The whole floor was set up for intensive care, Norfolk Naval Medical Center having been built with war casualties in mind. Intensive Care Unit Number Three was a room twenty-five feet square. The only windows were on the corridor wall, and the curtains had been drawn back. There were four beds, only one occupied. The young man in it was almost totally concealed. The only thing not hidden by the oxygen mask covering his face was an unruly clump of wheat-colored hair. The rest of his body was fully draped. An IV stand was next to the bed, its two bottles of fluid merging in a single line that led under the covers. A nurse dressed like Tait in surgical greens was standing at the foot of the bed, her green eyes locked on the electrocardiograph readout over the patient’s head, dropping momentarily to make a notation on his chart. On the far side of the bed was a machine whose function was not immediately obvious. The patient was unconscious.
“His condition?” Ivanov asked.
“Critical,” Tait replied. “It’s a miracle he got here alive at all. He was in the water for at least twelve hours, probably more like twenty. Even accounting for the fact that he was wearing a rubber exposure suit, given the ambient air and water temperatures there’s just no way he ought to have been alive. On admission his core temperature was 23.8 °C.” Tait shook his head. “I’ve read about worse hypothermia cases in the literature, but this is by far the worst I’ve ever seen.”
“Prognosis?” Ivanov looked into the room.
Tait shrugged. “Hard to say. Maybe as good as fifty-fifty, maybe not. He’s still extremely shocky. He’s a fundamentally healthy person. You can’t see it from here, but he’s in superb physical shape, like a track and field man. He has a particularly strong heart; that’s probably what kept him alive long enough to get here. We have the hypothermia pretty much under control now. The problem is, with hypothermia so many things go wrong at once. We have to fight a number of separate but connected battles against different systemic enemies to keep them from overwhelming his natural defenses. If anything’s going to kill him, it’ll be the shock. We’re treating that with electrolytes, the normal routine, but he’s going to be on the edge for several days at least I—”
Tait looked up. Another man was pacing down the hall. Younger than Tait, and taller, he had a white lab coat over his greens. He carried a metal chart.
“Gentlemen, this is Doctor — Lieutenant — Jameson. He’s the physician of record on the case. He admitted your man. What do you have, Jamie?”
“The sputum sample showed pneumonia. Bad news. Worse, his blood chemistry isn’t getting any better, and his white count is dropping.”
“Great.” Tait leaned against the window frame and swore to himself.
“Here’s the printout from the blood analyzer.” Jameson handed the chart over.
“May I see this, please?” Ivanov came around.
“Sure.” Tait flipped the metal cloud chart open and held it so that everyone could see it. Ivanov had never worked with a computerized blood analyzer, and it took several seconds for him to orient himself.
“This is not good.”
“Not at all,” Tait agreed.
“We’re going to have to jump on that pneumonia, hard,” Jameson said. “This kid’s got too many things going wrong. If the pneumonia really takes hold…” He shook his head.
“Keflin?” Tait asked.
“Yeah.” Jameson pulled a vial from his pocket. “As much as he’ll handle. I’m guessing that he had a mild case before he got dumped in the water, and I hear that some penicillin-resistant strains have been cropping up in Russia. You use mostly penicillin over there, right?” Jameson looked down at Ivanov.
“Correct. What is this keflin?”
“It’s a big gun, a synthetic antibiotic, and it works well on resistant strains.”
“Right now, Jamie,” Tait ordered.
Jameson walked around the corner to enter the room. He injected the antibiotic into a 100cc piggyback IV bottle and hung it on a stand.
“He’s so young,” Ivanov noted. “He treated our man initially?”
“His name’s Albert Jameson. We call him Jamie. He’s twenty-nine, graduated Harvard third in his class, and he’s been with us ever since. He’s board-certified in internal medicine and virology. He’s as good as they come.” Tait suddenly realized how uncomfortable he was dealing with the Russians. His education and years of naval service taught him that these men were the enemy. That didn’t matter. Years before he had sworn an oath to treat patients without regard to outside considerations. Would they believe or did they think he’d let their man die because he was a Russian? “Gentlemen, I want you to understand this: we’re giving your man the very best care we can. We’re not holding anything back. If there’s a way to give him back to you alive, we’ll find it. But I can’t make any promises.”
The Soviets could see that. While waiting for instructions from Moscow, Petchkin had checked up on Tait and found him to be, though a religious fanatic, an efficient and honorable physician, one of the best in government service.
“Has he said anything?” Petchkin asked, casually.
“Not since I’ve been here. Jamie said that right after they started warming him up he was semiconscious and babbled for a few minutes. We taped it, of course, and had a Russian-speaking officer listen to it. Something about a girl with brown eyes, didn’t make any sense. Probably his sweetheart — he’s a good-looking kid, he probably has a girl at home. It was totally incoherent, though. A patient in his condition has no idea what’s going on.”
“Can we listen to the tape?” Petchkin said.
“Certainly. I’ll have it sent up.”
Jameson came around the corner. “Done. A gram of keflin every six hours. Hope it works.”
“How about his hands and feet?” Smirnov asked. The captain knew something about frostbite.
“We’re not even bothering about that,” Jameson answered. “We have cotton around the digits to prevent maceration. If he survives the next few days, we’ll get blebs and maybe have some tissue loss, but that’s the least of our problems. You guys know what his name is?” Petchkin’s head snapped around. “He wasn’t wearing any dogtags when he arrived. His clothes didn’t have the ship’s name. No wallet, no identification, not even any coins in the pockets. It doesn’t matter very much for his initial treatment, but I’d feel better if you could pull his medical records. It would be good to know if he has any allergies or underlying medical conditions. We don’t want him to go into shock from an allergic reaction to drug treatment.”
“What was he wearing?” Smirnov asked.
“A rubber exposure suit,” Jameson answered. “The guys who found him left it on him, thank God. I cut it off him when he arrived. Under that, shirt, pants, handerchief. Don’t you guys wear dogtags?”
“Yes,” Smirnov responded. “How did you find him?”
“From what I hear, it was pure luck. A helicopter off a frigate was patrolling and spotted him in the water. They didn’t have any rescue gear aboard, so they marked the spot with a dye marker and went back to their ship. A bosun volunteered to go in after him. They loaded him and a raft cannister into the chopper and flew him back, with the frigate hustling down south. The bosun kicked out the raft, jumped in after it — and landed on it. Bad luck. He broke both his legs, but he did get your sailor into the raft. The tin can picked them up an hour later and they were both flown directly here.”
“How is your man?”
“He’ll be all right. The left leg wasn’t too bad, but the right tibia was badly splintered,” Jameson went on. “He’ll recover in a few months. Won’t be doing much dancing for a while, though.”
The Russians thought the Americans had deliberately removed their man’s identification. Jameson and Tait suspected that the man had disposed of his tags, possibly hoping to defect. There was a red mark on the neck that indicated forcible removal.