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  CATCH THE FEVER FOR

  TESS GERRITSEN’S

  NEW YORK TIMES BESTSELLING

  THRILLERS!

  GRAVITY

  “Tess Gerritsen is an automatic must-read

  in my house.”

  —Stephen King

  BLOODSTREAM

  “Gerritsen’s descriptions of horror and

  terror . . . are riveting.”

  —Los Angeles Times

  HARVEST

  “The best medical thriller I’ve

  read since Coma.”

  —James Patterson

  Available from Pocket Books

  “What Anne Rice is to vampires, Gerritsen is to the

  tale of medical suspense. She is better than Palmer,

  better than Cook . . . yes, even better than Crichton.

  If you’ve never read Gerritsen, figure in the price of

  electricity when you buy your first novel by her . . .

  ’cause baby, you are going to be up all night.”

  —Stephen King

  LIFE SUPPORT

  “A gripping book. . . . Toby Harper is an engaging heroine capable of genuinely inspired sleuthing.”

  —Good Housekeeping

  “One of the most exciting novels of the year . . . . The characters are well-drawn, believable, and fully realized . . . . A riveting novel.”

  —Maine Telegram

  “Another suspenseful read . . . hold[s] the reader right up to the last page.”

  —Nashville Tennessean

  “Evocative characters, a life-threatening plot that grabs the reader by the throat, even the uncertainty of what lies ahead for Toby and Dvorak—all combine to make LIFE SUPPORT a prescription for entertainment and a provocative examination of controversial medical issues not to be missed.”

  —BookPage

  “Shocking. . . . Gerritsen again parlays professional knowledge, a snappy writing style, and offbeat characters into an entertaining thriller.”

  —San Jose Mercury News

  “A fast-paced plot that is startling, surprising, and frightening.”

  —Abilene Reporter-News (TX)

  “Taut, suspenseful, and downright chilling.”

  —Contra Costa Times (CA)

  “Truly frightening. . . . The chills begin on page one and keep you spellbound throughout.”

  —Rapport

  “[A] page-turning medical thriller. . . . This is a book you’ll have trouble putting down. . . . Pulse-pounding.”

  —Anderson Independent Mail (IN)

  “Exceptional vitality. . . . Crescendoing suspense.”

  —The News-Journal (Daytona Beach, FL)

  AND DON’T MISS

  TESS GERRITSEN’S . . .

  GRAVITY

  “As riveting as The Hot Zone, this page-turner proves that Gerritsen is tops in her genre. . . . [A] one-stop, nonstop read. . . . Moves at a furious pace, twisting unpredictably.”

  —USA Today

  “Tess Gerritsen, the reigning champion of the medical thriller, throws one twist after another until the excitement is almost unbearable.”

  —San Jose Mercury News

  “Compelling and convincing. . . . [A] nail-biting tale of genetic misadventure.”

  —Publishers Weekly (starred review)

  “Gerritsen treats us to some of the best medical gore and speculation about extraterrestrial life found anywhere outside The X-Files.”

  —Entertainment Weekly

  “Space research lifts Gerritsen to the top of the ladder as Michael Crichton and Robin Cook wave from below.”

  —Kirkus Reviews

  “A powerful new thriller.”

  —Seattle Post-Intelligencer

  “Thrilling . . . fast-paced, scary, and loaded with insider information.”

  —The Plain Dealer (Cleveland)

  BLOODSTREAM

  “Scores a bull’s-eye.”

  —Chicago Tribune

  “An intricate thriller . . . a tale sure to fascinate.”

  —People

  HARVEST

  “Harvest will make your heart skip a beat.”

  —USA Today

  “Harrowing. . . . Harvest quite literally has gut-level impact.”

  —San Francisco Chronicle

  Books by Tess Gerritsen

  Harvest

  Life Support

  Bloodstream

  Gravity

  Available from POCKET BOOKS

  The sale of this book without its cover is unauthorized. If you purchased this book without a cover, you should be aware that It was reported to the publisher as “unsold and destroyed.” Neither the author nor the publisher has received payment for the sale of this “stripped book.”

