Dr. Steven Jenkins clinked his wedding band against the computer mouse on his stand-up desk near a two-story window overlooking a dreary winter skyline above the ice-encrusted landscape surrounding the Coma Recovery Center in Cold Spring, New York. A well-groomed goatee, a shade lighter than his thinning, silver hair, extended from his prominent chin.

He gazed at the monitor through gold-rim glasses and mumbled at the email reply from his Internet service provider and their incompetent security department. Despite their failed attempt to resolve a recent data breach, he maintained a robotic demeanor as cold and unwavering as the parchment on his Harvard diploma.

On the verge of a life-changing scientific breakthrough, he dismissed what some would label a modern miracle. For Dr. Steven Jenkins, miracles never factored into the life-or-death equation. The work of God he left to men of the cloth. The work of science fell under his purview, grounded in meticulous medical research and systematic trials reaffirming the framed Thomas Edison quote on his wall: “I have not failed. I’ve just found 10,000 ways that won’t work.”

Late for rounds, he gathered the digital voice recorder from the polished mahogany credenza with a framed wedding photo and a hardcover copy of Gray’s Anatomy. The tome was sandwiched between piles of medical journals sprouting colored tabs from the highlighted pages inside.

He grabbed his white lab coat from the hangar behind the door and stretched his arms through the sleeves. Outside his office, he swiped his badge at a keypad reader and punched a six-digit code to access the patient care wing inside the multistory research and coma treatment facility. He took the stairs to the first-floor vending machines in the break room behind the marble tile atrium and opened his tri-fold wallet. “Don’t waste your time,” he told a visitor of South American lineage wearing a No Escort badge clipped to the zippered pocket on the front of his Nappa leather jacket the color of kidney bean red. “It doesn’t give change.”

He eyed the man who stood toe-to-toe with a snack machine, repeatedly thrusting his thumb on the change button. A dark cross tattoo revealed itself on his wrist jutting out from his jacket sleeve. A jagged scar down his jawline suggested trauma from a deep laceration with a large knife or other non-surgical instrument. Too casual to be a corporate lackey in jeans and hiking boots, his rugged appearance suggested someone long on street smarts and short on academic achievement. “The cafeteria opens in an hour. If you tell them the machine stole your change, they’ll refund your money.”

The visitor slapped the side of the vending machine in frustration. “This is not about the money,” he spoke in a Columbian accent, his dark eyes fixed and unflinching. “It’s the principle.”

“What brings you here?”

The newcomer relaxed his rigid posture and turned away from the vending machine when a nurse emerged from the stairwell down the hall and disappeared inside the building. “You graduated summa cum laude from Harvard Medical School,” he informed Dr. Jenkins. “You finished your post-doctoral research at Oxford, where you specialized in neuroscience. You completed your residency at Bellevue Hospital and served as Chief of Neurosurgery for eight years at Johns Hopkins. You’ve published thirty-seven times in The American Journal of Medicine—”

“Thirty-eight,” Dr. Jenkins corrected the peculiar visitor. “How do you know—”

“You won the Nobel Prize for your application of noninvasive hyperbaric oxygen treatment on patients with traumatic brain injuries. Married. No children. Both parents deceased.” The stranger noticed the armed guards stationed near the X-ray scanner inside the main entrance several feet from the enclosed revolving door. “You serve as the Medical Director of this facility with staff privileges at Hudson Psychiatric Hospital. Your career spans forty years, and yet, you’ve gone from bleeding edge research and a Nobel Prize, to babysitting comatose patients in a rehabilitation ward.”

Dr. Jenkins eyed him for a moment. “Is there something I can do for you?” he asked, uncomfortably aware of his agitated tone.

“I work for a pharmaceutical research corporation.”

“In what capacity?”

“Freelance consultant. My employer received your inquiry about investment opportunities in your research.”

“I applied for a federal grant, not a shark tank loan.”

“Your grant was denied.”

“Under whose authority?”

“My employer has a vested interest in your work.”

“Your employer?”

