The Hot Zone Read Online Free Page A

bleeding in the ICU . A young doctor named Shem Musoke ran to the scene. Dr. Musoke was widely considered to be one of the best young physicians at the hospital, an energetic man with a warm sense of humor, who worked long hours and had a good feel for emergencies. He found Monet lying on the gurney. He had no idea what was wrong with the man, except that he was obviously having some kind of massive hemorrhage. There was no time to try to figure out what had caused it. He was having difficulty breathing—and then his breathing stopped. He had inhaled blood and had had a breathing arrest.
    Dr. Musoke felt for a pulse. It was weak and sluggish. A nurse ran and fetched a laryngoscope, a tube that can be used to open a person’s airway.Dr. Musoke ripped open Monet’s shirt so that he could observe any rise and fall of the chest, and he stood at the head of the gurney and bent over Monet’s face until he was looking directly into his eyes, upside down.
    Monet stared redly at Dr. Musoke, but there was no movement in the eyeballs, and the pupils were dilated. Brain damage: nobody home. His nose was bloody and his mouth was bloody. Dr. Musoke tilted the patient’s head back to open the airway so that he could insert the laryngoscope. He was not wearing rubber gloves. He ran his finger around the patient’s tongue to clear the mouth of debris, sweeping out mucus and blood. His hands became greasy with black curd. The patient smelled of vomit and blood, but this was nothing new to Dr. Musoke, and he concentrated on his work. He leaned down until his face was a few inches away from Monet’s face, and he looked into Monet’s mouth in order to judge the position of the scope. Then he slid the scope over Monet’s tongue and pushed the tongue out of the way so that he could see down the airway past the epiglottis, a dark hole leading inward to the lungs. He pushed the scope into the hole, peering into the instrument. Monet suddenly jerked and thrashed.
    Monet vomited.
    The black vomit blew up around the scope and out of Monet’s mouth. Black-and-red fluid spewed into the air, showering down over Dr. Musoke. It struck him in the eyes. It splattered over his white coat and down his chest, marking him with stringsof red slime dappled with dark flecks. It landed in his mouth.
    He repositioned his patient’s head and swept the blood out of the patient’s mouth with his fingers. The blood had covered Dr. Musoke’s hands, wrists, and forearms. It had gone everywhere—all over the gurney, all over Dr. Musoke, all over the floor. The nurses in the intensive care unit couldn’t believe their eyes. Dr. Musoke peered down into the airway and pushed the scope deeper into the lungs. He saw that the airways were bloody.
    Air rasped into the man’s lungs. The patient had begun to breathe again.
    The patient was apparently in shock from loss of blood. He had lost so much blood that he was becoming dehydrated. The blood had come out of practically every opening in his body. There wasn’t enough blood left to maintain circulation, so his heartbeat was very sluggish, and his blood pressure was dropping toward zero. He needed a blood transfusion.
    A nurse brought a bag of whole blood. Dr. Musoke hooked the bag on a stand and inserted the needle into the patient’s arm. There was something wrong with the patient’s veins; his blood poured out around the needle. Dr. Musoke tried again, putting the needle into another place in the patient’s arm and probing for the vein. Failure. More blood poured out. At every place in the patient’s arm where he stuck the needle, the vein broke apart like cooked macaroni and spilledblood, and the blood ran from the punctures down the patient’s arm and wouldn’t coagulate. Clearly his blood was not normal. Dr. Musoke abandoned his efforts to give his patient a blood transfusion for fear that the patient would bleed to death out of the small hole in his arm. The patient continued to bleed from the bowels,