Chapter 1

Rostislov Rises

Dusted white by the Mojave’s desert alkali, he could have been the ghost of a soldier who died during the blistering summer of 1942 when General George Patton used the Mojave to train his battalions for the invasion of Libya. Limited to a quart of water per day, dozens of Patton’s eighteen-year old infantrymen neglected to take salt pills and died of sunstroke.  Others cooked inside Sherman tanks where temperatures soared to one hundred and forty degrees.

If these soldiers did not die in Libya, Normandy or Germany, they were equally a cost of war.  Department of Defense telegrams that described dying of thirst in the Mojave triggered a far weightier grief than the four hundred thousand that expressed regret for soldiers who fell in Europe or the South Pacific.  Whether by artillery shell, bullet, or mine, death on a foreign field of battle offered a bleak comfort.  Those sons, at least, perished while defending the United States and, in time, their surviving fathers and mothers, their brothers and sisters would come to honor a death in the sands of North Africa or a volcanic beach on Iwo Jima.

The parents, however, of boys who collapsed in the Mojave would never comprehend how their son could die from a lack of water within sight of Camp Young.  Sixty years later, death in the blistering California wasteland still defined utter waste. 

A circle of color stained the figure’s alkali coated camouflage. Bright red, two inches above his fourth rib, caked by the blowing dust, the bullet had blown him back into the basalt boulders. Within seconds after the high velocity slug exited out his back, the hole in his rib closed and his right lung began to leak air into his thorax. As the pressure increased, his lung collapsed against his heart that, in turn, gradually crowded against his left lung.   

Filled with blowing alkali dust, his breathing faded to repetitive, shallow gulps. Less than a minute remained before the gulping faded to the desperate rattle that preceded death. Searching in the pocket of his cargo pants, his left hand closed around a ballpoint pen. Sterilizing the steel tip was not possible and forming his lips into a prayer against infection, he gathered his strength, located the hollow between his third and fourth rib and pushed the tip into the hard muscle. The tip penetrated a quarter inch. He pushed harder. Another quarter inch. His third try forced the clip through the thoracic membrane into his chest cavity. Dismissing the pain, he unscrewed the top and removed the ink cartridge. A soft hiss issued from the plastic tube. His right lung slowly began to inflate.

The bullet had just missed his liver. An inch lower and he'd be dead. Relieving the chest pressure only postponed the inevitable. He gripped the Browning .270 that lay in the dust and drove the barrel into the pumice.  Using the rifle as a crutch, he rolled from his back onto his knees. A minute passed before he struggled to his feet.

He fought to order his priorities.

Find medical help. 

Twenty-nine Palms Marine Air Ground Combat Center was seventy miles away. The next closest was Desert Regional Medical Center in Palm Springs. If he survived long enough to reach a Surgeon, his wound would trigger an inquiry. The mortar attack in Dallas and the killings in Los Angeles would be traced to the firefight in Amboy. In a week, possibly ten days he’d be charged. And yet, absent a surgical team trained in battlefield trauma he’d be dead in forty minutes.

Triage the bullet hole.

He slipped the curved Kurad dagger from his belt. Unbuttoning his camouflaged blouse he split his bloodstained undershirt from collar to waist, sliced a ragged three by three inch square then used his left index finger to stuff it deep into the bullet hole. The cotton plug might buy an hour. 

A series of deep, wracking coughs summoned bloody phlegm to his lips.  Gathering the blood onto the back of his tongue, he spit onto a basalt boulder.  A black, quarter size clot, hung for a moment then dropped into the black pumice.  

The insistent, melody of the whore’s ringing phone insinuated into the wind driven dust. He slipped it from the left pocket of his pants. When he slid the arrow to answer, his thumb left a bloody swipe across the glass face.

"The Assassin is moving," the Caller advised him. 

"I’m aware." His confession was punctuated by a deep wheeze.

“Is he wounded?”

“No.”

A pause.  "And you?"

"A bullet in my chest. Another in my leg."

Two seconds preceded a brief question.  "Can you walk?"

"Not long." The cough doubled him over.  When it eased, he managed,  “He took the woman."

"Her value was solely to lead us to him."

Another deep, ragged cough.  

"Do not talk." the Caller said. "Help is coming."

Two hundred feet below and half a mile across the overlapping lava, a BMW X-5 was partially hidden behind a basalt outcrop. Staggering from one step to another, the soldier continued downhill.

His code name was Rostislov. Forced upon him by the Russians, kept because it reminded him of his years in Lubyanka––soldier, warrior, avenger, executioner, his allegiances and loyalty were unflagging. There was no need to attach a first name to the wounded man. He was Afghani by birth, abducted from the Kunduz Madrassa, trained by the KGB. Translated from the Russian, Rostislov equated roughly to “Usurp Glory!” Soldier was accurate enough. He was an expert in the use and function of U.S., Russian, Czech and German assault rifles. He could shoot a possible score at two hundred meters. He’d earned a red armband in Muay Thai, was fluent with a knife and accurate out to sixty meters with an automatic pistol. He knew advanced first aid and basic battlefield surgery. Along with French, German and Spanish, he spoke Pashto, Dari and Russian. Most valuable of all, his Oxford English allowed him to pass through European Union and U.S. border controls without notice.

Blood stained from right pocket down to his waist. Thirty minutes remained before shock dropped him. 

Yeats’s “Second Coming,” was required reading at the Institute. To stiffen his resolve, he now whispered. “Turning and turning in the widening gyre, the falcon cannot hear the falconer.”

The Altai Falcon had stooped over Dallas. The Peregrine, Barbary Falcon, Gyrfalcon and Merlin remained hidden under the BMW X5’s folding back seat. A dozen men had achieved martyrdom to place them in his hands. Rostislov could not lose the weapons. He needed to launch all before he died.

A .270 shell casing glittered on the ground. He almost blacked out when he bent to retrieve the brass cylinder. Two others lay nearby. He slipped all three into his cargo pants. The whore’s slender middle finger lay next to the cartridge. Her ring finger was a yard away. Both nails were painted a bright red. He picked the fingers out of the gravel and dropped them in his pocket. The bloody garden sheers lay a foot away.  He slipped them into his left pocket then dragged himself up the .270 to his feet. Blood was filling his lung. A deep hacking erupted from his chest. A water bottle lay in the pumice. He was desperately thirsty. Empty. The whore had poured it onto the rocks. Gray margins would soon close upon him. Thirty minutes remained before his eyes rolled back and he pitched onto his face.  Until then he would persevere. One foot in front of the other, downhill toward the distant lava flows.

The Caller dialed a Las Vegas number.

The plastic Surgeon’s cell phone buzzed in the pant pocket of his blue scrubs. He had just excised a crescent moon from a woman's eyebrow. In a week, a red scar would remain. In a month, a thin, white contrail would record the blade’s passage. In six, a familiar youth would define her eyes. Friends would wonder why the woman looked suddenly rested. Half a dozen would gossip about a younger man. None of her friends would suspect cosmetic surgery. For that reason, the Surgeon's operatory was reserved a year in advance.

The Surgeon’s cell continued to buzz against his thigh. His son and daughter alone had the number and they were given strict instructions to call only in an emergency. Turning to his anesthetist, the Surgeon apologized, “You’ll have to excuse me. Monitor her vital signs.”

His surgical team was stunned. The Surgeon never stepped away from an operation. Never. The patient’s margins still needed to be closed. 

He did not offer an explanation, simply turned from his unconscious woman, exited the operatory and crossed to his office where he touched the small green key.

A link to his youth stepped back into his life. "Our Prince blesses you," the Caller recited

The Surgeon was stunned. His memory had always served as a source of pride but that morning he needed ten seconds to recall the correct response. Part shock, part fear, the precise phrases slowly returned. "If that is true,” he quietly recited. “Then I am, indeed, honored." His answer opened the first lock.

"He prevails upon your hospitality to aid his servant. . .at the same time you serve Allah." The Caller opened a second lock

The Surgeon almost believed the call would never come.  Now that it had, he considered hanging up. Studying the phone’s red key, he realized far too much was at stake to engage in desperate acts. Reluctance heavy in his reply, he inserted the third verbal key. "I have been waiting for his summons. My Prince is well? He continues to rejoice in the embrace of his wives and sons?"