  This book is a work of fiction. Names, characters, places and incidents are products of the author’s imagination or are used fictitiously. Any resemblance to actual events or locales or persons, living or dead, is entirely coincidental.

  Originally published in hardcover in 1997 by Pocket Books

  A Pocket Star Book published by

  POCKET BOOKS, a division of Simon & Schuster, Inc.

  1230 Avenue of the Americas, New York, NY 10020

  www.SimonandSchuster.com

  Copyright © 1997 by Tess Gerritsen

  All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever. For information address Pocket Books, 1230 Avenue of the Americas, New York, NY 10020

  ISBN: 0-671-55304-6

  eISBN: 978-1-4391-4073-4

  First Pocket Books paperback printing August 1998

  19

  POCKET STAR BOOKS and colophon are registered trademarks of Simon & Schuster, Inc.

  For information regarding special discounts for bulk purchases, please contact Simon & Schuster Special Sales at 1-800-456-6798 or [email protected]

  Front cover illustration by Larry Rostant

  Printed in the U.S.A.

  To Jacob, Adam, and Josh—

  the guys in my life

  ACKNOWLEDGMENTS

  With many thanks to:

  Emily Bestler, who can make any book shine

  Ross Davis, M.D., neurosurgeon and Renaissance man

  Jack Young, who cheerfully answers my oddest questions

  Patty Kahn, for all her research assistance

  Jane Berkey and Don Cleary, my navigators in the publishing world

  And most of all, to Meg Ruley, who always points me in the right direction. And then walks me there.

  LIFE

  SUPPORT

  1

  A scalpel is a beautiful thing.

  Dr. Stanley Mackie had never noticed this before, but as he stood with head bowed beneath the OR lamps, he suddenly found himself marveling at how the light reflected with diamondlike brilliance off the blade. It was a work of art, that razor sharp lunula of stainless steel. So beautiful, in fact, that he scarcely dared to pick it up for fear he would somehow tarnish its magic. In its surface he saw a rainbow of colors, light fractured to its purest elements.

  “Dr. Mackie? Is something wrong?”

  He looked up and saw the scrub nurse frowning at him over her surgical mask. He had never before noticed how green her eyes were. He seemed to be seeing, really seeing, so many things for the very first time. The creamy texture of the nurse’s skin. The vein coursing along her temple. The mole just above her eyebrow.

  Or was it a mole? He stared. It was moving, crawling like a many-legged insect toward the corner of her eye. . . .

  “Stan?” Dr. Rudman, the anesthesiologist, was speaking now, his voice slicing through Mackie’s dismay. “Are you all right?”

  Mackie gave his head a shake. The insect vanished. It was a mole again, just a tiny
fleck of black pigment on the nurse’s pale skin. He took a deep breath and picked up the scalpel from the instrument tray. He looked down at the woman lying on the table.

  The overhead light had already been focused on the patient’s lower abdomen. Blue surgical drapes were clamped in place, framing a rectangle of exposed skin. It was a nice flat belly with a bikini line connecting the twin flares of the hip bones—a surprising sight to behold in this season of snowstorms and winter white faces. What a shame he would have to cut into it. An appendectomy scar would certainly mar any future Caribbean tans.

  He placed the tip of the blade on the skin, centering his incision on McBurney’s point, halfway between the navel and the protrusion of the right hip bone. The approximate location of the appendix. With scalpel poised to cut, he suddenly paused.

  His hand was shaking.

  He didn’t understand it. This had never happened before. Stanley Mackie had always possessed rock steady hands. Now it took enormous effort just to maintain his grip on the handle. He swallowed and lifted the blade from the skin. Easy. Take a few deep breaths. This will pass.

  “Stan?”

