Lethal Treatment Read online

  “Megumi, bring him up a bit,” I said. “Ayesha, get systolic pressure over 110.”

  Ayesha’s artfully drawn eyebrows disappeared below her cap. “That’s too high.”

  Ugh. I’d sung her praises too soon. Or I hadn’t factored in the flip-side of her being my brakes if need be. Not a good time to indulge in said role.

  “Ayesha—just do it.”

  My snap made her exchange a quick look with Megumi, who was already carrying out my order. I braced myself for an argument, but Ayesha only lowered her gaze, and opened the drip to maximum.

  I almost flinched. I’d come to count on the protective vetting of her disputes. There had been memorable times when they’d given me pause long enough to reach a different course of action, stopping me from making serious or maybe even fatal miscalculations. But if she wasn’t contesting my decision now, she must believe her input wasn’t needed. Sure prayed I deserved her faith.

  Ayesha was more than my top nurse and partner. Beside being my brakes, she was my left hand. My right one was Matt McDermott.

  They’d been the first two I’d approached. With my plans of creating medical crisis crews and sanctuaries outside the system, for the people who fell out of its favor and below its radar.

  Both had already left regular medical practice, spurred by tragedies that had derailed their lives forever. Each had indelible reasons to mistrust the system, to abhor corruption, injustice, oppression and crime. And each had already been doing all they could to fight back. Bottom line was, they’d already relinquished all expectation of a conforming or even safe life.

  Beside all that, they were unparalleled medical professionals, with limitless potential and kindred leanings.

  Shall we say, perfect candidates and my top choices for the total insanity I’d had in mind?

  I’d met them both during our joint stints with Global Crisis Alliance. But it wasn’t until I’d left GCA that I’d approached them with my plans. To drag them with me onto a path of no return outside the realm of the sanctioned, and into a murky one where there were no laws or safety nets but the ones we made.

  I was still amazed they’d even heard me out. For I hadn’t “left” GCA. I’d been thrown out, barely escaping criminal persecution following the Sudan “incident.”

  That alone would have given anyone else pause. But I’d pegged them right. Being dishonorably discharged after such a massive infraction had actually been one of my feature attractions to them.

  And the more I’d elaborated on my plans, the more they’d perked up. As if I’d at last handed them the means to end the maddening futility that had been tormenting them.

  Not that they’d said yes on the spot. They’d cross-examined me mercilessly. To make sure it wasn’t shock and bitterness at being stripped of everything I’d ever worked for talking, making me spout impossible goals I didn’t really mean and extreme measures I was nowhere up to.

  But mainly they’d wanted to make sure I wasn’t following in my Dad’s footsteps.

  Not that I’d considered this to be a bad thing. I mean, Dad took care of business. When everyone else danced around what needed to be done, and perpetuating the status quo.

  Luckily, no matter the sweeping opinion of me as a loose cannon, I’d had more restraint—oh, okay, just less guts and strength. And less experience and resources. Not to mention less incentive and impetus. Up until then, I hadn’t been exposed to one-thousandth of what had driven my father down the path he’d taken. Even now, I’d say I was only at the one-hundredth mark in comparison to him.

  But with their every question and suggestion, Matt and Ayesha had had me course correct at the drawing board, had made me avoid my Dad’s early mistakes, starting the way he’d ended up, careful, organized, in control. I hoped.

  But Matt and Ayesha had always had more faith in me than I had in myself. When they’d made sure I did know what I was talking about, and was flexible enough to let my deputies influence my decisions when need be, they’d thrown in their lots with me, come what may.

  After securing my co-leaders, we’d moved on to building our ranks. We’d first recruited five more core team members, then we’d spread our mission statement and interviewed candidates. We’d been careful. And I mean paranoid-careful. Founding our “extralegal” outfit, we’d had to be, to avoid at all costs the law’s notice and weirdos’ interest.

  It had taken some doing, and exhaustive background checks and tests, to sift through the candidates, deciding who had what it took, and would hold up under the pressure. Not only of the rigorous training, but of being in the field, outside established systems’ protections and predictabilities.