The Caller did not waste time. "As you must be aware, our Prince was martyred."

The Surgeon hesitated before he quietly confessed. "I mourn his martyrdom as I rejoice upon his ascension to paradise."

Connection confirmed, the Caller got to the point. “Your skills are sought by a wounded brother.”

The Surgeon knew the wounded brother had to be of enormous value, for the Caller to contact him. He hesitated before reciting, “I am grateful to serve all my brothers,” A word out of place, or a pause, would end the exchange.

“Time is precious!” The Caller offered the expected response.

“The years pass without markers.” The Surgeon offered the next key. “What is the nature of his wound?”

“A bullet in his lung.”

“How much time has passed?”

“Ten minutes…at most”

“And he is conscious?”

“For the moment.”

“His breathing is labored?”

“His coughing is painful to hear.”

“Where is he now?”

“To the south, walking across the desert.”

“Walking?” The Surgeon did not argue the possibility. It was doubtful the wounded man could travel more than a mile. At the very least, a slug to his lung would destroy a lobe. If it struck a rib and fragmented, or failed to exit, the punctured lung would force air into the thorax. As the pressure increased, the lung would collapse, crushing the heart and functioning lung against the ribs. The victim would turn a cyanic white and die gasping for air.

“His faith in God is unshakeable but he has little time.”

The Surgeon was no fool. Enormous personal risk would be required to save the dying man. Only the instrument of vengeance who infected the ex-President and his Cabinet deserved such effort. “Could this be the brother who was present in Dallas?” He unwisely referenced the recent Marburg attack.

The Caller avoided a reply. “That is of no importance.” Innocent on the surface, his next question concealed a razor’s edge. “Is your devotion strong?”

His reply lacked fervor. “It is.”

“Strong enough to aid our brother?”

The Surgeon struggled with the consequences of helping the wounded man or crushing the phone beneath his elegant heel.  His response was brief. “Tsa,” he quietly agreed. “You are in contact with him.”

“The reception fades.”

“How far has he traveled?”

“There is no way to know. A vehicle is close. Allah willing, he will drive until he loses consciousness.”

“That will occur within the hour.” The Surgeon advised him. “The clock is running. You will direct him to me.” He was careful not to mention Las Vegas.

The Caller understood. “I will remain in contact.”

The Surgeon disconnected. Slipping the cell phone into his pocket, he meticulously scrubbed his hands, re-gloved, replaced his sterile mask and returned to the operatory where he rapidly closed the incision beneath his patient’s eyebrow. Distracted by the call, he nicked a facial nerve. The eye would be gripped with flurries of essential blepharospasm ticks.  It was the first time the Surgeon’s insurance would be forced to settle a claim.

John Steinbeck knew the desert west of Needles, California where the old Route 66 abandons Highway 40 and cuts south through the shimmering reach of creosote, yucca and Mormon tea.  Driven to finish “The Grapes of Wrath” Steinbeck wrote, “But the river is a stranger in this place. Up from Needles and over a burned range, and there's the desert. And 66 goes on over the terrible desert, where the distance shimmers and the black center mountains hang unbearably in the distance.” 

East of Amboy, the rough desert road alternated tire shredding shale with deep washouts and choking dust.  Steinbeck believed Route 66 was ”the mother road, the road of flight,” and, in an attempt to see, smell and feel what the hollow eyed migrants faced as they crossed the Mojave on hemp rope laced around wooden spoke rims, in 1937 he traced 66 from Chicago to Los Angeles. When Steinbeck finally descended into the Mojave, the heat, desolation and distance spoke through him to Tom, Ma and Pa.

“In the driver's seat, Tom and Al and Pa, and Winfield on Pa's knee, looked into the bright descending sun, and their eyes were stony, and their brown faces were damp with perspiration. The burnt land and the black, cindery hills broke the even distance and made it terrible in the reddening light of the setting sun.

Al said, "Jesus, what a place. How'd you like to walk acrost her?"

"People done it," said Tom. "Lots a people done it; an' if they could, we could."

"Lots must a died," said Al”

Not all tourists who follow Steinbeck’s Mother Road into Amboy, California are lost. Oscar and Jane Holding were searching for what remained of abandoned gas stations and crumbling motels when they slowed for “Roy’s.”  During the couple’s eight-day round trip from Saint Louis to Los Angeles, Jane purchased postcards in Essex and Barstow. On the strength recommendations from half a dozen websites, she added Amboy Crater to her list.

They were two miles west of Roy’s when a two hundred and fifty feet high black cone appeared out Oscar’s window. Set aside as a Natural Landmark in 1973, the Crater was ten thousand years old. Successive flows created two large lava lakes, dozens of parasitic tubes and splatter cones.  To pacify Jane, Oscar agreed to hike to the crater rim. That day, however, a forty mile an hour wind gathered dust from the Mojave’s white alkali pans. Rushing through the crater’s collapsed wall, the wind climbed the crater's cone where it formed a two-meter rotor above the rocky rim.  The hike to the rim would take two hours. The blowing dust would add forty minutes. Oscar guessed if they climbed to the crater they would reach Los Angeles during rush hour. He glanced at his wife.

She was now in her early sixties. Gone gray ten years earlier, she still possessed the energy of a woman half her age. 

Oscar looked across the desert toward the black cinder cone. Dust banners waved in the wind.  “Looks like we’ll have to skip that hike,” he forced the least regret into his voice.

Jane let a moment pass before she replied, “But, Oscar, we’d planned ––”

“We didn’t count on this wind.” He interrupted. “If we stop, we’ll sit in traffic.” The minivan’s digital clock showed eleven o’clock.

Jane had looked forward to climbing the Amboy Crater. “The internet says the view is worth the time.”

“Between the wind and dust, no way we’ll make it to the top.” His voice had an edge.

“You said you wanted to photograph the desert training area.”

“Four circles of tent rocks and that one lousy memorial wasn’t much of a training area.  We should have stuck to the Interstate.”

“A shot from the rim might ….

He was shaking his head.  “No.  I won’t risk my Nikon in this alkali!” 

Jane watched the approaching crater. Oscar charged six thousand dollars to their Visa for the professional body and three zoom lenses. The Nikon however, proved to be too heavy for her to hold and too expensive to trust with strangers. Now, a little less than halfway through the trip, the photos centered Jane in front of Route 66 motels, abandoned restaurants or, ten minutes before, “Roys” in Amboy.

 Blowing dust obscured the crater rim. “Damned alkali,” Oscar swore without passion.

Thirty-five years married to Oscar Holding taught Jane to pick her fights. At the risk of ruining what remained of the morning, she reminded him,  “We’ve spent four days in the van. It wouldn’t hurt to stop for half an hour.”

He refused to look away from the road.

“We’re taking the northern route back to Chicago.” She was frustrated.  “This is our last chance to collect some lava.”

“Jesus! If it’ll make you happy, I’ll stop!” Oscar hit the brakes and yanked the minivan onto the gravel shoulder.  Reaching behind Jane’s seat, he removed the Nikon body and a 100-400 millimeter zoom from its case. Attaching an extender, he screwed the lens to the body, braced his left elbow on his hip, looked through the eyepiece and focused on the crater rim.  He inhaled, released half and squeezed.  Repeating the process, he took three frames then returned the camera body and telephoto to the case.   

“Oscar,” she held her emotions in check.

“That shot was a good one.”  Sarcasm filled his response. “I’ll frame it for you.”

Jane Holding could care less if Oscar’s photographs turned out.

Returning to the driver seat, he pulled back onto Route 66 and accelerated west toward the Bullion Mountains.  If he had paused to review the digital images, he would have noticed a silhouette on the crater’s rim. The minivan was two miles west when, far in the rear view, the anomaly slowly metamorphosed into a man.

Years of training helped Rostislov bury his pain, place his feet precisely on the steep volcano path and focus on the SUV. When he coughed, a clot lifted from his lungs to his throat. A new, deep whistle rose from his chest as he followed the trail that snaked down toward the black basalt flows

In time he reached the volcano’s base where he staggered across the rough lava flows. He was weaving, dragging one foot past another. Falling was not an option.  He lacked the strength to rise from the dusty path and placing one foot in front of the other, he ignored his burning chest and stumbled across the rough ground. He managed one step then, doubling over, vomited a stream of liver colored blood onto the black pumice.  

