Nerves of Steel Read online

  PRAISE FOR CJ LYONS:

  NERVES OF STEEL

  “A perfect blend of romance and suspense. My kind of read.” ~New York Times bestselling author Sandra Brown

  “CJ Lyons brings a fresh and fascinating new voice into the genre. A great read.” ~New York Times bestselling author Heather Graham

  “Tensions sizzle in this hot new medical thriller by CJ Lyons. Think you know what’s going to happen next? Guess again...” ~New York Times bestselling author Lisa Gardner

  “Pulse-pounding suspense and hair-raising chills...a story of danger and intrigue that defies any reader to put it down.” ~New York Times bestselling author Susan Wiggs

  “A page-turner of a story. NERVES OF STEEL is taut, gripping and nonstop. Don’t miss it!”~New York Times bestselling author Carla Neggers

  LIFELINES

  “A spot-on debut...Lyons delivers a breathtakingly fast-paced medical thriller.” ~Publishers Weekly

  “A winner!” ~Romantic Times, Top Pick

  “Simply superb…riveting drama…a perfect ten.” ~Romance Reviews Today

  “Characters with beating hearts and three dimensions.” ~Newsday

  “A pulse-pounding adrenalin rush! Reminds me of ER back in the days of George Clooney and Julianna Margulies.” ~New York Times bestselling author Lisa Gardner

  “Tense, whip-smart medical scenes.” ~New York Times bestselling author Tess Gerritsen

  “Packed with adrenalin. I can’t recall a hospital novel that so thrilled me.” ~New York Times bestselling author David Morrell

  “An exciting debut...Engrossing, intriguing...” ~New York Times bestselling author Heather Graham

  “A fantastic and wild journey through the fast-paced world of a big-city ER...an adrenalin rush and an all-around great read.”~ New York Times bestselling author Allison Brennan

  “…Harrowing, emotional, action-packed and brilliantly realized. CJ Lyons writes with the authority only a trained physician can bring to a story, blending suspense, passion and friendship into an irresistible read.” ~New York Times bestselling author Susan Wiggs

  “CJ Lyons’ debut novel is simply exceptional. The action never lets up…keeps you on the edge of your seat.” ~Roundtable Reviews

  LIFELINES “explodes on the page…I absolutely could not put it down.” ~Romance Readers’ Connection

  WARNING SIGNS

  “This page-turning medical mystery will keep readers captivated.” ~ 4 Stars, Romantic Times Book Reviews

  Lyons “is a master within the genre.” ~Pittsburgh Magazine

  “This exhilarating medical thriller gets the blood pumping.” ~The Mystery Gazette

  “A powerful and dramatic look into the frenzied world of emergency medicine...Lyons’ characters are dynamic and genuine. Readers need only shut their eyes to imagine this group on the big screen.” ~Suspense Magazine

  “Sure to keep readers enthralled…a suspenseful and engaging tale that comes to an exciting conclusion. Readers won’t want to miss this one.” ~Romance Reviews Today

  “This fast-paced, suspense-filled story will leave you breathless and begging for more.” ~Romance Novel TV

  “I did not want to put it down….An incredible way to spend a few hours!” ~5 Cups, Coffee Time Romance

  “A great fast-paced read….Not to be missed for fans of ER and Grey’s Anatomy.” ~4 ½ Stars, Book Addict

  URGENT CARE

  “Adrenalin pumping.” ~The Mystery Gazette

  “…Vivid characters and an overlying air of menace.” ~ 4 Stars, RT Book Reviews

  “Kept me guessing on the edge of my seat.” ~4.5 out of 5, Errant Dreams

  “Riveting.” ~Publishers Weekly Beyond Her Book

  “Smart and intriguing, and her character development is so incredible that she leaves me literally breathless waiting to see what will happen next.” ~Becky Lejeune, Bookbitch.com

  Books by CJ Lyons

  Angels of Mercy Series:

  LIFELINES

  WARNING SIGNS

  URGENT CARE

  ISOLATION, coming soon!

  BORROWED TIME

  NERVES OF STEEL

  BLIND FAITH

  Shadow Ops Series:

  CHASING SHADOWS

  LOST IN SHADOWS

  This book is a work of fiction. Any references to historical

  events, real people, or real locales are used fictitiously. Other

  names, characters, places, and incidents are the product of the author’s imagination, and any resemblance to actual events or locales or persons, living or dead, is entirely coincidental.

