Chapter 1
The Sikorsky helicopter thundered through the icy February night, its blades chopping
against wind gusting off the Ohio River. In the rear-facing passenger seat, Dr. Cassandra
Hart swallowed hard to keep down the chilimac she'd eaten earlier. Wishing it was only
motion sickness, she tugged at her safety harness. There was no room to breathe, not enough
air.
Motion sickness she knew how to fix. Irrational claustrophobia was another story. A
curse, a weakness she refused to reveal, forcing her to mask her panic.
The view outside Cassie's window wasn't helping. The helicopter's blades tore into the
low-hanging clouds, shredding them into tattered, ghostly remnants. Rain pelted the scarred
Lexan windows, ricocheting like shrapnel.
Typical of Pittsburgh, a city constantly teetering on the edge of bankruptcy, few of
the buildings they passed were lit. The ones that were, such as the Cathedral of Learning and
PPG Place, stood like sentries in the dark, guarding against a pre-dawn invasion.
She bit down against another wave of nausea, her pulse drumming through her ears
in time with the rotor blades. Across from her, Eddie Marcone, her flight paramedic, lounged
in his seat, playing a hand-held computer game, oblivious to her distress and their impending
doom.
A blast of wind catapulted the Sikorsky skyward. Cassie's restraints tightened against
the sudden motion, squeezing against her chest. Gravity yanked them back down with a jolt
strong enough to snap her jaws together.
"Weather's moving in fast," Zack Allan, their pilot, said. His voice reverberated
through her headset. "Might have to turn back, doc."
Turn back? Cassie rubbed her clammy palms on the legs of her Nomex flight suit.
Right now the landing pad at Pittsburgh's Three Rivers Medical Center seemed like a distant
Nirvana. A Nirvana that would have to wait. The patient they were flying to retrieve, a girl
found in the frigid waters of the Ohio River, couldn't.
"Ten minutes," she told Zack, denying the fight or flight instinct raging through her,
every muscle quivering with the desire to escape. "We'll scoop and run, just give me ten
minutes."
The Sikorsky bucked again. "They can send her by ground," Eddie said, his glare
reminding her that her decision affected all of them, not only her patient.
"It'll take too long. This girl doesn't have that kind of time."
That was the problem with living in a city built around three rivers and several
mountains. Tunnels, bridges and roadwork conspired against the rapid transport of trauma
victims.
Zack's sigh resonated through her headset and she knew she'd won. Hah. If you could
call being locked inside this flying death trap winning.
"You've got five minutes," he said.
They flew lower. The turbulence decreased from head-swimming, stomach-flipping
to mere filling-rattling. The Sikorsky shuddered then landed on the last intact slice of
macadam remaining at the on-ramp of the West End Bridge. Rotor wash overturned several
orange PennDOT barrels, sending them skittering across the broken asphalt. Sleet pounded
the helicopter. Cassie didn't need to look; she knew Zack was scowling.
"Hey, Hart," he shouted over the rumble of the engine, "one second late and I
swear—"
Her fear drained away, replaced with the adrenalin of anticipation. A rescue squad
sat at the entrance to the bridge, its lights aimed down the embankment that led to the Ohio
River. At the water's edge two medics struggled to roll a small, pale form onto a neon orange
backboard. Her patient.
Eddie joined her and they scrambled down the gravel slope. "Why do you have to
always push the envelope? You know the pilot's got the final call."
"Zack's a worrier." Her gaze focused on the medics, and the girl's unmoving body.
"There's nothing wrong with that. Not when it's my ass on the line." He slipped in
the wet scree and fought to catch his balance. "What makes this patient so important you're
willing to risk my life?"/p>
Cassie ignored him, rushing forward as one of the medics slipped, almost dumping
her patient into the river. She reached out to help stabilize the backboard, splashing icy water
over her boot tops while Eddie arranged their gear on a pile of torn-up paving bricks.
"What've we got?" She raised her voice to be heard above the wind whistling through
the bridge girders as they sloshed their way onto solid ground. A dark, tangled curl whipped
free of its barrette. She twisted it behind her ear where it joined the rest of her rain-frizzled
hair dripping down the back of her neck.
"Don't know. Could be a jumper," one of the medics shouted.
The girl was maybe fourteen, fifteen tops. Her lips were blue, her face pale, her
blonde hair waterlogged. For a long moment Cassie couldn't find her pulse. There. Slow,
thready, but definitely there. Good girl. Don't give up now.
"Severe hypothermia." Mud squished beneath her, revealing sharp rocks below it as
Cassie knelt at the girl's head. "She's apneic. I need to tube her."
"We don't have time," Eddie said.
"Just give me a second," she muttered, her attention focused on her patient. The girl's
skin felt cold, waxen. Wake up, Sleeping Beauty. Cassie's fingers parted her patient's blue-
tinged lips. It was a difficult position to maneuver in, but she slid the endotracheal tube into
place in one smooth movement. She reached for the ventilation bag to force oxygen into the
girl's starving lungs.
"Slick," Eddie said in grudging admiration as he secured the tube with a few quick
wraps of tape.
"Now or never, Hart," Zack shouted down from the helicopter.