He did not know how long it took to reach the BMW X5. It might have been an hour, two or ten. Time had stopped. Pain supplanted any digital or mechanical clock works. The tick of his heart, the scrape of bone against bone, muscle spasms, blood rising in his chest, all proceeded at a measured, predictable pace. When the blue BMW wavered out of the blowing dust, he retrieved the key from his right front pocket, opened the door and sagged into the driver’s seat. Slipping the key into the ignition, he heard the engine catch then dragged the selector into reverse and pressed the accelerator. The SUV bounced backward until the rear bumper crashed into a four-foot lava rock wall. The driver door slammed shut.  He pulled the selector into drive and blundered forward into a basalt boulder. The impact crushed the front bumper. He reversed once more, turned the steering wheel to a stop and followed the rough gravel road toward the distant black stripe of the National Trails Highway.

The whore’s phone rang. 

The Caller was tracking the phone’s GPS coordinates.  “You have reached the SUV and are traveling north.”

Rostislov coughed deeply in reply.

“Help has been summoned.”

Weaving from one gravel shoulder to the other, the BMW reached the intersection with the National Trail Road.

The Caller’s voice returned. “Turn right, now.” Three minutes later, when a rough desert road arced north, deeper into the desert, the Caller instructed. “Left here.”

He had no sensation of turning the wheel, pressuring the accelerator, or applying the brakes. He could not read the instruments on the curved, leather dash or see the vortex of dust that filled the rearview. With his vision fading out of focus, he believed that God was driving the SUV. 

The Surgeon rapidly dialed a number.

A male voice answered on the third ring. “Las Vegas Helivac.”

“Emmett?”

“He’s in the hanger.”

“Could you say it’s an emergency.”

“It always is.” He placed his hand over the receiver.  “Em, phone!  He says it’s an emergency.”

The helicopter pilot was restrained.  “Em here.”  

“Emmett, this is Dr––” The Surgeon used his Americanized name. The Surgeon had repaired Emmett King’s infant son’s cleft palette and now, a decade later, the eleven old boy was both remarkably handsome and a superb athlete. No evidence remained of the devastating birth defect.

King Air was struggling before the operation and the pilot made the first five of sixty payments before the Surgeon suggested a compromise.  Emmett King could repay his debt by flying the Surgeon’s friends and patients around Las Vegas.

The pilot’s reserve evaporated. “Doctor what’s your emergency?“

“I’m in need of a favor.” The Surgeon said. 

Emmett Kings remembered his son’s strong, handsome face. “Anything.”

“Before you agree, my request is not inconsequential. “

“Ask.”

The Surgeon started with a lie. “A patient fell while crossing a fence. His hunting rifle discharged. The bullet struck him in the chest.” 

Two dozen years of flying helivac insulated Emmet King from all but the most bizarre effects of human stupidity. Shooting yourself with a rifle wasn’t easy. Nine times out of ten, it was another shooter, or a botched suicide. The doctor might have gotten his facts wrong.

The Surgeon revealed as much as he knew. “The Victim is driving north on a desert road toward Las Vegas. You will need to fly south into the Mojave. I checked NOAA. The forecast is for high winds and blowing dust.”

The helicopter pilot did not waste time. “The ship is fueled,” he said. “I’ll file a flight plan en-route. We can be in the air in three minutes.”

Gratitude tinted the Surgeon’s reply. “An EMT will assist my surgical nurse. They can be at your helicopter in fifteen minutes.” 

“The rotor will be turning.” Glancing at the waiting 407, Emmett asked, “Has either worked around helicopters?”

“Both have experience.” This time the Surgeon told the truth.

Rostislov did not know how far he had driven on the desert road. The Caller fed him directions. Issued in a calm monotone, the instructions were basic.  “Straight, right, left.” Rostislov’s training and ferocious desire to survive helped maintain a steady forty miles an hour. And when his vision faltered, Allah’s hand moved the steering wheel. Pressed hard against the black basalt cliffs, dusty ranches slowly gave way to played out mines until all that remained were the saltpans and creosote brush stretching north into the Great Basin.

Half a liter of coagulated blood now filled his right lung.  His camouflage shirt was stained a dark red, the seat crusted black. He was transitioning between a class two and three blood loss. His heart rate increased to one hundred and twenty beats at the same time his pulse pressure decreased. An increase in lactic acid triggered by a cellular lack of oxygenation pushed his breath rate to twenty inhalations per minute. The bloody hands that gripped the X5’s leather padded steering wheel betrayed the faint cyanic blue of fading oxygen saturation.

He had less than fifteen minutes before a drop in both his systolic and diastolic blood pressure triggered an end of life crises. His breath rate would climb as his vision faded. What blood remained would be diverted to his brain, kidney and heart. In the final stage, a failing pulse would signal his rapid lapse into unconsciousness. At that point his training and will would cease to matter. He would slump over the wheel and run off the gravel road. 

Death would follow in three minutes.

Chapter 2

Air Ambulance

Las Vegas Plumbing Supply had been closed for three hours when Jason Barrett parked next to the material yard. Exiting his F-150, he walked to the metal gate and shook the woven steel fence. An old padlock banged against the metal bars. A thick growl issued from a weathered plywood box.  Barrett shook the gate again. A square head appeared from the box’s shadows. Black eyes locked on the EMT the dog exploded across the yard and crashed into the gate.  Barrett waited until the pit bull locked onto the woven wire then kicked it in the nose.  The dog’s ferocious bark exploded to an insane roar.  Barrett smiled and punched “record” on his cell phone.

The pit bull’s screaming ring tone was pretty fucking funny in a bar. It was far less funny when Barrett’s tattooed forearms were locked behind the UNLV coed’s knees.

She was a natural redhead with thick, shoulder length hair, cinnamon freckles, speckled alabaster breasts and long willing legs. The phone roared five times, hesitated, then started again. Only Las Vegas Fire Department Dispatch had the EMT’s emergency number.

Hips working frantically against his, the redhead warned “Jason don’t you dare!”

The ring tone roared from the night table. “Fuck!” He glanced at his phone.

Her hands anchored to his thick triceps, she hissed, “Goddamnit Jason! No!”

He gave her six strong strokes, grabbed the phone and yelled. “FUCK!”

“Jason Barrett?” The Surgeon’s calm British accent filled the room.

The EMT deleted the cell’s speaker, raised the phone to his ear and panted, “Wrong Number!”

“There’s been a hunting accident.” The Surgeon interrupted him.  “A hunter was shot in the chest.”

The EMT drove inside the redhead. “I’m busy! Call someone else!” Sweat dripped onto her heavy breasts.

“You flew helivac in Afghanistan?” The Surgeon was out of time.

Two tours taught Barrett all he needed to know about sucking chest wounds. An hour from a Las Vegas emergency room, the hunter was a dead man walking. Las Vegas averaged three shooting deaths a week. North of the Strip, the weapons of choice were handguns. Nine-millimeter, forty-five, AR-15, a 30.06 loaded with hundred and fifty grain deer loads, the caliber and elapsed time to an Emergency Room determined survival. Hands, arms, feet legs––the Victims drove themselves to a hospital. Chest, stomach, head, friends and family screamed for 911.

“You’re familiar with King’s Heliport?”

Given a choice between finishing the redhead and intubating a corpse, he’d stick with the girl. “I told you I’m busy.” The EMT started to hang up.

“Hear my offer!” The Surgeon checked his Philip Patek. King Heliport was fifteen minutes away. “Will ten thousand dollars cover your time?” The Surgeon pressed.

The coed’s right hand locked in his long hair.

The EMT countered with a figure he assumed the Surgeon would refuse. “Fifteen thousand dollars.”

There was no time to haggle. “Agreed.” The Surgeon said. “The bullet passed through his right lung. I will provide six liters of O negative blood.” Further details were not necessary.

“Cash…” Barrett cursed himself.

“You’ll be paid when you return.” Dark circles ringed the Surgeon’s eyes. “I have one further requirement. You will not speak to either the flight nurse or pilot. You will also forget the flight as soon as you deliver the patient to the clinic. Be at the heliport in fifteen minutes.”

“Fifteen minutes.” The EMT repeated. 

The Redhead rose to her elbows. “You’re not leaving?”

