The windows were of smoked glass, allowing people to look in from the viewing platform without distracting the attention of the surgeons below. A man stood on the platform with his arms folded, observing the surgery going on within the theater below as Tyrell and Lopez joined him.
“Dr. Holloway?”
Dr. Graham Holloway was shorter than Tyrell and armed with quick, alert blue eyes and an aura of supreme confidence.
“Detective Tyrell,” he said, shaking Tyrell’s hand.
Tyrell introduced Lopez before looking down into the theater below. Eight surgeons surrounded a patient on the table, the theater filled with computers and complex-looking devices all connected to each other and the patient with a web of wires and tubes.
“What can I do for you?” Holloway asked.
“I understand that you’re the senior surgeon here,” Tyrell said, transfixed by the surgery below them.
“I’m the most experienced by years but there’s no real order of seniority.”
“Okay,” Tyrell said, opening his notebook. “When you perform surgery on your patients, how often is it necessary to put them into a homeostatic state?”
“Only when we’re required to perform deeply invasive brain surgery in hemorrhagic brain injuries or aggressive melanoma cases.”
“Cancer?” Lopez asked from one side.
“Yes. Very occasionally patients will be referred to us suffering from malignant tumors close to the brain stem or deep in the cerebral cortex.”
“And if you are required to perform such a procedure, you might bring the patient’s heartbeat down to a crawl,” Tyrell suggested. “How would you go about that?”
“There are several methods,” Holloway said, “but the principal ones include chemicals that relax the major organs. Another is via induced hypothermia.”
Tyrell caught Lopez’s look of surprise. Dr. Holloway didn’t miss the silent exchange. “It might help if you were to tell me what the problem is,” he suggested.
Tyrell nodded.
“We noticed some unusual pathology in the autopsies of three bodies discovered yesterday morning. All three had suffered from the early stages of hypothermia.” Tyrell saw Holloway raise his eyebrows at that. “You’re aware that it’s been nearly eighty degrees across the District over the past few days.”
“Go on,” the surgeon said quietly.
“The medical examiner confirmed that all three individuals showed excessive hydrogen sulphide in their blood.”
“Anything else?”
“All of the victims were of the same blood group, O-negative, but originally their blood had been AB, suggesting a transfusion.” Tyrell took a breath. “Given what I’ve just told you, what would be your best estimate of the kind of procedure that these individuals were subjected to?”
Holloway let out a long breath before speaking.
“It’s possible that a human body cooled using a saline solution to transfuse blood could suffer effects somewhat like frostbite if the procedure was poorly conducted.”
“They were actually frozen?” Lopez asked, mortified.
“Yes, it’s a common procedure developed to make open-heart surgery easier and is being enhanced for battlefield trauma victims and automobile accidents. By rapidly cooling the body using a chilled saline solution, a form of controlled hypothermia can be induced in the victim, slowing their metabolism to clinical death.”
“How does it work?” Tyrell asked.
“The patient is anesthetized, hooked up to a heart-bypass machine, and receives heparin, which is made from cow’s gut, to prevent blood clotting. The heart is then stopped via intravenously administered potassium chloride. The body is cooled over a period of about one hour to a temperature of around sixteen degrees Centigrade, essentially as cold as a corpse. We then drain the blood from the body and replace it with a chilled saline solution. By this time the patient is clinically dead, with no heartbeat, no blood, and no brain activity. Surgery is undertaken and when the work is complete the process is reversed, ending with a small electrical charge applied to the heart to initiate rhythm.”
“And this is done on a regular basis?” Lopez asked.
“Only in extreme cases to allow prolonged access to the brain or heart,” Holloway admitted. “Long-term hypothermic methods have only been conducted so far on dogs and mice in an experimental manner. The method was reported as having a success rate of better than eighty percent. The dogs even answered to their own names.”
“Eighty percent,” Lopez repeated softly. “And the other twenty?”
“Hard to tell in animals,” Holloway said, “but probably a condition similar to posttraumatic stress or schizophrenia. Mood swings and evidence of depression were noted, along with motor deficiency.”
Tyrell nodded, thinking furiously now.
“What about the altered blood group of the victims?”
“Entire blood transfusions are not uncommon,” Holloway said, “but would only occur to prevent rejection of foreign organs.”