  Copyright 2009, CJ Lyons

  All rights reserved, including the right of reproduction in

  whole or in part in any form.

  Library of Congress Case # 1-273031561

  NERVES OF STEEL

  CJ Lyons

  CHAPTER 1

  The Sikorsky helicopter thundered through the icy February night, its blades chopping against wind gusting off the Ohio River. In the rear-facing passenger seat, Dr. Cassandra Hart swallowed hard to keep down the chilimac she'd eaten earlier. Wishing it was only motion sickness, she tugged at her safety harness. There was no room to breathe, not enough air.

  Motion sickness she knew how to fix. Irrational claustrophobia was another story. A curse, a weakness she refused to reveal, forcing her to mask her panic.

  The view outside Cassie's window wasn't helping. The helicopter's blades tore into the low-hanging clouds, shredding them into tattered, ghostly remnants. Rain pelted the scarred Lexan windows, ricocheting like shrapnel.

  Typical of Pittsburgh, a city constantly teetering on the edge of bankruptcy, few of the buildings they passed were lit. The ones that were, such as the Cathedral of Learning and PPG Place, stood like sentries in the dark, guarding against a pre-dawn invasion.

  She bit down against another wave of nausea, her pulse drumming through her ears in time with the rotor blades. Across from her, Eddie Marcone, her flight paramedic, lounged in his seat, playing a hand-held computer game, oblivious to her distress and their impending doom.

  A blast of wind catapulted the Sikorsky skyward. Cassie's restraints tightened against the sudden motion, squeezing against her chest. Gravity yanked them back down with a jolt strong enough to snap her jaws together.

  "Weather's moving in fast," Zack Allan, their pilot, said, his voice reverberating through her headset. "Might have to turn back, doc."

  Turn back? Cassie rubbed her clammy palms on the legs of her Nomex flight suit. Right now the landing pad at Pittsburgh's Three Rivers Medical Center seemed like a distant Nirvana. A Nirvana that would have to wait. The patient they were flying to retrieve, a girl found in the frigid waters of the Ohio River, couldn't.

  "Ten minutes," she told Zack, denying the fight or flight instinct raging through her, every muscle quivering with the desire to escape. "We'll scoop and run, just give me ten minutes."

  The Sikorsky bucked again. "They can send her by ground," Eddie said, his glare reminding her that her decision affected all of them, not only her patient.

  "It'll take too long. This girl doesn't have that kind of time."

  That was the problem with living in a city built around three rivers and several mountains. Tunnels, bridges and road work conspired against the rapid transport of trauma victims.

  Zack's sigh resonated through her headset and she knew she'd won. Hah. If you could call being locked inside this flying death trap winning.

  "You've got five minutes," he said.

  They flew lower. The turbulence decreased from head-swimming, stomach-flipping to mere filling-rattling. The Sikorsky shuddered then landed on the last intact slice of macadam remaining at the on-ramp of the West End Bridge. Rotor wash overturned several
orange PennDOT barrels, sending them skittering across the broken asphalt. Sleet pounded the helicopter. Cassie didn't need to look; she knew Zack was scowling.

  "Hey, Hart," he shouted over the rumble of the engine, "one second late and I swear--"

  Cassie ignored him as she wrenched the door open, stepped out into the night and moved away from the rotors, ducking her head until she cleared the blades. Straightening, she turned into the westerly wind and stole a moment to breathe.

  Her fear drained away, replaced with the adrenalin of anticipation. A rescue squad sat at the entrance to the bridge, its lights aimed down the embankment that led to the Ohio River. At the water's edge two medics struggled to roll a small, pale form onto a neon orange backboard. Her patient.

  Eddie joined her, and they scrambled down the gravel slope. "Why do you have to always push the envelope? You know the pilot's got the final call."

  "Zack's a worrier." Her gaze focused on the medics and the girl's unmoving body.

  "There's nothing wrong with that. Not when it's my ass on the line." He slipped in the wet scree and fought to catch his balance. "What makes this patient so important you're willing to risk my life?"

