A/N- terrashelties had a question about the plausibility of the victims sustaining consciousness while the villain performed a mediastinal sternotomy without there being a lung collapse. I went out on-line and did a bit of research and these are the things I found that support my assumption that the villain could do this:
Each lung is enclosed in a separate area within the chest called the pleurae or pleural sacs. The pleurae are the airtight membranes that cover the outer surface of the lungs and line the chest wall beneath the ribcage. If an object punctures the chest wall and allows air to get into one of these areas, the lung within that area begins to collapse. In order for both lungs to collapse, both sides of the chest would have to be punctured.
The mediastinum is the interpleural space between the two lungs and is the region in mammals between the pleural sacs. It contains the heart and all of the thoracic viscera except the lungs. When a sternotomy is preformed the pleurae are not affected by the incision down the long axis of the mediastinum and therefore unless Shelly screwed up and tore the pleurae while she split the sternum apart the lungs should remain functional.
Terrashelties observation made me think and question the entire plot of this story. That is not necessarily a bad thing. This is one of the reasons that reader feedback is so invaluable to a writer. Your questions and observations help us to do better work and refine our research. So thank you for the question terrashelties, I appreciate it.
Please note that the fire sequence in this chapter was researched in two ways. One: My husband is a volunteer fireman and I went over the sequence with him. Two: I found an MDSR report that details the issues and procedures associated with a fire in a hospital where the piped oxygen is affected. See foot note at the end of the chapter.
Chapter Thirty-Eight
It was five minutes to two and Sarah Barken sat at the nurse's station thinking that she needed to get the hell off night shift. The sheer boredom was going to drive her absolutely buggy.
'The closest thing to exciting that's happened is the cute, no scratch that, absolutely dreamy hunk of an FBI agent coming over to ask for coffee because he can't leave his charge, and would I mind finding someone who could bring a cup up to him.
Would I mind? Man I'll brew it myself for you doll!'
Sarah had practically jumped at the opportunity to get coffee for this guy. Maybe she could even get his number. She was incredibly curious about the reason he was here. Was it some sort of criminal mastermind that he was guarding in the room across the hall? She tried to get a look at the patient in the bed when she brought the coffee but the hunky FBI guy came to the door and wouldn't move out of the way. She did notice that the patient was restrained so she decided that it must be some sort of criminal.
'Imagine that; a real live actual criminal right across the hall from me guarded by a totally babalicious FBI agent!'
Sarah sighed. That was well over an hour ago and she was wondering if he might want more coffee soon.
'God nothing interesting ever happens on nights!'
She heard the sound of breaking glass coming from the room across the hall and got up to investigate. As she came around the corner of the desk at the nursing station she heard a loud bang and the door across the hall reverberated making her stop in her tracks. Within a second or two of that bang a powerful explosion rocked the floor and the door to room 466 flew across the hallway slamming into the nursing station desk right where she had just been sitting. The concussion sent her flying and she fell hard against the wall as a jet of flames shot out of the open threshold setting off the alarms.
Sarah sank down against the wall dazed, confused and more than a little frightened when a third explosion sent debris flying out of the room. Sarah covered her head with her arms as bits of wood and metal shot out across the hall. Something in her mind clicked into place and all of the R.A.C.E. training came flooding back to her in an instant. Thick black smoke started billowing out into the hallway and she knew that the third blast occurred as the hose attached to the piped oxygen wall outlet ruptured.
Now pure oxygen was feeding the fire and helping it to spread. The first order of priority was to rescue patients but as she gazed at the inferno that had become room 466 she realized there was no one to rescue in that room. She needed to alert other personnel and she started shouting.
"Fire! Fire in room 466! Help! Fire!"
She got up on her hands and knees to stay underneath the smoke as the other members of her staff came running down the hall. She knew that the next step was to try and contain the fire but there was no chance of doing that now. The next few minutes passed in a haze of confusion. There were screams and shouts, the fire suppression systems had kicked on automatically while tripping the circuit breakers for the unit plunging the entire floor momentarily into darkness before the emergency red lights came on casting an eerie glow everywhere.
