The Twelfth Card (Lincoln Rhyme 6)

But he'd learned that it was times like this, with cops everywhere, that people were lulled into carelessness. You could often get much closer to them than you otherwise might. The medium man now strolled casually through the crowds in the direction of the museum, just another commuter, an Average Joe on his way to work.

*

It's nothing less than a miracle.

Somewhere in the brain or the body a stimulus, either mental or physical, occurs--I want to pick up the glass, I have to drop the pan that's burning my fingers. The stimulus creates a nerve impulse, flowing along the membranes of neurons throughout the body. The impulse isn't, as most people think, electricity itself; it's a wave created when the surface of the neurons shifts briefly from a positive charge to a negative. The strength of this impulse never varies--it either exists or it doesn't--and it's fast, 250 m.p.h.

This impulse arrives at its destination--muscles, glands and organs, which then respond, keeping our hearts beating, our lungs pumping, our bodies dancing, our hands planting flowers and writing love letters and piloting spacecraft.

A miracle.

Unless something goes wrong. Unless you're, say, the head of a crime scene unit, searching a murder scene in a subway construction site, and a beam tumbles onto your neck and shatters it at the fourth cervical vertebra--four bones down from the base of the skull. As happened to Lincoln Rhyme some years ago.

When something like that occurs, then all bets are off.

Even if the blow doesn't sever the spinal cord outright, blood floods the area and pressure builds and crushes or starves the neurons. Compounding the destruction, as the neurons die they release--for some unknown reason--a toxic amino acid, which kills even more. Ultimately, if the patient survives, scar tissue fills the space around

the nerves like dirt in a grave--an appropriate metaphor because, unlike neurons in the rest of the body, those in the brain and spinal cord do not regenerate. Once dead, they're numb forever.

After such a "catastrophic incident," as the men and women of medicine so delicately put it, some patients--the lucky ones--find that the neurons controlling vital organs like lungs and heart continue to function, and they survive.

Or maybe they're the unlucky ones.

Because some would rather their heart stopped cold early on, saving them from the infections and bedsores and contractures and spasms. Saving them too from attacks of autonomic dysreflexia, which can lead to a stroke. Saving them from the eerie, wandering phantom pain, which feels just the same as the genuine article but whose searing aches can't be numbed by aspirin or morphine.

Not to mention an utterly changed life: the physical therapists and the aides and the ventilator and the catheters and the adult diapers, the dependency . . . and the depression, of course.

Some people in these circumstances just give up and seek out death. Suicide is always an option, though not an easy one. (Try killing yourself if all you can move is your head.)

But others fight back.

"Had enough?" the slim young man in slacks, white shirt and a burgundy floral tie asked Rhyme.

"No," responded his boss in a voice breathless from the exercise. "I want to keep going." Rhyme was strapped atop a complicated stationary bicycle, in one of the spare bedrooms on the second floor of his Central Park West town house.

"I think you've done enough," Thom, his aide, said. "It's been over an hour. Your heart rate's pretty high."

"This is like bicycling up the Matterhorn," Rhyme gasped. "I'm Lance Armstrong."

"The Matterhorn's not part of the Tour de France. It's a mountain. You can climb it, but you can't bike it."

"Thank you for the ESPN trivia, Thom. I wasn't being literal. How far have I gone?"

"Twenty-two miles."

"Let's do another eighteen."

"I don't think so. Five."

"Eight," Rhyme bargained.

The handsome young aide lifted an acquiescing eyebrow. "Okay."

Rhyme had wanted eight anyway. He was elated. He lived to win.

The cycling continued. His muscles powered the bicycle, yes, but there was one huge difference between this activity and how you'd pedal a stationary bike at Gold's Gym. The stimulus that sent the impulse along the neurons came not from Rhyme's brain but from a computer, via electrodes connected to his leg muscles. The device was known as an FES ergometer bike. Functional electrical stimulation uses a computer, wires and electrodes to mimic the nervous system and send tiny jolts of electricity into muscles, making them behave exactly the same as if the brain were in charge.

FES isn't much used for day-to-day activity, like walking or using utensils. Its real benefit is in therapy, improving the health of badly disabled patients.