Experts Praise Kira Peikoff
DIE AGAIN TOMORROW
Â
“
Die Again Tomorrow
held me captive me from the
opening chapterâin which a murdered woman is
subjected to a secret medical procedure that brings
her back to life. From there the story takes off like
a rocket, full of surprises, fascinating science, and
vivid characters. If you enjoy the medical thrillers
of Crichton and Cook, this book is for you. I can't
recommend it highly enough.”
âDouglas Preston
Â
“Peikoff's thrillers are really scary and scarily real.”
âTaylor Stevens
Â
NO TIME TO DIE
Â
“Breathless thrills and pace, but real substance too: a
perfect mix of nail-biter and thought-provoker, from a
writer to watch. Highly recommended.”
âLee Child
Â
“
No Time to Die
is an intelligent, exciting tour de force;
the story is tight, the characters are fascinating, and the
twists are terrific and totally unexpected . . . A crackling
good read.... Has the magic touch.”
âMichael Palmer
Â
“
No Time to Die
takes a terrific, original premiseâ
what
if someone literally could not age?
âand turns it into a
heart-pounding thriller that keeps its surprises coming to
the last page. Fans of Michael Crichton will love this.”
âJoseph Finder
Â
“Chilling, intelligent, and incredibly thought-provoking.
This uniquely imagined page-turner propels us to the
brink of medical scienceâand proves we should be
careful what we wish for. Fans of Michael Palmer and
Robin Cook will be mesmerizedâas will anyone who
has contemplated their own mortality.”
âHank Phillippi Ryan
Â
“A twisting, suspenseful thriller with an irresistible
scientific hook worthy of Michael Crichton: what if
we had the power to stop aging? What if buried in
our own DNA is the fountain of youth?”
âWilliam Landay
Â
“Piekoff spins a frightening tale involving bioethics
and science that asks hard questions . . . The novel
proves worthy thanks to Zoe Kincaid, a young girl
with terrible genetic makeup. Hopefully Peikoff
has plans to bring her back.”
â
RT Book Reviews
(3 stars)
Â
“
No Time to Die
is a mesmerizing medical suspense
as Kira Peikoff deftly balances a timely deep look at
the ethics of genetic research inside of an action-packed
twisting biological thriller. With a solid cast, readers
care about what happens to Zoe.”
â
Mystery Gazette
Â
“A delightfully brainy and thrillingly suspenseful
novel with attention-grabbing, violent, and mysterious
action . . . Scientific information and speculation
are presented with excited clarity . . . Peikoff offers a
frightening display of ambition, competition,
and careerism gone wild.”
â
Washington Independent Review of Books
Â
“Peikoff understands plotting and the final twist is a
great surprise . . . Ultimately, it's easy to see this book
translated to the big screen; it feels like an action movie
as it plumbs an idea captivating people since Herodotus
wrote about eternal youth in 500 B.C.”
âNJ.com
Â
“A fast-paced thriller with sound cutting-edge science
to explore the fundamental mysteries of agingâ
mysteries that, for the first time in history, we are
now close to unraveling.
No Time to Die
may be
fictional, but it vividly evokes the most exciting
aspect of my research to date.”
âDr. Richard Walker,
editor-in-chief,
Clinical Interventions in Aging
Â
“Defeating aging may be far harder than
No Time to
Die
suggests, but it's definitely possible. Unfortunately,
terror of aging has paralyzed humanity, slowing critical
research and costing untold lives: maybe yours. By
highlighting in fiction aspects of this tragedy that are
all too real, Peikoff may just save some.”
â
Aubrey de Grey,
Ph.D., Chief Science Officer,
SENS Research Foundation
PART ONE
Numberless are the world's wonders, but none
more wonderful than man . . .
From every wind, he has made himself secureâ
from all but one:
In the late wind of death he cannot stand.
Â
âSophocles'
Antigone
, 5th century BC
Â
Â
Contrary to popular belief, death is not a moment
in time, such as when the heart stops beating,
respiration ceases, or the brain stops functioning.
Death, rather, is a processâ
a process that can be interrupted well after
it has begun.
Â
âSam Parnia, MD, PhD,
Director of Resuscitation Research at
Stony Brook University
School of Medicine, 2013
1 minute dead
H
er body undulated in the sea. It swayed with the waves, rising and falling, a rag doll in the froth. Seaweed clung to the dark tangle of her hair. Facedown, she floated on the crest of a swell, then plummeted with the breaker. Her slender limbs splayed out, strangers to pain. She was nothing now but a marionette at the mercy of the tide. White foam engulfed her body and carried it express to the shore.
It washed up on the beach. The tide receded. Her cheek lay against the sand, her eyes swollen closed. Her mouth hung open. Salt water trickled out.
The first person to notice was a little boy digging for crabs. He scooted over and squatted in front of her face.
“Time for wakey,” he said. He planted his chubby thumb and forefinger on her eyelid, pried it open, and gazed into her unseeing pupil.
“Wakey,” he said, frowning. He poked her limp arm. Nothing happened.