  Cassie ignored him, rushing forward as one of the medics slipped, almost dumping her patient back into the river. She reached out to help stabilize the backboard, splashing icy water over her boot tops while Eddie arranged their gear on a pile of torn-up paving bricks.

  "What've we got?" She raised her voice to be heard above the wind whistling through the bridge girders as they sloshed their way onto solid ground. A dark, tangled curl whipped free of its barrette. She twisted it behind her ear where it joined the rest of her rain-frizzled hair dripping down the back of her neck.

  "Don't know. Could be a jumper," one of the medics shouted.

  The girl was maybe fourteen, fifteen tops. Her lips were blue, her face pale, blonde hair waterlogged. For a long moment Cassie couldn't find her pulse. There. Slow, thready, but definitely there. Good girl, don't give up now.

  "Severe hypothermia." Mud squished beneath her, revealing sharp rocks below it as Cassie knelt at the girl's head. "She's apneic. I need to tube her."

  "We don't have time," Eddie said.

  "Just give me a second," she muttered, her attention focused on her patient. The girl's skin felt cold, waxen. Wake up, Sleeping Beauty. Cassie's fingers parted her patient's blue-tinged lips. It was a difficult position to maneuver in, but she slid the endotracheal tube into place in one smooth movement. She reached for the ventilation bag to force oxygen into the girl's starving lungs.

  "Slick," Eddie said in grudging admiration as he secured the tube with a few quick wraps of tape.

  "Now or never, Hart," Zack shouted down from the helicopter.

  She acknowledged the pilot's words with a nod but did not alter the rhythm of her hands. The February wind burnt her face as she leaned over her patient, trying to shelter the girl. Cassie couldn't spare a hand to wipe the rain away, so she ducked her face into the shoulder of her bomber jacket.

  The acrid, smoky smell of wet leather jolted through her, and suddenly she was twelve again, standing in icy water, clutching her father's hand. She shook her head, chasing the errant memory back to its proper place.

  "Slow now," she told Eddie and the medics. "Don't jostle her."

  Severe hypothermia, trauma from a possible fall, cold-water immersion, shock--the odds against her patient were overwhelming. They slogged their way up the steep, muddy hill, zig-zagging around broken pieces of asphalt and other debris left behind by the PennDOT crew.

  "Give us a hand already," Cassie called to the policemen huddled beside their cruiser, supposedly directing traffic through the urban wasteland of deserted warehouses and road construction. Not that there was any traffic in the predawn hours of a Monday morning.

  With the extra manpower they were able to quickly haul her patient up to the waiting Sikorsky. Cassie jumped in and positioned herself at the head of the stretcher.

  "Hang on, it's gonna be a rough ride," Zack announced.

  The helicopter's powerful engine revved. Cassie's heart slammed against her rib cage as the craft shook. After an initial upward lurch, winds began to buffet them without mercy.

  A coffin, she was riding in a metal coffin.

  She squelched the thought, forcing her attention onto her patient. The girl's oxygen level was marginal, heart rate low, blood pressure non-existent. Cassie slid her trauma scissors along the seams of the girl's Pitt sweatshirt, tugging the heat-stealing sodden cotton away. A shower of small green tablets spilled from a plastic bag tucked into the girl's bra.

  She scooped up the pills, examining their unique triangular shape. "FX. Looks like it's the real thing, too."

  Fentephex, or FX, was the drug industry's latest "miracle" analgesia that had crossed over from hospital use to street abuse. Already this year, the drug had killed six of Cassie's patients. She wasn't about to lose a seventh.

  Eddie finished securing the IV line. He ran his fingers over the purplish raised needle tracks lining the girl's thin arms. "She's been shooting it."

  "Push the Narcan. I'll set up a drip." There were at least two dozen pills twisted into the baggie. How had the girl gotten her hands on that much FX? Cassie shoved the bag of drugs into her pocket and reached for a syringe.

  Without warning, the helicopter dropped. Gravity grabbed Cassie, tearing her away from her patient. Her stomach somersaulted, and she scrambled for a handhold. She looked up. One of the pinnacles of the PPG Tower rushed toward them. Normally the glass tower with its fairytale spires stretching toward the sky was one of her favorite Pittsburgh landmarks. Tonight it seemed a nightmarish dagger.