“Lindquist Pharmaceuticals. They’re a growing firm who specialize in—”

“I’m aware.”

The stranger retrieved a silver business card holder from his jacket pocket. “My employer ranks number eight in annual revenue. They plan to become number one.”

“By selling erectile dysfunction pills?”

“By marketing the first coma recovery pill.”

“There’s no pill for treating coma patients.”

“Not yet.”

Dr. Jenkins took the business card and read the company title printed above a street address, absent an employee name. “What are you proposing?”

“My employer is intrigued by your research. They speculate you’re on the verge of a medical breakthrough. One that would give new life to millions of comatose patients.”

“And generate billions in new revenue for your company.”

“Capitalism is not a crime.”

Dr. Jenkins reexamined the business card. “Who are you, exactly?”

“A consultant.”

“I got that part, Mr.—”

“Sanchez. Felix Sanchez.”

“Like the Olympic champion?”

“Who?”

“London, 2012. Felix Sanchez won gold in the four hundred-meter hurdles.”

“I’m just a consultant.”

Dr. Jenkins slid the business card inside his lab coat pocket. “What do you want from me, Mr. Sanchez?”

“Results. My employer intends to bring your product to market within a year.”

“Impossible. I have at least two more years of phase three trials. A new NDA filing with the FDA could take years in itself.”

“Time your wife cannot afford to waste in her condition.”

“How do you know about my wife?”

“That’s not important.”

Dr. Jenkins checked his gold-plated watch with a brown leather strap; a wedding gift from his wife of more than thirty-five years. “I’m not interested in working with Lindquist Pharmaceuticals, but I am inclined to call security. If you’ll excuse me…”

Felix put his hand out to block Dr. Jenkins’ path. “You haven’t heard the details of our offer.”

“I’m familiar with your employer’s reputation for circumventing federal regulations. I’m not about to jeopardize my career to help Lindquist meet their time-to-market goals.”

Felix produced an iPad, unlocked the screen, and held it in front of Dr. Jenkins’ face. The visitor’s demeanor remained impassive as he waited for a response.

Dr. Jenkins skimmed summaries of the medical histories of the former coma patients he’d treated unsuccessfully. “These records are confidential.”

“Your phase three human trials started two years ago, Dr. Jenkins. Without FDA approval to proceed.”

“Those trials were sanctioned.”

“Not by the FDA. You’ve been illegally treating phase three patients to accelerate your research.”

“So now you’re blackmailing me?”

“I’m not in the business of extortion, Dr. Jenkins. I’m offering you an opportunity to continue your work without legal repercussions. With the broader resources my employer can bring to bear, I’m confident you will achieve our time-to-market goal.”

“And what if I refuse?”

“For your wife’s sake, I suggest you reconsider.”

Dr. Jenkins scratched his cheek, contemplating the veracity of the arrogant thug who called himself Felix Sanchez. “Our network was hacked recently. Sensitive research data was stolen. Much like the contents in your iPad. I need to know if Lindquist was involved.”

Felix put his phone away. “My employer had no involvement.”

“Your employer has ties to organized crime and international drug trafficking.”

“Allegedly. My employer is not in the business of stealing intellectual property. Nor have they ever been indicted for any crimes.”

Dr. Jenkins mulled over his options. Clearly, Lindquist had a vested interest in his work and more knowledge of his previous human trials than he could ignore. Their reputation for engaging in criminal enterprise notwithstanding, Lindquist had deep pockets and the resources to accelerate his coma recovery research. Despite his moral, ethical, and legal obligations to the medical community, his wife’s condition took precedent. “I’d like to speak with Lindquist management directly.”

Felix nodded, then motioned toward the lobby. “My employer requested I tour your research facility.”

“Another time. I’m late for rounds.”

“Your patients are comatose, Dr. Jenkins. They’re not going anywhere.”

“Fine,” Jenkins snapped. “But no pictures or video recording.”

“You’re the boss, Cabrón.”