He started to cry. A woman jogged toward him but stopped short.
Then she screamed.
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7 minutes dead
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Two ambulances arrived at the same time. A pair of emergency medical techs jumped out of the first one and raced to her body, where a crowd of about ten sunbathers had gathered. Some were taking turns trying to deliver chest compressions while others stood to block the view of nearby children. The second ambulance waited at the curb; its purpose was to preserve the organs of a corpse for harvesting and donation in case attempts at resuscitation failed. With Key West's popular opt-out program, everyone who died in the city was assumed to be a consenting donor unless otherwise indicated.
As the two EMTs approached the body, they saw right away that her skin was waterlogged and turning bluish. Frothy salt water spewed out of her mouth as if from an erratic hose.
“Out of the way,” the older one commanded. His voice carried an air of authority that matched his jaded expression. The younger tech followed on his heels with a case of equipment slung over his shoulder. He was in his late twenties, about the same age as the drowned woman.
The crowd parted and stepped back.
The first EMT dropped to his knees and grabbed her wrist. No pulse. He flung her disheveled hair off her face and opened her eyelids. Despite the bright morning sunlight, her pupils were fixed and dilated.
The younger tech covered her body with defibrillator pads and attempted to shock her heart. When nothing happened, he switched to giving her chest compressions, hard and fast, about one hundred per minute. Salt water tainted with blood kept dribbling out of her mouth.
“She's flatlined,” the older tech said after two minutes. “We should just declare her.”
The other man kept on pushing, though his arms were tiring. “No, let'sâgive her aâchance,” he sputtered. “She's so young.”
His colleague looked skeptical, but nodded. “Let's switch, you do the line.”
The young tech rolled off her chest and tried to inject a peripheral line with epinephrine into her arm, but her skin was so mottled that he couldn't find the vein. He cursed under his breath and moved on to the next last-ditch step.
As the older man continued to deliver fast compressions, grunting and sweating, the other hauled a canister of oxygen and a plastic breathing tube out of the supply bag. Using an L-shaped laryngoscope, he pushed up the roof of her mouth to see down into her throat.
That was when he noticed a piece of what looked like black neoprene cloth lodged inside her cheek.
That's weird,
he thought, and tried to pull it out, but it wouldn't easily dislodge, so he bypassed it. Her throat was extremely swollen and he had to work hard to shove the breathing tube all the way in.
“Should I just put the epinephrine down the tube?” he asked.
“You knowâthere'sâcontroversy about that,” the other man huffed, still doing compressions. “It doesn'tânecessarilyâhelp survival.”
“What does she have to lose?”
He seized the drug and pushed 2 milligrams into her tube. Then he connected her to the oxygen tank, and the men switched positions again so neither tired for too long.
Every two or three minutes, they switched, while one checked her pulse on her neck, her groin. Nothing. Her skin was now a frightening shade of blue.
After twenty-one minutes, the older man pushed on her chest for the last time and rolled off her, sweating profusely.
“We should just stop, I don't know why you want to save the world all the time.”
The young man glared, but didn't rush to perform any further compressions. “She had her whole life ahead of her.”
It didn't help that she was beautiful: he imagined how her cascade of black hair might have draped across her tanned shoulders, how her green eyes might have lit up when she laughed. She had the athletic figure of a swimmerâflat abs, toned biceps, defined calves. With a body like that, he wondered how she could have succumbed to the waves, even in high tide. Some things would forever be a mystery.
“We have to accept it. She's gone. I'm calling it.” The older tech glanced at his watch. “Time of death: 10:12
A.M.
”
A few of the onlookers turned away. One made the sign of a cross over his chest and bowed his head.
The young EMT sighed and radioed to the waiting ambulance to come claim her body. Then he removed her breathing tube and packed up all the equipment. He tried to think of the bright side: a young, otherwise healthy person was a prime candidate for cadaver organ donation; as many as fifty lives could be saved or improved from her body alone.
Within seconds, two more bored-looking EMTs arrived with a stretcher and nodded at the pair who had failed.
“We can take it from here. Thanks.”
They lifted her corpse and strapped it in, wasting no time hauling it to their own ambulance. As they tipped the stretcher to load it, her drying hair fell over the edge and glinted in the warm November sun.
Inside, a white-haired doctor was waiting. He beckoned to the EMTs to hurry. They scrambled in after loading the stretcher, just as the doctor pulled the door shut behind them. Exhilaration radiated from his flushed cheeks, but his demeanor was steady.
He was the famedâsome would say infamousâDr. Horatio Quinn, who had vanished from the public eye seven years prior. Now approaching eighty, his back was stooped, his arthritic fingers gnarled, his messy brows furrowed. But behind his tortoiseshell glasses shone an insatiable hunger for truth that kept him as young as the first day he ever walked into a lab.
He placed one hand on the woman's lifeless forehead and smiled.
“Gentlemen,” he said, “close the blinds. This is when the fun begins.”