  The Sikorsky lurched. "Damn it, Zack!" Eddie's voice sounded through her headset.

  Cassie couldn't tear her gaze away from the gleaming lights of the tower. They pulled at the helicopter, a siren song beckoning them to their doom. The helicopter pitched to the right. She squeezed her eyes shut.

  A blink of an eye. A split second. If anyone knew how fast a life could change, it was Cassie. Who would come to her funeral? She had no family left.

  Careless of her to lose everyone like that--how foolish of her to be the last one standing.

  The helicopter climbed, then dropped once again, engines screaming in protest. Acid scratched at the back of Cassie's parched throat. She forced her eyes open. The tower filled her window. Thirty years weren't enough, she decided. Not nearly enough. Her mind filled with a vision of twisted steel, smoke and fire. Would there be anything left to bury?

  Focus on your patient. You're not dead yet. Neither is she. Cassie reached for her patient's wrist, her fingers automatically feeling for the pulse. Stronger now that they had fluids going, but there were a few irregular beats. And the girl's skin was still deathly cold. All this jostling around wasn't helping her over-stressed heart.

  The glass tower loomed over them. With a shriek and a final howl of its engines, the Sikorsky righted itself, swerving away from disaster.

  A few minutes later, the lights of Three Rivers Medical Center came into view. Before they could land, the shrieking of monitor alarms filled the cabin.

  "V-fib." Cassie reached for the girl's carotid artery. "No pulse."

  "Hell." Eddie began chest compressions.

  Cassie charged the defibrillator. She forced air into the girl, squeezing the bag valve mask. The defibrillator buzzed, signaling its readiness.

  "Clear!" Cassie planted the paddles on their patient's chest. Electricity shot through the girl's chest. "Nothing." She exchanged the paddles for the epinephrine and injected the heart medication into the IV.

  The helicopter thudded down onto the landing pad. The doors slid open, and helping hands reached in to move their patient. Cassie took over chest compressions. She wove her fingers together and pistoned her palms against the girl's breastbone. The wind hurled wasp-stings of sleet against her skin. Cassie ignored it, pausing only to fling her hair out of her face w
ith an impatient shake of her head. The barrette that once restrained it was long lost, probably at the bottom of the river.

  Damn it, Cassie thought in rhythm with her chest compressions. You are not going to die. Not on my watch.

  CHAPTER 2

  If Detective Mickey Drake closed his eyes, the rain pounding against the dumpster lid sounded a lot like gunfire from a modified TEC-9. Splat-patta-pat-pat. Not as loud as the movies made it out. Less bang, more pop.

  Drake didn't close his eyes. Instead he kept them riveted on the third floor window of the East Liberty apartment building where Lester Young was rocking the night away with his woman.

  The wind did little to dissipate the stench of urine, rotting chicken, and sour milk that clung to the alley. Gray mist swirled past Drake in tatters as transparent as promises from old lovers.

  He shifted his weight, crammed his bare hands deeper into the pockets of his Navy peacoat, and tried to ignore the thud of the rain against garbage bags overflowing with moldering, dirty diapers. The only light on the block came from the apartment's naked window and one overworked street lamp whose yellow glow struggled to make it as far as the pavement below.

  Yesterday was Drake's first day off in two weeks. But when Lisa Dimeo, the straitlaced prosecutor working with the Pittsburgh Police Bureau's FX Taskforce, called to tell him she'd finally convinced her boss that they had enough probable cause to go for a warrant, he had joined in the hunt. No way he was going to let a little thing like sleep stop him from bringing in Lester Young.

  Drake had scoured all of the drug-dealing, murdering, sonofabitch's hideyholes until, about one in the morning, he tracked Lester to his strawberry's Ruby Avenue apartment. Drake had been a good boy, called for backup, waited for Kwon to arrive with the warrant. Lester wasn't walking on any technicality. Not this time.

  "You need some help out there, DJ?" Janet Kwon's voice drilled through his earpiece. "Thought you went to take a leak. That was twenty minutes ago."

  Her voice was good humored, but colored with concern. Not solely concern about his well being. Kwon's concern was that he'd done something to screw up. Again. Which was why he stood out here, freezing his butt off, instead of trapped inside the Intrepid with Kwon and her discerning glances.