“A hunter got shot in the chest.” There was no time to search for his boxers. “I’ll be back in two hours.”

“Fuck that! I’ll be gone. For good!” She swung her legs over the edge of the bed and stood.

Barrett had forgotten her name. It might have been Cindy, or Candy, he confused the two.  Better to keep it simple. “Honey, I’ll be right back.”

“Jason, I’m not one of your Strip whores!”

 “Honey I know that!” He pulled his designer Levis over his bare hips, dragged last night’s sweaty dress shirt over his head and stuffed his feet into his work boots. His emergency bag was locked in his Ford truck. It contained everything he’d need. Bandages, blood pressure cuff, syringe, stethoscope, adrenalin, airway, the air ambulance stocked duplicates.

“Jason, you leave and you can lose my number!”

“Honey, don’t be like that. It’s my job.  Some guy shot himself.”

“And how many does that make today?” She demanded.

Eighteen months flying shot to shit soldiers in Afghanistan taught the EMT everything he needed to know about time. “Two, a dozen, what difference does it make?” Each second divided life and death.

 “He’ll be dead before you get there! ”

“I don’t have a choice!” Barrett retrieved his keys from the dresser.

“You do too have a choice!” She screamed in reply. “The choice is between me and the money!”

Time was up. “It’s not like that.” He tried to think of what he might be forgetting.

“Fuck you Jason!” Bending to retrieve her bra, shirt, panties and slacks from where she walked out of them, she crossed to the bathroom and slammed the door.

 “Honey I’ve got to go. I’ll be back! Two hours max!”

“I’m not listening!” She yelled through the door

“I promise …”

“Dream on Jason!”

Ten seconds passed. It was time Barrett could not afford. “That doctor offered fifteen thousand dollars for two hours.” He checked the room for anything he’d forgotten. “I’ll give you ten percent…fifteen hundred dollars to kiss and make up!”

Listening from behind the locked door, the Redhead didn’t want to end it with the EMT. At least not that morning. Between midnight and eight, she’d counted seven orgasms. Seven was a lucky number in Vegas and each convulsion made her value him more. Nevada counted billions trading money for sex. This was different. The sex was free. The fifteen hundred dollars was an apology.

The bathroom door opened. She walked naked across the room, rose to her toes and planted her lips on his neck. Before he could stop her, she sucked a dark, red hickey beneath his ear. “I hope you crash!” she was serious.

The EMT’s phone roared as he started his Ford truck.

“One final detail.” The Surgeon said. “Do not discuss this flight with anyone. Now…or in the future.”

The EMT realized he had underbid his time.

Surgical Nurse, Emily Hampton once dated the Surgeon. Looking back she realized dating was too strong. They’d had a one-night stand. If she once hoped the Surgeon would marry her, following that single night in bed, he stopped answering his phone. When she continued to call he changed his private number. Two months passed when, desperate to see him outside the operatory antiseptic tile walls, she spent a cold January night parked down the street from his home in the foothills.

It was five a.m. when he appeared at the front door with his new girlfriend. She was dark, elegant, leggy. Their kiss was long, familiar and passionate. She started down the front walk, paused and hurried back.   They kissed again, his hand slipping possessively onto her bottom. Emily watched her slip into a new Mercedes and disappear toward downtown Las Vegas’ early morning glow.

Years of working for the Surgeon gave her the barest insight into his past. A decade of medical school and residency were followed by a specialization in Plastic Surgery. Brilliant artist, in the time since he graduated, ten thousand operations exposed a woman’s physical mysteries until even the most beautiful were reduced to intricate tangles of nerves, muscles, bones, tubes, bags and filters that could be dissected and rebuilt.

Following a year of expensive therapy, Hampton met a carpenter who found her utterly fascinating. Phil was a good man, an attentive father but a poor provider and a mediocre lover. The marriage’s sole value was the two children who she loved without measure.

Emily Hampton may have been devoted to the Surgeon but risk-trumped loyalty. Her husband subcontracted interior finish––cabinets, doors, base and trim. He hadn’t held a serious job in eighteen months. Worse, he’d exhausted his unemployment. No wonder they hadn’t slept together in a year.

Who was to blame? The Federal Government? The State of Nevada?   Behind on the rent, credit cards, truck payment and the kid’s braces, she was too poor to place blame. With no way of knowing the EMT’s fee, she picked a round figure. Twenty thousand dollars would get the bill collectors off her back. It would also pay her divorce lawyer.

The Surgeon led Emily Hampton from the operatory out a back door and into a waiting taxi where he handed her a cooler with six liters of O negative whole blood. The driver was Mid-Eastern, Iraqi, possibly Iranian. He was silent during the fifteen minutes it took to break every limit south on Highway 15 to the heliport. Turning hard left into King Air, the taxi sped through an open gate across the flight line and skidded to stop next to the Bell 407 Air Ambulance.

The pilot opened the taxi’s door but did not ask her name. Instead, he helped her into the helicopter’s medical bay, tightened her shoulder harness and handed her a set of earphones.

Fourteen minutes after he answered the Surgeon’s call, Jason Barrett dumped his truck next to the King Air’s office and sprinted across the flight line to the helicopter.  The turbine was spinning when he shoved his bag into the medical bay, buckled into the aft seat next to the nurse and latched the door.

Enveloped by the scorching desert air that followed him into the bay Emily Hampton detected the strong smell of sex.

Turning to the emergency bay Emmett King looked at Barrett and raised his voice over the turbine roar. “The Doc says I should call you EMT!” He nodded to Emily. “You're the Nurse. I’m the Pilot. We’ll stick to those names.”  He opened the throttle and when the rotor was spinning, feathered the left pedal and lifted the cyclic. The helicopter rose off the concrete pad and when it cleared the hanger, turned south.

Rescuing the severely injured forced Emmett King to fly at night, in bad weather or deep into his fuel reserves. Distance, winds and the size of a search area only increased the danger.

Running out of kerosene twice forced an emergency auto-rotation––a power off, rotor-spinning free fall. Best case he would find an empty parking lot, worst he’d scatter the ship across half a dozen tract roofs.  During the past twenty-six years, he’d survived both––one totaled ship, one without a scratch.

One hundred and forty knots per hour amounted to drilling a one-inch hole in the main tank. Cruising at one hundred and thirty-three knots, added distance at the cost of time.  Absolute maximum range was three hundred and twenty-four miles. Spinning the turbine at max pitch at max rpm would reduce that distance by a third. Emmett King kept one eye on the horizon and one on the fuel gauge. Speed destroyed distance. The pilot would have time for one full throttle flyby before his dwindling reserves forced him to return to Las Vegas.  Surgeon’s patient or not, whoever was bleeding out in the desert was as good as dead.

Seated in front his office computer, the Surgeon scanned a topographic map of the Mojave. Dispatching Emmett King to rescue a shooting Victim without alerting the Las Vegas Police could cost the Surgeon his license. If the Victim died during the flight, neither the police nor the Las Vegas coroner could learn about the body.

The Victim’s broken rib, lacerated lung and massive blood loss stacked the odds against survival.  He would need to live long enough for King to deliver him to the Surgeon’s private clinic.

And then?  The Surgeon would do his absolute best. This once, however, his best might not be enough.

Patients risked their lives every time he opened a breast, ran a scalpel along a jaw or touched a steel blade to an eyelid. A lone, surviving bacteria on a doubly sterilized instrument would overwhelm the Surgeon’s years of study and training. Still, he had never filed a death certificate. If the Victim survived the Helivac, the Surgeon would close the hole in his chest and deliver him to the Caller.

And if he died?

The Surgeon would have no choice but commit his body to the desert.

The X5 slowed from forty, to thirty to twenty. Rostislov’s vision faded. He struggled to keep the SUV on Kelso Cima Road’s rutted surface. With his foot on the throttle and his hands on the wheel, he missed a gentle right hand bend. As the BMW blundered into the desert, Rostislov squandered his remaining strength.  The SUV slewed back onto the dirt road.

The Surgeon called the King Air Helibase dispatcher who patched him through to the air ambulance.

“King Air, 08362,” King repeated the Bell 407’s serial number.

The Surgeon’s calm voice filled King’s earphones. “The Victim’s cell phone reception is intermittent,” he reported. “The last known latitude and longitude was 34.723555-114.927979.”