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33 minutes dead
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Dr. Quinn lifted a corner of the rubber floor pad and pressed his index finger to a tiny sensor. Together, he and the two EMTs turned to stare at a blank white area on the wall a few inches below the ceiling, near the head of the corpse. They heard a click, followed by a whirring sound. Then four cracks materialized in the shape of a square about two feet across and two feet wide. It was a door. The edges popped out and slid to the left, revealing a secret compartment in the depth.
“Never gets old,” muttered Chris, the tech with the best poker face around.
His new apprentice, Theo, rubbed his hands together in anticipation.
The doctor reached inside the hole and extracted an automatic CPR deviceâa small round machine the size of a helmet. He put it on the dead woman's sternum, securing it around her chest with a band pulled tight. Right away the machine started to deliver perfect chest compressions to the highest standards of timing and forceâwith no chance of tiring. Next, the doctor opened her mouth and inserted a laryngoscope attached to a camera so he could visualize her trachea.
He frowned; a piece of shredded black cloth was stuck between her teeth and cheek. It had a fraying string wrapped around her tooth.
What the hell is that?
he thought. He yanked it out and flicked it away, then slipped in a breathing tube connected to a ventilator and a portable oxygen tank. He set the CPR device at ten breaths per minute.
“Game on,” he whispered near her ear.
At the same time, while Theo connected her arm to a standard blood pressure cuff, Chris retrieved a black circular pad from the secret hole. It looked like an eye patch, but with a narrow blue tube connecting to a digital display: it was a cerebral oximeter that used near-infrared light to measure the amount of oxygen getting to her brain. He stuck it on her forehead above her right eye. The display quickly lit up with a red number: 5 percent.
“Why is it still so low?” Ty asked at her left side. “Shouldn't it be coming up already?”
“It will.” Dr. Quinn was standing at her head, twisting his frail body to reach up into the hole. “You'll see.”
What he took out next looked like a red gun, but with a long needle in place of a barrel. It was an intraosseous device that could shoot drugs directly into bone, bypassing veins.
“My favorite toy,” he declared. He leaned over the corpse, pressed the gun against her left shoulder, and fired. It recoiled as a pin lodged itself in her bone. He shot three more pinsâone into her other shoulder and just below each knee. The techs watched with a mixture of awe and envy at his precision. Then he attached a line into each pin that would serve as a conduit for the drugs.
Chris and Theo moved aside in the cramped space as he positioned himself next to her left shoulder. “Now,” he said with relish, “for the moment of truth. I want the X101 first.”
“Got it.” Chris handed him a tube of chilled clear fluid that had been stored in a container inside the hole.
Dr. Quinn cradled it in his hands with the affection of a father. It was his life's work in a vialâthe culmination of decades, the reason he had once been celebrated and then viciously destroyed, accused of intellectual theft by a jealous colleague, driven out of research, driven almost to suicide. If not for the Network's rescue seven years ago, he might very well have been as dead as the corpse before him.
He had designed the drug to exploit the critical time between a person's death and the death of their brain cellsâroughly a four- to eight-hour window, maybe even longer. But by injecting an inhibitor of the calpain enzymeâthe signal to brain cells that it was time to dieâthe process could be slowed down, the window expanded, and the brain temporarily protected from damage. One dose of X101 had bought an additional ten hours of brain cell preservation in animal trials, and now, at last, he was secretly testing it in humans.
He injected a single dose into the woman's left shoulder. Working quickly, the other men addressed her remaining lines: Chris injected her right shoulder with an icy slurry of water to chill her down rapidly from the inside out. Into her left knee, Theo injected an experimental solution filled with billions of microglobules of fat, each of which contained a dose of oxygen. When released into her body, it would provide a welcome gush to her brain and other organs. In the last line, her right knee, the doctor injected one final drug: coenzyme Q. It was meant to protect mitochondria, the energy-producing part of cells. But the oxygen slurry and the coenzyme Q, both commercially available, were worthless without the X101 to prevent neurons from dying.
Next Theo got to work using the ultrasound machine installed in the ambulance to locate the carotid artery in her neck, then he inserted a thick catheter with two separate tracks, pushing it down near her heart.
“Nice work, Theo,” the doctor commented.
He took over and connected the catheter to a portable machine called an ECMO that pumped blood in a loop outside the body, infusing it with oxygen and cleansing it of carbon dioxide, before cycling it back into the dead woman.
At the same time, Chris inserted a catheter into her groin to start a drip of epinephrine to bring up her blood pressure.
“Hey!” Theo exclaimed, pointing at the cerebral oximeter on her forehead. “It's already up to forty-five percent.”
“Told you,” the doctor said. “But it's still got a ways to go. We want it at seventy percent. Now ice her.”
Maneuvering around the stretcher in the tight space, Theo reached into the secret hole and loaded his arms with nearly a dozen artificial ice packs. Together, he and Chris covered her arms, legs, and stomach to cool her down quickly from the outside, in addition to the inside. A thermometer indicated that her current temperature was 95 degrees, but the ice would bring it down to 70. Cold was key: it slowed down decay, snatching back time from the impending claws of irreversible death.
“Excellent, gentlemen,” the doctor announced. “Let's hit the road.”