  Mackie looked up and saw that Dr. Rudman was frowning. So were the two nurses. Mackie could read the questions in their eyes, the same questions that people had been whispering about him for weeks. Is old Dr. Mackie competent? At the age of seventy-four, should he still be allowed to operate? He ignored their looks. He had already defended himself before the Quality Assurance Committee, had explained, to their satisfaction, the circumstances of his last patient’s death. Surgery, after all, was not a risk-free proposition. When too much blood pools in the abdomen, it’s easy to confuse one’s landmarks, to make the wrong slice.

  The committee, in their wisdom, had absolved him of blame.

  Nevertheless, doubts had seeped into the minds of the hospital staff. He could see it in the nurses’ expressions, in Dr. Rudman’s frown. All those eyes watching him. Suddenly he sensed other eyes as well. He caught a fleeting glimpse of dozens of eyeballs floating in the air, all of them staring at him.

  He blinked, and the terrible vision was gone.

  My glasses, he thought. I will have to get my glasses checked.

  A drop of sweat slid down his cheek. He tightened his grip on the scalpel handle. This was just a simple appendectomy, a procedure a lowly surgical intern could pull off. Surely he could manage this, even with shaking hands.

  He focused on the patient’s abdomen, on that flat belly with its golden tan. Jennifer Halsey, age thirty-six. A visitor from out of state, she had awakened this morning in her Boston motel room suffering from right lower quadrant pain. With the pain growing worse, she had driven through a blinding snowstorm to the ER at Wicklin Hospital, and had been referred to the surgeon on call for the day: Mackie. She knew nothing about the rumors concerning his competence, nothing about the lies and whispers that were slowly destroying his practice. She was merely a woman in pain who needed her inflamed appendix removed.

  He pressed the blade to Jennifer’s skin. His hand had steadied. He could do it. Of course he could do it. He made the incision, a smooth, clean slice. The scrub nurse assisted, sponging up blood, handing him hemostats. He cut deeper, through the yellow subcutaneous fat, pausing every so often to cauterize a bleeder. No problem. Everything’s going to be fine. He would get in, remove the appendix, and get out again. Then he would go home for the afternoon. Maybe a little rest was all he needed to clear his head.

  He slit through the glistening peritoneum, into the abdominal cavity. “Retract,” he said.

  The scrub nurse took hold of the stainless steel retractors and gently tugged open the wound.

  Mackie reached into the gap and felt the intestines, warm and slippery, squirm around his gloved hand. What a wondrous sensation, to be cradled in the heat of the human body. It was like being welcomed back into the womb. He exposed the appendix. One glance at the red and swollen tissue told him his diagnosis had been correct; the appendix would have to come out. He reached for the scalpel.

  Only as he focused once again on the incision did he realize that something was not quite right.

  There was far too much intestine crowded into the abdomen, twice as much as there should be. Far more than the woman needed. This wouldn’t do. He tugged on a loop of small bowel, felt it glide, warm and slick, across his gloved hands. With the scalpel, he sliced off the excess length and set the dripping coil on the tray. There, he thought. That was much neater.

  The scrub nurse was staring at him, her eyes wide over the surgical mask. “What are you doing?” she cried.

  “Too much intestine,” he answered calmly. “Can’t have that.” He reached into the abdomen and grasped another loop of bowel. No need for all this excess tissue. It only obscured his view of things.

  “Dr. Mackie, no!”

  He sliced. Blood pulsed out in a hot, arcing spray from the severed coil.

  The nurse grabbed his gloved hand. He shook it off, outraged that a mere nurse would dare interrupt the procedure.

  “Get me another scrub nurse,” he commanded. “I need suction. Have to clear away all this blood.”

  “Stop him! Help me stop him—”

  With his free hand, Mackie reached for the suction catheter and plunged the tip into the abdomen. Blood gurgled up the tube and poured into the reservoir.

  Another hand grasped his gown and pulled him away from the table. It was Dr. Rudman. Mackie tried to shake him off, but Rudman wouldn’t let go.

  “Put down the scalpel, Stan.”

  “She has to be cleaned out. There’s too much intestine.”

  “Put it down!”

  Struggling free, Mackie swung around to confront Rudman. He’d forgotten he was still holding the scalpel. The blade slashed across the other man’s neck.