'The power's out! The monitors will all be off, the respirator for the woman in 458! Oh God!'
Sarah looked to her staff. The second night shift nurse and three aides were all looking to her for instructions.
'Well Sarah, you wanted excitement!'
"We can't contain the fire. Maggie pull the alarm!" Sarah shouted pointing to the alarm just above the nursing assistant's head.
"Janice shut down the pipeline zone valves for this floor. Go now!" Sarah shouted to her fellow nurse.
"Julie and Margo start down the hall in that direction; get everyone out! Take them down to the ER for the time being. Maggie you and I will get the patients on this end of the hall out."
Alarms were sounding all over the place and the smoke was thick and choking her. She and Maggie had to get past room 466 which was a blazing inferno that the fire suppression system wasn't touching because it was being fed by the ruptured oxygen pipeline. Sarah spared a thought for the two men in that room.
'They're dead, no one could survive that. I can't even get near the room.'
She pushed those thoughts aside; she had to save the people that she could. She crawled on her hands and knees behind the desk of the nurses station instructing Maggie to do the same. The room door lay tilted against the desk and offered a modicum of protection from the intense heat from the blaze. They quickly made their way around the far side of the station and got up to evacuate the rest of the patients from the floor. Keeping crouched low they split up pulling beds from each room and wheeling them quickly down the hallway toward the elevators.
By then, security personnel and staff members from every other floor had come up to the fourth floor to assist in the evacuation. Turning the zone valves off had cut off the supply of oxygen to every other patient on the floor and some of these patients needed to be sent immediately to the emergency room. Sarah stood at one end of the floor triaging which patients rode down the elevator first while Janice did the same at the other end.
The fire department had been alerted automatically by the hospitals internal system and a second and third alarm went out when the head of the security force verbally called in the multiple explosions to the fire department. The evacuation of the affected floor and the floors above and below continued at a break neck pace. A majority of the patients were shunted down to the Emergency Department because it was the furthest away from the east wing of the hospital where the explosions had occurred.
When the head of hospital security saw which room the problem originated from he immediately called the number given to his staff if anything were to happen concerning the occupants of that room.
Megan drove to LA County General at close to eighty miles an hour. She called David and told him that there had been an explosion at the hospital and to get there as quickly as possible. She made it from her apartment to County in less than fifteen minutes and had to show her badge to get past the Fire Marshall who had declared the scene a hazard zone. He had ordered the evacuation of the entire wing of the hospital that was affected by the blast.
The initial two blasts had caused severe damage to the room of origin but it had also weakened the ceiling and floor and he was afraid of a structural collapse. Even though the pipeline zone valves had been shut down there was still plenty of oxygen getting into the room and feeding the fire. The initial explosion had not only blown the door to the room off it's hinges but had blown out the windows leaving a gaping hole in the side of the building allowing plenty of airflow to feed the fire.
Megan was not allowed to go up to the fourth floor and was feeling incredibly frustrated. She understood the danger but she had to find out about her people.
"I've got men up there! They were in the room where the explosion occurred!"
A tall fireman who had been directing his men turned to her.
"If you had men inside that room miss, there is no way they could have survived. Some form of incendiary device went off; it's the only way that the amount of damage could have occurred. I've got men up there on that floor; it's not safe for them let alone a civilian. I'm sorry but you can't go up there."
"But my men; I have to know!"
The chief turned away from Megan and spoke quickly into his radio.
"McGee, did you find anyone in that room?"
"Two survivors were taken down. They were in the bathroom connected to the room. Check with the ED!"
The fire chief turned back to tell Megan what to do but she had already taken off at a dead run for the emergency department.
With the sudden influx of patients evacuated from the east wing of the hospital that couldn't be put into unoccupied rooms in others areas the ER had transformed into pure pandemonium. Megan knew that Colby and Don would probably be in bad shape and she approached the nearest doctor showing her badge asking where patients injured in the explosion would have been taken.
With the state of near panic in most of the patients the doctor was wholly unimpressed with Megan's badge and he told her that she would have to take a seat in the waiting area for the time being. David arrived as Megan was about to lose her patience with the doctor and took her buy the arm pulling her aside. The doctor she had been speaking with moved off to help with a screaming woman covered in soot.
