With a Vengeance: Medical Thriller

Wilde

One

2003 — St. Louis, Missouri

It was the cicadas that pushed everything into critical mass.

The cicadas and a paranoid schizophrenic.

The cicadas, a paranoid schizophrenic, and a hat made of defective aluminum foil.

But mostly, it was the cicadas.

St. Louis in the summer is miserable enough. Hot, humid, and suffocatingly still, it resembles an anteroom to hell. Tempers shorten. Frustrations sharpen. What would be annoying any other time becomes unbearable.

But that summer was even worse. A cicada population of biblical proportions had awakened from two separate periods of dormancy. Breeding and eating at a ferocious rate in their hurry to mate and die, the insects whined out a satanic symphony of grinding dissonance that could incite a saint to suicide. St. Louisans were no more immune.

Within days, minor car accidents escalated to hostage situations, suburban soccer moms were arrested on felony weapons violations, and sporting events saw more action in the stands than on the field. The recently declining violent crime numbers swept right back up, police ran double shifts, and emergency departments started stockpiling antipsychotic drugs like nuclear arms.

Which meant that nobody was really surprised when the disturbance call went out at 11:32 a.m. on a late July morning for the four hundred block of Ohio Avenue on the city’s south side. A bare-bones kind of street, Ohio boasted faded brick multiple-family dwellings that housed the substrata of people hanging on to the fringes by their fingertips; new immigrants, ex-project inhabitants, chronic defaulters. In a word, the kind of block where disturbance calls were as common as bill collectors.

Usually, though, the calls came long after lunch, when the avenue’s less wholesome tenants woke from their nightly revelries. Eleven-thirty was a little early, even on this kind of hot, still, muggy day.

But then, the cicadas were out.

The responding unit arrived on the scene at precisely 11:53 a.m. to be met by a young black woman up to her elbows in toddlers, and one teary-eyed ten-year-old in a pom-pom skirt. A baby on one hip and a hand on the other, the mother didn’t bother to wait for the cops to get all the way out of the car before she started in on them.

He crazy! she shrieked, waving her free hand at the undersized cheerleader who slumped next to her. "He tried to boil my baby, say she a devil, and all she done was try and sell him some damn candy bars. You get in there and drag his skinny white ass down here ’fore I boil it myself, you hear? My Sherees, she gotta sell forty bars by tomorrow, and he got the whole box in there, that crazy fucker."

Busy slipping batons into belts and caps onto heads, the cops, a rare two-person ride that consisted of a young white male and a more mature black woman, nodded like synchronized swimmers.

You know this man? the female officer asked.

He jus’ moved in a coupla’ weeks ago, the mother said, following them up the sidewalk, the kids orbiting in place. He in there with squirrels and bats and shit. I saw it when I grabbed my baby. Motherfucker’s crazy!

After a few more pertinent questions, the officers left the woman in the street and ambled into the unremarkable square brick building whose only ornamentation was a bouquet of blue plastic flowers stuck into the address, atop which several of the ubiquitous cicadas were mating.

Back on the street, the young mother raised her voice above the noise to regale gathering neighbors with her eyebrow-raised, neck-snapping rendition of Sherees’s run-in with the new neighbor. She’d gotten to the point where she’d grabbed little Sherees out of the crazy motherfucker’s arms when two quick pops brought the group to sudden silence.

Gunshots.

From the second floor of the apartment building.

Everybody turned that way. Little Sherees, her tears dried, looked up at her stunned mother. Mama, you tell them ’bout the gun that man stuck up his pants?

Which was about the time the crazy motherfucker started yelling about hostages.

Maggie O’Brien was still securing her medic vest when she opened the door to the command trailer at the corner of Ohio and Wyoming. A normally unprepossessing 120 pounds over a five-foot-five-inch frame, Maggie looked instead like an extra from a Chuck Norris movie. Her thick umber hair was tucked up under a blue kerchief, and her rather normal figure was rigged out in blue-dyed urban cammos, elbow and knee pads, jump boots, Eagle pack, Camelback hydration system, body armor, overloaded medic vest, and gas mask. She carried her Kevlar helmet under her arm and her gloves in her helmet. SWATBabe, as her friends had dubbed her, was on duty.

