The Icarus Effect Read online

  “Adam Berndt.”

  “Hi, Doc Adam, it’s Carol in recovery. The older Bennett boy says he’s leaving.”

  Harvey sat on the edge of the bed, lacing up his hiking boots. He couldn’t quit looking at the spattered blood stains on the toes, as well as on his pant legs. Seeing them forced him to relive the entire attack all over again. He hurried with the laces and stood up to leave.

  “Why do you have to go, Harvey?” Zach asked. His eyes were red and wet.

  “I just do,” Harvey said, pausing at the door. “Tell Mom I’m gonna hitch a ride home. I’ll just see you guys when you get there.” He walked out, not daring to look back.

  In the corridor, Harvey started to turn right toward the elevators, but he didn’t want to have to pass the nurses station and face that nurse again. He looked to his left, spotting a sign for the stairs. He followed the sign that way, disappearing from view of the nurses station as the corridor bent around a ninety degree turn. He saw the door for the stairway ahead, and picked up his pace. He needed to get away.

  The elevator doors slid open just after Harvey turned the corner, and Doctor Berndt stepped out. He strode quickly down the hall, pausing at the nurses station. “Is he still there, Carol?”

  “He was a couple of minutes ago,” Carol said. “He went in to get dressed. Haven’t seen him come out, yet.”

  “Thanks.” Berndt headed toward Room 375. He was almost to the door when a voice came over the intercom.

  “Doctor Berndt to Intensive Care. Doctor Berndt, report to Intensive Care, immediately.”

  Berndt swore under his breath, and turned back toward the elevators. Carol was already checking her computer monitor as he went by, so he didn’t bother looking at his pager.

  “Is it a code?” Berndt asked as he broke into a trot.

  Carol nodded, a grim look on her face. “Room 512.”

  Berndt had already guessed the room number. Johnson Bennett’s room.

  Harvey opened the door at the bottom of the stairwell and walked out into the lobby. He shot a cautious look at the reception desk, but the woman there was engaged in a conversation with an old lady pulling an oxygen bottle on a wheeled stand. He kept going, exiting through the double doors and breathing a sigh of relief as he got outside. He looked around for a moment, then had a sudden moment of clarity.

  He wanted to go home, but he had no way to get there.

  He knew that his mom had driven up from Twin Falls, but the idea of snagging the car and leaving his family stranded made him feel like a bigger jerk than he already did.

  A couple of hundred yards to the west, beyond several large parking lots fronting the hospital campus, he could just make out where Highway 93 passed through town, leading away to the south. As he stared off into the middle distance, several tractor-trailer rigs passed in a group. He started off, crossing the parking lot in the direction of the highway.

  When Doctor Berndt rushed in to room 512, there were several other doctors and nurses already there, working intently on Johnson Bennett. The heart monitor next to his bed showed an irregular jagged line without the symmetrical, prominent peaks and shallow valleys characteristic of a healthy heartbeat. Johnson’s line looked more like a very messy signature.

  “What’s his status?” Berndt asked as he came in.

  “He’s in V-fib,” the resident reported as he pulled the paddles from the defibrillator and powered the unit up. Ventricular fibrillation, or V-fib, refers to a condition where the heart beats irregularly without enough strength to actually pump blood. The condition is fatal if not treated quickly.

  “Lost the pulse,” a nurse said.

  “Clear!” the resident made sure everyone had their hands off of Johnson, then placed the paddles against his torso, one on the right side of his chest, the other low on his left ribcage. The defibrillator discharged with a sound like a giant electric stapler. Johnson’s muscles contracted, lifting his torso partly off the bed. Berndt checked the heart monitor. It jumped, then flattened out, then went back to the random, shaky line.

  “Again,” Berndt ordered. “Have we started him on Heparin?”

  “Five thousand,” the resident said as he placed the paddles again. “Clear!” Again the machine made the stapling noise, and again Bennett’s lower back arched like a bow. But this time, the heart monitor simply went to a flat line, the steady monotone of the alarm filling the room.

