Face of Evil

CHAPTER NINE

February 20, 2011

If a skier manages not to be smashed against a tree, or carried over a cliff, or crushed by the weight of the snow and debris, he can survive an avalanche.

For about twenty minutes.

After that, most survivors of the initial impact and burial will die of asphyxiation.

A few lucky ones might find a pocket of air and hold on as their body temperature plummets and blood is diverted from their extremities to their vital organs.

The cruel truth, though, is that even if they manage to be rescued alive, they are still very likely to die, except in the cushy comfort of a hospital bed, a catheter and an IV shoved into them, instead of in an icy grave.

The key to surviving an avalanche is to be rescued within that first, critical half hour.

Matthew Cahill was under the ice for three months.

The facts of the case were unbelievable, so Dr. Jack Travis, the trauma specialist on call in the emergency room, chose to ignore them and deal instead with what he saw in front of him: a patient suffering from extreme hypothermia, typical of someone buried under the snow for an hour instead of months.

In all likelihood, Matt was headed right back to the morgue.

Hypothermia was a condition that Travis, having worked in the ski resort community for a decade, had plenty of experience dealing with.

Matt's body temperature on arrival was sixty-nine degrees. Travis covered him with heating blankets and put him on an epinephrine drip to elevate his blood pressure.

The patient was totally unresponsive to stimuli and his pupils didn't react to light, which indicated to Travis that Matt had suffered anoxic encephalopathy-severe and irreversible brain damage.

Travis ordered a complete metabolic panel, chest X-rays, and an MRI to see just how grim things were. But when the results came back, the doctor was stunned by what he saw.

The blood oxygen and muscle enzyme counts were normal.

The lungs were clear.

And the brain scan showed no swelling at all.

It was as if Matthew Cahill wasn't hypothermic at all, just deeply asleep.

But with the nerve response, pupil dilation, and core body temperature of a corpse.

And he was rapidly defrosting.

There really was nothing Travis could do except wonder how it was possible and wait to see what happened next.

So that's exactly what he did.

He pulled a stool up beside Matt's bed and waited, along with the leaders of nearly every department in the hospital except pediatrics and oncology.

But even those two department heads found excuses to be in the ER, having heard the news, which was already beginning to spread far beyond Mammoth Peaks.

In fact, a stooped-backed fisherman floating down the Yangtze River in a flat-bottomed wooden sampan was using his iPhone to catch up on the hash-marked tweets about "the frozen man" at the exact moment that Matthew Cahill startled everyone in the ER by taking a sharp breath and opening his eyes.

Travis bolted up and leaned over Matt, looking into the man's questioning eyes.

"You're alive," Travis said.

It was supposed to be a reassuring statement, but to Matthew Cahill, it sounded more like a question, one that he was expected to answer.