It was hard to believe such a small device held the promise of reviving Kat. The procedure—known as transcranial direct-current stimulation, or tDCS—would deliver a low-level current of electricity into specific areas of Kat’s brain, hopefully waking her out of her vegetative slumber.
If successful, they would quickly return to Julian’s MRI suite, where with any luck his deep-neural-net computer could help Kat communicate once more.
That was the plan.
But to accomplish even this brief miracle was not without significant cost to the patient—literally the final price.
Once the bed was locked in place, the net of EEG electrodes was draped over Kat’s scalp, while Julian directed placement of the second unit’s leads.
“Position and tape the first set of pads over her prefrontal cortex,” the neurologist ordered. “Here and here. Then the second on the lateral sides of her neck. But be careful of the basilar skull fracture. Be as gentle as possible.”
Lisa hovered at his side, making sure this last order was followed.
Julian shifted to calibrate the tDCS unit. “The plan is to run a continuous high-frequency current into her prefrontal cortex,” he told her, “while directly stimulating both the patient’s vagus nerve in her neck and thalamus in her brain via the implanted electrodes.”
Lisa pictured all that electricity flowing into Kat’s nervous system. “What’s the chance of success? Of waking Kat back up if she’s in there?”
“We’ll do our best. We’re employing two techniques shown to wake patients in minimally conscious or vegetative states. The first was developed at the University of Liège in Belgium, where stimulating the thalamus with electricity temporarily aroused fifteen people from various degrees of coma, enough so that they could respond to questions. The thalamus basically acts as the on/off switch for the brain. Stimulate it at ten hertz, you go to sleep. Target between forty and a hundred, you wake up. It’s been repeated successfully here in the States, even used on an outpatient basis for caregivers to administer at home.”
Julian sighed.
“What?” Lisa asked.
“Your friend is in far worse shape than those patients. It’s why I’m hoping that stimulating her vagus nerve at the same time—which connects to the brain’s arousal and alertness centers—will help us wake her. At least, the technique has shown great success in reviving patients at a French research hospital.”
Lisa prayed it would work.
“But it’s not a cure,” Julian reminded her. “If it works, the effect will only be temporary. And either way—with as much amperage as will be flowing into her already fragile state—this attempt will likely leave the patient brain dead.”
In other words, we’re about to fry Kat’s circuits.
She nodded, having warned the same with Monk. “She would’ve wanted us to try.”
Still, Julian hesitated, looking concerned.
“What’s bothering you?” she asked.
“The unknown.”
“What do you mean?”
He waved a hand over the efforts here. “We still know so little about how the brain functions. While those research hospitals had success with electrical stimulation, we’re still in the dark as to why it works.”
Lisa couldn’t care less at this moment.
As long as it worked.
“All set, doctor,” a nurse reported and stepped back from the patient.
Julian reached to the switch on the tDCS unit. He cast one final look her way.
Lisa repeated Monk’s last words to her. “Do it.”
He flipped the switch.
1:49 P.M.
Out of the blackness, a star burst far above. It was only the barest twinkle, but it was enough to disturb the darkness. Awareness coalesced, hazy, frayed throughout. It took a seeming eternity to draw forth consciousness and memory, to even remember her name.
Kat . . .
She focused on that light. It remained faint, yet in such endless darkness, it was a bright beacon. Kat felt as if she had fallen into a deep well, where only a single pale star was visible. She knew she had to climb out of that pit, toward the light. But it remained hard to concentrate, her awareness waxing and waning, fading in and out.
Still, she built a mental palace inside her mind’s eye, picturing the stone walls of that well. She dug in fingers, braced her legs, and slowly climbed toward that light. As she struggled, the star brightened.
But this reward came with a punishment.
With each inch gained, pain grew. The star pulsed, casting forth waves of agony. Kat had no choice but to weather that storm, to push both against it and into it. She clawed upward into that light, into that unrelenting torment. She now burned in the darkness, her fingers were flame, her eyes boiling in her skull.
