these brain virus cases, the patients are maintaining perfect values on their own. It’s the darnedest thing I’ve ever seen. There’s just no reasonable explanation.”
Salinas moved to the other side of the bed, never taking his eyes off his charge. He continued to talk in a monotone that seemed to quiver with uncertainty, maybe even fear. “When a patient is comatose, they usually have a flat line EKG. Frankly, they almost never wake up. The brain is dead, and with our present knowledge, we have no way to repair it or bring it back. The patient simply becomes a vegetable of sorts. The heart continues to beat but everything else must be done for him. Fluids in, fluids out, breathing, electrolytes, temperature, everything.”
Shelby nodded and asked, “That’s what’s happening here?”
“No, with these HBV victims, nothing seems to follow expected norms. Let me try to explain what’s happening here. Normally, when people are brought to the emergency room with trauma, they are unconscious or in shock. They feel no pain for the first thirty minutes or so. Most of the time people don’t realize the extent of their injuries because of this mild shock. However, after thirty or forty minutes, they usually begin to experience the realities of their injury. Without proper management, they may go into deep shock with vaso-vagal reactions.
“We see a lot of head injuries in ER. It’s a very common cause of death and disability. Almost half of these victims are unconscious when they are admitted to the hospital.” Salinas paused, trying to pick his words. “A lot of these people just don’t make it. They simply die from their injuries. Come here, I want to show you something.”
Shelby moved closer. Salinas pulled down the patient’s lower eyelid and shined a small penlight into the eye. Shelby caught a quick breath and stared into a black pool that covered the entire iris. “Notice the eye is fixed and dilated,” Salinas said. Shelby stared into the depth of an eye that had been robbed of life and the ability to communicate, to love or to hate.
“That’s a sure sign he’s brain dead,” Salinas continued, “but when we run an EKG, there’s more activity on the strips than you would ordinarily see on a normal healthy person. However, they don’t follow any pattern we would expect. I mean no one has ever seen waves like these.”
Salinas shook his head in bewilderment. “There’s no way this person should be alive now. He came in with severe head trauma and a collapsed lung. In fact, this one had several broken ribs and a sucking chest wound. When the EMS arrived he had no pulse, but the ECG showed normal activity. When the ER attendant pierced the heart with a cardiac needle, he found the heart had burst from the trauma. When he did a paracentesis, he found a cavity full of blood. Almost every bone in this man’s body has been broken or shattered. He was hit by a garbage truck on the interstate. He should be dead, not lying here in a bed, somehow living on his own with no life support. This is unnatural to the extreme.” When Salinas released the eyelid, it didn’t move back into place. He gently closed it and turned off the penlight, looking perplexed.
“Doctor, are you saying these five men are all in some sort of coma?” Shelby asked. “I’m sorry, but I’m having a hard time understanding all of this.”
“No, Captain. These men are not in a coma. Their condition is in most ways, just the opposite from a coma. In a coma, there’s a flat EKG indicating little or no brain activity. These men have very active EKGs and somehow…somehow they are keeping themselves alive. We don’t see any tissue repair, but somehow they’ve taken a lickin’ and kept on tickin’.” Salinas seemed embarrassed by his choice of words and tried to justify them. “The nurses are calling them the Timex Men.”
Chapter 2
Salinas was about to say something else when his pager went off. “Dr. Salinas to ER, STAT.”
“I hope it’s not another one,” he said. He looked very apprehensive as he turned and started off in a rush, seeming to forget that Shelby was there. By the time they reached the elevators, Salinas was in a run. Not wanting to wait, he turned to the stairs and dashed through swinging doors. Shelby looked at his watch as the doors slammed in his face. 8:00 a.m. already? Quickly he pushed the heavy door open and rushed into the stairwell. He could hear Salinas somewhere just below him. The footsteps were quick, and then he heard a door open and slam shut. It was quiet in the stairwell. All he could hear were his own steps and the sound of his heart thumping in his ears.
The EMS paramedics had called ahead to Ben Taub Hospital. The emergency room staff was waiting when Shelby raced into the hallway near the trauma rooms. When the double glass doors slid open with a swishing sound, four paramedics and three uniformed police officers rushed in. All seven of them were struggling frantically to control a naked man on the gurney. Perspiration dripped from their faces as they quickly moved into Trauma Room One.
Although he was strapped to the cart, the man on the gurney screamed, struggling with unbelievable force. Shelby stood back against the wall, out of the way of the trauma room personnel and the seven men who were still in a battle to hold the ghastly looking man in place. Blood soaked the gurney, streaming from a gash in his chest. With each scream, blood spurted from his mouth.
“Can’t you give him something to quiet him down? Man, he’s strong,” one of the uniformed police officers shouted to Salinas, as he wiped sweat and blood from his own face with his shirtsleeve.
Dr. Salinas looked up at the officer. Blood stood in beads on the doctor’s glasses and his face. The front of his shirt and coat were covered with blood. He started to say something to the senior ER resident but decided against it. Instead, he went back to work on what had become HBV victim number six.
Now the shock/trauma unit of the ER had only one responsibility and that was to control the bleeding caused by the penetrating wound.
“Let’s move it,” Salinas ordered. The ER team pushed their way into positions around the table. Each had their own job as trays of needles, sponges, forceps and knives were shifted into place. Clamps were used to control the bleeding. A dozen hands inserted catheters and tubes. They all were working to stabilize a man who was only known as John Doe.
“Sponge,”