The four hundred block of Ohio had been evacuated of all but police equipment and personnel. Two perimeters had been established, the interior perimeter two apartment houses wide, the exterior taking up the entire block. Strobes flashed, radios crackled, uniforms cluttered the street, and a smaller knot of like-camouflaged men clustered near the midnight blue trailer Maggie approached just beyond the interior perimeter.

Maggie had been beeped no more than fifty minutes earlier and had joined the rest of the newly minted St. Louis City/ County Cooperative Special Weapons and Training Team only moments before. It was her third call as the team’s Tactical Emergency Medic, the first that was still active by the time the team arrived. The very first in which she’d been called into the trailer. She hoped nobody noticed that her hands were shaking.

You want me, Lieu? she asked, stepping up into a tiny space containing way too many bodies and an overworked air-conditioner.

Other side of the trailer, Mags, the scene commander said from where he was bent over a grease-pencil-marked schematic of the block. We have a medical situation inside the negotiators need you to help with.

Maggie nodded and backed out. It was standard operating procedure that the command center stayed separate from the hostage negotiators. The negotiators needed to establish a positive relationship with the hostage taker, something that could be jeopardized if that negotiator looked up to see the commander sending in the troops on a shoot to stop order. The way the St. Louis team had set it up, a third person stationed himself with the negotiators to relay news to command by headset. When a hostage situation involved a possible medical problem, the medics were trained to evaluate and assist along with the negotiators.

So Maggie knocked on the back door of the divided trailer and waited for one of the extraneous personnel to decamp before climbing aboard.

We’ve got a medical person coming to talk to you, Bob, one of the negotiators was saying into the phone, his voice low and calm and soothing. The kind of voice you’d use with a jittery horse or a crazy person. …yeah, sure, sit back a second. Let me fill her in, and I’ll let her talk to you.

The negotiator was a middle-aged, medium-sized black guy with old, soft eyes and fidgety hands who looked oddly out of place in jump boots and high-tech gear. Surreptitiously putting the caller on hold, he turned Maggie’s way.

Well, don’t you look fine, he greeted her with a smile.

She grinned back. I look like a click beetle on steroids. It wouldn’t do to give her father’s old partner the kiss she usually greeted him with. Hi, Uncle John.

Tommy would be so proud.

Maggie held on to her smile by force of will. She didn’t need to know how proud her father would be right now.

Oh, shit, the other guy in the trailer moaned. I just knew it. If we have a crazoid, O’Brien can’t be more than five feet away.

The other guy Maggie knew, too. A sergeant out in Manchester where Maggie played paramedic part-time, he was trim and slim and military-issue, right down to his blond buzz cut and snapping gray eyes. And he just loved being a cop.

What do you mean? John asked, forehead creased.

The other guy scowled. Don’t you know? Maggie here’s not just a nut magnet. She’s the pilgrimage destination for every psychotic, schizophrenic, and dome-headed geek in the Midwest.

Slander, Flower, Maggie disagreed. I’m sure I don’t pull any more netjobs than anybody else.

Flower, nicknamed in an homage to Bambi because of his unfortunate preference for Mexican food, hooted in derision. So you really think it’s a coincidence that you’re the medic called for a guy who tried to parboil a pom-pom girl because her candy bars were possessed?

Maggie shot Flower a sheepish grin. Could happen to anybody.

Maggie spent a moment wiping the sweat from her forehead. It was damn near a hundred degrees outside, she was carrying about seventy pounds of equipment on her, and the cicadas were driving her to distraction. And to top it off, she had to score her first negotiating gig with John, whom she respected more than almost anyone in the world. Even the meat locker air-conditioning in the trailer wasn’t much help.

I assume the medical condition is more than just little voices? she asked.

John’s smile was a bit tight. Suspect and hostage have both suffered gunshot wounds. Suspect to the right arm, hostage to the right thigh. That’s all he’ll give us so far. The suspect’s name is Montana Bob.

Maggie forgot about the humidity and sat down on the other chair. Bob? she asked, peeking out the window. No kidding. And in an apartment, too. I’m so glad. He’s been camped out beneath the Fourteenth Street overpass for years.

You know him? John asked.

Didn’t I tell you she would? Flower retorted.

