Authors: Mark Hitchcock
“You know I can't rule out an act of war,” Barlow said.
“I'm not suggesting you do, Mr. President. I'm just giving my opinion.”
“Well, I guess that's why you're on the general's staff.” Barlow rubbed his face.
O'Tool had been speechless since being summoned to the spontaneous meeting, something that surprised Jeremy. The man had been a motormouth since arriving at USCYBERCOM. He looked pale. Apparently this was more reality than he liked.
Barlow studied the man and then turned his attention to Jill Sherwin. “Colonel, please call the hospital and get an update on Frank.”
She rose and moved to the desk, where a phone waited. The group sat in silence. Jeremy couldn't speak for the others, but he felt as if his internal organs had been scooped out with a melon baller.
Sherwin asked her questions, listened, and hung up. She returned to the seating area. “Sir, the doctor reports that Mr. Grundy is awake and alert and causing trouble because the doctor won't release him.”
Somehow Barlow found the strength to smile though it lacked any evidence of joy. “That's Frank. We need to spring him before he hurts the medical staff.” His gaze went distant. No one interrupted his thinking. No matter where he was, Barlow was the president of the country, even deep below the ground.
After a moment, Barlow spoke. “I am obligated to maintain a constitutional government no matter how extreme. For now, I have to assume that the VP, congressional leaders, cabinet members, and others are detained or dead. Therefore I am appointing an ad hoc government.” He paused as if weighing his words.
Barlow took a deep breath and held it as he pushed to his feet. The pain was obvious. During high school, Jeremy had broken two ribs while playing football in the street. There was no such thing as a comfortable position in that condition. A simple sneeze could drive a strong man to his knees. The others rose with him.
“From this moment until I rescind this decision, or until we can constitute a viable government, the following shall be true.” He looked at O'Tool. “Senator, you are now speaker of the house.” He quickly raised his hand. “I know you're a member of the senate, but you served three terms in the lower house, and we need a bicameral legislature. Of course, you have no house to be speaker of, but this is the best we can do at this hour. Do you understand?”
“I do, Mr. President.”
“Frank Grundy will be the acting VP.” Barlow addressed O'Tool again. “Tell me you agree, Mr. Speaker.”
“Um, sure. I meanâ¦yes, sir. I agree.”
“Good, that constitutes congressional approval.” Another pause. “General Holt, you are now the secretary of defense and the new head of the Joint Chiefs of Staff and will serve in those capacities until I relieve you. Do you accept?”
Holt came to attention. “Yes, sir. I do.”
Next he faced Jeremy. Jeremy's stomach went into free fall. “Colonel, I am giving you a field promotion to brigadier general. You will be the second member of the JCS. I don't know when you're eligible for promotion, so consider this a frocking. Is that okay with you, General Holt?”
“It is, sir.” Frocking. Jeremy had seen it a few timesâthe awarding of the rights and insignia of higher rank to a member of the military who is not eligible for promotion.
“Sorry I don't have a star to pin on you, Jeremy. Do you accept this promotion?”
“I do, sir.” Jeremy's heart quivered. He was uncertain what to think.
“Colonel Sherwin, you will remain base commander. I need you to get our communications up and running. I also need you to select some of your best people to serve in various positions. I'll let you know what those are when I have it figured out. One thing I need right away is an assistant. All of this has to be put into writing and prepared for signatures.”
“Yes, sir.”
Barlow rubbed the center of his chest and looked like a man with the worst case of indigestion ever. “We have just formed the most bizarre government in US history. God help us.”
“Amen,” Jeremy said.
R
oni Matisse hustled down the hospital corridors toward the OR wing. Emergency lighting hanging from the ceiling and over the doors cast eye-stinging light. It was like facing an oncoming car with its bright lights on. The halls quickly filled with people, ambulatory patients, administrative staff, maintenance personnel, and workers from the cafeteria.
She pushed through them as fast as she could until she reached the waiting room just outside the double doors that opened to operating rooms.
“Excuse me.” The voice was elderly and came over Roni's shoulder. Her first impulse was to ignore the person, but something in the voice made her stop.
“Yes?”
“Can you tell me what happened? What's going on?” The woman was short, bent at the shoulders, with gray hair peeking from beneath an out-of-style wig.
“No, ma'am. All I know is the generator quit. They should have it working again soon.”
“But you're a doctor, right?” Her eyes were wet, and the glow of the battery powered lights made the woman look pale.
“Yes, but I don't know any more.”
“Is my husband okay?”
“I don't know, ma'am. I don't think I treated your husband.”
“He's in surgery. I'm worried. He fell and broke his arm. They're putting metal things in it.”
Titanium screws and plates
. It must have been a serious break. “I'm sorry, ma'am. I don't have any answers for you, and I have to go.”
“But⦔
Roni put her hands on the woman's shoulders. “Look, I know waiting is hard, especially on a day like this.”
Had there been days like this?
“If I learn anything, I'll come tell you, but it could be a little while. Just wait here. Someone will talk to you as soon as possible.”
The woman dabbed at her eyes with a tissue that looked as if it had endured a few hours of twisting. She moved away, feeling guilty with each step.
“His name is Jacob.”
A sign on the doors read H
OSPITAL
P
ERSONNEL
O
NLY
. Instinctively, Roni punched the large metal square on the wall to activate the automatic doors. Nothing happened.