  “Move over,” Berndt said, elbowing his way to Johnson’s side. He started doing chest compressions as the nurse monitored the oxygen going through the mask over Johnson’s mouth. “Anybody see where his wife went?” Berndt asked as he worked. The nurse sitting at Johnson’s head looked up.

  “She stopped at the desk a few minutes before he coded, said she was going to go find her son. They’d had an argument earlier, and the kid took off.”

  “Wonderful,” Berndt said. “Let’s get a heart catheter prepped, I want to be able to get in there in a hurry after we get his pulse back.”

  Berndt caught a sudden movement out of the corner of his eye. Diana Bennett was standing in the doorway, eyes wide, one hand over her mouth.

  “Claudia,” Berndt said to one of the nurses, “will you take Mrs. Bennett to the waiting room, please?”

  Claudia turned, seeing Diana for the first time. “I sure will.” She walked quickly to Diana, folded an arm around her and escorted her out. The door swung shut behind them.

  “Intracranial pressure has increased dramatically, Doctor,” the resident said. “That original hematoma may be getting larger, or he may have had a stroke.”

  Berndt paused his compressions, and the nurse searched for a pulse. She shook her head, and Berndt resumed CPR. “All right folks, we need to get the pressure off his brain. Tom, prep to place an EVD.”

  “Doc, we don’t have a neurosurgeon on duty,” the resident answered. “Doctor Chambliss went home two hours ago.”

  “I’m aware of that, Tom,” Berndt said, his voice strained as he worked on Johnson. “But there is a pathologist on duty in the morgue, which is gonna be this man’s next stop if we don’t get the pressure off his brain and get his heart going again. Now prep for the EVD, please.”

  An External Ventricular Drain, or EVD, is a small tube inserted through a surgical penetration of the skull which allows cerebrospinal fluid to be drained, relieving pressure on the brain. As the medical team worked to place the EVD, Berndt continued chest compressions, pausing frequently to allow the nurse to check for a natural pulse. Each time he paused, she responded with a grim shake of her head.

  Tom worked quickly to set up the surgical drill, but then hesitated when it came to locating the point on Johnson’s head for the hole. Berndt understood why the young doctor was reluctant - without careful placement, the EVD could cause more problems than it solved. The swelling of Bennett’s head made locating the proper spot for the EVD even more uncertain. Even under the best circumstances, it was a procedure left for a qualified neurosurgeon to perform, but in this case, Berndt knew they couldn’t afford to wait. Johnson was crashing. They had minutes, maybe less to save him, and Berndt was going to do everything he could to get it done.

  “Take over here,” he said, keeping the compressions going until Tom came alongside and relieved him. Berndt then quickly grabbed a flexible plastic ruler and measured eleven centimeters straight up Johnson’s forehead from the bridge of his nose. Marking that spot, he then measured three centimeters from it toward Johnson’s right side. Marking the second point was harder, since it was in the area of scalp the bear had torn off, so Berndt simply placed his finger on it for reference. Then he picked up the drill.

  Working quickly, he bored a small hole through Johnson’s skull. He was careful not to go too deep, to avoid damaging the brain tissue itself. Getting through the bone, he carefully withdrew the bit.

  “Dural knife,” he said, holding out his right hand. The nurse placed it in his palm without missing a beat. Berndt used the knife to make a careful, cross
shaped incision through the dura - the tough protective membrane surrounding the brain. “EVD catheter,” Berndt ordered. The nurse handed him a thin plastic tube with a long, surgical steel wire inside. Berndt carefully inserted the catheter into the incision he’d just made. Adjusting the angle so as not to miss the right lateral ventricle, he pushed the catheter into the hole, using steady pressure. There was a slight pop as the catheter penetrated the ventricle.

  Under normal circumstances, the catheter should have allowed excess cerebrospinal fluid to flow out of the brain cavity in a slow drip, releasing the growing pressure on the brain. But when Berndt inserted it into the lateral ventricle, the fluid squirted out of the end of the catheter in a sudden, steady stream. Normally the fluid would be mostly clear, but what came out of Harvey’s catheter was mostly all blood - a lot of blood.