  And here we were, four years later, sixty-eight strong, from all medical disciplines, and sixteen nationalities. People who, like us, had despaired of health systems and humanitarian establishments alike. Professionals who’d been going crazy being shackled by laws, regulations and financial realities and restrictions that served everyone but the sick, the helpless and the oppressed.

  And then there was our extensive network of part-timers and affiliates. We counted every possible job among those. From cooks to technicians to forgers to bricklayers to bookkeepers to hackers. They handled all non-medical aspects of our operations, each doing their part in keeping us functional and undetected.

  Last but not least, of course, there were our benefactors. From the willing to the extremely unwilling. It took a lot of money to run our Sanctuaries, to keep our operations versatile and solvent.

  Ayesha’s sharp inhalation brought my focus back to her. “Systolic BP ninety, and rising.”

  I nodded, groped for Mendoza’s hand, willing him to hang on, my throat closing. Ayesha threw me a bolstering glance.

  Would I ever get used to my team’s—especially my core seven’s—way-beyond-the-call-of-duty-and-sanity support and dedication? It remained inexplicable to me, when I’d almost gotten them killed a dozen times. Actually, way more than that. That number had been exceeded during our last skirmish alone, with that white-slavery ring in Sarajevo.

  But those seven continued to go as far as needed to get the job done. Including leading double lives. Or dropping their previous lives completely. Like I had. And they continued to follow my lead unwaveringly.

  “BP a hundred. Are you sure about this, Cali?”

  Now that she felt it okay to let it surface, Ayesha’s agitation hit me between the eyes.

  She was one hell of a surgical nurse, holstering an exhaustive twenty-year experience and an astounding diagnostic skill. Apart from the horrors in her past, she’d lost her last regular job because she’d exposed the mistakes of someone with too much power. Her concern now was right on the money.

  After an uneventful procedure, I wouldn’t have raised Mendoza’s pressure that high, as it risked dislodging my seal and reinitiating bleeding. But as I hadn’t seen myself actually sealing the rupture, raising his pressure was necessary to find out if it was still leaking. If his blood pressure failed to rise, or rose then plummeted, I’d know it was.

  Then I’d rush to open him up and rummage in his abdomen through the mess of fresh bleeding and clotted blood to find the breach and fix it. When in the best of circumstances, the open approach was a last ditch attempt, as it carried a far higher risk of complications—or death. This was far from the best circumstances.

  But what had Ayesha vibrating with worry was that my diagnostic test could also be what would kill him. When his aneurysm ruptured, his body had reflexly lowered his pressure to minimize bleeding to prolong survival. But I was forcing it to rise now. If I’d failed to seal the rupture, he’d bleed out too abruptly, and I’d most probably have no time to open him up. Or I would, only to face a gush, rather than a leak. I’d probably end up with a dead patient whether I opened him or not.

  The other option, what most surgeons would probably pick in this situation, was the wait-and-see one. To be conservative in raising his pressure, and if my seal was successful, he’d be okay. If it wa
sn’t, he’d continue bleeding internally, and his system would be totally shut down by the time I opened him up. He’d still end up dying on table, or even after I succeed in fixing the aneurysm.

  The conservative route was a fifty-fifty chance. It also totally depended on luck. My way was a hundred-percent result either way, and it had nothing to do with that damned capricious bitch. It counted on previously substantiated stuff, like my instincts and expertise. But mostly, on that moment when my plug had slotted into the interruption. I’d felt it in my every cell.

  I nodded affirmation to Ayesha and a fat drop of sweat streaked down my forehead. She blotted before it fell on my visor in those seamless motions that sometimes made me feel we’d developed into one big symbiotic creature.

  Tension buzzed up my rigid muscles. Any moment now I could be racing to open Mendoza up as a last desperate measure, one I doubted he’d survive.

  Unable to bear the drag of seconds, or the accumulation of doubts, I broke down and started preparing for the absolute worst. Once he plummeted, I’d have ten minutes tops.