  Rudman screamed and clapped his hand to his throat.

  Mackie backed away, staring at the blood seeping out between Rudman’s fingers. “Not my fault,” he said. “It’s not my fault!”

  A nurse yelled into the intercom: “Send Security! He’s going crazy in here! We need Security STAT!”

  Mackie stumbled backward, through slippery pools of blood. Rudman’s blood. Jennifer Halsey’s blood. A spreading lake of it. He turned and bolted from the room.

  They were chasing him.

  He fled down the hallway, running in blind panic, lost in a maze of corridors. Where was he? Why did nothing seem familiar? Then, straight ahead, he saw the window, and beyond it, the swirling snow. Snow. That cold, white lace would purify him, would cleanse this blood from his hands.

  Behind him, footsteps pounded closer. Someone shouted, “Halt!”

  Mackie took three running steps and leaped toward the rectangle of light.

  Glass shattered into a million diamonds. Then the cold air whistled past him and everything was white. A beautiful, crystalline white.

  And he was falling.

  2

  It was a scorching day outside, but the driver had the air conditioner going full blast, and Molly Picker was feeling chilled as she rode in the backseat of the car. The cold air blowing out the vent by her knees seemed to knife straight up her miniskirt. She leaned forward and rapped on the Plexiglas partition.

  “Excuse me?” she said. “Hey, mister? Could you turn down that air conditioner? Mister?” She rapped again.

  The driver didn’t seem to hear her. Or maybe he was ignoring her. All she saw was the back of his blond head.

  Shivering, she crossed her bare arms over her chest and scooted sideways, away from that vent. Staring out the car window, she watched the streets of Boston glide by. She didn’t recognize this neighborhood at all, but she knew they were headed south. That’s what the last sign had said, Washington Street, South. Now she looked out at boxy buildings and barred windows, at clumps of men sitting on front stoops, their faces glossed with sweat. Not even June, and already the temperature was in the eighties. Molly could read the day’s heat just by looking at the peop
le on the street. The languid slump of their shoulders, their slow-motion shuffle down the sidewalks. Molly enjoyed looking at people. Mostly she looked at women because she found them so much more interesting. She would study their dresses and wonder why some wore black in the heat of summer, why the fat ones with big butts chose bright stretch pants, why nobody wore hats these days. She would study how the pretty ones walked, their hips swaying ever so slightly, their feet perched, perfectly balanced, on high heels. She wondered what secrets pretty women knew that she didn’t. What lessons their mamas had passed along to them, lessons that Molly had somehow missed. She would gaze long and hard at their faces, hoping for divine insight into what makes a woman beautiful. What special magic they possessed that she, Molly Picker, did not have.

  The car stopped at a red light. A woman in platform heels was standing on the corner, one hip jutted out. Like Molly, a hooker, but older—maybe eighteen, with lustrous black hair that tumbled all over her bronzy shoulders. Black hair would be nice, thought Molly wistfully. It made a statement. It was not an in-between color, like Molly’s limp hair, which was neither blond nor brown and made no statement at all. The car window was darkly tinted, and the black-haired girl couldn’t see Molly staring at her. But she seemed to sense it, because she slowly pivoted on her platform heels to face the car.

  She was not so pretty after all.

  Molly sat back, feeling oddly disappointed.

  The car turned left and continued southeast. They were far from Molly’s neighborhood now, heading into territory that was both unfamiliar and threatening. The heat had driven people out of their apartments and they sat fanning themselves in shady doorways. Their gazes followed the car as it passed by. They knew it did not belong in this neighborhood. Just as Molly knew she did not belong here. Where was Romy sending her?

  He hadn’t given her any address. Usually a scrawled street number was thrust in her hand, and she was responsible for scrounging up her own taxi. This time, though, there’d been a car waiting at the curb for her. A nice car, too, with no telltale stains on the backseat, no stinky wads of tissue paper stuffed in the ashtray. It was all so clean. She’d never ridden in a car this clean.