She faltered, slipping down that mental well.
With all her strength, she pinioned her fiery limbs against the walls and caught herself. Overhead, the light dimmed. She wanted to cry, to succumb, to fall back into the cool darkness, but— Must keep going.
She pictured why.
A baby at her breast. Kissing the barest wisp of hair. A tiny body swaddled, smelling of innocence and trust. Later, laughter under blankets. Salty tears wiped, hurts consoled. Endless questions about everything and nothing.
She climbed again, using those memories like a balm against that burn.
After an interminable and unknowable time, murmurs rose around her, ghosts in the darkness, voices too garbled to make out.
She soldiered onward into the fire, knowing she must keep fighting.
Even if it kills me . . .
Finally, one voice grew clearer, a stranger, his words fragmented but there.
“. . . sorry. . . . not working . . . must accept she’s not . . .”
Then the star vanished, blinking out, severing everything.
The well vanished around her.
No . . .
Unsupported, Kat tumbled back into the swallowing darkness. She screamed as she was consumed.
I’m still here, I’m still here, I’m still—
7:02 P.M. WET
As the F-15 banked toward its final approach, Monk tilted his helmet to the craft’s canopy and studied the Portuguese coastline. The dark Atlantic below crested against the lights of Lisbon, a bright starscape, a man-built reflection of the clear winter sky.
The pilot straightened the jet’s wings. The nose dipped steeply. Monk’s stomach climbed as the aircraft dropped swiftly earthward.
Almost there.
Upon arriving at the coast, they had been ordered into a holding pattern by the tower at the Sintra Air Base, a Portuguese military facility twenty miles outside central Lisbon. Monk had imagined the base’s air traffic control was not accustomed to having a U.S. military jet request a priority landing on one of its runways.
Considering his earlier impatience and anxiety, he should have been aggravated by the delay. Instead, he wished the pilot could circle several more times. He was still struggling with the news from Lisa’s call ten minutes ago.
We failed. She’s gone.
The doctors had used the words brain dead, a term that in a thousand years could never be used to describe Kat. How could all that brilliance have gone dark?
With the visor of his flight helmet locked over his face, he couldn’t even wipe his tears. Not that he wanted to. She deserved those tears. He closed his eyes, leaned his head back. Their steep dive still held his stomach pressed against his diaphragm, which quivered with barely restrained sobs that threatened to rack his entire body.
Kat . . .
The jet suddenly shoved its nose into the sky. The plane shot upward, going nearly vertical, engines screaming toward the stars. Monk could not even gasp, not with a grizzly sitting on his chest. The g-forces pinned him back into the seat. His vision darkened at the edges.
Then the jet leveled as suddenly, jacking Monk’s body up against his restraints.
What the hell?
The pilot radioed back. “Sorry about that. New orders. D.C. wants us to divert to Paris. Immediately.”
Paris?
“Also, got another call asking for you,” the pilot said. “Patching it over.”
Monk expected Painter had an explanation for the sudden change in itinerary. He also hoped this diversion had something to do with the woman pulling their strings, some good news to offset the last call.
As soon as the connection was made, Monk cut to the chase: “What’s going on? Please tell me you’ve learned something about Valya.”
A pause followed, long enough to make Monk wonder if the sudden maneuver skyward had knocked loose a communication cable. This was further reinforced when the speaker finally spoke, the voice modulated and robotic.
And unfortunately, all too familiar.
The ransom video played again in his head.
“It seems you’ve learned my identity,” the caller said.
Monk pictured Harriet’s scared face, his girl balanced on the knee of her kidnapper. Rage swelled through him.
The alteration of the voice ended, allowing the pale witch’s Russian accent to shine forth clearly.
“Just as well. Now we can talk more freely, da? Just you and I.”
16
December 25, 9:28 P.M. CET
Paris, France