The pair left the break room. Dr. Jenkins swiped his badge at a scanner on the wall outside a glass door with magnetic locks, granting access to a secure hallway leading toward a private elevator. A short ride delivered them to a raised floor area inside a massive server room fed by a dedicated HVAC system. Framed articles from the American Journal of Medicine filled one wall, citing breakthroughs in coma recovery therapy and the stunning results from a promising new drug therapy. “This server room runs twenty-four/seven. We store our research data on virtual machines. High speed links connect this facility to other major hospitals in the country. This enables us to share data with other physicians who manage patients in need of our assistance. Until recently, our network security had never been compromised.”

“My employer can help with that.”

Dr. Jenkins walked his visitor to another corridor, past a glass-enclosed work area where researchers gathered near lab equipment. Behind the workers, whiteboards were covered with hand-drawn diagrams of crystal structures, interspersed with complex chemical formulae. “These are all post-doctoral scientists. We do a portion of our chemical analysis and drug development here, but much of this facility is geared toward patient rehabilitation from traumatic brain injuries. We work with select candidates whose blood chemistry and brainwave patterns indicate a higher-than-normal probability of a neurological recovery. With traditional medicine, patients who eventually emerge from a vegetative state, or long-term coma, spend months or years in ongoing therapy for behavioral management of their newfound anxiety, depression, and sleep disorders. My research centers on the neurological revival of physical, functional, and cognitive impairments. More specifically, I focus on the brain stem, which manages unconscious controls for body temperature, blood pressure, heart rate, and breathing.”

Felix didn’t respond, he simply followed Dr. Jenkins over an encapsulated archway spanning from one portion of the building to the next. Floor-to-ceiling windows overlooked a room occupied by patients and medical staff. A young woman in a hospital gown lied motionless on her back with her arms at her sides, seemingly oblivious to the sound of wooden blocks clapped near one ear. Other patients apparently ignored pinpricks to their skin, bright lights shined intermittently in their eyes, or hands dipped into buckets of ice water.

“What is this?” Felix asked.

“For mild to moderate cases, we employ various sensory stimulation techniques through the use of objects and specific environmental controls. Patients we successfully revive from short term coma begin a routine of physical, speech, and occupational therapies. To the untrained eye, these treatments seem arcane.”

“Treatments? I just saw a man being suffocated with a paper bag!”

Dr. Jenkins motioned Felix beyond the glass-enclosed walkway toward a labyrinth of interconnecting hallways monitored by surveillance cameras. “The disruption of air flow encourages deeper breathing, which in turn, dilates the capillary blood vessels in the brain and reduces the potential for seizure. For some coma patients in this ward, a rigorous course of multisensory stimulation helps motivate the reticular activating system of the brain.”

“Retical what?”

“The reticular activating system. The part of your brain responsible for arousal and alertness. A brain functioning at a normal level will typically respond to sensory stimuli caused by applications of pain, pressure, touch, temperature, vision, and hearing. Combined with physical therapy and specific nursing care, patients treated in such a manner remain at optimum condition for rehabilitation at their time of awakening. The coma recovery procedures we use for these patients are the least invasive—and often the least effective.”

“What is your success rate?”

“Success depends on the severity of a patient’s condition. The less time spent in a comatose state the better. If not successfully revived after several weeks, a coma patient enters a minimally conscious or prolonged vegetative state. Some patients with severe brain damage remain in a persistent vegetative state indefinitely. Those who are able to recover consciousness usually do so within a year or less. And roughly twenty percent of those will suffer moderate to severe disability. The prognosis for complete recuperation without acute neurological deficit remains in the single to low double digits.”

“I’m not impressed.”

Dr. Jenkins presented his badge to another card reader and entered his PIN to gain access to a new corridor with more floor-to-ceiling windows overlooking a set of recovery rooms. “Me neither, which is why I’ve been working on a more aggressive protocol.”

Felix put his nose to the glass like a seal in an underground aquarium. In one corner, he saw a dark-skinned man sitting upright on a hospital bed eating food from a serving tray. Across the room, a young girl climbed out of her bed to reach a wheelchair. “Who are these people?”