Maggie smiled. Oh, sure. You’ve seen Bob, Uncle John. He hangs around the Toe Tag Saloon all the time. He’s a regular at the Biltmore. The Biltmore being the nickname for Blymore Memorial, one of the big trauma hospitals in the area where Maggie served most of her time as a trauma nurse. Brings me flowers. Bob’s a paranoid schiz with delusions of U.N. invasions. Which means the candy bars aren’t really satanic. Probably more along the line of a transmitter from ‘them.’

Them? John asked.

She smiled. You know, John. ‘Them.’ CIA, FBI, aliens. The ones who are trying to take over. The ones who wire his head and try and get him to do bad things. The candy bars probably had a diabolical device planted in them—computer chips being the latest favorite—to control his mind.

To kill him, actually, John said.

Maggie nodded. He is kinda fun to play with, isn’t he?

The hostage he shot, Flower snapped, is an officer.

Maggie stopped cold. We know who it is?

Her Uncle John looked hard at her. Yeah, Mags. It’s Sean Delaney. He’s fine right now. We want to keep him that way.

Maggie was real proud of herself. She didn’t give herself away by any more than by a blink or two.

You know him, too, I’m assuming? Flower asked.

Uncle John smiled gently. Maggie knows everybody in the city. She grew up in the department.

Maggie did her best to smile back. Delaney’s dad and Tommy were asshole buddies, she said. We kind of grew up together.

Then, before John could reassure her again, she set down her helmet and held out her hand for the headset. Tell me what the status is.

Delaney and Myla Parker answered a disturbance call. Evidently Montana Bob saw the uniforms and pulled out the .38 nobody knew he had. Sean got Myla out before Bob got him. That’s been about…. oh, seventy-five or so minutes ago.

Myla’s okay?

Yeah.

And Sean took a shot in the thigh?

Right. He says it’s—

Just a scratch, Maggie answered along with him. He said the same thing last year when we put a chest tube in him.

A breath. A quick close of the eyes to lock out Uncle John’s distress.

Okay. Maggie nodded and flipped the mike on. Bob? she greeted her longtime patient, her tone an instinctive echo of John’s. It’s Maggie-o, Bob. Can you talk?

There was a brief moment of silence, a scuffling sound on the line, and then the tremulous voice Maggie knew so well. You bastards. You’ve taken her, too.

Maggie couldn’t help but grin. Well, at least she was on familiar turf. No, Bob, I swear, it’s Maggie. Nobody’s hurt me. You know I won’t let ’em hurt you if you listen real close.

Nothing.

Bob?

Prove it.

Maggie fought down the urge to scream and nodded. Okay, Bob, can you see the big blue van outside? I’m gonna step out the door and give you our sign. Now, I’m going to be dressed like them, Bob, but that’s okay. They’re here just to make sure nothing worse happens, you understand? If you listen to me, nobody else is going to get hurt. Okay?

I’ll shoot you if you’re lying.

John, on the other headset, twitched with distress. Maggie waved him off. I hope you would, Bob. Now, watch out the window.

Be advised, Flower was murmuring into his own headset to the command post. Subject is approaching the front window. Believed to be nonhostile.

C2 to A10, Maggie heard in the receiver taped to her free ear. Make entry to building on my word.

Which meant that while they knew where Bob was, the entry team was going to sneak inside to get closer to Bob’s apartment.

Maggie yanked off the headset and eased her way out the door. It was oddly quiet out there, even the cicadas hushed. Weapons had been raised a notch higher, all attention focused on that window.

Maggie saw a shadow in the apartment window, saw the blinds raised. She caught the sight of a lot of pale skin and the dull glint of metal and almost laughed.

What the hell? one of the guys demanded.

C2 to A10, suspect is visible inside one number three window. Go now.

Maggie ignored the voice. She never acknowledged the dark snake of police that slipped toward the rear door. Lifting her arm as high as she could, she flipped the Longhorn salute. There was a pause, and then the odd figure in the window disappeared. Maggie squeezed back inside the van.

Did I see what I thought I saw? Flower demanded, lowering the binoculars he’d been using.

A naked man wearing a steel pot on his head? Maggie asked, reclaiming her chair. Sure. His aluminum foil hat must have stopped working.

What does that have to do with the Longhorn salute?

Bob went to University of Texas, she said, sliding the headset back on.