I'm an idiot
. She took hold of the stainless steel handle and pulled the heavy door open. The corridor on the other side had the same eerie glow of emergency lights.
“Dr. Matisse.” Surgical nurse Loren Grimm's expression matched her name. “Do you know what's going on?”
“I have an idea, but I can't be sure. All I really know is the generators went out.”
“They'll be back up in a minute, right?”
“I hope so. Where am I needed?”
“We have three surgeries underway. We had four, but I just moved one to recovery before things went out again.”
“What about the others?”
“OR-2 has an orthopedic surgery. Upper arm. They've been at that one for a while. My guess is they'll be closing soon. OR-3 is a trauma-induced abdominal aortic aneurysm. They went in about an hour or so ago. Or so I hearâI was occupied. OR-4 is a blocked intestine. OR-1 is empty.”
“I'm going to gown up and see if I can help. You're going to have to do the same. First, see who needs what. I'll help where I'm needed most. Then pull in some nurses. We're going to need some extra hands even if they do nothing but hold a flashlight.”
“I can't believe this is happening.” Loren slipped on a surgical mask and a pair of sterile gloves.
Roni donned a fresh pair of scrubs and washed her hands as if preparing for a procedure. For all she knew, she was.
Loren appeared in the scrub area just as Roni had finished rinsing. As she dried, Loren pulled the first set of surgical gloves from their container.
“They want you in OR-3.”
“The aorta?”
“Yes. Patient is a thirty-two-year-old male. He was one of the patients from the train accident. Began complaining of abdominal pain. CAT revealed an aneurism on the descending aorta. Apparently the injury weakened the vessel. The patient has a history of hypertension, so the condition may have been preexistent and aggravated by the accident.”
“Initial injury?”
“Blunt trauma to chest. Xiphoid process cut the liver. First surgery went well. His postoperative complaints were attributed to the surgery. You know how crazy the place has been. No one thought there was a secondary cause.”
All of this sounded familiar. Roni had been involved in similar surgeries. She couldn't blame the doctors. She would have assumed the same thing.
Loren continued. “A sonogram found the bulge on the artery.”
Roni could picture the body's major artery with a bubble on the side. If the aneurysm gave way, the patient could be dead in minutes. “I assume Austin is the lead on this.”
“Yes, Dr. Roth was the initial surgeon.”
Roni felt bad for the patient. One surgery was grueling enough; two was something no patient should be asked to endure.
“I'll go see if he needs an extra pair of hands.” Roni left the scrub room and entered OR-3. She was greeted with a loud, angry voice, tinted with fear.
“What is going on out there?” Blood covered the safety shield in front of the surgeon. The artery must have given way.
“I don't know for sure,” Roni said, “and you don't want to know my guess.”
Roth looked up. Even in the dim emergency light she could see the stress on the man's face. Charles Fulton was the anesthesiologist. Several nurses stood nearby, each focused on her task. One nurse held an emergency flashlight over the open belly of the patient. The emergency lights mounted to the walls created shadows increasing the odds of a mistake. Surgeons needed lots of light.
Roni stepped close. “What can I do?” The room reminded her how electronics-dependent surgery had become. The bank of monitors every anesthesiologist needed to monitor the status of a patient under general anesthesia was blank. No EKG, BP, body temperature, respiration, blood oxygenâ¦nothing. A nurse worked a blood pressure cuff. Another worked an Ambu bag, forcing air into the patient's lungs.
“We're getting ready to hang another unit of blood. I got so much blood in here I can't see what's going on. Suction doesn't work. We could use an extra pair of hands in here. I need a clean field to close up the aorta.”
She moved to the side of Roth and used some gauze to soak up the blood pooling around the abdominal organs. This kind of surgery was risky to begin with and nearly impossible in an OR with no power. A patient's only hope with a ruptured aorta was to already be on the operating table. The man had that going for him. Roth was a gifted surgeon. What he lacked in social skills, he made up for in surgery. If Roni ever needed surgery, she hoped Roth would be the doctor on the other end of the scalpel.
Five minutes further into the surgery, all of Roni's optimism evaporated.
“BP is dropping,” the nurse said.
“Respiration is shallow and labored,” Fulton announced. “We're losing him.”
Twenty minutes later, he was gone.
Roth filled the OR with swearing worthy of a longshoreman and kicked over the instrument tray. “We can't operate like this. It's impossible. I feel like we're in the Civil War, amputating legs with rusty saws. This is the twenty-first century!”
He turned on Roni. “What happened out there?”
“Generators went off, and I think they're off for good.”
“That can't be.”
Roni didn't answer. She removed her bloody gloves and threw them in the hazardous waste bin.
“Where are you going?” Roth asked.
“To see if I'm needed in the other surgeries. If not, I'm going to CCU and see how they're faring.”
“CCU⦔ The mention of the cardiac unit softened his tone. “That has to be a nightmare.”
Roni paused at the doors. She was the head of trauma surgery, and they were looking to her for direction. She moved a few steps back into the theater. “I have no idea when power will be back online. It may be a long time. If so, we have our work cut out for us. I need everyoneâsurgeons, nurses, staff, everyoneâto pitch in. Everything is dead. Something has taken out the electronics, and I mean everywhere. At least everywhere I looked. Make yourselves useful, people. Find a hole and fill it. Intensive care, ER, pediatrics, ICUâ¦We're going to have to be creative. Really, really, creative.”