"Megan, what happened?"
"I don't know and no one is helping me to find our guys. All I know is that they were pulled out of the bathroom and brought down here."
David looked around for a moment as if to get his bearings. He had seen the hole in the side of the building and figured that if Don and Colby were alive they would probably be in critical condition. He saw a sign over an area near the rear of the department that read 'Surgical Acute'
"Come on, let's try down here."
With the controlled chaos erupting everywhere in the emergency department Megan and David didn't have too much trouble moving through the area. A couple of times they were stopped by staff but their badges allowed them to proceed. No one who stopped them knew anything about the men they were looking for so they proceeded to look in every room in the acute surgical area for their fellow agents.
"Megan! Over here!"
David and Megan had split up and were searching opposite sides of the subunit when David poked his head into a trauma room and saw Don. He was lying on his back; stripped down and covered up to his waist with a sheet. His hands and arms were covered in black soot from the fire and his face was covered in blood and grime. There was a resident suturing the back of his head while another doctor looked at x-rays of his skull.
The resident doing the suturing looked up when Megan and David came into the room.
"Hey, you can't be in here!"
Both of them pulled out their badges as they approached and Megan took the lead.
"This man is an FBI agent who was in the room where the explosion occurred. He's a patient in this hospital and there was another agent with him. Where is the other man?"
The two men exchanged glances and the doctor holding the x-ray stepped forward.
"Another man was critically wounded in the blast. He has been taken up for emergency surgery. I don't know much about his condition, only that he was critical and..."
Megan shot a worried frown at David before turning back to the doctor.
"His name is Colby Granger and he was on duty protecting Agent Eppes." she said pointing at Don. "I need to know what ever you can tell me doctor."
"What ever happened up there was pretty bad. I saw Mr. Granger briefly but was not assigned to his case. I am taking care of Mr. Eppes, but it looked like there was a lot of shrapnel damage. I can't be sure of anything but there was copious amounts of blood and it looks like he may have suffered some pretty bad burns. I don't really know because another doctor was taking care of him. He was only down here long enough to stabilize him for transport up to the OR. What I was told when they were brought down here was that when the firemen found them they were in the bathroom and Mr. Granger had used his body as a shield to protect Mr. Eppes."
Megan swallowed hard as she imagined what had happened and felt her legs weaken slightly. David reached out and put a steadying hand on her back.
"How is Agent Eppes?" Megan inquired in a slightly unsteady voice looking at Don.
"Mr. Eppes, hit his head on the sink and suffered a skull fracture. He has a severe concussion and there is a fair amount of swelling around his brain. I don't expect that he will be conscious for quite some time, at least not until the swelling subsides. He has second degree burns on his legs. The sternotomy incision on his chest is stable and we have reapplied a new VAC bandage. Mr. Eppes; excuse me Agent Eppes is an extremely lucky man. If the other agent hadn't shielded him he would not have survived the blast, not with his preexisting injuries."
"How can we find out about Agent Granger?" David asked.
"Go up to the surgical unit; use the elevator at the back of the department with red stripes on it. Take it up to the second floor and the intake desk is off to the right. I'm sorry about your other agent."
Megan had gotten her emotions under control and looked at the doctor and the resident working with Don.
"Has anyone else had contact with Agent Eppes?"
"Some of the nursing staff but it's been pretty crazy down here since the entire east wing has been dropped on us."
"Listen to me carefully. No one and I mean absolutely no one is to have access to this man. Do what you have to for him then get him ready for transport. As soon as he is ready to go, put a sheet over him and tell anyone who asks that he died of his injuries, even any other FBI agents. The only ones who will know that this man is alive are the four of us in this room. Do you understand?"
"Transport to where?"
"I'll take care of that. I want to go and check on my other agent then we will be back down here to take care of the transfer personally. Oh and we will need EMT uniforms; one for each of us. Please have this ready as quickly as possible."
"That, I mean… I can't just…"
"Listen to me doctor; your ER is a mess because someone tried to kill this man. The safest thing for your patients is for that killer to think that he accomplished his goal. We will need an ambulance standing by. I know that this is a little outside of your realm of experience but I trust that you have the connections to get this done for me."