  I forgot to breathe as I rushed through the preparations, expecting Ayesha to give me bad news any second.

  Just as oxygen deprivation was starting to get to me, she exhaled loudly. “Pressure 115/70 and holding over the last five minutes.”

  I binged on a gigantic inhalation, letting the tremors of drowning relief claim me.

  We raced through finishing up, placing drains in his abdomen, siphoning off blood into the cell-saver machine, and heparinizing it before auto-infusing it back into him. In minutes, I rechecked his vitals, topped off his sedation and analgesia, then jotted down his postop care.

  It was only after Ayesha and Megumi took Mendoza to IC that I let everything in me sag, body and being.

  This was the second disaster I’d averted today.

  And the day was still young. At one pm, it was practically an infant. In this life I’d made, that maze of moral minefields and criminal catacombs I navigated, real trouble usually began after sunset.

  But what else was new?

  On to the next conflict.

  At least I for once knew what that was.

  Two

  Three hours later, Mendoza was doing great in IC.

  I checked in on him one last time, before I had to leave the Sanctuary. This time he opened his eyes, almost immediately aware and alert.

  Ayesha gently explained what happened, what I’d done. The censored version, where there’d been no mid-procedure catastrophe and no post-procedure gamble. He turned his head to search for me, his genial, lined face moved and thankful. Then his gaze fell on me, and he stared blankly.

  It took him a long moment to recognize me. I bet he did only because he was used to seeing me leaving the Sanctuary in crazy ass disguises. As the ultimate in discretion, like all of our employees, he’d never batted an eye at any of them. I bet he only did now because he’d just surfaced from anesthesia. I wasn’t about to tell him it was on his behalf, that I was about to go pay a visit to the guy who almost made me kill him.

  Mendoza thanked me profusely, making me wince as I remembered how I’d put him in danger, counting on nothing but my instincts and skills. Knowing him, he would have still thanked me as fervently even if he knew. He would have considered I’d done what had to be done. Like the rest of our teams, he had this exalted opinion of me. It weighed on me more every day, made my every decision and breath harder.

  Swallowing a lump of affection, I kissed his weathered cheek and warned him that this was the first and last time he’d ever allow any of his vital organs to go off like that. I walked out as he chuckled, and danced a jig outside IC to the wonderful sound.

  My good mood didn’t last. It plummeted the moment I stepped out into the back alley that was our LA Sanctuary’s secure day exit.

  As I hopped on ridiculously high heels among hills of trash that hadn’t been collected in weeks, I added the stinging in my feet and the stench singing my sinuses to that damned supplier’s debts.

  By the time I reached the relatively uncluttered stretch of cracked asphalt, I realized my heels were clicking an uneven staccato. Great. I’d lost one of the plastic tips. My ire rising at the dissonance, I turned into a less stomach-turning side street of the slum.

  Not that Los Angeles County called it that. Slums around here were officially called “disinvested neighborhoods.” Silver lining was, these areas, being bedlams of crowding and lawlessness, were perfect for our Sanctuary’s undetected existence. Where else could we run an underground healthcare/humanitarian facility? And have direct access to society’s outcasts, those who needed us most? And have our fingers on the pulse of the crime and corruption that flowed through the country and their tributaries abroad?

  Sure, this place was nowhere as bad as some of the ghettos we’d been in other countries. Overcrowding here meant ten thousand people per square mile and poverty meant a median income of less than twenty grand a year. We’d been in places where over a hundred thousand swarmed in less area, with housing conditions that made this slum extravagant living, and destitution took on subhuman definitions.

  But the point was, it was as bad as it got around here, making it the best location for our establishment.

  I took a turn down Main Street and added still more acrimony and torment to the bill I’d present to my swindling supplier. My disguise was killing me.

  The stilettos felt like spikes digging into my heels. The makeup that transformed me into someone else was probably seeping into my bloodstream. The skintight mini-dress and waist-long red wig were eroding my skin and scalp. It all qualified as slow-cooking torture to me, when my natural habitat was sneakers, jeans, scrubbed face and braid.

