Excerpt of Blood Double by Neil McMahon

Chapter One

Carroll Monks was standing on the spot he thought of as
the bridge of Mercy Hospital's emergency room. It was like
the command deck of a ship, the point from which he could
monitor most of what was going on at any given time: the
eight private cubicles, six of which were occupied; the
trauma room, which was not; the activities of his
resident, nurses, and other staff; the softly bleeping
monitors and blinking lights of the complex instruments;
and the main desk, where the charge nurse worked at a
computer. Monks could glimpse through the glass doors into
the waiting room, which held a further group of
postulants, most of them in discomfort, none in severe
distress. He could hear the ongoing radio report of a team
of paramedics in the field, attending to a mild heart
attack that did not require his intervention.

This was the way the ER was most of the time, busy but
stable - and tensed for whatever might burst through the
oors that would throw it into organized frenzy.

It was a damp Tuesday evening in March, 7:07 p.m.

Monks sensed a stir in the waiting room, a tiny ripple of
movement that caught his gaze. A woman was coming in. He
got an instant impression as she yanked open the door,
framed inits light. She was about twenty, pretty, sturdily
built, with black hair and golden skin: Asian. Heavily
made up, wearing a short black dress. On her own feet,
with no obvious injury.

But moving fast. Half-running, on spike heels, to the
desk. Speaking urgently to the receptionist, pointing back
outside.

The receptionist leaned forward, puzzled.

The Asian woman closed her eyes and quickly placed her
palms together beside her tilted face, a child's gesture
of sleep. Then she jabbed her finger toward the outside
again.

Monks said, “Nurse!” and moved for the door.

The cool wet air of the San Francisco night blurred his
eyes, and he squinted to focus in the orange-yellow glow
of the parking lot's lights. Twenty yards ahead, a figure
lay sprawled on the sidewalk, with another crouched over
it. Their faces were touching. Monks felt an instant of
eerie terror, the shocking sense that he had stumbled onto
an act of desperate passion gone wrong, or even a vampire
ripping into its victim's throat.

But then the crouching man's face lifted, and Monks saw
one hand pinching the downed man's nostrils, the other
positioned behind the neck. This was not violence, it was
mouth-to-mouth resuscitation.

Monks turned to yell behind, “I've got an unconscious man,
he's not breathing, let's go,” and dropped to his knees
beside the sprawled figure. His fingers touched the neck
to find the carotid artery's pulse. It was barely
detectable. He thumbed an eyelid open and could just make
out the blank round iris, the pupil shrunk to a pinpoint.
The body was shutting down.

The crouched man, like the woman, was Asian: small, wiry,
gaunt-faced. His eyes watched Monks.

“Ovahdose,” he said. His hands moved to make a quick
gesture of jabbing a needle into his arm.

The other man was Caucasian, in his late thirties. His
face was dirty and abraded, as if from falling. But his
shirt was hand-woven, tailored cotton, and his shoes
leather loafers that also looked handmade. His teeth were
beautifully cared for. This was not the sort of junkie
Monks was used to, and his first guess would have been
respiratory failure from another cause - except for what
the Asian man seemed to be telling him.

Monks said, “Are you sure?”

The Asian shook his head in incomprehension. “Ovahdose,”
he said again, and bent back to the mouth-to-mouth. He was
quick and efficient, obviously trained; had sustained the
fragile hold on life for critical minutes.

Monks decided to believe him.

Monks craned around. Two nurses were coming fast with a
gurney, kneeling with the Ambu bag to take over breathing.
The Asian man exhaled one last breath into the receiving
lungs, then moved out of the way in a crouching roll that
made Monks think of a paratrooper's landing fall.

He strode ahead into the ER, calling orders, stepping into
gloves and barrier gown. The nurses prepped the patient,
putting a rolled towel behind his neck, hooking him to a
cardiac monitor, preparing an IV. A respiratory therapist
took over the Ambu bag, now hooked to an oxygen source. A
third nurse arrived with a clipboard to note procedures
and times.

His gaze swept the room. His daughter Stephanie, in her
first year of medical school, was working part-time as a
hospital attendant. When Monks was on duty, she liked to
visit the ER, getting a feel for it. She was standing
against a wall, hands clasped like a shy girl waiting to
be asked to dance: eager to help, afraid to interfere.

He called to her, “Take over recording.” It would free up
the nurse, and give Stephanie a look at why she might want
to choose another specialty.

“I'm having trouble breathing for him, Doctor.” The
therapist was holding the mask against the patient's face
with one hand and squeezing the plastic sack hard with the
other, but the lungs were not inflating well. Monks
stepped in, pulled the jaw forward, and leaned close to
listen. Over the weak breaths came the harsh sound of
stridor: vocal cords or tongue had swollen, obstructing
the passage.

He said, “Let's get an oral airway in.” He held the mouth
open while she inserted the device, a flanged four-inch
tube, to allow air past the tongue. He realized he was
taking deep breaths himself, that he was unconsciously
resisting what was happening, reassuring himself that it
was not happening to him. He braced himself for the next
step, the insertion of an endotracheal tube. It was a
risky procedure...