  Fifteen minutes later, an exhausted Berndt stepped back from Harvey’s side. They’d worked frantically to contain the cranial bleeding, but it had been too much, too fast. Harvey’s heart had never resumed beating on its own, despite the efforts of the medical team performing CPR while Berndt had worked to stop the cranial bleed. Now, Berndt dropped his hands to his side in defeat. He reached up and pulled his surgical mask off, revealing the anguish on his face.

  “Call it, Tom.”

  Tom looked up at the wall clock. “Time of death, 4:17 P.M.”

  Diana sat in the waiting room, not sure what to do. She wanted to be in the room with her husband, but knew she couldn’t. She didn’t understand what was happening to Johnson. His condition had seemed unchanged when she went to look for Harvey, but when she came back, Johnson had been surrounded by doctors and nurses, all working frantically. The nurse who’d escorted her out had only told her that he was in distress and they were working to stabilize him, then she’d gone back in. She sat there for a while, frustrated by not knowing what to do. Finally, she got up and started pacing the room, five steps up and five steps back. She still felt helpless, but the repetitive motion was at least giving her something else to focus on. She’d lost count off how many turns she’d made when she turned once again and found Doctor Berndt approaching. She stopped cold.

  The doctor looked exhausted. His face was drawn, his eyes red. He made an effort to straighten his posture, even going so far as to force a small smile, but all he succeeded in doing was looking even more pained. Diana felt the room spinning, but managed to stagger to a chair and sit down before she collapsed.

  She knew.

  “Mrs. Bennett,” Berndt faltered. “I’m so sorry. We did everything we could. I’m afraid he’s gone.”

  Diana couldn’t respond. All she could get out was a stuttering sob.

  “Johnson was fighting several huge battles at the same time, Mrs. Bennett,” Berndt continued, taking the chair next to her. “A massive concussion, multiple traumatic injuries to his upper body, as well as the bacterial infection and traumatic brain injury from the bear’s bite. He just had too much to overcome at once.”

  “But what happened?” Diana sobbed. “He was stable when I left the room…” she covered her face in her hands. Her shoulders heaved as she cried. Berndt put a hand on her shoulder.

  “He suffered an arrhythmia,” he said. “That’s a dangerously irregular heartbeat. We used a defibrillator to try to get him back to a normal rhythm, but then he went into full cardiac arrest. While we were dealing with that, the swelling on his brain spiked. We performed a procedure meant to drain the cerebrospinal fluid from around his brain, to relieve the pressure, but he hemorrhaged. We just couldn’t stop the bleeding.”

  Diana looked up, her eyes red and swollen. “What, he had a stroke?”

  “It looks that way. It’s likely that he had a blood clot lodged in a vessel inside his brain cavity. That may have caused the vessel to rupture, which would have brought on the initial swelling and intracranial pressure. We should have been able to relieve the pressure by draining some of the cerebrospinal fluid, but there was heavy intracranial bleeding, and we couldn’t stop it.”

  Diana couldn’t process all of this. Johnson had been with her almost all her life. He’d always been a rock, just a quiet, steady, strong man who seemed like nothing could hurt him. “Was he in pain?”

  Berndt shook his head. “He was in a drug-induced coma, so no. He wasn’t aware of the outside world.”

  “But you told me he might be able to hear me!” Diana’s voice was pleading.

  “Yes, I did,” Berndt admitted. “Look, Mrs. Bennett, there is so much we still don’t know about how the human brain functions. There are studies that have found that people in comas have shown response to contact from their loved ones. When I told you that, I was willing to try anything to help Johnson get through an incredibly daunting recovery. I still think it was worth trying, for you to talk to him. But I also believe that based on the severity of his condition and the comatose state he was in, he couldn’t feel pain. It was never my intent to mislead you or give you false hope. It was my intent to do absolutely everything we could to help your husband.”

  Diana stared at him for a moment, confusion all over her face. Her eyes suddenly cleared, and she looked newly terrified. When she spoke, her voice was small, barely a whisper, and her expression was bleak.

