"Then what?"
"Well, the onset of symptoms would take about sixty seconds. Thirty seconds more for the full effects of the drug to present themselves. The victim would collapse then, say, ninety seconds after the injection. Breathing stops completely about the same time. The heart is starved for oxygen. It will try to beat, but it's not delivering any oxygen to the body, or to itself. Heart tissue will die in about two or three minutes — and will be extremely painful as it does so. Unconsciousness will happen at about the three-minute mark unless the victim had been exercising beforehand — in that case, the brain will be highly infused with oxygen. Ordinarily, the brain has about three minutes' worth of oxygen in it to function without additional oxygen infusion, but at about the three-minute mark — after onset of symptoms, that is; four and a half minutes after being stuck — the victim will lose consciousness. Complete brain death will take another three minutes or so. After that, the succinylcholine will metabolize in the body, even after death. Not entirely, but enough so that only a really sharp pathologist will pick it up on a toxicology scan, and then only if he's prepped to look for it. The only real trick is to get your test subject in the buttocks."
"Why there?" Davis asked.
"The drug works just fine with an IM — intramuscular — injection. When people are posted, it's always faceup so that you can see and remove the organs. They rarely turn the body over. Now, this injection system does leave a mark, but it's hard to spot under the best of circumstances, and then only if you're looking at the right area. Even drug addicts — that will be one of the things they check for — don't inject themselves in the rump. It will appear to be an unexplained heart attack. Those happen every day. Rare, but not at all unknown. Tachycardia can make it happen, for example. The injector pen is a modified insulin pen like the kind Type I diabetics use. Your mechanics did a great job of disguising it. You can even write with it, but if you rotate the barrel, it swaps out the pen part for the insulin part. A gas charge in the back of the barrel injects the transfer agent. The victim will probably notice it, like a bee sting but less painful, but inside a minute and a half, he won't be telling anybody about it. His most likely reaction will be a minor 'Ouch' and then rub the spot — if that much. Like a mosquito bite on the neck. You might slap at it, but you don't call the police."
Davis held the safe "blue" pen. It was a little bulky, like a third-grader might use on his first official introduction to a ballpoint pen after using thick-barrel pencils and crayons for a couple of years. So, as you approached your subject, you took it out of your coat pocket, and swung it in a reverse stabbing motion, and just kept going. Your backup hitter would watch the subject fall to the sidewalk, maybe even stop to render assistance, then watch the bastard die, and get up and go on his way — well, maybe call an ambulance so that his body could get sent to the hospital and be properly dismantled under medical supervision.
"Tom?"
"I like it, Gerry," Davis replied. "Doc, how confident are you about this stuff dissipating after the subject goes down for the count?"
"Confident," Dr. Pasternak answered, and both of his hosts remembered that he was professor of anesthesiology at the Columbia University College of Physicians and Surgeons. He probably knew his stuff. Besides, they'd trusted him enough to let him in on the secrets of The Campus. It was a little late to stop trusting him now. "It's just basic biochemistry. Succinylcholine is made up of two acetylcholine molecules. Esterases in the body break the chemical down into acetylcholine fairly rapidly, so it is very likely to be undetectable, even by someone up at Columbia-Presbyterian. The only hard part: to have it done covertly. If you could bring him into a doctor's office, for example, it would just be a matter of infusing potassium chloride. That would put the heart into fibrillation. When cells die, they give off potassium anyway, and so the relative increase would not be noticed, but the IV mark would be hard to hide. There are a lot of ways to do this. I just had to pick one that is applied relatively conveniently by fairly unskilled people. As a practical matter, a really good pathologist might not be able to determine the exact cause of death — and he would know that he didn't know, and that would bother him — but that's only if the body is examined by a really talented guy. Not too many of them around. I mean, the best guy up at Columbia is Rich Richards. He really hates not knowing something. He's a real intellectual, a problem solver, and genius biochemist in addition to being a superb physician. I asked him about this, and he told me it would be extremely difficult to detect even if he had a heads-up on what to look for. Ordinarily, extraneous factors come into play, the specific biochemistry of the victim's body, what he's had to eat or drink, ambient temperature would be a huge factor. On a cold winter day, outside, the esterases might not be able to break down the succinylcholine because of a diminution of chemical processes."
"So, don't do a guy in Moscow in January?" Hendley asked. This deep science stuff was troublesome for him, but Pasternak knew his stuff.
The professor smiled. Cruelly. "Correct. Also Minneapolis."
"Miserable death?" Davis asked.
He nodded. "Decidedly unpleasant."
"Reversible?"
Pasternak shook his head. "Once the succinylcholine is in the bloodstream, there's nothing you can do about it… well, theoretically you could put the guy on a ventilator and breathe for him until the drug metabolizes — I've seen that done with Pavulon in an OR — but that would be a stretch. Theoretically possible to survive, but very, very unlikely. People have survived being shot right between the eyes, gentlemen, but it's not exactly common."
"How hard do you have to hit your target?" Davis asked.
"Not very, just a good poke. Enough to penetrate his clothing. A thick coat might be a problem because of the length of the needle. But ordinary business wear, no problem."
"Is anyone immune to the drug?" Hendley asked.
"Not to this one, no. That would be one in a billion."
"No chance he'd make noise?"
"As I explained, it's like a bee sting at most — more than a mosquito, but not enough to make a man cry out in pain. At most, you'd expect for the victim to be puzzled, maybe to turn around and see what caused it, but your agent will be walking away normally, not running. Under those conditions, without a target to yell at, and since the initial discomfort is transitory, the most likely reaction is to rub the spot and walk on… for about, oh, ten yards or so."
"So, rapid-acting, lethal, and undetectable, right?"
"All of the above," Dr. Pasternak agreed.
"How do you reload it?" Davis required. Damn, how has CIA not developed something this good? he wondered. Or KGB, for that matter.
"You unscrew the barrel, like this" — he demonstrated—"and take it apart. You use an ordinary syringe to inject a new supply of the drug, and swap out the gas charge. These little gas capsules are the only hard part to manufacture. You toss the used one into a trash can or the gutter — they're only four millimeters long and two millimeters wide — and reinsert the fresh one. When you screw in the replacement, a little spike in the back of the barrel punctures it and recharges the system. The gas capsules are coated with sticky stuff to make them harder to drop." And just that fast, the blue one was "hot" except for the absence of succinylcholine. "You want to be careful with the syringe, of course, but you'd have to be pretty stupid to stick yourself. If you cover your man as a diabetic, you can explain away the presence of syringes. There's an ID card to get insulin refills that works just about anywhere in the world, and diabetes has no outward symptoms."
"Damn, Doc," Tom Davis observed. "Anything else you could deliver this way?"