The pilot glanced at his airspeed indicator. The 407 was holding one hundred and forty knots across a blurred sea of sagebrush and creosote. “Are those numbers current.” King inquired.

“No. They’re ten minutes old.”

King punched the numbers into GPs and checked his ground speed against the intersection of the coordinates. The Air Ambulance could sustain maximum speed for two hours. At the limit of its range, the Bell would have five minutes on target.  Any longer and the turbine would suck fumes ten miles short of the Surgeon’s clinic.  When the engine flamed out, the air ambulance would plummet into Las Vegas’s western tracts.  King rechecked his fuel. The tanks were short by three gallons. The air ambulance was racing south to crash.

The Surgeon’s voice filled the earphones. “Can you see a road?”

“We’re crossing open range… no roads.  Your figures are correct?”

“Within the standard margin of error.  Can you factor your closing speed into that last fix?”

“Not accurately.” The pilot input the helicopter speed, added sixty miles then divided the total by six. Ten minutes amounted to thirty-five miles. He glanced at the GPS. A road appeared on the screen. The elevation showed as a series of colors ranging from the bright blues of dry riverbeds, to the red of an intersecting ridgeline that rose in front of the 407. The GPS tracked the desert road to the ridge where it turned east into a deep canyon. The ridge closed at one hundred and sixty kilometers per hour. He gentled back on the cyclic. The helicopter roared through a low saddle.  The pilot squinted south across the bright Mojave Desert. In the distance, a gravel road bisected the dry creosote and saltpans.

Rostislov’s blood loss eventually blocked the nerve impulses to his arms. While his heart raced above hundred and forty beats a minute his blood pressure slipped to eighty over fifty-five. He could no longer slow the X5. His hands held the wheel; his foot remained on the accelerator. A front tire caught a rut; the BMW turned hard left, bounced over the grader berm and exploded through massive, dry sagebrush. The SUV traversed thirty meters over creosote and rock out crops before the front end rolled off a four-foot bank and slammed into a dry wash. The abrupt stop deployed the air bag that instantly deflated, leaving Rostislov staring at a rocky ridge in front of the BMW’s collapsed hood. The rear wheels continued to spin, driving the SUV harder into the bank. Before Rostislov could shut off the ignition, he slowly slumped over the steering wheel.

Strapped into the 407’s left seat, Emmett King glanced at the fuel gauge and missed the X5. The EMT caught reflection off the BMW’s rear bumper and triggered his microphone. “Ten o’clock off the port side.” The BMW was nose down in a dry wash, rear wheels spinning, nearly invisible from the air.  From the angle of the SUV, the extraction would drive Barrett to his limit.

A hard, banking turn brought the helicopter over the BMW. The Pilot raised the nose and flared into a vortex of dry alkali dust. He left the turbine running. The EMT jumped from the bay. Emily Hampton was a second behind, her white shoes leaving a line of tracks in the alkali.

Rostislov was slumped over the steering wheel. Blood soaked his camouflaged shirt, pants and filled the seat between his legs. A thousand surgical procedures had hardened the nurse to blood loss and yet, the volume shocked her. If the driver was not dead, he soon would be. She checked his carotid artery for a pulse. It feathered against her index finger. Tearing open his shirt, she noted his chest’s translucent blue pallor, the bullet hole above his nipple and the ballpoint pen stuck between his ribs.  Only someone trained in battlefield triage would know to use the pen. Whoever he was, the Victim was no hunter.

The EMT inserted an IV in Rostislov’s arm, plugged the surgical tubing in a liter of O Negative Blood then hooked the plastic bag on the door.

“Start with seven hundred milliliters,” the Nurse cautioned. Too much O Negative, too quickly, could kill him. Years of training warned her that she traced a fine line between saving his life and inducing further hemorrhagic shock. She inserted a chest tube to drain off the fluid. Dark, partially clotted blood bubbled out.

Before the EMT, slipped an oxygen mask over the Victim’s mouth and dialed the flow to maximum, he studied the Victim’s face. A second later he couldn’t remember the Victim’s eyes, nose, mouth or chin. He had black hair.  Beyond that not a thing to distinguish from a ten thousand other faces. Afghanistan taught him the Victim had fifteen minutes max. Flying at full throttle, the Bell 407 was forty minutes out from Las Vegas.  He wasn’t going to make it.

The Nurse needed twenty seconds to reach the same conclusion.  Counting the Victim’s shallow, intermittent breaths and faint pulse, she estimated the Victim’s life was counted in minutes.

The Victim’s body drained the first liter of O Negative. The EMT tossed the empty plastic bag next to the BMW and started a second unit.

The EMT freed the Victim’s hands from the wheel. The Nurse crowded next to the EMT to help.  He smelled of sex and sweat and taking a single, shallow breath she noted the bright, circular hickey on his neck.

The Victim’s eyes flickered open.  “My duffle,”  he gestured toward the back seat.

Time was gone. The Victim had exceeded the golden hour. The EMT locked his hands around his left wrist and dragged him out of the seat into the gulley’s sandy floor. The Nurse held the bag of O Negative as the EMT hooked one arm behind the Victim’s knees, the other behind his head and struggled to his feet. Crossing to the washout’s bank, the EMT drove his heels into the loose dirt and carried the Victim up the four-foot incline.

The EMT was twenty yards from the Bell when the Pilot appeared.  Grabbing the Victim’s legs, King followed the EMT to the open medical bay where they half lifted; half threw him onto the litter. The Nurse was a second behind, checked the oxygen flow and adjusted the mask.

The EMT replaced the empty liter of blood.

The Pilot was shutting the door when the Victim regained consciousness.  Dragging the mask off his face, he whispered, “My duffle…it’s in back…” The accent was faint, perhaps eastern.

“No time!” The Pilot yanked on the handle.

The Victim’s leg blocked the door.  “It will be stolen.”

“Fuck!” The Pilot yelled.  “We’re twenty minutes beyond maximum!”

The Pilot and EMT tried to force the Victim’s leg into the ship. It was locked in place. The open door prevented take off.

“Fuck!” The EMT yelled. “It’s your life! ” Diving out of the bay, he sprinted back to the BMW. The duffle was wedged between the seats on the back floor. The EMT grabbed the webbed handles and pulled. Burdened by the duffle’s unexpected weight the EMT struggled up the bank and back to the Bell. Tossing the heavy bag into rear storage hatch he dove into the open bay, slammed the door and latched it. The rotor spun, the Pilot eased in pitch and pulled back on the cyclic. A geyser of white dust followed the Bell as it lifted and banked north toward Las Vegas.

“That fucking duffle just cost you your life,” The EMT yelled. “It must be valuable!”

Close to death, the Victim was offended by the EMT’s repeated profanity. His mouth started to work.

The EMT strained to hear above the rotor.

“Binoculars…a knife for cleaning game.  Nothing…of worth…to any …” the Victim managed. His vision closed from the perimeters of his black pupils.  The Assassin’s face filled his mind.

Chapter 3

Las Vegas Clinic

Rotor at max pitch, the Allison 250-C47B turbine temps bumping against red limits, the Bell 407 was a tick below one hundred and forty knots.  Emmett King checked the fuel gauge. The 407’s tanks held 128 gallons of AV4 refined kerosene.  An auxiliary tank added eighteen more to that total.  He moved the cyclic left then right. The digital gauge switched from green to red and back to green. Tank levels were cascading toward empty.  King held his breath as the digital readout sank to three eights. The gauge was accurate to five gallons.  Less than thirty gallons remained. Las Vegas was a hundred miles off the nose.  Figure forty minutes on thirty gallons. The 407 was twenty miles short.

King keyed the intercom. “Give me his vitals!” No sense risking the ship for a corpse.

The Nurse checked the Victim’s pupils. “Marked tachycardia and tachypnea. We’ve run a second IV into his femoral artery.” She took his blood pressure. “Systolic blood pressure is falling!” The 407’s floor was slick with blood. The nurse knew the sum of the two IVs was insufficient. Inadequate perfusion. The Victim was four liters and a hundred miles from bleeding out.         

The Nurse pressed a stethoscope to the Victim’s left pectoral. Chest auscultation was impossible in thunderous confines of the helicopter but the nurse did not need to a stethoscope to know his right lung was filling with blood. 