  “What am I going to tell my boys?”

  A wave of pity flooded over Berndt. Diana Bennett didn’t know that her oldest son had already left the hospital.

  3

  Iter in Principio

  Twin Falls, Idaho

  Two Days Later

  Harvey had managed to hitch a ride with a long haul trucker who was going all the way through to Salt Lake City. The trucker took him as far as Pocatello, where he was quickly able to get a ride with another trucker, who took him most of the remaining hundred-plus miles to Twin Falls. He’d made it home late that first night.

  Once he got home, Harvey had plenty of time to consider things. He’d been regretting his decision to leave the hospital ever since he initially stuck out his thumb along the side of Highway 93 in Kalispell, but he hadn’t quite been able to swallow his pride. It felt like jumping off a cliff - once you make the leap, you can’t very well change your mind and go back. So Harvey had just kept on going, convincing himself that nobody wanted him around. Besides, they all probably blamed him for what had happened, anyway.

  The sound of a car door slamming outside made Harvey jump. He got up off the couch and peered out the front window in time to see Zach and Mom walking across the lawn. They weren’t talking or looking at each other, and both of their faces were expressionless and ashen. They looked exhausted.

  Worst of all, Dad wasn’t with them.

  Harvey yanked open the front door as Zach came up on the step. “Hey,” Harvey said. “Dad still in the hospital?”

  Zach gave him an incredulous look. “What do you care?” he snapped, shoving his way past Harvey and into the house. Harvey watched him go, then turned to find his mom standing right in front of him on the porch. He noticed that his heart was pounding.

  Diana slapped him hard across the face.

  Harvey took a backward step, looking at his mom in shock as she, too, brushed past him and into the house.

  “Pack your things and get out,” she said, her voice flat.

  “What?” Harvey was stunned. “Why? Where’s Dad? Is he ok?”

  Diana half turned. “Your father’s dead. And you’re not welcome here any more.”

  Harvey gaped at her. He felt like somebody’d just punched him in the gut. Somebody big.

  “I’m going to take a nap,” Diana said, turning and disappearing down the hall. “Don’t be here when I get up.”

  Twin Falls, Idaho

  10:15 P.M.

  Lucas Gòdia was surprised to see his best friend Harvey sitting on his front porch, illuminated in the glow of the headlights as Lucas pulled into the the driveway. Harvey had a duffel bag at his feet. Lucas shut the engine off and stepped out of the truck, reaching back in across the seat t
o grab his thermos and cooler.

  “What’s up, mi hermano?” Lucas asked. “Little late, no?”

  Harvey looked up. “Hey, brother,” he said. “I need a favor.”

  Lucas tilted his head to one side, looking at Harvey intently. He always reminded Harvey of a curious dog when he did that. He jangled his keys. “Come on in, then.”

  Twenty minutes later, Harvey finished his story. He drained the last of the coffee Lucas had brewed for him, and looked across the little table at his friend.

  Lucas shook his head. “That’s all she said? ‘Don’t be here when I get up’?”

  “Don’t forget the part about me not being welcome there any more.”

  “That’s rough.” Lucas stood up and took both empty cups to the sink. The kitchen was a tiny extension off of the tiny living room, with one tiny bedroom and a tiny bathroom attached at the other end. The whole place was smaller than Harvey’s living room. Well, smaller than his mom’s living room, anyway.

  “So,” Lucas said. “You need to crash here, I guess?”

  Harvey nodded. “If you don’t mind, Lucas. You’re the only one I know that has his own place.”

  Lucas spread his arms and looked around in mock pride. “Mi castillo es tu castillo.”

  “Thanks,” Harvey said, looking at the table. “But that’s not all, man. I need a job, too. I don’t have any money.”

  Lucas sighed. “Can’t help you there,” he said. “I’d put in a word for you at the dairy, but they already hired all the help they need for this year. As a matter of fact, they just had to let some people go because they’re slowing production. Something about a drop in milk prices, I think.”