Hence the moniker, ‘Montana Bob,’ obviously.

Maggie grinned. The CIA took over Texas years ago.

I’d heard that, John concurred.

Bob? she asked, back on line. You there?

Thank you, Maggie, he whispered. You walked the valley of death for me. Just for me, for me. But you have to get out. They know I know, and they’re going to kill me. I don’t want them to kill you, too.

Well, they can’t kill me, Maggie assured him, "because I don’t know, so it’s okay. I promise."

Watch our brave Maggie boogie-board that big delusion pipeline, Flower murmured behind her. Maggie, sweating as she thought of the policeman on Bob’s floor, ignored him.

No, Maggie, Bob argued, they will. They’ve killed Sancho and Urban and the dog and snake. They’ve killed them all, and I know. I know because I heard them whispering in the night, I saw them, I hear them now, with their radios in their wings just waiting for me to step outside. They’re trying to get a message to me right now, can you hear ’em?

Every crazy in the Mississippi Valley thought the cicadas were trying to get a message to them. Maggie wasn’t the only one who wished the damn things wouldn’t sound so much like radio static.

I hear it, Bob, but that’s not what I—

They’re here, though, Maggie, killing and killing in their night angel suits, black as night, black as death—

Which is why we’re dressed up this way today, Maggie assured him, wondering who his new imaginary playmates were. Bob was always imagining cabals. But he’d never imagined anybody named Sancho as a victim before. Maybe he’d been reading Man of La Mancha. Or Dr. Doolittle. We’re trying to fool them into getting you out safe. But we can’t unless you help us, Bob. That officer you have, he’s one of us. He’s my friend. And we’ve got to get him treated, or they’ll hurt you, Bob. They’ll hurt us all, okay? They’ll know.

They already know, Maggie. All of them. It’s why they tried to get me to take that phone. The one with the computer chip in it.

No, that was just to talk to you, Bob. To try and figure out a way to get you out safe. But you figured out a way, didn’t you? You used your own phone. You know your phone is safe, because you check it and wrap it in Saran wrap, just like I told you.

That’s it, Maggie. But I think they’re listening anyway. I don’t think I have much time.

Then let’s get you two taken care of, Bob, okay? I want you to tell me about the officer’s injuries. You need to help him so I can sneak you away before they know. Please?

I can’t, Maggie, he whined pathetically, the drone of the insects almost louder than his voice. I can’t think.

Then look, she commanded. Look at his leg. Come on, Bob. You can do this. Tell me what it looks like.

It took Maggie twenty minutes to get a good picture of what was going on inside and to talk Bob through basic first aid. It took another two hours for John to talk Montana Bob out of his apartment. By that time, the temperature had scaled up another fifteen degrees, the neighbors were arguing with the cops, and the news crews had grown more plentiful than the cicadas. Maggie spent the time out on the street making sure her team was hydrated and trying like hell not to think of what was going on in that apartment.

Bob had only suffered a superficial wound, one the team could safely dispatch back to the ambulance that was stationed beyond the outside perimeter. Officer Sean Delaney, though, who had pushed his partner back out the door before Bob could close it on them, had been bleeding for a good couple of hours, and nobody wanted him to try and make it out of the apartment. So when Bob opened his apartment door, the entry team that was by now positioned in his hallway would sweep him out like bad dirt, and Maggie and her partner would run in from where they waited alongside the gas team to treat the cop while the building was secured.

A10 to C2, stand by, Maggie heard in her earpiece. Subject door is opening.

Bob was coming out. Everybody outside suddenly went quiet as they watched the building entrance, as if they could see the drama unfolding. Tucked behind trees and hedges, the containment team kept their guns leveled on the field while watching the entire scene. Even the cicadas seemed to pause, until all Maggie heard was radios and the gas team guy’s heavy breathing.

Suspect secured! she heard in her earpiece. M1 and 2 enter.

Maggie struggled to redistribute all the weight she carried as she climbed to her feet. She was sweating like a horse, her heart rate was damn near red-lining, and Sean lay upstairs bleeding all over Montana Bob’s floor. Good thing she was in shape for shit like this.