“These patients represent our most extreme cases. Previously thought to be untreatable. Most have spent years in a persistent vegetative state. Forgotten by all except their closest friends and family and shunned by a medical community driven more by profit than providing long-term quality care. My research incorporates hyperbaric oxygen treatment for select candidates with certain types of brain injury.”

“How can you be sure it will work on every patient?”

“I can’t. No two cases are alike. I start with single-photon emission-computed tomography to assess brain function, blood flow rates, and metabolism in isolated planar images of the injured brain tissue. Our bodies need oxygen to live. Traumatic brain injuries need oxygen to heal. After a thorough neurological screening to assess cognitive functions, intracranial pressure, motor, verbal, eye response and other variables, patients are subjected to hyperbaric oxygen pressurized to three times ambient. Nearly six times the normal amount of oxygen reaches the brain and stimulates inactive cells. The increased blood flow to oxygen-starved cells helps spur blood vessel growth and expedites healing of the damaged brain tissue. Some patients awaken during one session as if they arose from a good night’s sleep without the usual confusion, disorientation, or amnesia associated with most recoveries. Other patients take longer to awaken. A small percentage of them never recover.”

“How small?”

Dr. Jenkins hesitated before he replied. “Roughly thirty percent.”

“You said you were working on a better protocol?”

“These are clinical trials with human beings. Not cars off an assembly line. Even patients who respond favorably can take months to regain full control of their bodily functions, depending on the person’s neurological deficit.” Dr. Jenkins escorted Felix down a spiral staircase that opened to a spacious room with a submarine-style oxygen chamber. He used the control panel to activate the unit. “Hyperbaric oxygen treatment has been successfully used for decades with FDA approval for the treatment of air or other gas embolism, carbon monoxide poisoning, thermal burns, and decompression sickness. Our lab is the only one in North America approved for clinical trials to treat coma patients. This extends to specific treatment for acoustic neuroma, arteriovenous malformation, brain aneurysm, hemifacial spasm, and meningiomas or slow-growing tumors buried in the membranous layers surrounding the brain and spinal cord.”

“What are the risks?”

“Middle ear injuries, temporary myopia, seizure, death…”

“Side effects?”

Dr. Jenkins powered down the chamber. “Most subjects respond favorably. A few percentage experience abnormal kidney function or elevated heart rate, high blood pressure, irregular development of red blood cells, disruptive breathing patterns, chronic headaches, ulcers, or loss of memory.”

“I’d rather be comatose.”

“Have you ever been comatose, Mr. Sanchez?”

“No, but—”

“Your brain conducts an orchestra of electrical impulses between cerebral hemispheres adjoined at your cerebral cortex. Your hair grows unimpeded. Your muscles atrophy. Your bones decalcify, fracture, dislocate, deform. You suffer from chronic infections, bed sores, depression, mental regression, and hormonal deficiencies. You remain unresponsive to stimuli. You’re trapped inside your own body for days, weeks, months, or years in a vegetative state, unaware of your immediate surroundings and unable to communicate. You drain your bladder into a catheter. A nasogastric tube delivers nutrients to your stomach. You’re alive but not living, monitored by medical equipment and the occasional visit from an underpaid, overworked healthcare employee hired to change your diaper once a day—if you’re lucky.”

“I get it.”

“Do you? What would you give to recover from a coma? For a chance to hold your loved ones again? A chance to start over?” Dr. Jenkins withdrew the vibrating pager from his pocket. “If you’ll excuse me…” He held his key card near a set of double doors and approached a nurse running toward him from an adjacent room.

Felix tracked step-for-step behind him.

“She’s in V-fib!” the nurse declared emphatically.

Dr. Jenkins observed a female coma patient surrounded by medical monitoring equipment. The name on her chart read Mira Galloway. “How long has she been down?”

