hospital’s security videos shared the same mainframe that housed its impressive — though not entirely secure — patient information system, where Asad’s vital signs were just now being recorded by a special set of instruments.
Contrary to the calculations of the experts who’d said the accident wouldn’t produce any real injuries, the driver of Asad bin Taysr’s car had suffered a compound leg fracture, but otherwise everything was proceeding smoothly. Lia had indicated that Asad had been stunned but not hurt, exactly as planned. Now, however, Rubens realized that the terror leader’s blood pressure numbers were not what they had expected. He walked up the wide steps at the center of the Art Room to a set of consoles where an NSA doctor was monitoring the situation, standing by to give the team advice if needed.
“Asad’s blood pressure — is it wrong?” he asked.
“It’s low,” said the doctor. “It’s the opposite of what was supposed to happen from the drugs Lia gave him. Perhaps it’s a reaction to the knockout gas.”
“I see.”
“If it’s a reaction, I wouldn’t want to give him any more anesthetic. It might kill him.”
“On the other hand, he may really have a severe head injury requiring surgery,” said Rubens.
“Yes, that’s the problem.”
CHAPTER 8
Lia saw Dr. Ramil freeze as the bodyguard demanded that he save Asad. His face paled and his eyes seemed to push back in their sockets. He was the perfect picture of fear.
“Brother,” she whispered in her Egyptian Arabic, tugging at the bodyguard’s shoulder. “The gun may not be a good idea here. The doctors are not used to being threatened. If they are nervous, they may not be able to do their job.”
The man turned and glared down at her.
“And someone who sees it might call the police,” added Lia.
Something flickered in the bodyguard’s eyes — hate, she thought, though she wasn’t sure whether it was toward her or the police.
“I will be nearby,” the bodyguard told her. Lia needed the translator’s help to untangle his quick Syrian tongue. “If they do the slightest harm to him, scream, and I will run and send them to hell where they belong.”
Dean nudged Ramil into the curtained cubicle. The emergency room physician gave Dean and Ramil a quick read of the patient’s vital signs and condition: shallow head wound, unconscious, low blood pressure.
“There are other patients arriving,” said the doctor. “Can you take him?”
“Of course,” said Ramil smoothly.
Dean took a small penlight from a nearby tray and checked for a concussion. The pupils were nonreactive; Dean gave a loud “hmmmm.”
“Mr. Dean, there appears to be a problem with the patient’s blood pressure,” said the specialist back in the Art Room. “There’s a chance it may be a reaction to the drugs. His heart beat also seems irregular. You’ll want to make sure Dr. Ramil makes a note of it.”
Dean glanced up at Ramil, who was just checking Asad’s eyes with a borrowed penlight.
“Can we have skull films?” Dean asked. “We should get them right away. If there’s a hematoma—”
“I would strongly recommend a CT scan,” said Ramil. “As a precaution.”
“Yes, by all means,” said Dr. Ozdilick.
“Blood pressure is low,” said Dean.
“Is it?” said Ramil, bending over Asad.
Ramil had already seen the blood pressure, but he pretended now to notice it for the first time. He was not a neurologist, but he had extensive experience with trauma patients, and he knew that this was not only unexpected but a bad sign. It might mean not only that Asad had really been injured in the accident, contrary to expectations, but that the injury was life threatening.
On the other hand, there were no obvious signs of cranial swelling. There was no obstruction to his airways and he was breathing normally. His temperature was fine.
If anything, the drugs that Asad had been given should have raised his blood pressure slightly. So was this a reaction to them?
They had planned to check for a hematoma. It was part of the standard medical procedure for a potentially serious head injury. And since the bug could be spotted on a scan, the films taken before the implant could be substituted in the hospital’s high-tech system later on if Asad was kept overnight for observation. Now, though, they had to take the scan to really rule out a head injury.
In layman’s terms, a hematoma was a pool of blood that leaked into a place where it shouldn’t be; it had to be removed or a patient might die from the injury. If this was the case, the low blood pressure would cause the brain to receive less oxygen. At the same time, the arteries in the brain would attempt to overcome the flow restriction and dilate, increasing blood flow and amplifying the injury. The result would be fatal unless Ramil operated immediately to relieve the pressure.
He could do that. He hadn’t expected to, but he could.
Then again, the patient didn’t have any of the other symptoms Ramil would expect to accompany that sort of head injury. This might be a reaction to the drugs he’d been given.
Something which also could be fatal.
“We need to insure positive ventilation,” said Ramil. “Is there an anesthesiologist?”
“He’s been paged,” said the nurse.
“We can’t wait. We need an intravenous, and we’ll want to ventilate,” Ramil told the nurse, adding that she should prepare doses of morphine and fentanyl, and to have ephedrine on hand.
Ephedrine especially, he thought, but he had to play it as someone who didn’t know what was going on would.
“Pressure dropped a little,” said Dean. He wasn’t looking at the instruments, and Ramil realized he had probably been prompted by the medical expert back in the Art Room.
“Six milligrams of ephedrine,” said Ramil.
He caught Dean looking at him as he waited for the hypo.
“He’ll be all right,” said Ramil.
CHAPTER 9
“Tommy, you’re still at the bath? You have to get over to the hospital and back those guys up.”
“Rockman, you’re a worry wart, you know that?” Tommy Karr blinked as he stepped into the sunlight. After the damp, heavy air of the bath, the cool breeze felt bracing. He turned left, then right, getting his bearings. He was four blocks from the hospital and the rental car he’d left there, but none of the streets in this section of Istanbul ran in a straight line. His sense of direction seemed to have been scraped off with the dead skin and hair in the camel’s hair mitt. Finally he decided he was supposed to go right, and set out.
“The messenger reported the doctor was sleeping and wouldn’t wake up five minutes ago,” said Rockman. “What have you been doing?”
“Getting dressed. Paying the bill. What have you been doing? Where’s Sandy?”
“I’m going to run all three of you since you’re all supposed to be at the hospital,” said Rockman.
“I’m still on the line if you need me, Tommy,” said Sandy Chafetz.
“Ooo, a
“You’re in a goofy mood,” said Chafetz.