Maggie had made it halfway across the lawn in a bent-knee run when four of the entry team slammed back through the front door to send Montana Bob sprawling onto the sidewalk. Maggie saw him go down, saw the pot go skittering down the sidewalk as more cops piled on top like a rugby scrimmage.

In that moment she damn near forgot about Sean. Bob had shot a cop, and not one person on that pile was going to let him forget it.

Maggie, run! Bob was screaming, his cheek scraping into the sidewalk, his limbs sprawled and squashed like a frog on a driveway. He’s here, Maggie, get out! Get o-o-u-u-t!

And Maggie, even knowing that her first priority was the wounded policeman, had to stop.

Hey, you guys, go easy, she insisted, dropping into the fray. It’s not his fault. He’s just crazy. Come on, let him breathe.

When she got past all the riot gear to where Bob lay panting on the ground, she saw that there were tears on his sallow cheeks. I’m sorry, he whispered, his eyes pleading. I got you into this, Maggie. I’m so sorry…

Aw, c’mon, Bob, Maggie assured him, pushing his dingy hair back from his face as she surreptitiously checked to make sure that his injury was, indeed, superficial. It’s okay. I promise. They’ll take care of you now.

No, he countered sadly. They’ll kill me. You get out now, Maggie. Please…

Maggie, one of the team members said as he motioned everybody else to ease their holds on the suspect. We have him.

Maggie nodded, wishing she could make Bob feel better, and patted him on the cheek. Then, leaving him in safe hands, she lumbered up the stairs to the front apartment.

You asshole, she genially greeted the downed officer when she made it through the door.

Slouched against a wall decorated in right-wing newsprint, tacked-up roadkill, and marked-up news photos, Sean Delaney offered a whimsical smile and a halfhearted wave of the Hershey bar he’d been munching from the half-empty box on the floor. Want some candy, little girl?

Maggie smiled. You’re eating all that poor kid’s profits.

Hey, Bob and I had to keep our strength up. Paranoia’s a high-energy sport, ya know. Besides, I knew I’d have to be at my best when you showed up. With a waggle of his eyebrows, he patted the stained carpet. Come sit by me and make my pulse race, honey.

Maggie snorted unkindly and dropped to her knees alongside the second team medic. You must be bad, Delaney, she said, pulling equipment from her vest. That’s the worst excuse for sexual harassment I’ve heard since Eddie Kawalksi snapped my bra in sixth grade.

Delaney just grinned, his eyes fever-bright and his forehead creased with discomfort. I’m bleeding, O’Brien. That should get me some points.

You’ve been bleeding before, Delaney. Doesn’t get you anything but light-headed and wet.

No, Maggie, he disagreed. I got that from seeing you in cammos.

Maggie grinned as she checked his racing pulse. You really have to try and hang around with some humanoids sometime, Delaney. By the way, are you hypovolemic, or are you just happy to see me?

The other paramedic, a skinny guy named Jazz, had already secured Sean’s Beretta and was busy pulling out fluids and lines for some volume replacement. Maggie did a quick assessment and reached for her scissors. Even with the pressure bandage she’d talked Bob through applying, Sean’s pant leg was soaked and the floor beneath him sticky with old blood. The good news was that if the bullet had hit a major artery, Sean would have been dead an hour ago. So the bleeding wasn’t critical. It was, however, enough to make Maggie want to puke. And Maggie wasn’t a puker. At least about blood.

I’m always happy to see you, honey, Delaney managed, a little late and a little too quietly. Especially when I know you’re about to have your way with me.

Maggie looked at the mischievous light in those usually sharp green eyes. She saw the sweat stains on his uniform shirt, the lank, sticky hair that was usually brushed to a mahogany gleam, and the fact that his face, normally so strong and tan, was a little slack and the color of putty. Sean Delaney prided himself on looking like a poster child for St. Louis’s finest. Today, he looked like a fallen cop soufflé. And still, he had that gleam in his eyes. He was having a hell of a time.

Which really made Maggie mad. She wasn’t the one who should have been shaking here.

Don’t honey me, you uncoordinated, hormone-happy bog-trotter, she snapped, not nearly as hotly as she’d intended. Just shut up and let me get in your pants.

I thought you’d never ask.

You shouldn’t talk to her like that, Jazz finally objected. Jazz, who didn’t know either of them too well yet. It’s not right.