The doctor had gone very white but nodded mutely. Megan and David turned and left the suture room closing the door behind them before making their way to the elevators in the back of the emergency department.
The nurse at the surgical intake desk was completely flustered by the sudden appearance of two FBI agents showing badges and demanding information on a surgical patient.
"I'm sorry; I can't tell you anything about Mr. Granger. I understand what you are trying to say but until the doctor comes out of surgery there is really nothing I can do for you. I simply don't have the information that you need."
Megan was struggling for control of her emotions. Her normal response would have been a flippant remark but she was riddled with too much guilt to be sarcastic. Her ruling emotion at the moment was anger because it seemed that everywhere she turned tonight she kept hitting stone walls. David sensed this and tried charm on the young woman.
"Miss, I understand the position you are in. We are very concerned because a fellow agent was seriously wounded while on the job. We just need to know if he is going to make it."
"All I can tell you is that when Mr. Granger went into surgery, he was in critical condition. He had lost a lot of blood and they are still working on him. The on-call surgeon is Dr. Kendrick and he is one of the best surgeons I have ever worked with. It will be at least another couple of hours before Dr. Kendrick will be able to talk to you about your agent. I'm sorry but that really is all I know."
David took out a business card with his cell phone number on it and handed it to the nurse.
"We have to leave but we are coming back. If the doctor comes out of surgery before we get back please have him call us right away."
The nurse took the card and smiled sadly at them. She could see that the welfare of their man was personal for both of them especially the woman. She hoped that the doctor had good news for them when he got done, but she had her doubts. The patient was in pretty bad shape when he was taken into the OR and they had already called down to the lab for more units of blood.
"I'll have him call if your not back."
Megan gave the nurse a wane smile and turned to leave with David following behind. They made their way back down to the emergency department and when they entered the suture room where Don was they found that the resident had left but the doctor remained. Don had been hastily cleaned up and moved to a gurney. He was covered in a couple of blankets with one balled up near the foot of the gurney covering the VAC pump.
Megan had to appreciate the doctor's thoughtful preparation. A VAC pump would be a little hard to explain on a corpse. There were two EMT jackets on the stool next to the gurney. The doctor picked them up and handed them to the agents.
"Jackets were the best I could do. There is an ambulance sitting out in the bay and the driver and crew are having coffee in the lounge right now. I swiped the driver's keys along with these jackets so you need to hurry before he and his crew finish their paperwork and want to head back out."
David and Megan both looked thoroughly impressed with this doctor. They took the jackets and put them on as the doctor took a large sheet and covered Don completely with it.
They maneuvered the gurney out intro the ED corridor and the doctor, walking a few paces ahead of them, led them to the ambulance bay. As the pushed the gurney through the door he mumbled, "Rig 224 on the far left." Then he turned abruptly and headed back into the ER without a backward glance.
It took Megan and David only a moment to get the gurney loaded into the ambulance and they were off into the night quickly before anyone noticed the theft of the rig. David was driving while Megan opened her cell phone and made a call to set up the transfer to Huntington.
They had already arranged an isolation ward for Don when they had planned on moving him before and those preparations were still in place. She had one contact at Huntington who would know the identity of the incoming patient but no one else would have any idea who he was. He was going to be listed as John Doe and the head wound would only serve to make that a more credible story. Once the arrangements for Don had been made Megan was very quiet while David drove.
"He'll be ok Megan, Colby's a fighter."
"I asked him to take the night shift. He was there because I asked him to be there."
"Megan if it hadn't been Colby it would have been someone else. He saved Don's life; you heard what that doctor said. Colby wanted to be there for Don, and with his background in the military I'm betting that his response reaction to that situation was probably a hell of a lot better than mine would have been. From what I saw when I arrived I would have to say that the killer used a RPG pointed at the window to the room."
Megan turned to David a little startled. "You think that a grenade did that much damage?"
"Not an ordinary grenade, but an RPG can launch several different kinds of rounds. It could have been a shrapnel grenade or even a high-impulse thermobaric weapon."
