Patient One (20 page)

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Authors: Leonard Goldberg

Tags: #Fiction, #Mystery, #Thriller, #Commander-in-Chief, #white house, #terrorist, #doctor, #Leonard Goldberg, #post-traumatic stress disorder, #president, #Terrorism, #PTSD, #emergency room

BOOK: Patient One
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“You’d better not get sick and leave me here all alone, David Ballineau.”

“I don’t plan to,” he said, gritting his teeth together and willing his body to remain steady.

As they approached the President’s suite, the alarm on his cardiac monitor suddenly sounded.
Ping! Ping! Ping!
They dashed into the room and found Merrill draped over the edge of the bed, head down, with blood pouring out of his mouth and onto the floor.

“Oh, my God,” Carolyn gasped.

“Start filling the syringes!” David yelled and rushed to the President’s side.

The cardiac monitor showed that John Merrill had no blood pressure.

Twenty-one

“What do you think?”
Halloway asked Joe Geary over the speakerphone.

“That was our first and best option,” Geary answered without hesitation. “Unfortunately, ma’am, there’s a problem with any plan that goes through the adjacent rooms. A big problem. We discovered that the main support for that wing passes under the floor of the suites where the Secretary of State and his wife are located. If we set off our blasts there, the entire side of the Pavilion would collapse.”

Halloway shook her head despairingly. “Are you sure of that?”

“Yes, ma’am,” Geary replied. “We had it checked by a structural engineer.”

“So you’ve settled on the plan to blast your way in through the President’s bathroom. Is that correct?” Halloway asked.

“Yes, ma’am,” Geary said. “For now.”

“What do you mean ‘for now’?” Halloway asked quickly. “Are you considering other options?”

“No, ma’am,” Geary told her. “We’ll go with plan one. But if things suddenly change at the hostage site and we see a less risky opportunity to save the President, we’ll take it.”

Halloway didn’t respond. She did not like a fly-by-the-seat-of-your-pants operation. She glanced at the expressions of the other council members. They were all stone-faced.

“Sometimes, ma’am,” Geary went on, “unforeseeable events occur, and everything changes in a matter of seconds.”

“Yeah,” Toliver groused in a low voice. “Like the Mexican police suddenly showing up to protect a drug lord, and damn near ruining everything.”

“Hold for a minute,” Halloway said and pushed a button on the speakerphone. Then she gave Toliver a stern look. “Keep in mind we’re amateurs when it comes to rescue attempts and they’re professionals. So we’d better listen to every word they utter. They’re our best and only hope.”

Toliver slouched down in his chair, unconvinced and grumbling to himself, obviously not in favor of giving the Secret Service free rein. He glanced around the conference table, looking for supporters, but found none.

Halloway watched Martin Toliver sulk, detesting the man and his boorish behavior. Keeping her face even, she returned to the speakerphone. “Agent Geary, how far away are you from Los Angeles?”

“One hour and twenty-four minutes,” Geary replied.

Halloway’s eyes went to the digital clock on the wall. There were forty-eight minutes until the deadline. When the Secret Service plane landed they would be thirty-six minutes late. Two hostages were certain to have been executed. One at the deadline, a second thirty minutes later.

“Keep us informed.” Halloway switched the phone off, then gazed around at the council and said with a sigh, “They’ll never get back in time. And because of that, two innocent people are going to die.”

“There’s not much we can do about it,” Walter Pierce said. “The plane is flying at top speed.”

“Somehow we’ve got to buy another hour,” Halloway urged.

“Our only choice is to release the Chechen prisoners,” Alderman said, checking the clock. “If we hurry, there still may be time.”

“What good would that do us?” Toliver challenged. “The Russians won’t negotiate, and the terrorists won’t go for half a pie.”

Halloway jerked her head around. “How do you know that?”

“Know what?”

“That the terrorists won’t go for half a pie.”

Toliver shrugged. “They never do.”

“I’m afraid Martin is right,” Alderman interjected. “It’s almost always all or nothing with these bastards.”

“Let’s find out for sure,” Halloway said and signaled to the communications officer. “I need to talk with the commanding general at Guantanamo Bay.”

“What are you planning to offer Aliev?’ Alderman asked.

“Everything and nothing,” Halloway said mysteriously.

