The Final Push

For the thousandth time, Higgins reviewed his plan. First he’ll insert the syringe into the jugular venous catheter. Then he’ll pass the nasogastric tube through the nose and slip it halfway down the esophagus. This will induce gagging, coughing and agitation. Despite a lingering brain injury and depressed mental status, John Doe will writhe in the bed and fight the tube. The EKG tracing at the nurse’s station will be obscured by irregular lines of artifact, which happens whenever a patient moves. Then, with a firm push of thumb on syringe, millions of potassium-chloride ions will travel down the jugular vein catheter and into the right atrium of the heart. The potassium ions—the real killers of the duo—will quickly pass through all four chambers and down the coronary arteries, where they will infuse directly into the cardiac myocytes—the muscle cells of the heart. The cells will be instantly paralyzed. Doe’s heart will fibrillate. Organized contraction will cease. Blood flow to the vital organs will stop. The brain dies, the man dies.