two minutes. But two minutes could make all the difference.
On the table, Harrison was as dead as any man had ever been. His skin was an unhealthy shade of gray, lips and fingernails and toenails a cyanotic blue, lips slightly parted in an eternal exhalation. His flesh was utterly devoid of the tension of life.
However, aside from the two-inch-long shallow gash on the right side of his forehead, an abrasion on his left jaw, and abrasions on the palms of his hands, he was apparently uninjured. He had been in excellent physical condition for a man of thirty-eight, carrying no more than five extra pounds, with straight bones and well-defined musculature. No matter what might have happened to his brain cells, he looked like a perfect candidate for resuscitation.
A decade ago, a physician in Jonas's position would have been guided by the Five-Minute Limit, which then had been acknowledged as the maximum length of time the human brain could go without blood-borne oxygen and suffer no diminution of mental faculties. During the past decade, however, as resuscitation medicine had become an exciting new field, the Five-Minute Limit had been exceeded so often that it was eventually disregarded. With new drugs that acted as free-radical scavengers, machines that could cool and heat blood, massive doses of epinephrine, and other tools, doctors could step well past the Five-Minute Limit and snatch some patients back from deeper regions of death. And hypothermia—extreme cooling of the brain which blocked the swift and ruinous chemical changes in cells following death—could extend the length of time a patient might lie dead yet be successfully revived. Twenty minutes was common. Thirty was not hopeless. Cases of triumphant resuscitation at forty and fifty minutes were on record. In 1988, a two-year-old girl in Utah, plucked from an icy river, was brought back to life without any apparent brain damage after being dead at least sixty-six minutes, and only last year a twenty-year-old woman in Pennsylvania had been revived with all faculties intact seventy minutes after death.
The other four members of the team were still staring at Jonas.
Death, he told himself, is just another pathological state.
Most pathological states could be reversed with treatment.
Dead was one thing. But cold and dead was another.
To Gina, he said, “How long's he been dead?”
Part of Gina's job was to serve as liaison, by radio, with the on-site paramedics and make a record of the information most vital to the resuscitation team at this moment of decision. She looked at her watch—a Rolex on an incongruous pink leather band to match her socks—and did not even have to pause to calculate: “Sixty minutes, but they're only guessing how long he was dead in the water before they found him. Could be longer.”
“Or shorter,” Jonas said.
While Jonas made his decision, Helga rounded the table to Gina's side and, together, they began to study the flesh on the cadaver's left arm, searching for the major vein, just in case Jonas decided to resuscitate. Locating blood vessels in the slack flesh of a corpse was not always easy, since applying a rubber tourniquet would not increase systemic pressure. There was no pressure in the system.
“Okay, I'm going to call it,” Jonas said.
He looked around at Ken, Kari, Helga, and Gina, giving them one last chance to challenge him. Then he checked his own Timex wristwatch and said, “It's nine-twelve P.M., Monday night, March fourth. The patient, Hatchford Benjamin Harrison, is dead … but retrievable.”
To their credit, whatever their doubts might have been, no one on the team hesitated once the call had been made. They had the right—and the duty—to advise Jonas as he was making the decision, but once it was made, they put all of their knowledge, skill, and training to work to insure that the “retrievable” part of his call proved correct.
Dear God, Jonas thought, I hope I've done the right
On the table, Harrison was as dead as any man had ever been. His skin was an unhealthy shade of gray, lips and fingernails and toenails a cyanotic blue, lips slightly parted in an eternal exhalation. His flesh was utterly devoid of the tension of life.
However, aside from the two-inch-long shallow gash on the right side of his forehead, an abrasion on his left jaw, and abrasions on the palms of his hands, he was apparently uninjured. He had been in excellent physical condition for a man of thirty-eight, carrying no more than five extra pounds, with straight bones and well-defined musculature. No matter what might have happened to his brain cells, he looked like a perfect candidate for resuscitation.
A decade ago, a physician in Jonas's position would have been guided by the Five-Minute Limit, which then had been acknowledged as the maximum length of time the human brain could go without blood-borne oxygen and suffer no diminution of mental faculties. During the past decade, however, as resuscitation medicine had become an exciting new field, the Five-Minute Limit had been exceeded so often that it was eventually disregarded. With new drugs that acted as free-radical scavengers, machines that could cool and heat blood, massive doses of epinephrine, and other tools, doctors could step well past the Five-Minute Limit and snatch some patients back from deeper regions of death. And hypothermia—extreme cooling of the brain which blocked the swift and ruinous chemical changes in cells following death—could extend the length of time a patient might lie dead yet be successfully revived. Twenty minutes was common. Thirty was not hopeless. Cases of triumphant resuscitation at forty and fifty minutes were on record. In 1988, a two-year-old girl in Utah, plucked from an icy river, was brought back to life without any apparent brain damage after being dead at least sixty-six minutes, and only last year a twenty-year-old woman in Pennsylvania had been revived with all faculties intact seventy minutes after death.
The other four members of the team were still staring at Jonas.
Death, he told himself, is just another pathological state.
Most pathological states could be reversed with treatment.
Dead was one thing. But cold and dead was another.
To Gina, he said, “How long's he been dead?”
Part of Gina's job was to serve as liaison, by radio, with the on-site paramedics and make a record of the information most vital to the resuscitation team at this moment of decision. She looked at her watch—a Rolex on an incongruous pink leather band to match her socks—and did not even have to pause to calculate: “Sixty minutes, but they're only guessing how long he was dead in the water before they found him. Could be longer.”
“Or shorter,” Jonas said.
While Jonas made his decision, Helga rounded the table to Gina's side and, together, they began to study the flesh on the cadaver's left arm, searching for the major vein, just in case Jonas decided to resuscitate. Locating blood vessels in the slack flesh of a corpse was not always easy, since applying a rubber tourniquet would not increase systemic pressure. There was no pressure in the system.
“Okay, I'm going to call it,” Jonas said.
He looked around at Ken, Kari, Helga, and Gina, giving them one last chance to challenge him. Then he checked his own Timex wristwatch and said, “It's nine-twelve P.M., Monday night, March fourth. The patient, Hatchford Benjamin Harrison, is dead … but retrievable.”
To their credit, whatever their doubts might have been, no one on the team hesitated once the call had been made. They had the right—and the duty—to advise Jonas as he was making the decision, but once it was made, they put all of their knowledge, skill, and training to work to insure that the “retrievable” part of his call proved correct.
Dear God, Jonas thought, I hope I've done the right
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