A tall, thin, quiet guy with acne-pocked skin and hair like a blond Brillo pad, Jazz saw his job as a mission and all his patients holy. Jazz was never allowed near a phone during hostage negotiations, because he kept trying to get the hostage taker to take Christ instead. On the other hand, Jazz was one of the best trauma paramedics in the bi-state area, with the plus that the sound of gunfire didn’t spook him. Even if it was directed at him while he worked. So people overlooked his conversional tendencies.

It’s okay, Jazz, Maggie reassured him. Delaney knows I’ll pay him back later.

Jazz just shook his head like a mournful dog. Didn’t your father ever teach you that you deserve better than sexual taunts?

Maggie stopped cold. Delaney whistled through his teeth. Now you’ve done it, he said.

Maggie couldn’t quite take her eyes off the very sincere medic. Do you know who my father is? she asked.

Jazz actually blushed. It doesn’t matter.

Can I have my drugs now? Sean asked on a deliberate whine.

Maggie couldn’t quite answer.

How ’bout a donut? he demanded, tugging at her arm.

She looked down, startled, and shook herself. Eat another Hershey bar. Leaving Jazz quite out of it, she went after Delaney’s pants. Asshole, she muttered, but it wasn’t quite clear whom she was addressing.

Maggie didn’t get into the Emergency Department at Blymore to check on her patients for another hour. Technically her responsibility for them only lasted until the moment she delivered them into the paramedics’ waiting arms. After that she stayed with the team for cleanup and debriefing.

At today’s debriefing she heard how she’d handled her first hostage negotiation like a pro, and that if she ever cared for a perp before an officer again, she was going to get her cute little ass kicked right back to Nightingaleville.

Maggie grinned at the first and ignored the second. According to her charter, the commander was perfectly right. A tactical medic followed the good principles of triage, in which the more serious injury was treated first. And her officer had certainly suffered the more serious injury. By checking on Bob first, she’d thumbed her nose at very important priorities. And considering how Maggie felt about her team, in any other situation, she wouldn’t have hesitated.

But her intervention had helped the team control Bob. And Jazz had already been upstairs sharing the good news with Officer Delaney. Besides, Delaney didn’t need to know how much he’d scared her.

Because of the relatively quick solution to the action today, debriefing only lasted through two boxes of donuts. Quick enough for Maggie to get to the ED before they shipped Delaney off somewhere, slow enough, she hoped, to avoid most of the Sturm und Drang.

Instead, she walked through the sliding doors of Blymore Medical Center to be greeted by pandemonium. The press had arrived en masse, every cop with a ride was cluttering up the hallway, and Bob, instead of settling down, showed every sign of blowing like Krakatoa. And that didn’t even take into account that the waiting room was overflowing and mostly contagious.

This time, though, Maggie checked on Delaney first.

Well, buy me slippers and call me Dorothy, she heard behind her as she checked out the chart that hung on Sean’s door.

Maggie didn’t even bother to turn around. "You’ve never even seen Wizard of Oz, and you know it."

A tall, leggy African-American man in salmon-colored scrubs and marcelled hair swung a deliberately limp wrist at her. "I know. I am such a disgrace to my stereotype."

Maggie looked up at her friend’s horsey face and laughed. Well, practice. The entire press corps is out there. Think what you could do for the hospital if you went out there and did a few choruses of My Way.’

In feathers, her friend said. It could change the face of medicine as we know it.

Might do it some good, Martha.

Martha was her friend’s club name. His real name was Dr. Allen Fitzmaurice, MD, FACS, trauma surgeon and Emergency Department director. Standing six-foot-four, he weighed in at about 170 and was probably the ugliest man Maggie had ever seen. He was an even uglier woman.

Help! Bob screamed down in room three. Help! They’re going to kill me!

As was usual with crazies, Bob’s outburst set off three more screamers, who were all, evidently, at risk from the FBI. The rest of the packed hall escalated right behind them.

Is O’Brien here someplace? one of the docs demanded farther down the worklane. She snuck in, didn’t she?

Maggie ignored him, just as she always did. Is the officer going to live? she asked Allen instead.

She got an elegant shrug and a saucy grin. That bullet hit any higher and he coulda’ been night watchman in a harem.

Do me a favor and tell him that.

"You make