shuttle makes the most sense. If Kenichi needs to get home, then you come pick him up. Let the rest of us stay here and do our jobs.'
'Can a rescue wait that long?' asked Todd.
'How soon can you get that bird up here?' said Griggs.
'We have to talk logistics. Launch windows -- '
'Just tell us how long.'
Cutler paused. 'Flight Director Ellis is standing by. Go ahead, Flight.'
What had started as a closed and confidential loop between two physicians was now open to the flight director. They heard Woody Ellis say, 'Thirty-six hours. That's the earliest possible launch.'
A lot could change in thirty-six hours, Emma thought. An ulcer could perforate or hemorrhage. Pancreatitis could lead to shock and circulatory collapse.
Or Kenichi could recover completely, the victim of-nothing worse than a severe intestinal infection.
'Dr. Watson's the one examining the patient,' Ellis said. 'We're relying on her judgment here. What's the clinical call?'
Emma thought about it. 'He doesn't have an acute surgical abdomen -- not at the moment. But things could go bad fast.'
'So you're not sure.'
'No, I'm not.'
'The instant you give us the word, we'll still need twenty-four hours for fueling.'
A whole day's lag between a call for rescue, and the actual launch, plus additional time for rendezvous. If Kenichi suddenly took a turn for the worse, could she keep him alive that long? The situation had turned nerve- racking. She was a physician, not a fortune-teller. She had no X rays at her disposal, no operating room.
The physical exam and blood tests were abnormal but nonspecific. If she chose to delay rescue, Kenichi might die. If called for help too soon, millions of dollars would be wasted on an unnecessary launch.
A wrong decision either way would end her career with NASA. This was the tightrope Jack had warned her about. I screw up, and the whole world knows. They're waiting to see if I've got the right stuff.
She looked down at the printout of Kenichi's blood tests.
Nothing she saw there justified hitting the panic button. Not yet.
She said, 'Flight, I'm going to keep him on IVS and start NG suction. Right now his vital signs are looking stable. If I just knew what was going on in his belly.'
'So in your opinion, emergency shuttle launch is not yet indicated?'
She released a deep breath. 'No. Not yet.'
'We will nevertheless be poised and ready to light Discovery's candle, should it be necessary.'
'I appreciate that. I'll get back to you later with a medical update.' She signed off and looked at Griggs. 'I hope I'm making the right call.'
'Just cure him, okay?' She went to check on Kenichi. Because he would need attention throughout the night, she'd moved him out of the hab module and into the U.S. Lab, so the rest of the crew would not have sleep disturbed. He was zipped into a restraint bag. An infusion pump fed a steady flow of saline solution into his intravenous line.
He was awake and obviously in discomfort.
Luther and Diana, who'd been watching the patient, both looked relieved to see Emma. 'He vomited again,' said Diana.
Emma anchored her feet to hold her position and slipped the stethoscope on her ears. Gently she placed the diaphragm on Kenichi's abdomen. Still no bowel sounds. His digestive tract had shut down, and fluid would begin to accumulate in his stomach.
That fluid needed to be drained.
'Kenichi,' she said, 'I'm going to insert a tube into your stomach. It will help the pain, and maybe stop the vomiting.'
'What -- what tube?'
'A nasogastric tube.' She opened the ALSP medical kit. Inside was a broad array of supplies and drugs, a collection as complete a modern ambulance's. In the drawer marked 'Airway' were various tubes, suction devices, collection bags, and a laryngoscope. She tore open the packet containing the long nasogastric tube. It was thin and coiled, made of flexible plastic, with a perforated tip.
Kenichi's bloodred eyes widened.
'I'll be as gentle as I can,' she said. 'You can help it go by taking a sip of water when I ask you to. I'm going to insert end into your nostril. The tube will go down the back of your throat, and when you swallow the water, the tube will pass into your stomach. The only uncomfortable part will be right at the beginning, when I first slip it in. After it's in place, it won't bother you at all.'
'How long does it stay inside?'
'A day, at least. Until your intestines start working again.' added, gently, 'It really is necessary, Kenichi.' He sighed and nodded.
Emma glanced at Luther, who was looking more and more horrified by the idea of this tube. 'He'll need water to sip. Could get some?' Then she looked at Diana, who was floating nearby. As usual, Diana looked unperturbed, coolly detached from the crisis.
'I need NG suction set up.' Diana automatically reached into the ALSP kit for the suction device and collection bag.
Emma uncoiled the NG tube. First she dipped the tip in lubricant gel, to ease its passage through the nasopharynx. Then she handed Kenichi the pouch of water, which Luther had filled.
She gave Kenichi's arm a reassuring squeeze. Though dread was plain to see in his eyes, he returned a nod of consent.
The perforated end of the tube glistened with lubricant. She inserted the tip into his right nostril and gently advanced it deeper, into his nasopharynx. He gagged, eyes watering, and began to in protest as the tube slid down the back of his throat. She pushed it deeper. He was twitching now, fighting the overwhelming to thrust her away, to yank the tube out of his nose.
'Swallow some water,' she urged.
He wheezed and with a trembling hand brought the straw to his lips.
'Swallow, Kenichi,' she said.
When a bolus of water is passed from the throat into the esophagus, the epiglottis reflexively closes over the opening to the trachea, preventing any leakage into the lungs. It would also pass tube down the correct passageway. The instant she saw him begin to swallow, she swiftly advanced the tube, threading it the throat and down the esophagus, until it slid in far enough for the tip to be in the stomach.
'All done,' she said, taping the tube to his nose. 'You did fine.'
'Suction's ready,' said Diana.
Emma connected the NG tube to the suction device. They heard a few gurgles, then fluid suddenly appeared in the tube, flowing out of Kenichi's stomach, into the drainage bag. It was green, no blood, Emma noted with relief. Perhaps this was all the treatment he needed -- bowel rest, NG suction, and intravenous fluids. If he did indeed have pancreatitis, this therapy alone would carry him through the next few days, until the shuttle arrived.
'My head -- it hurts,' said Kenichi, closing his eyes.
'I'll give you something for the pain,' said Emma.
'So what do you think? Crisis averted?' It was Griggs speaking.
He had watched the procedure from the hatchway, and even though the tube was now inserted, Griggs hung back, as though repulsed by the mere sight of illness. He did not even look at the patient, but kept his gaze focused on Emma.
'We'll have to see,' she said.
'What do I tell Houston?'
'I just got the tube in. It's too early.'
'They need to know soon.'
'Well, I don't know!' she snapped. Then, swallowing her temper, she said more calmly, 'Can we discuss
