LITMIR.BIZ

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to the privileged few who had made the ascent. It wasn’t a secret that could be imparted to another; you yourself had to live it, to see, with your own eyes, the blackness of space and the blue of earth far below. To be pressed backward into your seat by the thrust of the rockets. Astronauts returning from space often wear a knowing smile, a look that says, I am privy to something that few human beings will ever know.

      Emma had worn such a smile when she’d emerged from Atlantis’s hatch over two years ago. On weak legs she had walked into the sunshine, had stared up at a sky that was startlingly blue. In the span of eight days aboard the orbiter, she had lived through one hundred thirty sunrises, had seen forest fires burning in Brazil and the eye of a hurricane whirling over Samoa, had viewed an earth that seemed heartbreakingly fragile. She had returned forever changed.

      In five days, barring a catastrophe, Chenoweth would share the secret.

      ‘Time to shine some light on these retinas,’ said Chenoweth. ‘My brain still thinks it’s the middle of the night.’

      ‘It is the middle of the night,’ said Emma.

      ‘For us it’s the crack of dawn, folks,’ Vance said. Of all of them, he had been the quickest to readjust his circadian rhythm to the new sleepwake schedule. Now he strode back into the O and C building to begin a full day’s work at three in the morning.

      The others followed him. Only Emma lingered outside for a moment, gazing at the shuttle. The day before, they had driven over to the launchpad for a last review of crew escape procedures. Viewed up close, in the sunlight, the shuttle had seemed glaringly bright and too massive to fully comprehend. One could focus on only a single part of her at a time. The nose. The wings. The black tiles, like reptilian scales on the belly. In the light of day, the shuttle had been real and solid. Now she seemed unearthly, lit up against the black sky.

      With all the frantic preparation, Emma had not allowed herself to feel any apprehension, had firmly banished all misgivings. She was ready to go up. She wanted to go up. But now she felt a sliver of fear.

      She looked up at the sky, saw the stars disappear behind an advancing veil of clouds. The weather was about to change. Shivering, she turned and went into the building. Into the light.

      July 23

      Houston

      Half a dozen tubes snaked into Debbie Haning’s body. In her throat was a tracheotomy tube, through which oxygen was forced into her lungs. A nasogastric tube had been threaded up her left nostril and down her esophagus into the stomach. A catheter drained urine, and two intravenous catheters fed fluids into her veins. In her wrist was an arterial line, and a continuous blood pressure tracing danced across the oscilloscope. Jack glanced at the IV bags hanging over the bed and saw they contained powerful antibiotics. A bad sign; it meant she’d acquired an infection—not unusual when a patient has spent two weeks in a coma. Every breach in the skin, every plastic tube, is a portal for bacteria, and in Debbie’s bloodstream, a battle was now being waged.

      With one glance, Jack understood all of this, but he said nothing to Debbie’s mother, who sat beside the bed, clasping her daughter’s hand. Debbie’s face was flaccid, the jaw limp, the eyelids only partially closed. She remained deeply comatose, unaware of anything, even pain.

      Margaret looked up as Jack came into the cubicle, and gave a nod of greeting. ‘She had a bad night,’ said Margaret. ‘A fever. They don’t know where it’s coming from.’

      ‘The antibiotics will help.’

      ‘And then what? We treat the infection, but what happens next?’ Margaret took a deep breath. ‘She wouldn’t want it this way. All these tubes. All these needles. She’d want us to let her go.’

      ‘This isn’t the time to give up. Her EEG is still active. She’s not brain dead.’

      ‘Then why doesn’t she wake up?’

      ‘She’s young. She has everything to live for.’

      ‘This isn’t living.’ Margaret stared down at her daughter’s hand. It was bruised and puffy from IVs and needle sticks. ‘When her father was dying, Debbie told me she never wanted to end up like that. Tied down and force-fed. I keep thinking about that. About what she said…’ Margaret looked up again. ‘What would you do? If this was your wife?’

      ‘I wouldn’t think about giving up.’

      ‘Even if she’d told you she didn’t want to end up this way?’

      He thought about it for a moment. Then said with conviction, ‘It would be my decision, in the end. No matter what she or anyone else told me. I wouldn’t give up on someone I loved. Ever. Not if there was the smallest chance I could save her.’

      His words offered no comfort to Margaret. He didn’t have the right to question her beliefs, her instincts, but she had asked his opinion, and his answer had come from his heart, not his head.

      Feeling guilty now, he gave Margaret one last pat on the shoulder and left the cubicle. Nature would most likely take the decision out of their hands. A comatose patient with a systemic infection is already on death’s threshold.

      He left the ICU and glumly stepped into the elevator. This was a depressing way to kick off his vacation. First stop, he decided as he stepped off on the lobby level, would be the corner grocery store for a six-pack. An ice-cold beer and an afternoon loading up the sailboat was what he needed right now. It would get his mind off Debbie Haning.

      ‘Code Blue, SICU. Code Blue, SICU.’

      His head snapped up at the announcement over the hospital address system. Debbie, he thought, and dashed for the stairwell.

      Her SICU cubicle was already crowded with personnel. He pushed his way in and shot a glance at the monitor. Ventricular fibrillation! Her heart was a quivering bundle of muscles, unable to pump, unable to keep her brain alive.

      ‘One amp epinephrine going in now!’ one of the nurses called out.

      ‘Everyone stand back!’ a doctor ordered, placing the defibrillator paddles on the chest.

      Jack saw the body give a jolt as the paddles discharged, and saw the line shoot up on the monitor, then sink back to baseline. Still in V fib.

      A nurse was performing CPR, her short blond hair flipping up with each pump on the chest. Debbie’s neurologist, Dr Salomon, glanced up as Jack joined him at the bedside.

      ‘Is the amiodarone in?’ asked Jack.

      ‘Going in now, but it’s not working.’

      Jack glanced at the tracing again. The V fib had gone from coarse to fine. Deteriorating toward a flat line.

      ‘We’ve shocked her four times,’ said Salomon. ‘Can’t get a rhythm.’

      ‘Intracardiac epi?’

      ‘We’re down to Hail Marys. Go ahead!’

      The code nurse prepared the syringe of epinephrine and attached a long cardiac needle. Even as Jack took it, he knew that the battle was already over. This procedure would change nothing. But he thought about Bill Haning, waiting to come home to his wife. And he thought about what he had said to Margaret only moments ago.

       I wouldn’t give up on someone I loved. Ever. Not if there was the smallest chance I could save her.

      He looked down at Debbie, and for one disconcerting moment the image of Emma’s face flashed through his mind. He swallowed hard and said, ‘Hold compressions.’

      The nurse lifted her hands from the sternum.

      Jack gave the skin a quick swab of Betadine and positioned the tip of the needle beneath the xiphoid process. His own pulse was bounding as he pierced the skin. He advanced the needle into the chest, exerting gentle negative pressure.

      A flash of blood told him he was in the heart.

      With one squeeze

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