She reached for the list of Chechen prisoners that had been faxed to the National Security Council. Somehow the terrorists had learned where every one of their fighters was imprisoned. There were twelve at Guantanamo Bay. None of the names were Arabic, but then Halloway knew that Chechens weren’t Arabs. They were from the Northern Caucasus region of the Russian Federation. And the type of terrorists the Russians and everybody else feared the most. Homegrown terrorists who knew the people and the customs and the terrain. They melted in with the rest of the population—until the killing started.

The communications officer called out, “Ma’am, I have General Nichols on the line.”

Halloway leaned forward and spoke into the phone. “General Nichols, this is Vice President Halloway.”

“Yes, ma’am.”

“General, I’m going to fax a list of Chechens we have imprisoned at Gitmo. There are twelve in all.”

“I’m well aware of the Chechens, ma’am,” Nichols said promptly.

“Do they have a leader?”

“Yes, ma’am,” Nichols reported. “Give me a moment to get his file.”

Halloway heard an order being issued, then the sound of papers being ruffled. She quickly organized the commands she was about to give.

Nichols’ voice came over the speakerphone. “Their leader goes by the name of Shamil.”

“Have him dressed and informed that he’s about to be released,” Halloway directed. “Then bring him to a room with a telephone. Tell him only that he is to speak with one of his Chechen brothers. Do you read me?”

“Yes, ma’am.” There was a pause as Nichols cleared his throat. “Ma’am, meaning no disrespect, but are you acting under the President’s orders?”

“I am,” Halloway said firmly.

“Could I have that order faxed to me, please, ma’am?”

Halloway hesitated and stared down at the unsigned document that transferred the powers of the Presidency to her. It was time to activate the Twenty-Fifth Amendment. She reached for her pen.

The Chairman of the Joint Chiefs of Staff grabbed the speakerphone and spoke into it. “Paul, this is Walter Pierce. Do you recognize my voice?”

“Yes, sir.”

“Then follow the Vice President’s commands,” Pierce said, his voice now rough as gravel. “We want that little bastard in a room with a phone in his ear, and we want him there within ten minutes. Got it?”

“Yes, sir.”

The phone clicked off.

Pierce leaned back and apologized. “Sorry about that, ma’am. But you should know that Nichols is a top-flight officer. He was just being doubly careful.”

“As we would expect him to be,” Halloway said, nodding. “Have an order sent to him under my name.”

“We’ll need an interpreter to overhear the conversation,” Alderman advised.

Halloway glanced around the Situation Room filled with staff and aides. Many were military, high-ranking and highly decorated. “Is anyone here fluent in Chechen?”

A middle-aged naval officer with a chest covered in ribbons stepped forward. “I am, Madam Vice President.”

“And you are?”

“Admiral Robertson, Director of Naval Intelligence, ma’am.”

“Stand by, Admiral.”

“Aye, ma’am.”

Halloway took another sip of lukewarm coffee, again thinking all they needed was another hour. An extra hour would save two lives and give the Secret Service enough time to activate their rescue plan. And she could get that hour if only the Russians would help. But they weren’t going to budge. They weren’t going to release their Chechen prisoners under any circumstances. That would be too—

An aide hurried over to Emmett Sanders and whispered an urgent message in his ear.

“Get it up on the video screen,” Sanders ordered. “And show their projected course.”

“What have we got?” Halloway asked, redirecting her thoughts.

“Trouble,” Sanders said and walked over to the large video screen. “The Mexican fighter jets are now on a direct course to intercept the plane carrying the Secret Service Special Ops team.”

Halloway asked quickly. “How near are they?”

Sanders pointed to the screen that showed four Mexican jets slowly closing in on Eagle Two. “They are three hundred and thirty miles due south. They’ll make contact in twenty minutes.”

Halloway strummed her fingers on the tabletop, thinking fast. “How far away is the
Reagan
?”

“Our Hornets can be there in twenty-eight minutes if we launch now,” Sanders replied immediately.

“Damn it!” Halloway cursed at the thought of even more American lives being lost. “The Hornets will still be eight minutes late, and that exposes our plane for nearly the entire eight minutes. That’s an eternity up there.”

“Unless Eagle Two can somehow evade those Mexican jets,” Sanders told her. “Otherwise they’ll be forced to land or be shot down.”

