Germ

And then the visual assault: a man lying in a near-black pool on the floor, a blossom of blood in the center of his torso. And Allen sprawled on a cot, mouth agape, one eye swollen shut, the other staring blindly at the ceiling.

"Oh no, no, no . . ."

Stephen's heel hit the pool and flew out from under him. His head cracked against the tile. He stared at the caged light in the ceiling, thinking for a moment that he was supposed to see something fantastic in it. Then he rolled his head backward and saw an upside-down version of the doorway and the dark corridor beyond. He rose from the gore, blood clinging to him from his armpit to his knee. He rubbed his head and went to his brother.

"Allen! Allen!" He shook Allen's shoulders, sickened by the way his head bounced limply and lolled to the side. "No, Allen! Not here, man! Don't give them the satisfaction!"

He aimed his fist at Allen's sternum and administered a precordial thump. The heart responded—slightly. He tilted Allen's head back, pinched the nostrils, and blew twice into his mouth, filling Allen's lungs. He found the base of the sternum and moved up two fingers. His hands nearly covered Allen's chest. He leaned over and pushed down . . . came up . . . pushed down . . . came up—pumping the heart for him. After thirty compressions, again he filled Allen's lungs.

The cardiac monitor fell silent, then beeped. Allen hitched up, gasping for breath, righting against Stephen's hands.

"Yes!" Stephen said and threw his arms around his brother.

Allen went limp. His head flopped back, and once again, the EKG machine took over the job of screaming for help in a sporadic, weak rhythm.

Stephen gave him another precordial thump and restarted CPR . . . two breaths . . . thirty compressions . . . breathing . . . pushing . . . He had to restrain himself from frantically pumping on Allen's chest without rhythm or meter. He wanted to force life back into him. Tears flew from his cheeks, splattering against Allen's bloody face. He pulled in a deep breath, gritted his teeth, and pushed.

Allen heaved up, gasping. Stephen reached behind his head.

"Allen! Stay with me."

The cardiac monitor beeped . . . beeped . . .

Allen seized Stephen's shoulders and hitched in two sharp, raspy breaths . . . then nothing . . . He fell limp again.

This time, there was no response to the precordial thump. Stephen scanned the room. No defibrillator. His eyes roamed the clutter scattered on the floor: X-ray film, surgical instruments, rolls of cloth tape . . . ampoules of medicine and syringes.

He swung off Allen's cot and dropped to his hands and knees on the floor. He snatched up an ampoule and read its label. Magnesium sulphate 8 mmol. Sometimes used during resuscitation, but under what conditions? He tried to remember. Administering CPR was one thing—kids learned that. Injecting drugs to restart a heart was something else completely—despite being seven credit hours away from earning an MD. Potassium chloride was a good example. Depending on the cause of the heart failure, potassium could either restart it or frustrate efforts that would otherwise work.

He kept scooping up and examining ampoules, hoping a solution would spring out at him.

Epinephrine. Adrenaline!

He found a syringe, loaded it up with the epinephrine, and gently injected the drug under Allen's tongue, which would cause it to work as quickly as an intravenous line. He breathed into him, then rose, his straight arms coming together over Allen's sternum. This time, as he pumped, he did not count. He prayed.

Acutely aware of the heart under his palms, he thought of the life that was slipping away. He remembered Allen the toddler who'd scribbled with Crayons on the walls . . . the eight-year-old who had crashed his bike, knocking out a tooth, and who had run to his brother for comfort instead of to Mom . . . the new teenager who'd shyly asked Stephen what it was like to kiss a girl. . . the young man who'd performed a near-perfect backflip on the living room floor when he received his acceptance to med school—only "near perfect" because after landing he had crashed down on an antique coffee table, obliterating it. He recalled his brother's face when—

Beep. Beep. Beep.

Allen pulled in heavy gulps of air. His eyes were open, but they were focused on something distant. Tears buckled on his lids, spilled over. He reached out blindly, felt Stephen's face and shoulder, and slid his arms around his brother's body, pushing his face into his chest.

Stephen hugged him in return and watched the EKG monitor. The rate was slow but steady. His vision blurred. He blinked away his own tears; they seeped into his beard and tickled his face.

"What happened?" Allen asked, the words scraping over his vocal cords like pebbles. "Where was I?"

Stephen squeezed him tighter. His hands and arms felt too much of Allen's skeleton. He said, "Maybe heaven, little brother. But heaven can wait for you. I got you now."