A sixth liter of O negative swung from a ceiling hook. The whole blood coursed down a surgical tube into the Victim’s right arm. Lacking volume to maintain systolic pressure, his heart raced at a hundred and seventy beats per minute. Pushing through the pulmonic valve into the pulmonary artery, the O Negative flooded into the right lung where the closed loop fell apart. No longer contained by capillaries and veins, the blood leaked down the chest wall and out the drain tube.

The Victim’s cyanotic lips and fingertips revealed minimal oxygen saturation. His heart was barely beating, an erratic lub, dub…lub that signaled imminent end of life.

The rotor roar was deafening. “Intubate him!” The nurse yelled toward the EMT who guided the endotracheal tube down his throat then reattached the oxygen. The Victim threaded a thin line between cardiac arrest and brain death.

A hundred miles north the Surgeon tracked the 407’s ground vector toward Las Vegas.

King’s last transmission was succinct. Fuel was low, the Victim was intubated. The EMT and Nurse were down to four liters of O negative. “He’s alive, barely!” the Pilot scanned the horizon for the Las Vegas casino towers.

The Bell would reach the Las Vegas limit in fifteen minutes. Add another five to the Surgeon’s clinic in the hills. Vital signs indicated the Victim had ten minutes max.

The gunshot lung would have killed a hundred other men. Age, conditioning, prodigious good luck and the direct intervention of God partially accounted for the Victim’s remarkable survival. The rest was attributable to his ferocious will to live or Fate. Whatever the cause, the next ten minutes were preordained.   

“You will save our brother’s life!” The Caller did not threaten. He didn’t need to. 

The Hippocratic Oath was hardwired to the Surgeon. It made no difference that the Victim was within minutes of cardiopulmonary arrest, failure was not an option. If he failed to operate within the next ten minutes, the Victim would die.

The Surgeon could not link a name or allegiance to the Caller. If the Victim died, the Caller would seek revenge. The Surgeon would try, and fail, to protect his son, daughter and wife. Near the end, after he had suffered the agony of watching them die, the Caller would turn to him. Fingernails, hands, feet, knees, genitals, his torturers would trace the receptor paths.

He wondered how a loan he’d accepted thirty years before had come to this.

“Status?” The Pilot’s voice filled the EMT’s earphones. 

“He’s intubated, heart rate one forty beats a minute, rapid breathing, pallor, sweating.  We’re on our last liter of O Negative.”

The Pilot had transported dozens of gunshot Victims and could teach a class in hypovolemic shock. Sucking chest wounds made a mess of the medical bay but cleaning up the blood was the least of his problems. The Surgeon left no doubt that the Victim must reach the operatory alive.  Dying in the helicopter was not an option.

A yellow warning light glowed from the instrument panel. Six gallons remained in the twin tanks.

The helicopter reached Las Vegas distant southern subdivisions.  Scattered tiled roofs, date palms, cactus gardens, green lawns and sporadic swimming pools raced beneath the skids.

The Pilot keyed the radio and was patched to the Surgeon.  “Give me your GPS coordinates.”

Pinpointing the clinic’s location on an open radio link was not an option.  “Check your phone,” the Surgeon instructed him. 

A text detailing the coordinates appeared.  He keyed the numbers into his GPS.  Still twenty-four miles out, the 407 wasn’t going to make it.  Eighteen miles, sixteen, the Pilot tracked the fuel pressure gauge.  Fourteen.  Yellow light blinking, the pressure held.

The Surgeon’s clinic sat on ten acres off Promontory Ridge Drive.  Owned by Las Vegas’ rich, recognizable and deliberately anonymous, the ten million dollar estates all faced east to the Las Vegas Casinos and the distant mirror of Lake Mead. The Surgeon valued––required the isolation and privacy of fifteen thousand square foot, two story structure. From the stone and cast iron front gate, the Clinic’s east face deliberately mirrored details from the surround estates.

Stone veneers, tile roofs, eight foot wood casement windows, a front entry supported by gothic columns and a ten foot mahogany door, what the façade did not reveal was the eight bedrooms, each with a private bath and a fully equipped business center.  The home contained a commercial kitchen, a theater, indoor swimming pool, steam room, gym and the cooks, house cleaners, personal trainers, masseuse, beautician and maintenance men for staff. 

Home, however, was not totally accurate.  Hidden behind native cedars and sapling bristlecone pines, desert landscapes and overlapping security, the house served as a refuge for the Surgeon’s recovering patients. If the neighbors guessed a six-month remodel converted the estate to a fully equipped hospital complete with an operatory and critical care unit, none saw it as a problem.  Especially when Scarlett J. the A list Hollywood starlet joined the clinic’s yoga instructor in the expensive cactus gardens.

Stars, starlets, politicians, the rich, the powerful, divorcees, widows, widowers––all searching for a second wind––none dared face colleagues, friends, or a new love interest bruised and swollen from surgery. The clinic provided an expensive solution but few who recuperated behind the tall windows, stone facades and desert gardens questioned, or remembered the cost. The Surgeon’s patients could easily afford the five thousand dollars per day. Many blamed a South Sea cruise, or more often an untimely death in the family for their six-week absence.

The clinic was wrapped in cool, cerebral colors of the ice used to reduce swollen jaws, eyes and breasts. One aged, still amusing comic compared the white marble floors, white walls, crisp white cotton sheets to the luminescent room where an ancient Kier Dullea died in Kubrick’s “2001: A Space Odyssey.” The Surgeon was too young to remember the movie, but was offended by the Comic’s sarcasm. The following morning, bruised, red, unhealed incisions glaring from his eyelids and neck, the Comic was dumped at Delta in the Las Vegas Airport. No explanation was forthcoming but long after the bruises disappeared and the scars faded, the Comic, though more youthful, lacked a critical confidence. His career never recovered.  

A warm, afternoon wind pushed through the upstairs library casement window. Below Clara N., a 1990s opera star whose breast implants had failed, sat on a teak bench.  While skin cancer was the least of her problem, she wore a wide brimmed rattan hat favored by dermatologists. A series of prior, disastrous surgeries had removed all fat and collagen from both breasts. The Surgeon could repair the heft and symmetry, but could not correct procedures that preceded his scalpel.  Her scars would require make up and lowered lights when she took a new lover.  If such a man existed in her future. 

His cell phone ring tone was “In The Bleak Midwinter” a song that balanced the crises waiting on the other end. It was the Pilot. “We’re eight miles out!”

The Surgeon lifted a pair of Zeiss binoculars of his desk and swept the southeast horizon.  The helicopter was fifty feet above the commercial roofs, flying at full pitch toward the western foothills.

The yellow fuel warning was blinking. True empty would show in the fuel pressure gauge. The first fluctuation would signal a final thirty seconds of turbine power. The GPS display indicated the 407 was four miles out when a hard, electric beeping filled the cabin. King prayed the Canooks built a fail-safe into the system to save desperate pilots who deliberately flew through the visual and audio warnings. A moment later, a woman’s computerized voice sounded in all headsets. “Out of fuel, land immediately,”

The EMT broke in. “Game over. Set it down.”

“We land, he dies,” the Pilot’s voice filled the headphones.  Fuel pressure was holding

“If we don’t, we all die,” The EMT had watched a CH-47 Chinook run dry in Afghanistan. None of the wounded survived. The pilot was shipped home in pieces. 

The Nurse interrupted. “We gave it our best shot.  He was too far out.  We have to land!”

“Insufficient fuel!” The computerized voice warned the crew. 

The Pilot countered. “Fuel pressure is holding!”

The computer added an order.  “LAND NOW!”

“I HAVE A FAMILY,” the Nurse yelled into the mouth microphone.

“Our fuel pressure…”

“LAND NOW!” The computer volume approximated a digital yell. The pilot searched for a switch to shut her up.  Short of throwing a circuit breaker, it didn’t exist.

 “We have to land!” The Nurse’s scream echoed the computer.  She refused to die with these cowboys.  

The EMT watched roofs race beneath the skids. “We’re too low for a soft autorotate.  The turbine starves and we die!” Panic edged into his voice.

 “I’ve got you in the binoculars,” the Surgeon’s voice filled their headsets. “Come west four degrees.

“Two miles out!” The pilot reported 

“FUCK THAT!” The EMT yelled.  “I didn’t volunteer for a suicide mission.”