  As for the neighborhood studs’ vulgar catcalls and propositions… Man. It was like their species had all pissed into each other’s minds. Was it too much for a woman to ask to be sexually harassed with the tiniest bit of originality?

  Yeah. Looking at the miscreants doing the harassing it sure was. They’d have to be admitted to my ER if they were ever assailed with an original thought.

  It had also been too much to hope that the supplier would end this peacefully. But he thought he could cross me and get away with it…

  Okay. So being crossed was a fact of my life. Par for the course when it was illegal suppliers I depended on for every pill, syringe and piece of equipment.

  I’d had the whole array of swindles—changing prices on delivery, wrong supplies, counterfeit products, faulty equipment, failure to deliver—the works.

  Not that anyone got away with any of that. Our methods of leverage or retaliation ranged from simple to compound—to pulverizing.

  This latest supplier was begging for the latter. And then some. The slug had taken exception to my demanding a refund through our triple-blind contacts. You see, I’d interrupted his packing for a Caribbean vacation. My bad.

  His threat had been watered down by distressed go-betweens, but had retained its clarity—bother him again and the authorities would track my contacts back to me and whatever operation I was running.

  If there was anything I hated more than wearing disguises, it was threats. You don’t hold a knife to my people’s neck and expect you’d walk away in one recognizable piece.

  I approached the edge of the sidewalk. Before I signaled for a cab, the minidress and stilettos worked on auto. The expanse of toned, spray-tanned legs stopped three at once.

  Ah, what would I do without men’s predictability? Yesterday I’d stood in this same spot in my utilitarian look for fifteen minutes before giving up and resorting to on-foot transportation. We didn’t use any of those services that pinpoint your location via GPS. Even using fake identities, it never paid to give anyone any way to track you.

  I jumped into the second cab. Liked the looks of the older driver better. I gave him the address the supplier didn’t think I knew. He thought he was as anonymous to me as I was to him.

  The maggot also didn’t under
stand that asking for a refund had been offering him a way out. That it was that or I’d retaliate. Now I would, to reinforce the rule that people either towed the line in dealing with me, made amends or got punished. It was that, not the money, that I cared about.

  All right, so I did care about the money. A lot. It was what made the world go round, whether I liked it or not. And in my line of work, I needed gushing streams of it, to the point I’d considered setting up a side operation counterfeiting the damned green. Since I was paying outlaws and criminals mostly, I would have if not for the hundred percent prognosis of catastrophic complications.

  But the quarter mil I’d paid for the “refurbished” angio wasn’t my real beef here. At one-tenth the real market value of a new model, I’d expected it to have issues. Not to be a not-quite-single-use dud, but still. I could ask one of our benefactors to plug the hole in our finances. Better still, I could relieve a local drug lord of a couple days’ income.

  But getting compensation anywhere else but from the depths of my supplier’s guts would be a precedent. One I wouldn’t allow to be set in the annals of the barbaric underworld we inhabited. That supplier would have to be yet another example and deterrent.

  But my personal grievance here, what I’d make him suffer for, was that because of him, I could have lost my patient.

  I didn’t handle loss well.

  And when it was due to human factors, especially those of the premeditated variety, I handled it viciously. Even if it had been averted this time, the supplier’s punishment would be in proportion to the tragic could-haves.

  Hmm. I didn’t feel like putting him in a total body cast. Not anymore. It wasn’t the answer anyway. Profound and lasting coercion didn’t work this way.

  Not that Matt agreed. It was why I’d refused to let him come. He’d left our last retribution case with compound open fractures of every limb designed to leave him almost fully crippled and in constant pain. That slime bag drug-peddling pimp had deserved a broken back, or preferably neck, but still—I liked to counteract cruelty with cunning, and evil with intimidation. I preferred to leave the bad guys running blind and scared. I almost always had use for them later—if they weren’t killers, rapists or comparable monsters, that was. So it was in my best interests to leave them still capable of running.