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the figure. Madness shone damply. Eyes caught the meager light and reflected back, like a wolf at night.
    It lumbered toward them, dragging a three-foot-long sickle across the planks. Lisa fled several steps down the hall. Ang Gelu spoke softly, palms raised in supplication, plainly trying to placate the ravening creature.
    “Relu Na,” he said. “Relu Na.”
    Lisa realized Ang Gelu recognized the madman, someone he knew from an earlier visit to the monastery. The simple act of giving the man a name both humanized him and made the awfulness all that more horrific.
    With a grating cry, the monk leaped at his fellow brother. Ang Gelu easily ducked the sickle. The figure’s coordination had deteriorated along with his mind. Ang Gelu bear-hugged the other, grappling him, pinning him to one side of the doorframe.
    Lisa acted quickly. She dropped her pack, tugged down a zipper, and removed a metal case. She popped it open with her thumb.
    Inside lay a row of plastic syringes, secured and preloaded with various emergency drugs: morphine for pain, epinephrine for anaphylaxis, Lasix for pulmonary edema. Though each syringe was labeled, she had their positions memorized. In an emergency, every second counted. She plucked out the last syringe.
    Midazolam. Injectable sedative. Mania and hallucinations were not uncommon at severe altitudes, requiring chemical restraint at times.
    Using her teeth, she uncapped the needle and hurried forward.
    Ang Gelu had the man still trapped, but the monk thrashed and bucked in his grip. Ang Gelu’s lip was split. He had gouges along one side of his neck.
    “Hold him still!” Lisa yelled.
    Ang Gelu tried his best—but at that moment, perhaps sensing the doctor’s intent, the madman lashed forward and bit deep into Ang Gelu’s cheek.
    The monk screamed as his flesh was torn to bone.
    But he still held tight.
    Lisa rushed to his aid and jammed the needle into the madman’s neck. She slammed the plunger home. “Let him go!”
    Ang Gelu shoved the man hard against the frame, cracking the monk’s skull against the wood. They backed away.
    “The sedative will hit him in less than a minute.” She would have preferred an intravenous stick, but there was no way to manage that with the man’s wild thrashings. The deep intramuscular injection would have to suffice. Once quieted, she would be able to finesse her care, perhaps glean some answers.
    The naked monk groaned, pawing at his neck. The sedative stung. He lurched again in their direction, reaching down again for his abandoned sickle. He straightened.
    Lisa tugged Ang Gelu back. “Just wait—”
    — crack —
    The rifle blast deafened in the narrow hall. The monk’s head exploded in a shower of blood and bone. His body fell back with the impact, crumpling under him.
    Lisa and Ang Gelu stared aghast at the shooter.
    The Nepalese soldier held his weapon on his shoulder. He slowly lowered it. Ang Gelu began berating him in his native tongue, all but taking the weapon from the soldier.
    Lisa crossed to the body and checked for a pulse. None. She stared at his body, trying to determine some answer. It would take a morgue with modern forensic facilities to ascertain the cause for the madness. From the messenger’s story, whatever had occurred here hadn’t affected just the one man. Others must have been afflicted to varying degrees.
    But by what? Had they been exposed to some heavy metal in the water, a subterranean leak of poisonous gas, or some toxic mold in old grain? Could it be something viral, like Ebola? Or even a new form of mad cow disease? She tried to remember if yaks were susceptible. She pictured the bloated carcass in the courtyard. She didn’t know.
    Ang Gelu returned to her side. His cheek was a bloody ruin, but he seemed oblivious to his injury. All his pain was focused on the body beside her.
    “His name was Relu Na Havarshi.”
    “You knew him.”
    A nod. “He was my sister’s husband’s cousin. From a small rural