“GODDMANIT!  LAND!” The nurse thought of her children. She would not trade her life for the anonymous figure on the gurney. At best, he had seconds to live.  She had done her best. “FUCK!” her scream drew the profanity out. “YOU HAVE NO RIGHT!”

“LAND NOW!” The computer shrieked.

King was used to panic in his medical bay. Gunshots, stabbings, DOAs, flight crews fighting to save a life, pain, fear and screams clung to the job. His eyes flicked from the approaching ridge to the fuel pressure.  Steady. The 407 was too low. He hauled back on the yoke. The nose came up. The remaining kerosene drained away from the pickup. They were a thousand yards out when the gauge flickered. The turbine coughed, pitching the crew forward.

“LAND NOW!”

The EMT pushed between the seats. What he planned when he reached the cockpit was a guess. The pilot was thirty feet above the tile roofs. Bumping the yoke would scatter the ship across a dozen tract homes.

The pilot yanked back on the yoke. The EMT crashed into the Nurse who fell across the Victim. All three slid into the rear bulkhead. 

 “The adobe colored house directly ahead!” the Surgeon’s voice filled their head phones. The landing pad is in back.”

The turbine starved a second time. The Nurse, EMT and Victim slammed into the forward bulkhead

“LAND NOW!”

King pushed the yoke forward, the remaining kerosene filled the pickup, the fuel pressure jumped. A concrete pad appeared behind the mansion. The pilot watched three figures guide a gurney from the rear of the house. One was the Surgeon. The 407 was six feet above the ground when the turbine starved a final time.  The ship dropped, hit hard, bounced and settled.

“LAND NOW!”

Five seconds elapsed before the rear door slid open. Two male orderlies grabbed the Victim and lifted him onto a gurney.

“LAND NOW!”

King hit the main power switch.  The voice stopped. 

Emily Hampton’s scrubs were soaked with blood. She looked at the pilot then followed the team through double stainless steel doors.

The rotor stopped. The EMT studied the medical bay. It was a slaughterhouse.  Turning to the pilot he said, “Fuck You.”

Emmett King ignored him.  He was calling the fuel truck.

The Surgeon lead the orderlies to an elevator that descended to a second level basement where the team followed a wide hallway to a second pair of stainless doors that opened into an Operatory.  Brightly lit and hygienically clean, the operatory was used for patients who demanded total anonymity.

His phone buzzed in his pocket.  The Caller dispensed with the cautionary greeting. “Our Brother has arrived at your clinic?”

“Yes.” The Surgeon stepped away from the team.

“How long will the surgery take?”

“I do not know.  Four hours,” It was a guess. “He would be better served by a Thoracic Surgeon,” The Surgeon’s bread and butter were blepharoplasties, brow lifts, breast augmentation and belt lipectomy.  Bleeders were restricted to veins, not major arteries. The Victim’s massive hemorrhage would push the Surgeon to his limit. The last time he assisted in a lung resection was twenty years before, during his surgical rotation at Stanford.

“That is not an option.” The Caller was unmoved

Transferring the Victim to the University Medical Center amounted to a death sentence. The Caller was wasting valuable time. “We will do our best.” The Victim was within minutes of cardiac arrest.

There was no irony in the Caller’s reply. “I am confident our brother will recover.” 

The male nurses positioned the gurney next to the operating table.  One scrubbed the stainless steel surface with disinfectant and draped it with a sterile sheet while the other quickly cut away the Victim’s camouflaged shirt.

The anesthesiologist entered the operatory. He was gowned and masked. With a brief nod to the team, he attached the respirator to the endotracheal tube. Hooking up the monitors, he checked the heart-lung bypass machine and infusion pump.

Emily Hampton pushed through the steel door and exchanged her bloody scrubs for a fresh set. For the first time she had a clear look at the Victim. He looked to be in his early thirties, but could have been ten years older––or five years younger. He was neither handsome, nor unattractive.  He was thin but had strong arms. A surprising lack of body fat defined his muscled stomach and large pectorals. It was a body formed by forced hikes through high mountains. The major flaws were two bullet holes: one in his right hand, the other directly below his right nipple.

The Nurse briefly wondered who the Victim was and how he’d managed to shoot himself in both his hand and lung with a deer rifle. She switched the empty O Negative for a full liter then threaded the drain tube into a plastic bag.  Turning the Victim on the operating table, the male nurses positioned him on his left side, right arm above his head then cut away his camouflage pants.

His right thigh was wrapped with a bloody bandage. 

“What’s this?” The Nurse selected a pair of sterile scissors from the surgical tray and cut through the overlapping layers of tape and gauze.  A purple, circular hole pierced his right quadriceps. The bruised, striated muscle had been scrubbed with Betadine. The bullet hole was packed with an antibiotic ointment. If the Victim had treated his leg, he’d done a damned good job.

The Surgeon appeared at her side. He had gowned, scrubbed, masked and gloved and now probed the margins of the bullet hole. Considering it had been impacted by a high powered round, the tissue looked healthy. No evidence of infection.

“Pretty clear this wasn’t an accident, or botched suicide.” The Nurse voiced what everyone else was thinking. “Someone tried to kill him.”

The Caller neglected to mention the second or third wounds. A wrinkling above the Surgeon’s mask betrayed his displeasure.

 “I want to be absolutely clear,” He looked from the nurses to Anesthesiologist. “What transpires in this operatory stays here.  Please re-bandage his leg,” he ordered.

The nurse washed the site with Betadine, fixed sterile pads at the entry and exit sites, wrapped his mid thigh with gauze and ran two parallel line of tape to hold the fresh bandage together.

Turning to the Victim’s chest, the Surgeon studied the entry wound beneath the right nipple then asked the male nurses to position him on his left side. Radiating out from a pronounced lump on his fourth rib, a large bruise covered a fracture. Why a .30 caliber round fired at point blank range hadn’t blown through the rib cage was a mystery.

The Victim’s damaged lung prevented the use of inhaled anesthetic. The Anesthesiologist was preparing to administer a sedative into IV. 

The Caller added one further detail. No sodium thiopental!

Sodium thiopental was related to sodium pentothal. Truth serum was the stuff of spy novels. Thiopental lasted far too long for plastic surgery. There was no need to keep a breast enhancement or eyelift under for twelve hours. Thiopental was better suited for medically induced comas or lethal injections.

Patients shed their deepest inhibitions under Thiopental. If the anesthesiologist asked, most would confess anything he wanted to hear.  Whether it was the truth, or not, was open to interpretation.

“No pentothal, thiopental or any generic derivatives, do you understand?” The Caller left no doubt about the consequences.

“There are better choices than thiopental,” the Surgeon replied.  Who was this anonymous deer hunter? He sensed the answer would simply place him in greater peril. 

The fuel truck arrived fifteen minutes after King Air’s 407 slammed onto the Clinic’s concrete helipad. Emmett King checked the skid’s attachment to the fuselage and decided the carriage would make it back to the heliport where the mechanics would check the struts for cracks and replace all the mounting bolts. 

The EMT had already called a taxi when the Pilot said “You can hitch a ride back in the ship,”

“Thanks,” The EMT shouldered his emergency pack. “One whirling dervish crash per day is my limit.”
        King watched the fuel truck backed into the clinic’s rear parking lot.   “Sorry about the landing.” He said. “It was either that or lose the Victim.”

“Shit happens. The Victim is as good as dead anyway.” The EMT agreed. “I’d guess that curvy little Nurse won’t be working another helivac any time soon.” He turned, wrote the clinic’s address on a note pad and followed the driveway. It was the last time Emmett King would see him.

He inserted the nozzle in the fuel port and signaled the driver.  He filled both tanks then switched the main power on, flipped the switch for the fuel pump and watched the gauge. It held zero for ten seconds then jumped to normal. He waited another ten then hit the starter. The turbine spun, he triggered the ignition and the jet fired.  He waited for pressure and temperature to stabilize then engaged the rotor. Pulling pitch he pointed the nose south beyond the Strip.

The 407 came in low from the north. King settled gently onto the pad and waited for the turbine to stop before he shut down all systems and exited the ship.  The mechanics approached the ballistic grade front windscreen. 

“It took a hard landing,” King advised them. “Check the usual. Skids, struts and replace all the attachment bolts.” As an afterthought he added.  “Call the cleaning service. The bay is a mess.” 