“Can you come up with some evasive maneuvers?” Halloway asked the former naval aviator.

“We can try,” Sanders said and swiftly pointed to the four Mexican jets closing in on their target. “Madam Vice President, it’s now or never. If we’re to have any chance of getting that plane home safe, we have to act.”

Without hesitating, Halloway gave the order. “Get those Hornets in the air!”

Twenty-two

David quickly began the
fifth mini-transfusion, injecting another 50 ccs of whole blood into the President’s IV line. Merrill was groaning and muttering through his stuporous condition. David’s gaze went to the transparent nasogastric tube and to the cardiac monitor beyond it. The gastric juice coming up remained bright red. And the President was still in shock, despite having received over 200 ccs of David’s blood. His blood pressure was 70/40, his pulse 140 beats per minute and thready.

“We’re not making much headway,” David said.

“At least he’s got some blood pressure,” Carolyn noted, filling the last of the syringes. “And he hasn’t shown signs of a transfusion reaction.”

“Which only means there’s no ABO incompatibility,” David told her, pushing blood in faster.

“Are you saying he could still have a bad reaction?” Carolyn asked.

“A really bad one,” David replied. “Remember, they had a lot of problems cross-matching him earlier, and that tells us there’s something in his plasma that doesn’t like other people’s blood.”

“Jesus! This poor man doesn’t seem to have anything going for him.”

“Except a pretty good nurse and doctor looking after him,” David said, checking the monitor again. The systolic pressure was still at seventy. “Pass me another syringe of blood.”

Carolyn handed him the syringe. She was thinking that Merrill’s survival was due far more to a good doctor than to a good nurse. How do you make a physician this good? Most doctors had difficulty dealing with a massive gastrointestinal hemorrhage, even when all the hospital’s facilities were available. And David was keeping the President alive with virtually none of the medical center’s resources. No blood bank. No endoscopist. No coagulation specialist. Every step, every treatment had to be improvised. Yet he never faltered, never lost his cool. She wondered if he had been a military doctor in combat. That would explain his nerve and quick wits under fire.

The President started mumbling again, the words indecipherable and jumbled.

Carolyn turned to David and asked, “Do you think the President suffered brain damage while he had no blood pressure?”

“Let’s hope not,” David said flatly. “Hand me another syringe.”

As she passed the seventh syringe, her eyes drifted over to the President, who was moving his arms and legs.
Well, at least his motor function is intact
, she told herself. But he could still be mentally impaired. Carolyn had seen that happen before. A brilliant professor of archaeology at the university was admitted to the hospital in severe shock. When he left he was wearing diapers and babbling nonsense. But he could still move his arms and legs.

“The fluid in his nasogastric tube is turning a lighter red,” David remarked, breaking into her thoughts.

Carolyn quickly looked over to the cardiac monitor. “And his pressure is up to 88 over 60.”

“Good,” David said and reached for the last two syringes of blood. “Now if we only had another half unit of blood, we could really get the President out of the woods.”

“That’s not going to happen,” Carolyn said.

“Tell me about it,” David pointed to a large syringe filled with water. “Would you connect that to his nasogastric tube and start lavaging his stomach again?”

Carolyn felt the syringe and commented, “It’s lukewarm now.”

“Make another ice slurry,” David directed. “Keep stirring it until it’s frigid enough to burn your fingertips. The colder the better.”

Carolyn prepared the fresh ice slurry and hastily lavaged the President’s stomach over and over. The gastric juice remained light red initially, then gradually turned pink, then yellowish brown. “I think the bleeding has stopped! The ice water must have done it.”

“That and the Factor VIII in the blood he received,” David said, showing little emotion. “But neither is going to last very long.”

“Maybe it’ll last until we get out of here.”

“Don’t bet on it.”

The President moaned loudly, then twisted and turned in his bed and moaned again.

The terrorist standing by the door stepped inside to check out the origin of the sudden sounds. David pointed to the President, then to his mouth. The guard nodded and went back into the corridor.

“David,” Carolyn said, motioning to the monitor, “his blood pressure is 96 over 70 and climbing.”

“Excellent!” David said and placed the final syringe aside. Suddenly the weakness in his legs returned. The room began to sway. Hurriedly he reached for the night table and waited for his unsteadiness to pass. “It’s doubly excellent, because we just ran out of blood.”