"A what?"
"Thermobaric weapons are nastier than conventional weapons because they use atmospheric oxygen, instead of carrying an oxidizer in their explosives. They are sometimes called fuel-air explosives or fuel-air munitions, heat and pressure weapons, or vacuum bombs. Bottom line is they produce more explosive energy for a given size than other explosives. The room burned up even after the fire suppression system came on. I saw that the fire department was using foam to put the fire out."
"Some thermobaric weapons work by first expelling a cloud of explosive mist using a small charge, then igniting it with a second charge. Basically there is a container of a volatile liquid or a finely powdered explosive. There are usually two separate explosive charges. After the munition is dropped or fired, the first explosive charge bursts open the container and disperses the fuel in a cloud that mixes with atmospheric oxygen. Once the fuel is appropriately mixed, the second charge detonates through the cloud."
"If they had been in that room…"
"They'd both be dead, no question. They were in the bathroom so I'm sure that the door offered the greatest amount of protection. The incendiary substance would not have gotten all over them or they would have gone up in flames like the rest of the room. This is all speculation but it seems the most logical explanation for what cause that kind of damage."
"What about Colby's injuries? It sounded like there was a lot of shrapnel flying around."
"A thermobaric weapon can also have a shrapnel canister or the device itself becomes the shrapnel. I would think that when we can get in there to examine the scene we are going to find that this was a custom weapon. The bathroom door offered protection from the fuel source but the second explosion, if there was one, could have turned that same door into lots of flying sharp pieces of wood or it could have shredded the door all together. We just won't know for sure until our forensics team can get in there. Who ever this assassin is; he knows his weapons. This was the best way to guarantee a kill."
"Only he didn't kill Don." Megan barked out a humorless laugh. "Thank God for Don's stubborn refusal to stay in bed. If he hadn't insisted that he be allowed to use the bathroom he would be dead and so would Colby."
David turned a corner and looked over at Megan.
"You know, we are breaking all kinds of laws here; grand theft auto for starters."
"Well, it's not theft if we're only borrowing it, but I get your point, we're going to need to wipe the rig down for finger prints and ditch it. I'd say we take it back to County but that might be a bit hard to explain. Let's just get Don safely transferred. I'll take care of getting him up to the isolation unit while you remove any evidence that we took this rig. When I come back out we'll start back toward County then ditch it. We'll have to take a cab back the rest of the way."
"What about calling Dan Hodges?"
"I don't want anyone else to know about Don. David, there is a leak in the Bureau. I don't like the fact that a hit took place on a supposed dead man."
"I get that, but we can trust Dan and there is also Charlie and Alan to consider. They are going to see the news tomorrow morning. There is no way to keep this from them. What are you going to tell them? We need at least one more person in on this, Megan."
"God, Charlie and Alan! Ok, you have a point. Call Dan when we get there. Have him meet us at Caldwell Park, that's where we'll ditch the rig."
David pulled into the ambulance bay at Huntington and they were met by a young woman dressed in scrubs.
"Hello agent Reeves. Is this our John Doe?"
Megan and David got the gurney out of the ambulance while Megan and the woman in scrubs wheeled it inside. David called Dan Hodges and gave him a brief run down of the situation then set about with alcohol and 4X4 gauze pads to wipe down every surface that they had touched inside the rig as well as the doors. He had just finished and when Megan re-appeared. He handed her a set of rubber gloves when she approached the ambulance.
"Here, put these on. Dan is on his way to Caldwell Park. How's Don?"
"Still unconscious; they are going to do another CT scan and send all of the reports directly to me. Lets get back; I want to check on Colby."
The strain in Megan's voice was evident and David sent a silent prayer that he was going to be all right. The last thing that they needed right now was another dead agent and he wasn't sure how any of them would handle the loss of another friend.
Footnote: The MDSR (Medical Device Safety Reports) article on Responding to Fires in Areas of Oxygen Use was my source material for the fire sequence. This article was published July 23rd 1994 and can be found at:
world wide web dot mdsr dot ecri dot org slash summary slash detail dot apex?doc underline id8164