The stress of running the 407 out of fuel exhausted Emmett King.  He finished a mental checklist then, as an after thought opened the cargo hatch.  The Victim’s duffle had shifted during the flight. Reaching in, he grasped the handle and lifted. The duffle was surprisingly heavy. Resisting an impulse to open the zipper, he figured whatever it held was none of his business and probably best left alone. Someone from the clinic would call for it that day, or the next. Emmett King crossed to his office and stored it in a closet that served as the Heli Service’s lost and found. 

He had barely settled behind his desk when he forgot about it. 

         To ensure the Victim remained fully sedated, the anesthesiologist ran an IV drip for Propofol. Filling the undamaged right lung with inhaled sevoflurane was not an option.  He attached the blood O2 and blood pressure cuff and turned to the patient monitor. Minimum O2 saturation. Blood pressure ninety over forty. Inadequate perfusion. The Victim blood loss was overwhelming the two IVs. The Surgeon checked the monitor and directed the Nurse to insert a third liter of plasma in his left arm.

“Scalpel.” He held out his right hand.  She selected a number ten. 

“I’ll need an eight,” he told her.

Time was critical.  Prior to a wedge resection, partial lobectomy or a full pneumonectomy, he needed to inspect the right lung, A thin line of blood followed the Surgeon’s pinstripe incision from the base of the Victim’s throat, down mid-chest, to an inch below his sternum. Delicate incisions that could be rapidly closed were not an option.

“I’ll need the oscillating bone saw,” The Surgeon eyes focused on the black, pistol shaped instrument on the sterile tray. Pressuring the trigger he carefully bisected the sternum. The nurse suctioned the debris then handed him the rib retractor. Three minutes after he started the Victims beating heart and breathing lungs lay illuminated beneath the operatory lights. 

Two liters of black coagulated blood filled the chest cavity. The Nurse suctioned fist sized black clots. The sound of warm bacon grease sucked through a straw filled the operatory as the suction clogged and cleared.

The nurse no longer regarded blood as a salty sea born mystical, life giving, red baptismal liquid. The only thing that truly mattered was the declining volume. 

She next cleaned the lung with a sterile pad. A deep wheeze issued from the chest cavity. She could barely keep up with the blood that poured from the upper lobe. It was a mystery how he was able to breathe.

Once the Nurse suctioned away the coagulated blood, the Surgeon did not need to search for the trauma. The tumbling bullet had destroyed the Victim’s upper right lobe. Moving the ruined lung, he found the mushroomed point imbedded in the fourth rib. He examined the deformed chunk of copper and lead and dropped it in a metal tray.

“I’ll need the DeBakey.” He said.

Hampton placed the twelve-inch right angle clamp in his hand.

He carefully closed the bronchial tube that supplied air to the right lung and gently slid the right lung out of the chest cavity. Blood poured out with each pulmonary contraction.

“Hemostats!”

The nurse placed the straight jawed, stainless instrument in his right hand.

“Another,” he took a second then a third and fourth. He worked quickly, precisely shutting off the major arteries first before addressing the major veins. 

He might have shut a gate valve. The bleeding slowed then stopped.  The Victim’s blood pressure started to climb. He now turned to the lung.  He was dismayed by what he discovered. A third of the Victim’s right lung had been reduced to hamburger. The traditional procedure would close off the bronchia and resection the lobe. The consequences of cutting away the lobe were enormous. The Victim would lose forty percent of his lung capacity. In one stroke of his blade the Surgeon could reduce the Victim to an old man. 

Caution resided in the Surgeon. He lived by the Hippocratic promise, “Do no harm.” Once the decision was made, he did not hesitate. He sectioned out the lacerated section and with rapid, precise stitches closed off the bronchia, major arteries and minor veins. 

As the minutes added to a quarter of an hour, he opened the DeBakey. The heart lung machine inflated the lung, the Victim breathed, before the Surgeon closed the jaws. The Victim convulsed. The anesthesiologist increased the flow. Flicking from vein, to bronchia, the Surgeon eyes revealed little. His manner was silent, precise. Hemostats were opened and closed, stitches were taken, tied off. The sectioned lobe finally slipped free. Bleeding was minimal. 

Clotting would stem the capillaries. Ten minutes, blood loss slowed then stopped. The Nurse bathed the lung in saline, suctioned then bathed it again.  His blood volume increased. 

“You can disconnect the femoral IV,” The Surgeon instructed.  Pressures continued to climb.

The anesthesiologist watched the Victim’s eyes flutter.  “He’s trying to wake up,”

“Tough bastard,” the Surgeon rarely used rough language. “His chest is still open.  Keep him under!”

The anesthesiologist increased the flow. The bleeding had stopped.    The Surgeon released the DeBakey. The lung slowly inflated and moved in time with the left. He checked for bleeding, then inserted a drain.

Lacking custom plates and screws to secure the bisected sternum, the Surgeon rapidly laced steel wires through holes drilled along the saw cut, twisted them tight then folded them flat against the bone. Checking to ensure precise alignment, he scoped the lung for further bleeding. The stiches were holding and he started to close. Laying the skin over the sternum, his stitches were rapid, precise.  He finished in ten minutes.  Scarring would be minimal.

The Victim’s vital signs climbed toward what, in light of the surgery, might be regarded as normal. The team looked from the Victim to the Surgeon.

To hide her emotions, the Nurse clapped her hands together.  Twice.   The male nurses and anesthesiologist glanced over then added their applause to hers.

The Surgeon glanced up from the patient.  An expression wrinkled his mask.  Smile, or frown, none of the team could tell.

The male nurses guided the gurney down a long hall into a recovery room for patients who required absolute privacy. When the anesthesia wore off, the famous would be lifted three floors by private elevator to a penthouse suite. Meals would be delivered, workouts, yoga, massage and the pool would all be reserved to guarantee one patient never met another. 

The male nurses aligned the gurney to a hospital bed, gently lifted the Victim then lowered him onto the cotton sheet. The Nurse stepped around them, hung the catch bag for the abdominal drain on a stainless hook. Monitors were attached to external skin electrodes on his chest. The Victim’s heart beat had settled into a slightly elevated 85 beats a minute, blood pressure was marginally depressed at 90 over 58, pupil response was normal, respiratory rate slightly elevated, temperature almost normal.

Following a facelift or breast augmentation, patients would be quickly revived. The Victim was different. The Anesthesiologist left the intravenous feed in place. For the time being he would remain sedated. 

The Surgeon stripped off his gown, mask and gloves and touched redial on his cell phone. When the Caller answered he reported, “Surgery went as well as can be expected,”

The Caller hesitated before inquiring.  “By as well as expected, he will recover?”

“It was necessary to resection his lung.” Though the Surgeon had not sweated during the four-hour surgery, his brow now speckled with perspiration. “The extent of the damage and blood loss left me no choice.”

“How much of his lung was removed?”

“Forty percent. We were fortunate to save the rest.”

“How will this impact his future health?”  The Caller stopped short of revealing what the Victim’s future might entail.

“His endurance will be affected…but many people function well on a partial lung.  I’m more concerned about infection.”

“Has he regained consciousness?”

“We are bringing him up slowly.”

“How long?”

“Six hours.  Maybe eight.”

“Call me if there is any change.”

“There is one more thing!” The Surgeon interrupted before he hung up. “We will need to move him to another location.”  

Silence.

“We are not able to provide suitable long term care.” The Surgeon said.

“Is it not true that your clinic hosts patients for weeks, occasionally months?”

“My patients aren’t typically shot in the lung.” 

“And yet post surgical care varies little from procedure to procedure.”

“The extent of his injuries requires round the clock––”

“For many reasons, it would be unwise to move him.” The Caller dismissed his protest. 

“His chances for survival depend on transferring him to a major trauma center.”

The Caller returned calm, detached. “We would be grateful if you could manage his recovery until he’s able to function on his own.”

Function on his own? The Victim would need to walk, feed himself, bath, dress, attend to personal details––his rehabilitation might require weeks not a few days.

“We are grateful for your help.” The Caller said.  “Once he is released, we will consider our debt paid in full.”

The Surgeon took a deep breath.  He knew better than to inquire whom the patient was or how he’d come to be shot in the Mojave Desert.