Carolyn saw him holding on to the edge of the table and asked, “Are you all right?”

“Just my leg,” David lied. “It’s throbbing a little.”

“Then go lie down on the couch for a few minutes,” Carolyn urged.

“It’s better,” David said, knowing if he lay down his leg would stiffen and he’d have to drag it around like a limp appendage. As it was, he stood little chance against the terrorists. With a dead leg, he stood none.

“Let’s try to awaken the President,” he went on, changing the subject. “Pat his cheek a few times and see if you can get a response.”

Carolyn gently struck Merrill’s cheek and called out, “Mr. President! Mr. President! Can you hear me?”

Merrill groaned and moved his head away from the noise.

“Again,” David directed.

Carolyn slapped Merrill’s face with more force and cried into his ear, “Mr. President! Mr. President!”

Merrill’s eyelids fluttered before they gradually opened. He blinked against the bright light. “Wh … where am I?”

“At University Hospital, Mr. President,” Carolyn told him.

Merrill slowly nodded and said groggily, “Oh, yes. Yes. The hemorrhage. Did I pass out?”

“You just drifted off,” Carolyn answered.

“Am I still bleeding?” Merrill asked through parched lips.

“No, sir. We’ve stopped it,” Carolyn replied, relieved that the President was oriented and had suffered no apparent brain damage. “We had to give you another transfusion.”

Merrill’s eyelids began to close. “I’m so tired. I feel like I could sleep for a month.”

“Go ahead and rest, Mr. President,” Carolyn said soothingly. “We’ll be nearby.”

Merrill closed his eyes and drifted off.

Carolyn moved over to David and whispered, “I thought it best not to tell him he passed out.”

“That wouldn’t have helped anything,” David agreed.

“Do you have any idea how long the blood transfusions will hold him in check?” Carolyn asked, keeping her voice low.

David shrugged. “I’d just be guessing.”

“Then guess,” Carolyn pressed.

“As soon as he’s used up the Factor VIII in my blood, all hell is going to break loose.”

“And how long will that take?”

“Not long at all, I’m afraid.”

Aliev stomped into the suite and came to the bedside. He stared down at the sleeping President and studied him before asking, “Why is your President making those loud sounds?”

“He was bleeding again,” David explained. “The blood was caught in his throat.”

Aliev looked down at Merrill once more. “He seems to be all right now.”

“That won’t last,” David said. “He could start hemorrhaging again in a matter of minutes.”

“Then you can stop it again,” Aliev responded, showing no concern.

“But we need more blood and plasma sent up to the Pavilion,” David implored. “Without them the President will die.”

“He looks fine to me,” Aliev said, unimpressed.

“Don’t you understand? He damn near died!”

“But he didn’t. So just continue doing the same things you are doing.”

“He desperately needs blood and plasma,” David pleaded. “And we have no more to give him.”

“Use your own, like you did before,” Aliev said tonelessly, and walked out.

Carolyn watched him leave and hissed through her teeth, “What a cold bastard!”

And smart
, David thought. The terrorists were so close to success. They weren’t going to take any chances now. They would keep the area absolutely secure. Nobody in, nobody out, until their demands were met.

Aliev stuck his head back into the suite. “Doctor, you may receive the blood for your President sooner than you think. To be precise, in thirty-six minutes.”

“Why thirty-six minutes?” David asked promptly.

“Because that is when the deadline comes to an end,” Aliev explained. “If our Chechen fighters are released, the President will receive his blood. If the prisoners are not freed, your President can hemorrhage all day and all night. It won’t bother us. You see, we will be busy killing hostages.”

Aliev walked away, humming under his breath.

Carolyn shuddered at the terrorist’s ruthlessness, and wondered who he would choose to kill first. Probably Sol Simcha, she guessed sadly. Not because the nice old man was of any value to them or to the outside world as a hostage. But because he was Jewish. And they would probably make him suffer, too. The bastards! She moved in close to David and asked in a barely audible voice, “Where is that rescue team?”

David shrugged. “I don’t know.”

“But they will come, won’t they?

“Eventually.”

“To hell with eventually!” Carolyn blurted out. “I don’t want to sit here like a lamb about to be slaughtered.”

David took her hand and squeezed it gently. “We’ve got to play it smart and wait for our chance.”

