Then as they were getting back into the refuge lock, Ann fell in a faint. On the way down she hit her head on the doorjamb. Sax caught her body as she was landing on a bench against the inner wall. She was unconscious, and Sax half carried her, half dragged her all the way into the lock. Then he pulled the outer door shut, and when the lock was pumped, pulled her through the inner door into the changing room. He must have been shouting over the common band, because by the time he got her helmet off, five or six Reds were there in the room, more than he had seen in the refuge so far. One of the young women who had so impeded him, the short one, turned out to be the medical person of the station, and when they got Ann up onto a rolling table that could be used as a gurney, this woman led the way to the refuge’s medical clinic, and there took over. Sax helped where he could, getting Ann’s walker boots off her long feet with shaking hands. His pulse rate— he checked his wrist-pad— was 145 beats a minute— and he felt hot, even lightheaded.
“Has she had a stroke?” he said. “Has she had a stroke?”
The short woman looked surprised. “I don’t think so. She fainted. Then struck her head.”
“But why did she faint?”
“I don’t know.”
She looked at the tall young woman, who sat next to the door. Sax understood that they were the senior authorities in the refuge. “Ann left instructions for us not to put her on any kind of life-support mechanism, if she were ever incapacitated like this.”
“No,” Sax said.
“Very explicit instructions. She forbade it. She wrote it down.”
“You put her on whatever it takes to keep her alive,” Sax said, his voice harsh with strain. Everything he had said since Ann’s collapse had been a surprise to him; he was a witness to his actions just as much as they were. He heard himself say, “It doesn’t mean you have to keep her on it, if she doesn’t come around. It’s just a reasonable minimum, to make sure she doesn’t go for nothing.”
The doctor rolled her eyes at this distinction, but the tall woman sitting in the doorway looked thoughtful.
Sax heard himself go on: “I was on life support for some four days, as I understand it, and I’m glad no one decided to turn it off. It’s her decision, not yours. Anyone who wants to die can do it without having to make a doctor compromise her Hippocratic oath.”
The doctor rolled her eyes even more disgustedly than before. But with a glance at her colleague, she began to pull Ann onto the life-support bed; Sax helped her; and then she was turning on the medical AI, and getting Ann out of her walker. A rangy old woman, now breathing with an oxygen mask over her face. The tall woman stood and began to help the doctor, and Sax went and sat down. His own physiological symptoms were amazingly severe, marked chiefly by heat all through him, and a kind of incompetent hyperventilation; and an ache that made him want to cry.
After a time the doctor came over. Ann had fallen into a coma, she said. It looked like a small heart-rhythm abnormality had caused her to faint in the first place. She was stable at the moment.
Sax sat in the room. Much later the doctor returned. Ann’s wristpad had recorded an episode of rapid irregular heartbeat, at the time she fainted. Now there was still a small arrhythmia. And apparently anoxia, or the blow to the head, or both, had initiated a coma.
Sax asked what exactly a coma was, and felt a sinking feeling when the doctor shrugged. It was a catchall term, apparently, for unconscious states of a certain kind. Pupils fixed, body insensitive, and sometimes locked into decorticate postures. Ann’s left arm and leg were twisted. And unconsciousness of course. Sometimes odd vestiges of responsiveness, clenching hands and the like. Duration of coma varied widely. Some people never came out of them.
Sax looked at his hands until the doctor left him alone. He sat in the room until everyone else was gone. Then he got up and stood at Ann’s side, looking down at her masked face. Nothing to be done. He held her hand; it did not clench. He held her head, as he had been told Nirgal had held his when he was unconscious. It felt like a useless gesture.
He went to the AI screen, and called up the diagnostic program. He called up Ann’s medical data, and ran back the heart monitor data from the incident in the lock. A small arrhythmia, yes; rapid, irregular pattern. He fed the data into the diagnostic program, and looked up heart arrhythmia on his own. There were a lot of aberrant cardiac rhythm patterns, but it appeared that Ann might have a genetic predisposition to suffer from a disorder called long QT syndrome, named for a characteristic abnormal long wave in the electrocardiogram. He called up Ann’s genome, and instructed the AI to run a search in the relevant regions of chromosomes 3, 7, and 11. In the gene called HERG, in her chromosome 7, the AI identified a small mutation: one reversal of adenine-thymine and guanine-cytosine. Small, but HERG contained instructions for the assembly of a protein that served as a potassium ion channel in the surface of heart cells, and these ion channels acted as a switch to turn off contracting heart cells. Without this brake the heart could go arrhythmic, and beat too fast to pump blood effectively.