“Less than a minute,” the nurse replied, grabbing the defibrillator cart as another nurse continued chest compressions. “She was fine when we finished her oxygen therapy and administered the standard injection. Her vitals were stable. No abnormalities.”

Dr. Jenkins viewed the portable patient monitor displaying heart rate, ECG, and pulse oximetry on a multicolor ten-inch screen. “Intubation tray,” he ordered calmly, but firmly, as he moved around the bed to tilt the patient’s chin slightly upward. “Stay with me.”

He inserted a laryngoscope inside Mira Galloway’s mouth, sweeping her tongue to the left before passing an endotracheal tube between her vocal cords and into her larynx to establish an open airway. “I’m in,” he told the nurse, who promptly attached an inflatable breathing bag to the rubber tubing and squeezed air into Mira’s lungs. “Give her one amp of epinephrine and charge to three hundred joules.”

Dr. Jenkins placed one defibrillator paddle to the front of Mira’s chest and one to her left side below her breast. “Clear!”

The shock rippled through Mira’s body. Engorged veins protruded down the side of her neck. Dilated pupils focused on the ceiling lights, her lips pale blue against her ashen face.

“She’s in V-tach,” the nurse reported. “Pulse ox is thready. One-sixty over forty.”

“Charge to three-fifty.”

“Charging…”

Dr. Jenkins read the sinus arrhythmia on the monitor. “Clear!”

Another jolt of electric current shocked Mira’s heart out of rhythm, causing the absence of sinus node currents to cease contractions.

The nurse scanned the monitor. “She’s asystole.”

Dr. Jenkins read the digital timer on the wall. “Give her one amp of atropine and another amp of epi.” He waited for the nurse to inject the drugs before he placed the paddles again. “Clear!”

“She’s still in V-tach,” the nurse responded.

“I’m aware.” Jenkins waited for the defibrillator to recharge. “Clear!”

“We lost her rhythm.”

“Push another amp of epi.”

“She’s been down for three minutes.”

Dr. Jenkins noted the pulse ox reading. “Get the sternum saw.”

The nurse nudged Felix aside and retrieved the surgical appliance. “We’re not equipped for surgery in here.”

Dr. Jenkins made a fist and flexed the muscles in his hand while the nurse slathered iodine between Mira’s naked breasts. “If we don’t, she’ll die on this bed.” He took the rechargeable saw from the nurse, prepared to rip through Mira’s chest plate and expose her dormant heart. He pulled the trigger to engage the reciprocating blade aligned above her rib cage.

“Doctor wait!”

Dr. Jenkins released the trigger and observed a normal sinus rhythm on the monitor. He looked down at Mira’s face to see her color return to a reddish hue.

“Pulse is one-thirty over ninety,” the nurse informed him, scowling at Felix who hovered like a pre-med student.

Dr. Jenkins took a loaded syringe from a sterile tray and injected the clear solution into Mira’s intravenous line. He used a stethoscope to assess Mira’s stable, but still somewhat irregular, heartbeat. “Put her back on the ventilator. Page me if she wakes up. I want a chest X-ray, CT scan, and full blood work up. CHEM-7, CBC, and lytes. Push five milligrams of diazepam. I don’t want her seizing again.” He draped the stethoscope behind his neck and redirected his attention at Felix while he exited the patient area. “You shouldn’t be in here.”

“Who is she?”

Dr. Jenkins made long strides toward another private elevator. “A long-term patient in our progressive treatment program. Her initial prognosis was poor, but in recent months she’s responded well to a new protocol.”

“How long has she been in a coma?”

“Ten years,” Dr. Jenkins replied when he turned to see the nurse intercept him. “What happened?”

“She regained consciousness.”

“Already?” Jenkins jogged back to Mira’s room to find her catatonic eyes staring at the ceiling. He shined a penlight at her dilated pupils and felt her radial pulse. “You gave us quite a scare,” he said, stroking Mira’s hair as she strained to lift her head off the pillow. “Don’t try to talk. You have a tube down your throat to help you breathe. I’ll take it out in a moment, but first, there’s something you should know.”