“Are you planning to grab one of their weapons?” Carolyn asked quickly.

David shook his head. “They’ve got us outnumbered and outgunned. And even if we managed to bring down a few, the others would start shooting hostages until we surrendered. Grabbing a weapon won’t get it done.”

“How will you do it then?”

“It’ll just happen,” David said without inflection. “There’ll be an opening, and they’ll die without being aware of what hit them.”

“How do you know so much about these things?”

“I read a lot.”

“Ah-huh,” Carolyn said, certain he was hiding something from his past. “Let’s get back to the opening you spoke about. Can you really get to someone pointing a gun at you without them knowing it?”

“There are ways,” David said vaguely.

Carolyn thought for a moment, then a mischievous glint came to her eyes. “You mean, like zapping them with defibrillator paddles?”

David smiled thinly. “You think you could take out all five of the bastards that way?”

“Just fantasizing,” Carolyn said. “But you never—”

John Merrill suddenly wheezed, with a loud rattle in his throat. He coughed hard to clear his airway and brought up bloody sputum that stuck to his lips before dripping off. Then more maroon-colored sputum came up.

Carolyn moaned. “Don’t tell me he’s bleeding into his lungs now.”

“It looks like it,” David said, lowering his voice to a whisper. “And if he really starts to hemorrhage into his bronchial tubes, he’ll drown in his own blood.”

“Can you do anything to stop it?”

“Not without more fresh plasma.”

“But he’ll suffocate to death, and he’ll be awake and know it’s happening.”

David thought at length before saying, “The next time you’re in the medicine room, grab a couple of vials of injectable Valium and syringes.”

“What good will that do?” Carolyn asked.

“If necessary, I’ll sedate him and suppress his cough so he won’t be aware of what’s happening,” David told her, then added grimly, “And he won’t struggle.”

“But … but that’ll be like killing him.”

David shook his head. “It’ll just be making his inevitable death easier.”

Suddenly an alarm went off far down the corridor. Carolyn dashed to the door and listened carefully, then called back to David, “I think it’s coming from Dr. Warren’s room.”

“Check it out,” David called back. “I’ll stay with the President.”

As Carolyn hurried away, David leaned against the night table, his legs like heavy weights again. And his thigh wound was throbbing badly. He eased himself down on the side of the bed and rubbed at his wound. But his mind was elsewhere, now thinking about the alarm bell that continued to ring. If it was William Warren, the alarm probably signaled the return of a stubborn ventricular tachycardia that hadn’t responded to lidocaine or bretylium. Bad news. Really bad news. Maybe the defibrillator would work. The throbbing in his thigh worsened, and he looked down at the dressing over his wound. Blood was soaking through. Shit. He hoped the sutures hadn’t come apart.

Carolyn ran into the room, pausing briefly to catch her breath. “You’d better come quick! Marci is
in extremis
!”

David rose as quickly as he could manage, then hesitated. “Aliev is not going to let us run down that corridor again. He was mad as hell last time, and this time he might just shoot us.”

“Maybe he won’t,” Carolyn urged, thinking fast. “Remember, he still needs us to keep the President alive.”

“Aliev may figure we’ve done all we can and decide to take his chances,” David countered. “And keep in mind they’ll be making their break out of here very soon. At that point we become expendable. You and I will be like extra baggage.”

“We still have to try,” Carolyn pleaded.

David sighed resignedly. He knew Carolyn was right. He couldn’t simply look away and make believe Marci didn’t exist. And maybe they could ease her suffering a little. He moved to the door and peeked out. A guard was ten feet away, smoking a cigarette. Aliev was nowhere in sight. David came back to Carolyn and said, “Aliev is not in the corridor.”

“I saw him and another terrorist stepping into the fire stairs,” Carolyn recalled.

“Was the door left open?” David asked quickly.

Carolyn nodded. “And that chain-like device was next to it.”

David knitted his brow, wondering if Aliev had gone to the roof to post a lookout. If he had, it was bad news. That would remove the roof as a point of entry for the Secret Service team. Shit!

“Maybe this is our chance,” Carolyn prodded.

“Yeah, I guess,” David said, knowing they were about to take a terrible risk. He peeked out into the corridor once more, and saw only a single terrorist. Hurriedly he turned to Carolyn.

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